• Journal of radiological science and technology
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• v.22 no.2
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• pp.41-46
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• 1999

Osteoporosis, which causes mainly fracture of the spine, proximal femur and distal radius by minimal trauma, is a major public health problem and its prevalence is steadily increasing in Korea according to the development of public health care. There are reliable methods for diagnosis based on bone densitometry. Early detection and intervention are important for reducing the incidence of fractures. A consensus definition of osteoporosis, based on bone density measurement, has been developed by the World Health Organization(WHO). In this study, bone mineral density(RMD) was measured by dual energy x-ray absorptiometry(DEXA) at the proximal femur and lumbar spine in 132 post-menopausal women. The purpose of this study is to find influential factors on the BMD of the proximal femur and the lumbar spine and to analyze correlation between BMD and the problematic factors. We obtained the following results : 1. Mean BMD score, T-score and Z-score of the proximal femur were $0.81(g/cm^2)$, -2.45(S.D.) and -2.09(S.D.) respectively and in the lumbar spine were $0.83(g/cm^2)$, -2.02(S.D.), -2.43(S.D.) respectively. 2. In correlation analysis between BMD and many factors, correlation coefficients were -0.467, 0.212, -0.321 and 0.241 in age, height, duration after menopause respectively. BMI and the residuals were comparatively small. 3. Correlation coefficients to age matched BMD, in height and body weight were 0.222 and 0.241, in age and duration after menopause were -0.268, -0.282. 4. The fracture threshold of proximal femur BMD to the 90th percentile was $0.845(g/cm^2)$. 5. At the result of multiple regression analysis, age, body weight, $BMI(kg/m^2)$ and duration after menopause described as significant variables.

• Journal of Korean Neurosurgical Society
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• v.63 no.1
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• pp.89-98
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• 2020

Objective : Ossification of posterior longitudinal ligament (OPLL) in the thoracic spine may cause chronic compressive myelopathy that is usually progressive, and unfavorable by conservative treatment. Although surgical intervention is often needed, the standard surgical method has not been established. Recently, it has been reported that posterior decompression with dekyphosis is effective surgical technique for favorable clinical outcome. The purpose of this study was to evaluate the surgical outcomes in patients with thoracic OPLL according to dekyphosis procedure and to identify predictive factors for the surgical results. Methods : A total of 25 patients with thoracic OPLL who underwent surgery for myelopathy from May 2004 to March 2017, were retrospectively reviewed. Patients with cervical myelopathy were excluded. We assessed the clinical outcomes according to various surgical approaches. The modified Japanese orthopedic association (JOA) scores for the thoracic spine (total, 11 points) and JOA recovery rates were used for investigating surgical outcomes. Results : Of the 25 patients, 10 patients were male and the others were female. The mean JOA score was 6.7±2.3 points preoperatively and 8.8±1.8 points postoperatively, yielding a mean recovery rate of 53.8±31.0%. The mean patients' age at surgery was 52.4 years and mean follow-up period was 40.2 months. According to surgical approaches, seven patients underwent anterior approaches, 13 patients underwent posterior approaches, five patients underwent combined approaches. There was no significant difference of the surgical outcomes related with different surgical approaches. Age (≥55 years) and high signal intensity on preoperative magnetic resonance (MR) image in the thoracic spine were significant predictors of the lower recovery rate after surgery (p<0.05). Posterior decompression with dekyphosis procedure was related to the excellent surgical outcomes (p=0.047). Dekyphosis did not affect the complication rates. Conclusion : In this study, our result elucidated that old age (≥55 years) and presence of intramedullary high signal intensity on preoperative MR images were risk factors related to poor surgical outcomes. In the meanwhile, posterior decompression with dekyphosis affected favorable clinical outcome. Posterior approach with dekyphosis procedure can be a recommendable surgical option for favorable results.

• The Journal of Churna Manual Medicine for Spine and Nerves
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• v.11 no.2
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• pp.57-64
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• 2016

This is a case report about left leg radiating pain treated with complex traditional Korean medical intervention, while the case did not responded to prolotherapy and extracorporeal shock wave treatment for lumbar herniated intervertebral disc (HIVD). The patient was diagnosed with a piriformis problem after a physical examination and was treated with lumbar and piriformis muscle treatment. After 9 sessions of treatment for 33 days, Numeric Rating Scale (NRS) for pain has been decreased from 8 to 3. Further studies with more cases and longer observation period should be conducted to provide evidence for optimum acupuncture procedure considering its effectiveness, safety and patients' compliance altogether.

• Journal of International Academy of Physical Therapy Research
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• v.9 no.2
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• pp.1513-1516
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• 2018

The purpose of this study was to identify the effect of upper thoracic mobilization on cervical alignment in stroke patients with forward head posture. The subject's of this study were two stroke patients with forward head posture and a cervical curve angle (four-line Cobb's method; FLCM) less than $40^{\circ}$. The intervention, central posterior-anterior (PA) mobilization, was applied to the T1-T4 vertebrae (upper thoracic spine) following the Maitland concept. This mobilization was applied three times per week for four weeks. In the results, the cervical curve angle (FLCM) increased for both subject 1 and 2. However, Jochumsen method score was decreased in subject 1, while it was increased in subject 2. These results demonstrate that upper thoracic mobilization had the positive effect on the cervical curve angle but not on Jochumsen method score. These findings suggest that PA mobilization on the upper thoracic spine could correct cervical curve angle measured by FLMC in stroke patients with FHP.

• Physical Therapy Rehabilitation Science
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• v.13 no.3
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• pp.274-284
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• 2024

Background: Mild pain can affect movement leading to disability, and impaired neck proprioception. Transcutaneous electrical nerve stimulation (TENS) has been recommended as an intervention for chronic and subacute neck pain with mobility deficits. Objective: The purpose was to investigate the effects of transcutaneous electrical nerve stimulation (TENS) for improving cervical spine proprioception and reducing pain, anxiety, and disability in young adults with mild neck pain. Methods: Twenty-two participants were recruited between the ages of 20-40 years old and randomized into control and intervention groups. Participants had chronic mild neck pain and not receiving pain treatment or medication, and did not have electrotherapy contraindications. The intervention group received a 30-minute TENS intervention and were instructed in a 2-week daily home-based TENS intervention. Outcome measures were visual analog scale, neck disability index, state-trait anxiety inventory, active range of motion (AROM) and joint position error (JPE). Results: Participants reported reduction in pain, disability, and anxiety post 30-minute intervention. Increase in right lateral flexion AROM and decrease in mean JPE extension post 30-minute intervention. Post 2-week intervention, reduction in pain, an increase in right lateral flexion AROM, and a reduction in mean JPE extension were also detected. Conclusion: People with chronic mild neck pain had a reduction in pain, anxiety, and disability post 30-minutes TENS treatment. Reduction in anxiety and disability with TENS treatment suggests that TENS may be beneficial in reducing pain, anxiety, and improving neck proprioception in young adults with mild neck pain.

• Physical Therapy Korea
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• v.27 no.1
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• pp.1-10
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• 2020

Background: Thoracic spine self-mobilization exercise is commonly used to manage patients with neck pain. However, no previous studies have investigated the effects of thoracic spine self-mobilization exercise alone in patients with chronic neck pain. Objects: The purpose of this study was to investigate the effects of thoracic self-mobilization using a tool on cervical range of motion (ROM), disability level, upper body posture, pain and fear-avoidance beliefs questionnaire (FABQ) in patients with chronic neck pain. Methods: The subjects were 49 patients (21 males, 28 females) with chronic neck pain. The subjects were randomly divided into an experimental group (EG, n = 23) and control group (CG, n = 26). For the EG, thoracic self-mobilization was applied. We placed a tool (made with 2 tennis balls) under 3 different vertebral levels (T1-4, T5-8, T9-12) of the thoracic spine and the subjects performed crunches, which included thoracic flexion and extension in supine position. Five times × 3 sets for each levels, twice a week, for 4 weeks. Cervical pain, disability, upper body posture, FABQ results, and ROM were evaluated at baseline, after 4 weeks of intervention, and at 8 weeks of follow-up. Assessments included the quadruple visual analogue scale (QVAS); Northwick Park neck pain questionnaire (NPQ); craniovertebral angles (CVA), forward shoulder angle (FSA) and kyphosis angle (KA) measurements for upper body posture; FABQ and cervical ROM testing. Results: The EG showed a statistically significant improvement after intervention in the QVAS (-51.16%); NPQ (-53.46%); flexion (20.95%), extension (25.32%), left rotation (14.04%), and right rotation (25.32%) in the ROM of the cervical joint; KA (-7.14%); CVA (9.82%); and FSA (-4.12%). Conclusion: These results suggest that, for patients with chronic neck pain, thoracic self-mobilization exercise using a tool (tennis balls) is effective to improve neck pain, disability level, the ROM, and upper body posture.

• Physical Therapy Korea
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• v.25 no.4
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• pp.37-45
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• 2018

Background: Posterior-anterior (PA) vertebral mobilization, a manual therapy technique has been used for relieving pain or stiffness treating in spinal segment for in clinical practice, however evidence to gauge efficacy is yet to be synthesised. Objects: This study aimed to investigate the effect of PA mobilization of the thoracic spine on the respiratory function in patients with low back pain (LBP). Methods: The study participants included 30 patients with chronic LBP. They were randomly allocated to the experimental and control groups. The experimental and control groups received PA mobilization of the T1-T8 level of the thoracic spine and placebo mobilization, respectively. All patients received interventions for 35 minutes a day, five times a week, over 2-week period, respectively. Forced vital capacity (FVC), forced expiratory volume in 1 second ($FEV_1$), peak expiratory flow (PEF), forced expiratory flow 25~75% ($FEF_{25{\sim}75%}$), and chest wall expansion were measured before and after the intervention. Statistical analysis was performed using independent t-test and two-way analysis of variance, and Pearson's correlation analysis was used to compare the correlation between respiratory function and chest measurement. Results: The experimental group showed significant improvements in FVC, $FEV_1$, PEF, $FEF_{25{\sim}75%}$ (p<.05), and chest wall expansion (p<.05) compared with the control group. Conclusion: PA mobilization of the upper thoracic spine may be beneficial for improving respiratory function parameters including FVC, $FEV_1$, PEF, $FEF_{25{\sim}75%}$, and chest wall expansion in patients with chronic LBP.

• Journal of Korean Neurosurgical Society
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• v.30 no.10
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• pp.1187-1192
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• 2001

Objective : The lateral extracavitary approach(LECA) to the thoracolumbar spine is known as one of procedure which allows not only direct vision of pathologic lesion, but also ventral decompression, and dorsal fixation of the spine through the same incision. However, some drawbacks of LECA, including the technically- demanding, time-consuming, unfamiliar surgical anatomy and excessive blood loss, make surgeons to hesitate to use this approach. This study is to provide the surgical anatomy of LECA using cadavers, for detailed informations when LECA is considered for the surgery. Methods : We performed the 10 cadaveric studies, 7 male and 3 female, and careful dissection was carried out on right side of thoracolumbar region, except one for thoracic region. The photographs with micro-lens were taken to depict the close-up findings and for demonstrating detailed anatomy. Results : The photographs and hand-drawings demonstrated the relationships among the musculature, segmental vessels and nerve roots seen during each dissection plane. The lateral branches of dorsal rami of spinal nerve and the transverse process were confirmed to be the most important landmark of this approach. Conclusion : We concluded that detailed anatomical findings for LECA through this step-by-step dissection would be useful during operative intervention to reduce the intraoperative complications in LECA.

• The Journal of Churna Manual Medicine for Spine and Nerves
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• v.12 no.2
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• pp.31-42
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• 2017

Objectives : This review aims to assess the effect of Wuqinxi exercise for osteoporosis. Methods : We searched 9 electronic databases(Pubmed, EMBASE, Cochrane Library, CAJ, Oasis, KISS, NDSL, KMBASE, KISTI) and related 2 journals until November 2017. We included randomized controlled trials(RCTs) of testing Wuqinxi exercise for osteoporosis. The methodological quality of RCTs related assessed by the Cochrane risk of bias tool. Results : 12 RCTs were eligible in our inclusion criteria. No statistical differences were found between the Wuqinxi versus no intervention, Wuqinxi plus antiosteoporosis medications versus antiosteo-porosis medications on lumbar spine, femora bone mineral density (BMD). However, Wuqinxi significantly improved lumbar spine BMD compared with antiosteoporosis medications (P < 0.00001). Additionally, the results showed a remarkable effect in improving pain score(VAS) when Wuqinxi or Wuqinxi plus antiosteoporosis medications (P < 0.0005) was used. Conclusions : There is evidence of Wuqinxi exercise for osteoporosis with meta-analysis. However, our systematic review has limited evidence to support Wuqinxi exercise for osteoporosis. because of low quality of original articles and further well-designed RCTs should be encouraged.

• Physical Therapy Rehabilitation Science
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• v.12 no.3
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• pp.268-277
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• 2023

Objective: The purpose of this study was to investigate the effects of Pilates breathing exercises on functional disability and lumbar flexibility in patients with non-specific chronic low back pain. Design: A randomized controlled trial. Methods: 30 patients with non-specific low back pain were selected and classified into an experimental group (n=15) and a control group (n=15). Both groups were assessed for functional disability using the Oswestry Disability Index and flexibility of the lumbar spine using the modified-modified Schober test before and after the intervention. The intervention was applied twice a week for four weeks. The experimental group performed Pilates breathing exercises followed by spinal stabilization exercises, while the control group only performed spinal stabilization exercises. Results: Both groups showed significant improvements in functional disability and lumbar flexibility after the intervention. However, when comparing between the two groups, the experimental group showed a more significant effect than the control group. Conclusions: The combination of Pilates breathing exercises and spinal stabilization exercises can be considered an effective approach to improve low back pain and prevent chronic pain in patients with non-specific chronic low back pain.