• International Journal of Fuzzy Logic and Intelligent Systems
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• 제10권1호
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• pp.65-72
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• 2010

For developing navigation system of total hip arthroplasty (THA) and evaluating hip joint kinematics, 3-D pose position of the femur and acetabulum in the pelvic coordinate system has been quantified. The pelvic coordinate system is determined by manually indicating pelvic landmarks in multidetector-row computed tomography (MDCT) images. It includes intra- and inter-observer variability, and may result in a variability of THA operation or diagnosis. To reduce the variability of pelvic coordinate system determination, this paper proposes an automated method in MDCT images. The proposed method determines pelvic coordinate system automatically by detecting pelvic landmarks on anterior pelvic plane (APP) from MDCT images. The method calibrates pelvic pose by using silhouette images to suppress the affect of pelvic pose change. As a result of comparing with manual determination, the proposed method determined the coordinate system with a mean displacement of $2.6\;{\pm}\;1.6$ mm and a mean angle error of $0.78\;{\pm}\;0.34$ deg on 5 THA subjects. For changes of pelvic pose position within 10 deg, standard deviation of displacement was 3.7 mm, and of pose was 1.28 deg. We confirmed the proposed method was robust for pelvic pose changes.

• 한국전문물리치료학회지
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• 제22권2호
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• pp.21-29
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• 2015

This study investigated the effect of a load of 15% body weight on trunk, pelvis and hip joint coordination and angle variability in subjects with and without chronic low back pain (CLBP) during an anterior load carriage task. Thirty volunteers participated in the study (15 without CLBP, 15 with CLBP). All participants were asked to perform an anterior carriage task with a load of 15% body weight. The outcome measures included the means and standard deviations for measurements of three-dimensional coordination and angle variability of the trunk, pelvis and hip joint. As CLBP patient group .06, control group .70, the correlation coefficient between the groups showed a significant difference only in trunk-pelvic in the sagittal plane (p<.05). Angle variability of CLBP patient group increased significantly in the trunk in frontal plane, the pelvis in all sagittal plane, frontal plane, transverse plane, and the hip in sagittal plane, the hip in frontal plane than angle variability of control group (p<.05). This results mean that the CLBP patient group showed a disconnected coordination pattern in the trunk-pelvis in the sagittal plane, an increased pelvic angle variability in all three planes, and hip angle variability in the sagittal, and frontal planes. The CLBP patient group may have developed a compensatory movement of the pelvis and hip joint arising from the changed stability due to the abnormal coordination patterns of the trunk-pelvic in the sagittal plane. Therefore, CLBP symptoms can potentially worsen in the pelvis and adjacent hip joint in CLBP patients who perform weight-related behaviors in their daily lives. Further research is needed to determine the three-dimensional characteristics of the electromyography and neuromuscular aspects of subjects with CLBP.

• 한국전문물리치료학회지
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• 제18권3호
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• pp.26-37
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• 2011

Although there have been various studies related to the body's movement from a sitting to a standing position (sit-to-stand task), there is limited information on the kinematic changes on the frontal and transverse planes. The purpose of this study was to ascertain how pelvic tilt affects kinematic changes in the frontal and transverse planes in the hip and knee joints during a sit-to-stand task. For this study, 33 healthy participants (13 female) were recruited. Each participant rose from a sitting to a standing posture at his or her preferred speed for each of three different pelvic tilt trials (anterior, posterior, and neutral), and the measured angles were analyzed using a 3-D motion analysis system. A one-way repeated measure analysis of variance was performed with Bonferroni's post hoc test. In addition, an independent t-test was carried out to determine the sex differences in hip and knee joint kinematic changes during the sit-to-stand tasks. The results were as follows: 1) The hip and knee joint angle in the frontal and transverse planes showed a significant difference between the different pelvic tilt postures during sitting in the pre-buttock lift-off phase (pre-LO) (p<.05). Compared to the posterior pelvic tilt posture, the anterior pelvic tilt posture involved significantly greater hip joint adduction and internal rotation, knee joint adduction, and reduced internal rotation of the knee joint. 2) Sex differences were found with significant differences for males in the initial and maximal angles in the frontal plane of the hip and knee joint (p<.05). Females had a significantly smaller initial abduction angle of the hip joint and a significantly greater maximal angle of the hip adduction joint. These results suggest that selecting a sit-to-stand exercise for pelvic tilt posture should be considered to control abnormal movement in the lower extremities.

• 대한통합의학회지
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• 제8권3호
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• pp.173-180
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• 2020

Purpose : The aim of this study was to assess the intra- and inter-rater reliability and validity of measurements of head, neck, and pelvis posture using a mobile application in subjects with forward head posture. Methods : Forty-eight volunteers (22 men, 26 women) participated in this study. Two raters independently examined whole body picture images in a lateral standing posture with arms crossed using a CA-Smart Posture Reminder (CA-SPR), and a rater took and calculated posture images twice to assess reliability. We measured five parameters: craniovertebral angle 1 (CVA1), anterior shoulder translation (AST), pelvic tilt (PT), knee angle (KA), and ankle angle (AA) in the subject's sagittal plane using CA-SPR. We examined whole spine X-ray images in the same position to assess validity. We measured four variables in the subjects: CVA2, translation distance (AHT), anterior pelvic plane (APP), and sacral slope (SS). The intra- and inter-rater reliability were calculated using the intraclass correlation coefficient (ICC). Convergent validity was calculated using Pearson's correlation coefficient. Results : The intra-rater reliability (ICC=.889 -.989) and inter-rater reliability (ICC=.800 -.980) were excellent for all variables measured using CA-SPR. The variables measured using CA-SPR and X-ray were significantly positively correlated (r=.623, p<.01). However, the correlation of the variables in the pelvis was not statistically significant. Conclusion : This study shows that a mobile application (CA-SPR) is a useful tool for measuring head and neck posture in subjects with forward head posture. However, further study is needed to measure pelvic variables when using a mobile application.

• The Journal of Korean Physical Therapy
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• 제10권1호
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• pp.127-138
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• 1998

This study was carried out tn invstigate and compare biomechanical characteristics during free speed gait in hemiplegic patients after stroke who took therapeutic exercise by analyzing kinematic and kinetic data in the sagital plane and electromyographic data. Six patients($41\~69$ years old) and age-matched six volunteers in good health(51-61 years old) wire studied. The patients were sorted into two groups, depending on their self-speed of walking : fast speed group(3 patients) and slow speed group(3 patients). The results were as fellows. : 1. In spatio-temparal parameters, affected and unaffected side of fast group showed symetry but blew group showed asymetry of single limb support, opposite foot contact and stance phase (p<0.05). Compared with normal group, patient group showed slower velocity, shoter stride length and longer double limb support (p<0.05). 2. In the pelvic anterior tilt, patient group showed lower valued than normal group. It. In the ground reaction force-vertical force, fast group showed similar double peak gragh compared with normal group, butvslow group showed lower values without double peak (p<0.05).

• 한국운동역학회지
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• 제19권3호
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• pp.435-448
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• 2009

본 연구는 노인의 계단과 경사로 오르기와 평지보행 동안 하지의 운동학적 변화를 분석하는 것이었다. 건강한 노인 14명(남:10, 녀:4)이 실험에 참여하였으며 측정도구는 삼차원동작분석기인 Vicon system(Vicon, Oxford Metrics, England)을 사용하였다. 보행주기 각 시점에서 하지 관절의 각도 변화를 보행 조건(평지, 계단, 경사로)에 따라 알아보기 위해 일요인 반복측정 분산분석(one-way repeated measure of ANOVA)을 사용하였다. 전후면상에서 골반은 평지 보행에서 보행 주기 동안 전방굴곡이 나타났으며 계단과 경사로 오르기에서 전방굴곡이 증가하였다. 고관절과 슬관절는 모두 평지보행과 비교해 계단 오르기에서 굴곡이 더 증가하였다. 족관절은 평지보행과 비교해 경사로 오르기에서 굴곡이 더 증가하였다. 좌우면상에서 보행 주기 동안 평지보행과 비교해 계단 오르기에서 골반이 크게 올라갔으며 고관절도 계단 오르기에서 내전과 외전의 변화가 크게 나타났다. 또한 슬관절도 계단 오르기에서 내반이 증가하였고 족관절 역시 계단 오르기에서 내번이 증가하였다. 수평면상에서 보행 주기 동안 골반은 평지 보행과 비교해 계단과 경사로 오르기에서는 내회전이 대체로 증가하였고 고관절은 계단과 경사로 오르기에서 내회전이 증가하였으나 통계적으로 유의한 차이는 없었다. 슬관절은 계단 오르기에서 대체적으로 내회전이 증가하였고 족관절은 계단 오르기에서 대체적으로 외회전이 증가하였다. 이러한 결과는 노인의 계단과 경사로 오르기는 평지 보행과 비교해 하지의 운동학적 보행 변수들을 크게 변화시키는 것을 알 수 있었다.

• Journal of Korean Neurosurgical Society
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• 제61권2호
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• pp.167-179
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• 2018

The prevalence of patients with adult spinal deformity (ASD) has been reported as high as 68%. ASD often leads to significant pain and disability. Recent emphasis has been placed on sagittal plane balance and restoring normal sagittal alignment with regards to the three dimensional deformity of ASD. Optimal sagittal alignment has been known to increase spinal biomechanical efficiency, reduce energy expenditure by maintaining a stable posture with improved load absorption, influence better bony union, and help to decelerate adjacent segment deterioration. Increasingly positive sagittal imbalance has been shown to correlate with poor functional outcome and poor self-image along with poor psychological function. Compensatory mechanisms attempt to maintain sagittal balance through pelvic rotation, alterations in lumbar lordosis as well as knee and ankle flexion at the cost of increased energy expenditure. Restoring normal spinopelvic alignment is paramount to the treatment of complex spinal deformity with sagittal imbalance. Posterior osteotomies including posterior column osteotomies, pedicle subtraction osteotomies, and posterior vertebral column resection, as well anterior column support are well known to improve sagittal alignment. Understanding of whole spinal alignment and dynamics of spinopelvic alignment is essential to restore sagittal balance while minimizing the risk of developing sagittal decompensation after surgical intervention.

• 한국전문물리치료학회지
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• 제16권1호
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• pp.1-9
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• 2009

An abdominal drawing-in maneuver (ADIM) with a pressure biofeedback unit can be used to prevent excessive lumbar lordosis during bridging exercise. Therefore, in this research, the effects of an ADIM on lumbar lordosis and lower extremity muscle activity during bridging exercise were investigated in thirty healthy adults. Surface electromyography (EMG) and VICON system were used to collect kinematic data and muscle activity, respectively. A paired t-test was used to determine a statistical significance. The results showed as follows: (1) When performing bridging exercise with an ADIM, the height of the anterior superior iliac spine and greater trochanter decreased significantly (p<.05). (2) When performing bridging exercise with an ADIM, the trunk extension angle and pelvic angle increased significantly (p<.05). (3) When performing bridging exercise with an ADIM, the EMG signal amplitude increased significantly in the rectus abdominis, internal oblique abdominis, external oblique abdominis, medial hamstring, and lateral hamstring (p<.05). (4) When performing bridging exercise with an ADIM, the EMG signal amplitude decreased significantly in the erector spinae (p<.05). From the result of this research, an ADIM trained with pressure biofeedback unit during bridging exercise is effective to prevent excessive contraction of erector spinae, to limit excessive motion of pelvis from sagittal plane and to increase muscle activity of abdominal muscles and hamstring muscle.

• Journal of Korean Neurosurgical Society
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• 제61권6호
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• pp.716-722
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• 2018

Objective : Lateral interbody fusion (LIF) is attractive as a less invasive technique to address anterior spinal pathology in the treatment of adult spinal deformity. Its own uses and benefits in treatment of adult degenerative scoliosis are undefined. To investigate the radiographic and clinical outcomes of LIF, and staged LIF and posterior spinal fusion (PSF) for the treatment of adult degenerative scoliosis patients, we analyzed radiographic and clinical outcomes of adult degenerative scoliosis patients who underwent LIF and posterior spinal fusion. Methods : Forty consecutive adult degenerative scoliosis patients who underwent LIF followed by staged PSF at a single institution were retrospectively reviewed. Long-standing 36" anterior-posterior and lateral radiographs were taken preoperatively, at inter-stage, 3 months, 1 year, and 2 years after surgery were reviewed. Outcomes were assessed through the visual analogue scale (VAS), 36-Item Short Form Health Survey (SF-36), and Oswestry Disability Index (ODI). Results : Forty patients with a mean age of 66.3 (range, 49-79) met inclusion criteria. A mean of 3.8 levels (range, 2-5) were fused using LIF, while a mean of 9.0 levels (range, 3-16) were fused during the posterior approach. The mean time between stages was 1.4 days (range, 1-6). The mean follow-up was 19.6 months. Lumbar lordosis was significantly restored from $36.4^{\circ}$ preoperatively up to $48.9^{\circ}$ (71.4% of total correction) after LIF and $53.9^{\circ}$ after PSF. Lumbar coronal Cobb was prominently improved from $38.6^{\circ}$ preoperatively to $24.1^{\circ}$ (55.8% of total correction) after LIF, $12.6^{\circ}$ after PSF respectively. The mean pelvic incidence-lumbar lordosis mismatch was markedly improved from $22.2^{\circ}$ preoperatively to $8.1^{\circ}$ (86.5% of total correction) after LIF, $5.9^{\circ}$ after PSF. Correction of coronal imbalance and sagittal vertebral axis did not reach significance. The rate of perioperative complication was 37.5%. Five patients underwent revision surgery due to wound infection. No major perioperative medical complications occurred. At last follow-up, there were significant improvements in VAS, SF-36 Physical Component Summary and ODI scores. Conclusion : LIF provides significant corrections in the coronal and sagittal plane in the patients with adult degenerative scoliosis. However, LIF combined with staged PSF provides more excellent radiographic and clinical outcomes, with reduced perioperative risk in the treatment of adult degenerative scoliosis.