• 대한물리치료과학회지
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• 제16권3호
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• pp.11-17
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• 2009

Background: The purpose of this study was designed to find out the effectiveness of reposition sense, muscle fatigue response on lumbar spine after apply lumbosacral stabilization exercise program to 4 patients with chronic low back pain and for 12 weeks. Method: In this study the reposition sense was measured in 3 angle(60, 30, 12) of the lumbar spine motion with blind by MedX test machine and the difference of instability to lumbar vertebra segments in flexion, extension test of standing position and spinal load test Mattress Test by Spinal Mouse. The stabilization exercise program was applied 2 times a week for 12 weeks in hospital and 2 times a day for 20 minutes at home. Result: The results of the present study were that the repositioning sense was appeared the most error in 12 angles of lumbar flexion and Men was appeared to decrease an error more than female in average value of 4 angles after 12 weeks. And average error of male was decrease more than female. Thus the effects of lumbosacral stabilization exercise was improved repositioning sense of prorioceptor. Fatigue response test(FRT) results, in male, was raised muscle fatigue rate during increase weight, on the other hand female appeared lower than male. Conclusion: As a results, lumbosacral stabilization exercise was aided to improvement of lumbar spine repositioning sense and vertebra segments stabilization. It was showed the rate of decrease in typically 12 degree angle point of each 3 angle(60, 36, 12). Especially, that spine instability patients will have a risk when in lifting a load or working with slight flexion posture around 12 degree during the daily of living life and it is probably to increase recurrence rate. Thus, not only lumbar extension muscle strength but also stability of vertebra segments in lumbar spine may be very important.

• Safety and Health at Work
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• 제11권3호
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• pp.307-313
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• 2020

Background: Many tasks in industrial and health care setting are involved with pushing and pulling tasks up or down on a ramp. An efficient method of moving cart which reduces the risk of low back pain should be concerned. This study aimed to investigate the effects of handling types (HTs) and slope on lumbar spinal load during moving a cart on a ramp. We conducted a 2 × 2 × 4 factorial design with three main factors: 2 HTs, 2 handling directions of moving a cart and 4 degrees of ramp slope. Methods: Thirty healthy male workers performed 14 tasks consist of moving a cart up and down on the ramp of 0°, 10°, 15°, and 20° degrees with pushing and pulling methods. Joint angles from a 3D motion capture system combined with subject height, body weight, and hand forces were used to calculate the spinal load by the 3DSSPP program. Results: Our results showed significant effect of HT, handling directions and slope on compression and shear force of the lumbar spine (p < 0.001). When the ramp gradient increased, the L4/5 compression forces increased in both pushing and pulling (p < 0.001) Shear forces increased in pulling and decreased in pushing in all tasks. At high slopes, pulling generated more compression and shear forces than that of pushing (p < 0.01). Conclusion: Using the appropriate technique of moving a cart on the ramp can reduce the risk of high spinal load, and the pushing is therefore recommended for moving a cart up/down on ramp gradients.

• Journal of Korean Neurosurgical Society
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• 제50권4호
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• pp.392-395
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• 2011

Idiopathic hypertrophic spinal pachymeningitis (IHSP) is a rare inflammatory disease characterized by hypertrophic inflammation of the dura mater and various clinical courses that are from myelopathy. Although many associated diseases have been suggested, the etiology of IHSP is not well understood. The ideal treatment is controversial. In the first case, a 55-year-old woman presented back pain, progressive paraparesis, both leg numbness, and voiding difficulty. Initial magnetic resonance imaging (MRI) demonstrated an anterior epidural mass lesion involving from C6 to mid-thoracic spine area with low signal intensity on T1 and T2 weighted images. We performed decompressive laminectomy and lesional biopsy. After operation, she was subsequently treated with steroid and could walk unaided. In the second case, a 45-year-old woman presented with fever and quadriplegia after a spine fusion operation due to lumbar spinal stenosis and degenerative herniated lumbar disc. Initial MRI showed anterior and posterior epidural mass lesion from foramen magnum to C4 level. She underwent decompressive laminectomy and durotomy followed by steroid therapy. However, her conditions deteriorated gradually and medical complications occurred. In our cases, etiology was not found despite through investigations. Initial MRI showed dural thickening with mixed signal intensity on T1- and T2-weighted images. Pathologic examination revealed chronic nonspecific inflammation in both patients. Although one patient developed several complications, the other showed slow improvement of neurological symptoms with decompressive surgery and steroid therapy. In case of chronic compressive myelopathy due to the dural hypertrophic change, decompressive surgery such as laminectomy or laminoplasty may be helpful as well as postoperative steroid therapy.

• Journal of Acupuncture Research
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• 제15권2호
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• pp.301-310
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• 1998

Infrared thermographic imaging visualizes noninvasively various abnormal condition by detecting the skin temperature. As the imaging represents the objective condition by the changes in blood flow under the control of autonomic nervous system, it is used to diagnosis and monitor the lumboscral radiculopathy. And asymmetry is important in the diagnosis of disc herniation. The most common type of disc herniation occurs psoterolaterally. This frequently causes nerve root compression leading to a radiculopathy in the distribution of the involved nerve root, most of which also provoke the asymmetric changes in thermography. Central disc herniation, which accounts for 5% to 35% of disc herniation, is typically associated with low back pain. But radiculopathy is usually abscent unless central disc heriniaton is large enough to cause compression of the cauda equina. To evalute the diagnostic value of the thermographic imaging in the diagnosis of central disc herniation, the imaging of 15 normal subjects and 48 patients with central disc herniation documented by CT scan were analyzed. The patients had either bilateral radiculophathy or no radiculopathy. The imaging of patient group with non rediculopathy did not show any significant thermal difference to control. While bilateral radiculopathy group reveled hypothermic pattern compared twith control. Thermal difference between left and right side did not present any significance in non radiculopathy group but hypothermia in bilateral radiculopathy group. Large herniation group demonstrated hyperthemic pattern while the others showed no significant change. Cranial caudal thermal difference did not show any difference between experiment groups. These results shows that infrared thermographic imaging can be used central disc herniation with bilateral radiculopathy, while it seems to little useful on the diagnosis of non radiculopathic disc herniation.

• Journal of Acupuncture Research
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• 제20권4호
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• pp.102-113
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• 2003

Objective: The purpose of this study is to examine the relation between the Obesity and the prevalence of LBP. Methods: From February 2001 to April 2001 we studied body composition, Body Mass Index, Basal Metabolic Rate, Obesity Degree, Waist Hip Ratio, percent body fat and muscular form of 40 patients with LBP and 40 patients with Internal disease, who visited Dong-Guk University Bundang Hospital by using Inbody 3.0. Results: 1. Sexual ratio in this study is 1:4(male:female). 2. Fluid, protein, mineral mass and BMR in patients with LBP are lower than those in patients with Internal disease, but percent body, WHR and obesity degree with LBP are higher than those in patients with Internal disease. 3. LBP prevalence is shown to rise with increasing WHR. 4. LBP prevalence is shown to rise with decreasing BMR. Conclusions: Patients with LBP are obeser than patients with Internal disease. LBP prevalence is shown to rise with increasing WHR in statistics. But LBP prevalence is shown to rise with decreasing BMR in statistics.

• Journal of Acupuncture Research
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• 제21권1호
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• pp.149-158
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• 2004

Objective: Herniation of Nucleus Pulpous(HNP) of L-spine is the most important reason that causes low back pain. The aim of this study is to investigate the effectiveness of Bee venom acua-acupuncture therapy for HNP. Methods: We divided HNP patient into 2 groups: Control group with acupuncture therapy only, and Experimental group with both acupuncture and bee venom acua-acupuncture therapy. To estimate the efficacy of treatment that applied for two groups, we used visual analog scale(VAS) and Oswestry disability index(ODI). We compared the VAS and ODI score of two groups statistically. Results & Conclusions: 1. In VAS, experimental group shows statitically significant improvement rate, but control group does not show statistical significance. 2. In ODI, both the experimental and control group shows statistically significant improvement. 3. By comparing the experimental and control group, there was more significant improvement in experimental group than control group of VAS and ODI. As a result, bee venom acua-acupuncture therapy can be used with acupuncture therapy for highly effective treatment for HNP.

• Journal of Acupuncture Research
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• 제24권5호
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• pp.97-104
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• 2007

목적 : 요통 환자에서 Modified-Modified Schober Test (MMST)와 관절 운동 범위를 비교하여 시각 통증 등급 평가에 있어서 타당도의 우위를 추정하여 보고자 하였다. 방법 : 요통으로 입원한 31명의 환자들을 대상으로 MMST, 관절 운동 범위 및 시각 통증 등급을 주 3회씩 입원 기간 동안 측정하였다. 각 측정 방법의 시행 순서는 무작위로 선택되었으며, 환자들은 맨발로 환자복을 입은 채 측정하였다. 결과 : 각 자료의 상관성을 분석하기 위하여 피어슨 상관계수가 사용되었다. 요추의 MMST 측정값(r=-0.61 ; 99%CI)이 요추의 신전 및 굴곡의 관절 운동 범위 측정값보다 시각 통증 등급에 통계적으로 의미 있게 나타났다. 또한 요추의 MMST 측정값(r= -0.77 ; 99%CI)은 요추의 신전 관절 운동 범위 측정값보다 요추의 굴곡 관절 운동 범위 측정값과 통계적으로 의미 있게 나타났다. 결론 : 이상의 결과를 통하여 요통 환자의 평가에 있어서 MMST가 관절 운동 범위보다 높은 타당도를 가지는 것으로 추정된다.

• 한국산업보건학회지
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• 제15권1호
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• pp.61-70
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• 2005

This study investigated the spinal loads(L5/S1 disc compression and shear forces) predicted from four biomechanical models: one EMG model and three optimization models. Three objective functions used in the optimization models were to miminize 1) the cubed muscle forces : MF3, 2) the cubed muscle stress : MS3, 3) maximum muscle intensity : MI. Twelve healthy male subjects participated in the isometric voluntary exertion tests to six directions : flexion/extension, left/right lateral bending, clockwise/ counterclockwise twist. EMG signals were measured from ten trunk muscles and spinal loads were assessed at 10, 20, 30, 40, 50, 60, 70, 80, 90%MVE(maximum voluntary exertion) in each direction. Three optimization models predicted lower L5/S1 disc compression forces than the EMG model, on average, by 31%(MF3), 27%(MS3), 8%(MI). Especially, in twist and extension, the differences were relatively large. Anterior-posterior shear forces predicted from optimization models were lower, on average, by 27%(MF3), 21%(MS3), 9%(MI) than by the EMG model, especially in flexion(MF3 : 45%, MS3 : 40%, MI : 35%). Lateral shear forces were predicted far less than anterior-posterior shear forces(total average = 124 N), and the optimization models predicted larger values than the EMG model on average. These results indicated that the optimization models could underestimate compression forces during twisting and extension, and anterior-posterior shear forces during flexion. Thus, future research should address the antagonistic coactivation, one major reason of the difference between optimization models and the EMG model, in the optimization models.

• Journal of Acupuncture Research
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• 제19권6호
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• pp.205-213
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• 2002

Objective : This study was to investigate on the Korean Bee-Venon acupuncture of Cauda equina syndrome which has been described as complex of low back pain, bilateral sciatica, saddle anesthesia and motor weakness in the lower extremity that progress to paraplegia with bladder and bowel incontinence. Methods : Clinical observation was done on Cauda equina syndrome in the Department of Acupuncture & Moxibustion, Kyungwon Inchon Oriental Medical Hospital from may 25 to June 24. The patients was treated with Korean Bee-Venon acupuncture at Samchosu(B22), Shinsu(B23), Taejangsu(B25), Pang-gwangsu(B28) and Yo-yang-gwan(Gv3) with oriental medicine treatment. We evaluated the bladder incontinence, duration of urination and area of anesthesia before and after treatment. Conclusions : 1. At the early time, gait disturbance was treated well, but discomfort bladder incontinence was remained. 2. The symptoms of Cauda equina syndrome especially bladder incontinence was recurred in short duration by Korean Bee-Venon acupuncture and oriental medicine treatment. 3. There was no significant changes in GOT/GPT before and after treatment.

• 대한인간공학회지
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• 제29권3호
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• pp.347-356
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• 2010

The purpose of this study is to analyze the spine stability by comparing muscle activation in various scaffold working conditions. The independent working conditions were designed by two levels of working height, existence and absence of safety handrail, and the two levels of expertise. The corresponding activities of the agonist and antagonist muscles of spine were simultaneously recorded by using EMG. As results, novice worker showed increased muscle activity while doing the task on the 2nd floor, absence of handrail. And expert showed the increase of co-contraction while working on the 2nd floor without handrail. Such co-contraction was found to increase the spine stability when the working condition become risky. On the other hand, the co-contraction was prolonged, the spine muscle fatique and disc pressure could be increased, which would increase the risk of musculo-skeletal disorder. The results of co-contraction in this study indicates that the motor control system responds to maintain the stability of the spine particularly when workers cognitively recognize the danger of falling or imbalance. This study also quantitatively accounted for the biomechanical cause of LBP among workers who has to prevent themselves from falling. Therefore, if can be said that safe environment preventing falling can also prevent workers from MSDs as well. Such knowledge can be applied to design ergonomic workplace environment as well as movable scaffold.