• Journal of Biomedical Engineering Research
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• v.44 no.2
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• pp.139-146
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• 2023

Osteoporosis is a disease in which the risk of bone fractures increases due to a decrease in bone density caused by aging. Osteoporosis is diagnosed by measuring bone density in the total hip, femoral neck, and lumbar spine. To accurately measure bone density in the lumbar spine, the vertebral region must be segmented from the lumbar X-ray image. Deep learning-based automatic spinal segmentation methods can provide fast and precise information about the vertebral region. In this study, we used 695 lumbar spine images as training and test datasets for a deep learning segmentation model. We proposed a lumbar automatic segmentation model, CM-Net, which combines the center point of the spine and the modified U-Net network. As a result, the average Dice Similarity Coefficient(DSC) was 0.974, precision was 0.916, recall was 0.906, accuracy was 0.998, and Area under the Precision-Recall Curve (AUPRC) was 0.912. This study demonstrates a high-performance automatic segmentation model for lumbar X-ray images, which overcomes noise such as spinal fractures and implants. Furthermore, we can perform accurate measurement of bone density on lumbar X-ray images using an automatic segmentation methodology for the spine, which can prevent the risk of compression fractures at an early stage and improve the accuracy and efficiency of osteoporosis diagnosis.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.16 no.2
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• pp.34-39
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• 2010

Purpose : The purpose of this study is to find out the evidence concerning the effectiveness of manual therapy intervention in the treatment of low back pain related to spondylolisthesis Methods : 12men with lumbar pain from L5~S1 spondylolisthesis of 2 or 3 grade were treated during 12-week period. The manual therapy applied twice per week. The results of back and radiating pain were measured by VAS, and abdominal muscle strength was measured by Power track II. The measurement of degree of slip in spondylolisthesis was confirmed by the lateral view of X-ray and took a measurements of the anterior displacement of a vertebral body in relation to the vertebral below. Results : 1. There was significant decrease in the back and radiating pain.(p<0.05) 2. There was significant increase in the abdominal muscle strength.(p<0.05). 3. There was significant decrease in the degree of the anterior displacement. Conclusion: The intervention of manual therapy for lumbar spondylolisthesis is effective in back pain, radiating pain, abdominal muscle strength and degree of the anterior displacement. So, nonsurgical treatment should be attempted before surgical treatment.

• Journal of the Korean Society of Physical Medicine
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• v.14 no.2
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• pp.21-28
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• 2019

PURPOSE: This study was conducted to compare different standing postures with the use of standing aids for lumbar spine posture and muscle activity, and to identify the most desirable standing posture. METHODS: The lumbopelvic angle was assessed based on static radiographic measurement on the sagittal plane. Lumbar lordosis, lumbosacral lordosis, and the intervertebral joint angle at L1/L5 and L5/S1 were measured using radiography in three standing postures (standing on level ground, standing with one foot on a platform, and standing on a sloped surface). In addition, muscle activity was measured using surface electromyography to examine the co-contraction of the lumbar and hip muscles. RESULTS: Lumbar lordosis, lumbosacral lordosis, and L5/S1 intervertebral joint flexion occurred with one foot on the platform. No significant differences were found between standing on a sloped surface and standing on level ground. However, muscle co-contraction was reduced with the use of standing aids. CONCLUSION: This study demonstrated that standing with a foot on a platform induced lumbar lordosis, but that there was no significant difference between standing on a sloped surface and standing on level ground. However, muscle co-contraction was reduced with the use of standing aids. Based on the motor control pattern as a predictor of LBP, the use of standing aids would help workers during prolonged standing.

• The Korean Journal of Nuclear Medicine Technology
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• v.27 no.2
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• pp.95-98
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• 2023

Purpose: The precision error of a bone density meter reflects the equipment and reproducibility of results by an examiner. Precision error values can be expressed as coefficient of variation (CV), CV%, and root mean square-SD (RMS-SD). The International Society for Clinical Densitometry (ISCD) currently recommends using RMS-SD as the precision error value. When a 95% confidence interval is applied, the least significant change (LSC) value is calculated by multiplying the precision error value by 2.77. Exceeding the LSC value reflects a significant difference in measured bone density. Therefore, the LSC value of a bone density equipment is an essential factor for accurately determining a patient's bone density. Accordingly, we aimed to calculate the LSC value of a bone density meter (Lunar iDXA, GE) and compare it with the value recommended by the ISCD. We also assessed whether the value measured by the iDXA equipment was below the LSC value recommended by ISCD. Material and Methods: The bone densities of the lumbar spine and thighs of 30 participants were measured twice, and the LSC values were calculated using the precision calculation tool provided by the ISCD (http://www.iscd.org). To check the reproducibility of the measurement, patients were asked to completely dismount from the equipment after the first measurement; the patient was then repositioned before proceeding with the second measurement. Results: The LSC values derived using the CV% values recommended by the ISCD were 5.3% for the lumbar spine and 5.0% for the thigh. The LSC values measured using our bone density equipment were 2.47% for the lumbar spine and 1.61% for the thigh. The LSC value using RMS-SD was 0.031 g/cm² for the lumbar spine and 0.017 g/cm² for the thigh. Conclusion: that the findings confirm that the CV% value measured using our bone density meter and the LSC value using RMS-SD were maintained very stably. This can be helpful for obtaining accurate measurements during bone density follow-up examinations.

• Journal of Radiation Industry
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• v.12 no.4
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• pp.311-316
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• 2018

Average life expectancy is getting longer due to medical developments and improvements in living standards. So much so that the elderly have an increased risk of developing osteoporosis. Therefore, it is important to prevent, diagnose, and treat the senile disease at an early stage through a bone density test. Bone density is measured by dual energy X-ray absorption (DXA). In this study, while using DXA, in cases when the measurements for both the lumbar and the femur could not be taken simultaneously, the correlation between both measurements were known, and the measurement of one area was used to make a clinical inference for the value of the other. Measurements were taken using Lunar Prodigy Advance (GE) for 43 participant with clinically significant fractures. Statistical calculations were produced and analysed regarding bone density. In case of T-score, lumbar spine produced a statistical result of $-2.112{\pm}1.836$ and femur neck was $-1.716{\pm}1.565$. In case of Z-score lumbar spine produced a statistical result of $-0.151{\pm}1.513$, and femur neck $-0.026{\pm}1.283$. It is indicated that the pearson correlation coefficient of T-score between lumbar spine and femur neck is high at 0.699, and the pearson correlation coefficient of Z-score is considered relatively high at 0.503. The correlation of bone density between lumbar spine and femur neck is shown to be statistically meaningful in T-score's p-value at 0.000 and Z-score's p-value at 0.001. In conclusion, it seems to have clinical usefulness that we can infer the result of one measurement through that of the other part tested, based on the knowledge of the correlation coefficients between lumbar spine and femur neck.

• Journal of Institute of Control, Robotics and Systems
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• v.18 no.8
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• pp.713-718
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• 2012

Lumber spine range of motion has been used to measure of physical and functional impairment by various tools from a ruler to 3D kinematic devices. However, pre-existing tools have problems in either movement or accuracy and reliability limitations. Accurate devices are limited by fixed space whereas simple devices are limited in measuring complex movements with less accuracy. In order to solve the location, movement and accuracy limitations at once, we have developed a novice measurement device equipped with accelerometer sensor and gyroscope sensor for getting three-dimensional information of motion. Furthermore, Kalman filter was applied to the algorithm to improve accuracy. In addition, RF wireless communication was added for the user to conveniently check measured data in real time. Finally, the measurement method was improved by considering the movement by a reference point. An experiment was conducted to test the accuracy and reliability of the device by conducting a test-retest reliability test. Further modification will be conducted to used the device in various joints range of motion in clinical settings in the future.

• 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.

• Physical Therapy Rehabilitation Science
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• v.6 no.2
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• pp.65-70
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• 2017

Objective: The purpose of this study was to examine the intertester reliability and validity of four nonradiologic measurements of thoracic spine rotation in healthy adults. Design: Descriptive laboratory study. Methods: This study was conducted on 20 male and 20 female university students aged between 19 and 26. To measure thoracic rotation, a goniometer, a bubble inclinometer, a dual inclinometer, and a smartphone application-clinometer were used. The measurement was performed twice for each device and the same measurement was performed by two examiners. The measurements were performed in the lumbar locked position. The arm in the direction of rotation was taken back and placed onto the back of the lumbar region. With right and left trunk rotation, the head was rotated together but remained in the center line so that the axial rotation was maintained. Both examiners performed the measuring procedures and directly handled the measuring instrument. All measurement results were recorded by the recorder. Results: The range of motion (ROM) of thoracic rotation in lumbar locked position for all four devices was 47 degrees. The intra-rater reliability estimates ranged from 0.738 to 0.906 (p<0.05). The inter-rater reliability estimates ranged from 0.736 to 0.853 (p<0.05). The goniometer, bubble inclinometer, dual inclinometer, and smartphone clinometer showed high validity (p<0.05). This result indicates that all four devices may be used by the same examiner and by other examiners obtaining follow-up measurement. Conclusions: The use of the goniometer, bubble inclinometer, dual inclinometer, and smartphone clinometer for measurements in the lumbar locked posture are reliable and valid nonradiologic measures of thoracic rotational ROM in healthy adults.

• Journal of the Korean Society of Food Science and Nutrition
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• v.30 no.1
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• pp.159-167
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• 2001

The objective of this study is to examine the factors affecting bone mineral density in pre- and postmenopausal women. The subject were 30 Korean premenopausal women with mean ages of 33.6 years, and 30 Korean post menopausal women with mean ages of 63.3 years without diagnosed diseases. Data for food and nutrient intake were obtained by the24-hour recall method. BMD of lumbar spine and femoral neck were measured by the dual-energy X-ray absorptiometry (DEXA). Anthropometric measurement were made, and a blood sample was taken for assay osteocalcin. The results are summarized as follows: 16.67% of the subjects in the premenopausal women and 87.33% of the subjects in the postmenopausal women was less than the korean RDA level exceping phosphorus and vitamin C. In the premenopausal women, BMD of lumbar spine is correlated significantly with anthropometric measurement such as weight, waist circumference, BMI, and body fat mass BMD of femoral neck for the premenopausal women is correlated significantly with weight, BMI, waist circumference, body fat mass, hip circumference, and BMDs of both site are negatively correlated with lean body mass, total body water, but they are not related with intake of nutrients in this study. In the postmenopausal women group, BMDs of both site are not significantly correlated with anthropometric measurement, but BMD of lumbar spine showed positive relation with intake of energy, protein, and carbohydrate. In conclusion, adequate nutrient intake, especially energy, protein have been suggested to prevent the loss of bone mineral density in the postmenopausal women. Also, adequate body weight and BMI have been suggested in the premenopausal women.

• Journal of the Korean Society of Physical Medicine
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• v.15 no.3
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• pp.69-77
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• 2020

PURPOSE: The aim of this study was to measure changes in spine inclination and thoracolumbar structure and morphology according to upper-extremity movements with and without resistance in order to evaluate the spine stability in workers. METHODS: Forty-eight middle-aged male workers (mean age, 40.48 ± 6.27 years) participated in this study. Using the spine analysis system, changes in the inclination of the spine and structure as well as shape of the thoracolumbar spine were measured. For posture measurement, the postures of standing, lifting the right and left arms (shoulder joint 90° flexion), and lifting with both arms were measured in random order. In addition, variables were measured using a resistance of 3 kg for each posture. The statistical significance level was set at α = .05 for all variables. RESULTS: There were statistically significant differences between the front and back inclinations of the spine, kyphotic curve of the thoracic spine, lordotic curve of the lumbar spine, rotation changes in the thoracolumbar spine, and rotation changes in the T4 vertebra (p < .05). However, there was no significant difference in the left and right tilts of the spine. In the post-hoc analysis, rotation changes in the T4 vertebra showed a significant difference in posture when resistance was applied to the left and right sides CONCLUSION: Causes of musculoskeletal diseases include excessive thoracic spine rotation, torsion, and hyperlordosis of the lumbar spine. Therefore, it is necessary to improve the working environment in order to ensure a healthy posture and prevent musculoskeletal diseases that can reduce the ability to carry various and/or excessive loads.