• Korean Journal of Applied Biomechanics
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• v.33 no.2
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• pp.73-83
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• 2023

Objective: Adolescent idiopathic scoliosis patients make up 40% of all scoliosis patients, and it is likely to increase even more because of the increase in sitting times due to the pandemic. Method: The subject of this study was a 16-year-old female student. The Cobb's Angle at initial value was 42° at the thoracic and 33° at the lumbar. The subject's height was 161.6 cm, and the type of scoliosis was 3CL. The brace was built with fabric materials with the size information from the X-ray information and actual measurements. The brace was made for the adolescents to wear for a longer time by making them put pressure on the same pressure points of the existing braces. The subjects were required to wear the device for 16 hours every day for three months. Additional features to check the pressure and time were synchronized through an app for easier communication and management with the responsible investigator. Results: After wearing the 3D Fabric brace, Cobb's angle changed from 42° to 33° at the thoracic and 33° to 23° at the lumbar. The ATR changed from 9° to 8° at the thoracic and 11° to 6° at the lumbar. As a result, the changes in the ATR angle do relate to the decrease of Cobb's angle, which made the angle of scoliosis that is bent in a three-dimensional way improve, making the height of the subject increase from 161.6 cm to 163.5 cm. Conclusion: Through this study, developing a brace that is made in the form of the 3CL to align the strap direction and putting pressure on the proper pressure points makes Cobb's angle and the ATR smaller. This means that there is a positive effect on the changes in height. A brace made of light fabric material is a good brace to help treat adolescent idiopathic scoliosis. There was an opinion that it is more comfortable to wear than existing braces, but it seems necessary to conduct a quantitative study about the before and after of wearing the brace and a survey for Korean specific cases.

• Journal of Korean Neurosurgical Society
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• v.39 no.4
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• pp.256-259
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• 2006

Objective : Having a reliable and reproducible measurement technique to measure the sagittal contour in vertebral fractures is paramount to clinical decision making. This study is designed to determine the most reliable measurement technique in osteoporotic vertebral compression fracture. Methods : Fifteen lateral radiographs of thoracic and lumbar fractures were selected and measured on two separate occasions by three spine surgeons using six different measurement techniques [Centroid, Harrison Posterior Tangent Methods and 4 different types of modified Cobb method]. The radiograph quality was assessed and the center beam location was determined. Statistical analysis including ANOVA for repeated measures was carried out using the SAS software [v 8.0]. Results : The inter and intraobserver variance of the Cobb method 4 and Harrison posterior tangent method were significantly lower than the other four methods. The intraobserver correlation coefficients were the most consistent using the Cobb method 4 [0.982]. which was followed by the Harrison posterior tangent [0.953] and Cobb methods 1 [0.874]. The intraobserver agreement [% of repeated measures within 5 degrees of the original measurement] ranged from 42% to 98% for each technique for all three observers, with the Cobb method 4 showing the best agreement [97.8%] followed by the Harrison posterior tangent method [937%]. Conclusion : The Cobb method-4 and Harrison posterior tangent methods, when applied to measuring the kyphosis, are reliable and have a similar small error range. The Cobb method 4 shows the best overall reliability. However, the centroid method and Cobb method using a fractured endplate do not produce an accurate result due to inter and intraobserver differences in determining the baseline.

• Journal of Acupuncture Research
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• v.25 no.1
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• pp.155-167
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• 2008

Objectives : The objective of this study was to observe the positive effects of acupuncture and bee-venom acupuncture treatment on lumbar hypolordosis. Methods : Acupuncture and bee-venom acupuncture were performed twice a week for 30 days to treat patients with low back pain patients showing a Cobb's angle [L1-S1] of less than $35^{\circ}$(treatment group=20, control group=13). Lumbar lordosis(Cobb's angle [L1-S1], Centroid angle [L1-S1]) was measured using an L-spine Lat. X-ray before and after treatment. Pain scales(VAS scale, ODI) were also was measured before and after treatment. SPSS 12K for Windows was used for statistical analysis of the results. Results : 1. VAS and ODI decreased significantly in the treatment group. 2. Lumbar lordosis, presented by Cobb's angle, increased significantly from $25.00{\pm}7.06^{\circ}$ to $30.95{\pm}10.02^{\circ}$ (p = 0.006). The increase of Cobb's angle in the treatment group $5.95{\pm}8.60^{\circ}$, and that of the control group was $-3.08{\pm}8.41^{\circ}$(p = 0.006). The increase of the Centroid angle of the treatment group was $3.85{\pm}8.83^{\circ}$, and that of the control group was $-2.92{\pm}7.63^{\circ}$(p=0.031). 3. Cobb's angle and Vas scale showed a significant correlation coefficient of -0.250(p=0.043). Increase of Cobb's angle and decrease of Vas scale showed a significant correlation coefficient of 0.420(p=0.015). Conclusions : Acupuncture and bee-venom acupuncture were verified to have a positive effect on pain alleviation of lumbar lordosis decreased patients while also affecting lumbar lordosis to be increased as a result of structural changes. It was also shown that lumbar hypolordosis has significant correlation with pain.

• Annals of Rehabilitation Medicine
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• v.42 no.6
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• pp.863-871
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• 2018

Objective To evaluate the association between progression of curvature of scoliosis, and correction for functional component in patients with juvenile idiopathic scoliosis (JIS). Methods We retrospectively reviewed medical data of patients prescribed custom molded foot orthosis (FO) to correct inequality of RCSPA (resting calcaneal stance position angle), and chose 52 patients (26 females, 26 males) with Cobb angle ${\geq}10^{\circ}$ in radiology and uneven pelvic level at iliac crest by different RCSPA (${\geq}3^{\circ}$) as a factor of functional scoliosis. They had different hump angle ${\geq}5^{\circ}$ in forward bending test, for idiopathic scoliosis component. Their mean age and mean period of wearing FO were $79.5{\pm}10.6months$ and $18.6{\pm}0.70months$. Results Cobb angle was reduced from $22.03^{\circ}{\pm}4.39^{\circ}$ initially to $18.86^{\circ}{\pm}7.53^{\circ}$ after wearing FO. Pelvis height difference and RCSPA difference, were reduced from $1.07{\pm}0.25cm$ initially to $0.60{\pm}0.36$, and from $4.25^{\circ}{\pm}0.71^{\circ}$ initially to $1.71^{\circ}{\pm}0.75^{\circ}$ (p<0.01). Cobb angle improved most in 9 months. However, there was no significant improvement for those with more than $25^{\circ}$ of Cobb angle initially. Mean Cobb angle improved in all age groups, but patients less than 6 years had clinically significant improvement of more than $5^{\circ}$. Conclusion JIS can have functional components, which should be identified and managed. Foot orthosis is useful in correcting functional factors, in the case of pelvic inequality caused by different RCSPA, for patients with juvenile idiopathic scoliosis.

• Journal of Korean Neurosurgical Society
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• v.55 no.6
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• pp.337-342
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• 2014

Objective : To determine deformity correction by postural correction and subsequent balloon inflation in acute vertebral compression fractures (OVCFs) and to examine the effect of bone mineral density on deformity correction. Methods : A totol of 50 acute OVCFs received balloon kyphoplasty. Lateral radiographs were taken and analyzed at five different time points : 1) preoperative, 2) after placing the patient in prone hyperextended position, 3) after balloon inflation, 4) after deposition of the cement, and 5) postoperative. All fractures were analyzed for height restoration of anterior (Ha), middle (Hm) and posterior (Hp) vertebra as well as Cobb angle and Kyphotic angle. The bone mineral density (BMD) of lumbar spine was measured by dual-energy X-ray absorptiometry. According to the T-score, the patients were divided into two groups which were osteoporosis group and osteopenia group. Results : Postoperative measurements of Ha, Hm and the Cobb angle demonstrated significant reduction of 4.62 mm, 3.66 mm and $5.34^{\circ}$ compared with the preoperative measurements, respectively (each p<0.05). Postural correction significantly increased Ha by 5.51 mm, Hm by 4.35 mm and improved the Cobb angle by $8.32^{\circ}$ (each p<0.05). Balloon inflation did not demonstrate a significant improvement of Ha, Hm or the Cobb angle compared with baseline prone hyperextended. Postural correction led to greater improvements of Ha, Hm and Cobb angle in osteoporosis group than osteopenia group (each p<0.05). Conclusion : In acute OVCFs, the height restoration was mainly attributed to postural correction rather than deformity correction by balloon inflation. BMD affected deformity correction in the process of postural correction.

• The Journal of Churna Manual Medicine for Spine and Nerves
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• v.7 no.2
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• pp.39-52
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• 2012

Objectives : The purpose of this study was to investigate the correlation between lumbar lordotic angle and the power of trunk flexors, extensors in normal adults Methods : 34 normal participants participated in this study. Their lumbar lordotic angle(L1-S1 Cobb's angle and L1-L5 cobb's angle) was measured by x-ray taken on lateral direction, erect cross-arm position. And muscle power of trunk flexors and extensors of each participant measured using Cybex HUMAC NORM. Results : 1. The average of L1-S1 Cobb's angle was $47.21{\pm}8.88^{\circ}$ and the average of L1-L5 Cobb's angle was $36.32{\pm}9.62^{\circ}$(Table IV). 2. The average ratio of trunk flexors/extensors was $6.44{\pm}19.31%$(Table V). The average power of the trunk flexors was $165.18{\pm}55.05$(Newton-Meter/kg), and the power of trunk extensors was $257.18{\pm}85.53$ (Newton-Meter/kg)(Table VI). 3. Lumbar lordotic angle has no relation to the ratio of trunk flexors/extensors(Table VII, Fig. 4). 4. Lumbar lordotic angle has no relation to both the power of the trunk flexors and extensors(Table VIII, Fig. 5, Fig. 6). Conclusions : These results suggest that the lumbar lordotic angle measured by radiograph could not evaluate the power and ratio of trunk flexors, extensors.

• The Journal of Korea Institute of Information, Electronics, and Communication Technology
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• v.4 no.2
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• pp.88-95
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• 2011

In this study, Image Processing Algorithms which can make intervertebral disk images distinct and be easy to apply when measuring X-ray image of spine by using Cobb's angle and can measure the stage of scoliosis pertaining to X-ray image including the whole length of spine by converting to just one spinal functional graph without appling Cobb's angle in every disk are proposed. In addition, The calculated average value of L per $1^{\circ}$ Cobb's angle as to X-ray image of spine results in 0.568 which can be a standard for detecting the stage of scoliosis.

• Journal of Korean Physical Therapy Science
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• v.16 no.4
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• pp.1-9
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• 2009

Background: The purpose of this study is to find out the effect on the improvement in idiopathic scoliosis when applying the orthopedic manual physical therapy and myofascial release technique. Methods: 20 patients in Cheon-An ${\bigcirc}{\bigcirc}$ hospital were selected as subjects whose Cobb's angle were higher than $10^{\circ}$ according to the radiograph. They were treated for 60 minutes a day, three days a week, and 8 weeks so that the total time of visit would be 24. We performed five tests (Moire test, X-ray, standing height test, Cobb's angle, pelvic level test, VAS) to indentifiy the therapeutic effects. Results: Four test results were improved more remarkably after those treatment than before(p<.001), except pelvic level test (p>.001). Conclusion: we confirmed that there were correcting effects on most of the valuation index from the primary analysis, which divided the subjects into 2 groups by Cobb's angle, but there were more effective in patients having lower than $25^{\circ}$. There were similarly correcting effects on most of the valuation index according to the secondary analysis, but there were particularly more effective in children.

• Korean Journal of Applied Biomechanics
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• v.26 no.1
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• pp.101-113
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• 2016

Objective: The purpose of this study was to investigate the effect of leg length discrepancy (LLD) on the human body during gait and standing posture. Methods: The study group comprised of 17 adult participants with LLDs of <1 cm. LLDs were artificially induced to 0, 1, 2, and 3 cm. The proportion of weight distribution, shift of the mean center of pressure, and Cobb's angle were measured in the standing position. Kinematic variables such as walking and striding width and time, and the proportion of stance phase for single- and double-limb gait were measured as well. The participants were required to either stand or walk on a treadmill (Zebris FDM) with a pressure plate, and the Cobb's angle measurements were obtained from radiographs. Results: A discrepancy of 3 cm in leg length resulted in a statistically significant shift of the center of pressure in the standing position. Moreover, the Cobb angle increased as the discrepancy became larger. The step length and width of the longer (left) leg during gait statistically significantly increased when the discrepancy was 2 cm. In addition, step time was statistically significant when the discrepancy between the longer (right) and shorter (left) legs was more than 2 cm. The proportion of single-limb stance phase was statistically significant as the discrepancy became larger, especially when the discrepancy was >2 cm for the longer (right) leg and 1 cm for the shorter (right) leg. Conclusion: The study showed that LLD influenced deformations of the human body and walking.

• Journal of Korean Medicine Rehabilitation
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• v.32 no.1
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• pp.63-72
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• 2022

Objectives This study was conducted to characterize scoliosis patients visiting Korean medicine hospital and to analyze the demands and factors affecting discomfort. Methods This retrospective study analyzed 33 scoliosis patients who visited Korean medicine hospital from March, 2021 to October, 2021. The data analysis consisted of three factors: (1) demographic characteristics, (2) characteristics of demands on Korean medicine (reasons for choosing Korean medical treatment, preferred treatment methods, most uncomfortable part, treatment priorities) and (3) discomfort factors (treatment experiences, diagnosed age and Cobb's angle). Statistical analyses were performed and a p-value≤0.05 was considered to be statistically significant. Results 43.75% of the patients chose 'effectiveness' for the reason why they preferred Korean medicine treatment. 'Chuna treatment' was the most preferred treatment method. The patients chose 'lower back' for the most uncomfortable part and 'pain' for the highest priority of improvement. The Cobb's angle of included patients was 16.02±7.65° and it is not much differ to average of Cobb's angle in Korean. Discomfort was more severe in the patients with treatment-experienced than treatment-naive. The score of discomfort in appearance and psychological were higher in the patients diagnosed in childhood or adolescent period than who were diagnosed after adult. Classification based on Cobb's angle showed no statistical difference. Conclusions Not only Cobb's angle but also other clinical factors should be considered for effective treatment in scoliosis. Also, It is necessary to pay attention to adult scoliosis patients.