• Journal of The Korean Society of Integrative Medicine
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• v.7 no.3
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• pp.181-188
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• 2019

Purpose: This study was performed to determine the effects of a gluteus maximus strengthening exercise on both spinal alignment and dynamic balance in subjects with kyphosis. Methods: We measured the kyphosis angle of 150 subjects and selected those whose kyphosis angle was > $50^{\circ}$. The participants included 10 male and 12 female college students. After a gluteus maximus strengthening exercise was applied, the subjects were measured by the formetric 4D and Biorescue systems. The collected data were analyzed by a paired t-test with the SPSS (Ver. 21) program for spinal alignment and dynamic balance comparisons both before and after the gluteus maximus strengthening exercise was completed. Results: The results regarding spinal alignment showed statistically significant decreases in pelvic tilt, kyphotic angle, and lordotic angle after the intervention (p < .05). However, trunk imbalance, pelvic torsion, surface rotation, and lateral deviation were not significantly different after the exercise. The results of the dynamic balance showed statistically significant increases in limits of stability after the exercise (p < .05). Conclusion: The above results suggest that the implemented gluteus maximus strengthening exercise may be effective for spinal alignment and dynamic balance in subjects with kyphosis.

• Journal of the Korean Orthopaedic Association
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• v.56 no.3
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• pp.208-214
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• 2021

Purpose: Verifying a reliable predictor of the progression of vertebral deformity in patients with acute osteoporotic fractures of the lumbar spine may be useful. A qualitative analysis of the muscle near the spine was performed using magnetic resonance imaging (MRI), and its correlation with a spinal deformity was determined under the hypothesis that the causes of the kyphotic deformity are associated with muscle reduction in the multifidus and erector spinae. Materials and Methods: The study was performed in a retrospective manner using the electronic medical records of patients who presented to the author's institution between January 2007 and March 2018, and were diagnosed with an acute lumbar fracture. The fat infiltration rates of the multifidus and erector spinae were measured using MRI taken at the time of injury, and the mean value was defined as the total fat infiltration rate (TFI). Based on lateral radiographs of the lumbar spine at the one-year follow-up, the loss of height of the vertebral body, the kyphotic angle and the wedge angle were measured. The statistical significance was confirmed by calculating the Pearson correlation coefficient. Results: One hundred twenty-nine patients, of which 30 were male and 99 were female, were examined. The mean age was 71.28 years. The mean T-score was -3.53±0.79 g/cm², and the mean fat infiltration was 15.20%±11.99%. TFI was positively correlated with age (R=0.373, p<0.001), compression rate (R=0.369, p<0.001), and Cobb's angle (R=0.386, p<0.001) after a one year follow-up, but negatively correlated with the BMD score (R=-0.252, p=0.004). As the fracture progressed to the lower lumbar level, the compression rate (R=-0191, p=0.030) and wedge angle (R=-0.428, p<0.001) at the time of injury tended to decrease. Conclusion: In patients with osteoporotic vertebral fractures, the fat infiltration rate may be an important predictor of conservative treatment. The prognosis of patients with a high-fat infiltration rate should be explained during patient education, and the patients must be monitored closely through short-term outpatient follow-up.

• 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.

• Physical Therapy Korea
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• v.26 no.2
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• pp.1-7
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• 2019

Background: In previous studies, changes in postural alignment were found when the slope was changed during walking. Downhill walking straightens the trunk by shifting the line of gravity backward. Objects: This study investigated the effect of the downhill treadmill walking exercise (DTWE) on thoracic angle and thoracic erector spinae (TES) activation in subjects with thoracic kyphosis. Methods: A total of 20 subjects with thoracic kyphosis were recruited for this study. All the subjects performed the DTWE for 30 minutes. A surface EMG and 3D motion capture system were used to measure TES activation and thoracic angle before and after the DTWE. Paired t-tests were used to confirm the effect of the DTWE (p<.05). Results: Both the thoracic angle and TES activation had significantly increased after the DTWE compared to the baseline (p<.05). An increase in the thoracic angle indicates a decrease in kyphosis. Conclusion: The DTWE is effective for thoracic kyphosis patients as it decreases their kyphotic posture and increases the TES activation. Future longitudinal studies are required to investigate the long-term effects of the DTWE.

• Journal of Korean Neurosurgical Society
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• v.30 no.12
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• pp.1388-1393
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• 2001

Objective : In the retrospective analyzing 19 consecutive patients with subaxial cervical spine(C3~T1) injury treated by posterior cervical fixation and fusion, clinical manifestation, radiologic finding, operative technique, and postoperative results following 6 months were analyzed. Materials and Methods : Most common fracture level was C4-5, mean age 41, and male to female ratio 13 : 6. The most common cause of injury was motor vehicle accident(17 cases). In 19 cervical procedures, interspinous triple wiring was done in 14 cases, lateral mass plating in 5 cases, and additional anterior fusion in 2 cases. Results : Twelve weeks after operation, all cases were reviewed by plain cervical radiogram. In 17 cases that treated by posterior fusion only, 14 cases(81%) had kyphotic angle change less than $5^{\circ}$, 2 cases(12%) $5-20^{\circ}$, and 1 case(6%) more than $20^{\circ}$. Overall fusion rate was 88%, and there was no significant difference of bone fusion rate between autogenous bone graft and allogenous bone graft. Conclusion : In the case of severe posterior column injury or displacement, posterior approach seems superior to anterior approach, but in the case of combined anterior column injury, anterior approach is considered necessary. In this study, posterior fixation and fusion might be acceptable procedure for subaxial cervical fracture and dislocation, owing to its high fusion rate, low kyphotic angulation and low operation related complication rate.

• Journal of Korean Neurosurgical Society
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• v.53 no.1
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• pp.26-30
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• 2013

Objective : The purpose of this study was to compare the results of three types of short segment screw fixation for thoracolumbar burst fracture accompanying osteopenia. Methods : The records of 70 patients who underwent short segment screw fixation for a thoracolumbar burst fracture accompanying osteopenia (-2.5< mean T score by bone mineral densitometry <-1.0) from January 2005 to January 2008 were reviewed. Patients were divided into three groups based on whether or not bone fusion and bone cement augmentation procedure 1) Group I (n=26) : short segment fixation with posterolateral bone fusion; 2) Group II (n=23) : bone cement augmented short segment fixation with posterolateral bone fusion; 3) Group III (n=21) : bone cement augmented, short segment percutaneous screw fixation without bone fusion. Clinical outcomes were assessed using a visual analogue scale and modified MacNab's criteria. Radiological findings, including kyphotic angle and vertebral height, and procedure-related complications, such as screw loosening or pull-out, were analyzed. Results : No significant difference in radiographic or clinical outcomes was noted between patients managed using the three different techniques at last follow up. However, Group I showed more correction loss of kyphotic deformities and vertebral height loss at final follow-up, and Group I had higher screw loosening and implant failure rates than Group II or III. Conclusion : Bone cement augmented procedure can be an efficient and safe surgical techniques in terms of achieving better outcomes with minimal complications for thoracolumbar burst fracture accompanying osteopenia.

• PNF and Movement
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• v.17 no.1
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• pp.41-46
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• 2019

Purpose: Continuous use of a smartphone increases the angle of forward bending of the user's cervical vertebrae, causing pain in the shoulders and back, including the thorax, lumbar region, and vertebrae. Although there are many studies on changes in the cervical spine due to smartphone usage, the changes in the shoulders, thoracolumbar spine, and pelvic have rarely been compared. The purpose of this study is to investigate the change in the spinal segments, shoulders, and pelvic when using a smartphone with both hands while in the standing position. Methods: This study was conducted on 35 adults in their twenties. The selection criteria for the subjects were limited to those in a similar age group, thus excluding posture differences according to age, and to those who did not have specific diseases or pain in the spinal and musculoskeletal system for 12 months prior to the study. In this study, we used a 3D spinal diagnostic imaging system (Back Mapper, Frickenhausen) to compare the changing conditions in each vertebral segment before and during smartphone usage with both hands while in the standing position. Posture differences according to smartphone usage were compared using the paired t-test for the motion of each spinal segment. Results: This study showed that the thoracic and lumbar angle increased posteriorly during smartphone usage (p<0.05). In addition, the anterior rotation angle of the shoulder bone significantly increased, but no significant difference occurred in the pelvic region. Conclusion: Based on the results of this study, smartphone usage with both hands while in the standing position showed that the spine, as a whole, forms a kyphotic curve. Therefore, we propose to present a postural guideline for correct smartphone usage, considering the change in each vertebral segment.

• The Journal of Korean Physical Therapy
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• v.26 no.4
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• pp.226-233
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• 2014

Purpose: This study was conducted in order to investigate the exercise limit that may occur depending on changes in postural alignment by examining the significance of postural alignment changes, foot pressure, and balance of patients with stroke. Methods: In this study, 50 patients diagnosed with a stroke were selected as subjects. Imbalance of postural alignment of the trunk, pelvic tilt of trunk rotation of the body, angle of kyphotic curving of the thoracic, and angle of lordotic curving of the lumbar vertebra were measured. Foot pressure was examined by measuring average pressure and weight bearing. Balance was examined by measuring the center of pressure and limit of stability. Results: The significance of postural alignment, foot pressure, and weight bearing of the non-paretic side was examined. In addition, the significance between postural alignment and balance was examined. Conclusion: It is thought that limits of foot pressure and balance in the standing position can be caused by postural alignment. Thus, both a therapeutic intervention program and postural alignment training should be provided together in order to improve the function of patients with stroke.

• Journal of International Academy of Physical Therapy Research
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• v.10 no.2
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• pp.1797-1802
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• 2019

Background: Breathing is the essential step of Pilates exercise and can be used to activate core muscles. Although the effects of breathing exercise on pain, breathing muscles, and cervical posture have been extensively studied, little is known about the impact of Pilates breathing on spinal posture and alignment. Purpose: To determine the effect of 3D-Pilates breathing exercise on spinal curvature and alignment of healthy adults during corrected to normal alignment. Design: One group pre-post test design Methods: Eighteen participants were given a 3D-pilates breathing exercise twice a week (20 minutes per session) for three weeks and warmed up for 10 minutes before each exercise session. To examine spinal curvature and alignment of each subject, this study used radiation free rasterstereography (Formetric III, Germany). Paired t-test and Wilcoxon signed rank test were performed to determine the difference between pre and post exercise. Results: There were statistically significant differences in height (p<.001), kyphosis angle (p<.05), trunk imbalance (p<.05), kyphotic apex (p<.01), cervical fleche (p<.05), pelvic tilt (p<.01), and lateral deviation (p<.05) between before and after 3D Pilates breathing exercise. However, there was no significant difference in lordosis angle. Conclusions: The study results indicated that three week 3D-pilates breathing exercise program could be presented as an effective rehabilitation method for improving spinal curvature and alignment.

• Journal of Korean Neurosurgical Society
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• v.41 no.5
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• pp.301-305
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• 2007

Objective : The postoperative subsidence of anterior cervical interbody fusion for cervical degenerative diseases gives rise to segmental kyphotic collapse, screw loosening, and chronic neck pain. So, intraoperative custom-made polymethylmethacrylate [PMMA] C-cage has been developed to prevent subsidence following anterior cervical fusion. Methods : A total of patients who underwent anterior cervical interbody fusion with a intraoperative custom - made cervical cage filled with local bone and demineralized bone matrix [group A] were analyzed prospectively from June 2004 to June 2005. These were compared with 40 patients who were treated with iliac bone graft [group B]. We evaluated subsidence ratio, change of segmental angle, distraction length and segmental angle. Statistical analysis was performed using independent sample t-test and Pearson correlation coefficient. Results : Group A had a statistically significant decrease in subsidence ratio [$0.64{\pm}0.43%$, p=0.00]. distraction length [$2.42{\pm}1.25\;mm$, p=0.02], and follow angle change [$1.78{\pm}1.69^{\circ}$, p=0.01] as compared with Group B. However, there was no statistically significant difference in postoperative segmental angle change [p=0.66]. On the analysis of the correlation coefficient, the parameters showed no interrelationships in the group A. On the other hand, subsidence ratio was affected by distraction length in the group B [Pearson correlation=0.448]. Conclusion : This operative technique would be contributed for the reduction of a postoperative subsidence after the anterior cervical interbody fusion procedure for cervical disc disease with moderate to severe osteoporotic condition and segmental loss of lordosis.