• Title/Summary/Keyword: Lumbar Region

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Reliability and validity of pelvic mobility measurement using a cushion sensor in healthy adults

  • Jung, Seung-Hwa;Kim, Su-Kyeong;Lee, Ji-Hyun;Choi, Soo-Ih;Park, Dae-Sung
    • Physical Therapy Rehabilitation Science
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    • v.9 no.2
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    • pp.74-81
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    • 2020
  • Objective: To prevent low back pain, an objective evaluation tool to evaluate pelvic mobility and exercise to improve the flexibility of the lumbar region is needed. The purpose of this study was to compare the results of pelvic mobility measurements using the Wii Balance Board (WBB) and Sensbalance Therapy Cushion (STC), evaluate the usefulness of the STC as a tool for measuring pelvic mobility. Design: Cross-sectional study. Methods: Fifty healthy subjects participated in this study. The subjects performed pelvic mobility range, proprioception, reaction time and reach of the arm using the STC. The pelvic movement parameter was measured two times to determine the intra-rater reliability. To measure the correlation between lumbar muscle tension and pelvic mobility, Myovision was used to measure tension of L4, L5 level erector spinae muscle. Correlations between measured variables were checked to determine the validity of the pelvic mobility assessment tool. Results: STC showed high test-retest reliability in pelvic tilt measurement and reaching task [intraclass correlation coefficients (3,1)=0.804-0.915]. The relationship between WBB and STC showed a significant positive correlation with the pelvic tilt and reaching task (p<0.05). Posterior tilt and erector spinae activation (Lt. L5) showed a significant negative correlation (p<0.05). Left, right tilt and erector spinae activation (L5) showed a significant negative correlation (p<0.05). Conclusions: This study confirmed the advantages of the STC and found efficiency as an objective measuring device of pelvic mobility.

Comparison of treatment outcomes in lumbar central stenosis patients treated with epidural steroid injections: interlaminar versus bilateral transforaminal approach

  • Sencan, Savas;Edipoglu, Ipek Saadet;Celenlioglu, Alp Eren;Yolcu, Gunay;Gunduz, Osman Hakan
    • The Korean Journal of Pain
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    • v.33 no.3
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    • pp.226-233
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    • 2020
  • Background: We aimed to compare interlaminar epidural steroid injections (ILESI) and bilateral transforaminal epidural steroid injections (TFESI) on pain intensity, functional status, depression, walking distance, and the neuropathic component in patients with lumbar central spinal stenosis (LCSS). Methods: The patients were divided into either the ILESI or the bilateral TFESI groups. Prime outcome measures include the numerical rating scale (NRS), Oswestry disability index (ODI), Beck depression inventory (BDI), and pain-free walking distance. The douleur neuropathique en 4 questions score was used as a secondary outcome measure. Results: A total of 72 patients were finally included. NRS, ODI, and BDI scores showed a significant decline in both groups in all follow-ups. Third-month NRS scores were significantly lower in the ILESI group (P = 0.047). The percentages of decrease in the ODI and BDI scores between the baseline and the third week and third month were significantly higher in the ILESI group (P = 0.017, P = 0.001 and P = 0.048, P = 0.030, respectively). Pain-free walking distance percentages from the baseline to the third week and third month were significantly higher in the ILESI group (P = 0.036, P < 0.001). The proportion of patients with neuropathic pain in the bilateral TFESI group significantly decreased in the third week compared to the baseline (P = 0.020). Conclusions: Both ILESI and TFESI are reliable treatment options for LCSS. ILESI might be preferred because of easier application and more effectiveness. However, TFESI might be a better option in patients with more prominent neuropathic pain.

Evaluation of the Effect of Location and Direction of the Scoliotic Curve on Postural Balance of Patients with Idiopathic Scoliosis (특발성 척추측만증 환자의 척추 만곡 위치와 방향이 자세 균형에 미치는 영향성 평가)

  • Jung, Ji-Yong;Kim, Jung-Ja
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.18 no.4
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    • pp.341-348
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    • 2017
  • This study examined the effects of the location and direction of the scolioti curve on postural balance in patients with idiopathic scoliosis. Fifteen subjects were divided into three groups: right thoracic curve group, left lumbar curve group, and double curve group. The dynamic trunk motion (angle variation in the lumbar, thoracolumbar, lower thoracic and upper thoracic region) and plantar pressure distribution (maximum force and peak pressure) were assessed using an ultrasound-based motion analysis system and Emed-at platform system. From the results, it was confirmed that patients with idiopathic scoliosis showed postural imbalance with an increased angle and pressure asymmetry according to the location and direction of the scoliotic curve for dynamic trunk motion and plantar pressure distribution. In addition, there were differences in the postural balance pattern between the single curve and double curve groups. Further studies for developing a rehabilitation training device will be conducted to improve the postural control ability and trunk balance as well as treat scoliosis based on the results of this study.

Relationship between needle depth for lumbar transforaminal epidural injection and patients' height and weight using magnetic resonance imaging

  • John, Hyunji;Sohn, Kyomin;Kim, Jae Hun
    • The Korean Journal of Pain
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    • v.35 no.3
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    • pp.345-352
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    • 2022
  • Background: Optimal needle depth in transforaminal epidural injection (TFEI) is determined by body measurements and is influenced by the needle entry angle. Physician can choose the appropriate needle length and perform the procedure more effectively if depth is predicted in advance. Methods: This retrospective study included patients with lumbosacral pain from a single university hospital. The skin depth from the target point was measured using magnetic resonance imaging transverse images. The depth was measured bilaterally for L4 and L5 TFEIs at 15°, 20°, and 25° oblique angles from the spinous process. Results: A total of 4,632 measurements of 386 patients were included. The lengths of the left and right TFEI at the same level and oblique angle were assessed, and no statistical differences were identified. Therefore, linear regression analysis was performed for bilateral L4 and L5 TFEIs. The R-squared values of height and weight combined were higher than the height, weight, and body mass index (BMI). The following equation was established: Depth (mm) = a - b (height, cm) + c (weight, kg). Based on the equation, maximal BMI capable with a 23G, 3.5-inch, Quincke-type point spinal needle was presented for three different angles (15°, 20°, and 25°) at lumbar levels L4 and L5. Conclusions: The maximal BMI that derived from the formulated equation is listed on the table, which can help in preparations for morbid obesity. If a patient has bigger BMI than the one in the table, the clinician should prepare longer needle than the usual spinal needle.

A Review Study on Movement System Impairment Syndromes (동태손상(動態損傷) 증후군(症候群)에 관한 연구 현황 고찰)

  • Kim, Jeong-Kyun;Kim, Hyun-Ho;Seo, Jae-Ho;Kim, Dong-Won;Park, Young-Jae;Park, Young-Bae
    • The Journal of Korean Medicine
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    • v.33 no.1
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    • pp.79-89
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    • 2012
  • Objectives: Sahrmann, an American physical therapist, has developed a set of movement-related diagnoses on musculoskeletal pain syndromes (MPS). We reviewed articles for studies of objectification and quantification of Oriental medicine diagnosis system about MPS. Methods: The authors reviewed a total of 12 studies found on PubMed to obtain movement system impairment (MSI)-based classification categories. Results: The MSI system has been developed for objectification and quantification of physical therapists' MPS diagnoses. The MSI system of classification is based on the basic premise that loss of precise movement is the result of specific repetitive movements and positions in everyday life. The MSI system defines 8 categories in the shoulder region, 5 in the lumbar region, and 7 in the knee region. Treatment involves (1) educating the person about the specific directions of alignment and movement that appear to be contributing to the musculoskeletal problem, (2) modifying the direction - specific alignment and movement patterns during daily activities, and (3) exercises to address the impairments. Conclusions: The authors propose that MSI studies could help to advance an Oriental medical diagnosis system on musculoskeletal pain syndromes, because MSI shares similarity with Oriental medicine in terms of holism, views of constant motion, and mi-byung (subhealth) treatment.

The effect of left & right range of motion according to general coordination manipulation treatment on cervical (경추의 전신조정 관절치료가 좌우 관절가동범위에 미치는 영향)

  • Kim, Hyoung-Su;Moon, Sang-Eun;Chae, Jung-Byung;Kim, Eun-Young
    • Journal of Korean Physical Therapy Science
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    • v.10 no.2
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    • pp.112-122
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    • 2003
  • The purpose of this study is to search effect that GCM joint treatment gets to right and left range of motion of neck, lumbar, trunk and anke joint. Estimated body deformity using GCM body type assesment chart then measured range of motion of each region. After control group did as act freely after do experiment premeasurement control group did postmeasurement. Each region was measured by measurer who each subject person differs. Experimental group did GCM joint treatment and all measurements each region by measurer who each subject person differs three times measured. When measure with each measurement, measured after leave and walk time interval for 10 minutes. For the analysis of the resulr of experiment the results is change amount comparison increased to keep in mind except ankle joint's dorsiflexion before experiment of experimental group and control group(P<.05). Before an experiment and after an experiment of experimental group, differed to keep in mind in right and left comparison of neck rotation, dorsiflexion, plantaflexin of ankle joint in change amount comparison(P<.05). Neck lateral flexion appears and displayed significantly level right and left difference than rotation after experiment of experimental group(P<.05). Because dorsiflexion, plantefleaion of ankle joint became similar right and left significantly difference did not appear(P<.05).

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Electrical Detection of Ear Acupuncture Points and Musculoskeletal Pain (경혈탐측기에 반응한 이혈(耳穴)과 신체 동통 부위와의 관계 연구)

  • Kang, Mun-Su;Park, Hyun-Chul;Kim, Lak-Hyung;Yu, Jeong-Suk;Song, Beom-Yong
    • Journal of Acupuncture Research
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    • v.24 no.6
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    • pp.187-193
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    • 2007
  • Objectives : The objectives of this study were to investigate the relationship between electrical detection of ear acupuncture points and musculoskeletal pain. Methods : 18 adults who have musculoskeletal pain without trauma factorsparticipated in this study. They answered the questionnaire and their ear acupuncture points were examined with electrical detectors. We analyzed the relationship between electrical detection of ear acupuncture points and musculoskeletal pain with concordance rate and validity. Results : Total concordance rates of the head region was 68.00%(questionnaire) 32.08%(investigation), that of vertebral region was 67.86%, 59.38%, that of both upper limbs was 86.67%, 39.69%, and that of both lower limbs was 50.00%, 23.46%. The true positive rate was 0.704, the true negative rate was 0.492, the false positive rate was 0.508, and the false negative rate was 0.296 in the validity test. In the head, two concordance rates of the temporal and occipital regions were relatively higher than those of the parietal and frontal regions. In the vertebral region, two concordance rates of the cervical and lumbar regions were relatively higher than those of the thoracic and sacrum regions. In the upper limb, two concordance rates of the shoulder and shoulder joints were relatively higher than those of the others. In the lower limb, concordance rates of investigation were relatively low at all areas. The right lower limb was relatively higher than the left in concordance rates of the questionnaire. Conclusions : The results suggest that electrical detection of ear acupuncture points can be used in the diagnosis and treatment of musculoskeletal pain.

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A Correlation between the Perceived Symptom of Musculoskeletal Diseases and Psychosocial Factors of Dental Professionals in C Region (C지역 치과종사자의 근골격계 질환 자각증상과 사회심리적 특성과의 관계)

  • Han, Ji-Hyoung;Kim, Jin;Nam, Soo-Hyoun;Kim, Chang-Hee
    • Journal of dental hygiene science
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    • v.10 no.4
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    • pp.279-286
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    • 2010
  • To investigate the correlation between the perceived symptom of musculoskeletal diseases and psychosocial factors in dental professionals in Chungcheong province, a self-administered survey was conducted on 206 dental professionals in Chungcheong province from March 9th, 2009 to March 28th, 2009. SPSS WIN 12.0 software was used to analyze the data and the following results were obtained. 1. As for the perceived symptom degree of musculoskeletal diseases based on measured body parts, the frequency of 'high' was the highest in all the parts of the body. 2. As for gender, females showed higher interest in musculoskeletal diseases than males (p=.000). As for age, subjects ranged 26~30 years showed the highest interest in musculoskeletal diseases, which was statistically significant (p=.000). 3. Work satisfaction showed a positive correlation with the perceived symptom of musculoskeletal diseases in lumbar group and lower extremity group. Work stress showed a weak negative correlation with the perceived symptom of musculoskeletal diseases in lumbar group and lower extremity group. Coworker satisfaction showed a positive correlations with the perceived symptom in upper extremity group and lower extremity group. Hospital satisfaction showed a positive correlations with the perceived symptom in upper extremity group, lumbar group and lower extremity group. Working environment satisfaction showed a positive correlations with the perceived symptom in neck group, shoulder group, upper extremity group and lower extremity group. This study showed a correlation between psychosocial factors and the perceived symptom of musculoskeletal diseases based on body parts. Therefore, psychosocial factors should be considered when the prevention and management program of musculoskeletal diseases are developed.

Bone-Preserving Decompression Procedures Have a Minor Effect on the Flexibility of the Lumbar Spine

  • Costa, Francesco;Ottardi, Claudia;Volkheimer, David;Ortolina, Alessandro;Bassani, Tito;Wilke, Hans-Joachim;Galbusera, Fabio
    • Journal of Korean Neurosurgical Society
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    • v.61 no.6
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    • pp.680-688
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    • 2018
  • Objective : To mitigate the risk of iatrogenic instability, new posterior decompression techniques able to preserve musculoskeletal structures have been introduced but never extensively investigated from a biomechanical point of view. This study was aimed to investigate the impact on spinal flexibility caused by a unilateral laminotomy for bilateral decompression, in comparison to the intact condition and a laminectomy with preservation of a bony bridge at the vertebral arch. Secondary aims were to investigate the biomechanical effects of two-level decompression and the quantification of the restoration of stability after posterior fixation. Methods : A universal spine tester was used to measure the flexibility of six L2-L5 human spine specimens in intact conditions and after decompression and fixation surgeries. An incremental damage protocol was applied : 1) unilateral laminotomy for bilateral decompression at L3-L4; 2) on three specimens, the unilateral laminotomy was extended to L4-L5; 3) laminectomy with preservation of a bony bridge at the vertebral arch (at L3-L4 in the first three specimens and at L4-L5 in the rest); and 4) pedicle screw fixation at the involved levels. Results : Unilateral laminotomy for bilateral decompression had a minor influence on the lumbar flexibility. In flexion-extension, the median range of motion increased by 8%. The bone-preserving laminectomy did not cause major changes in spinal flexibility. Two-level decompression approximately induced a twofold destabilization compared to the single-level treatment, with greater effect on the lower level. Posterior fixation reduced the flexibility to values lower than in the intact conditions in all cases. Conclusion : In vitro testing of human lumbar specimens revealed that unilateral laminotomy for bilateral decompression and bone-preserving laminectomy induced a minor destabilization at the operated level. In absence of other pathological factors (e.g., clinical instability, spondylolisthesis), both techniques appear to be safe from a biomechanical point of view.

A Study on the Activities of Daily Living Adaptation of Spinal Cord Injured Patients (척수손상자의 일상생활적응에 관한 연구)

  • Son, Kyung-Hyun;Kim, Chan-Kyu;Bang, Yoo-Soon
    • Journal of Korean Physical Therapy Science
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    • v.10 no.1
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    • pp.47-57
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    • 2003
  • The purpose of this study was to evaluate the problem on activities of daily living ; the problem which spinal cord injured patients have when they adapt in daily living ; Subjects were 113 members who used the hospital which is located in Kwangju-city from November 20, 2001 to May 20, 2002. The evaluation of the ADL was performed according to MBI and collected data were statistically analysed by SPSS PC for paired Chi-square test T-test, One way ANOVA and Duncan's post-hoc test. The result's were as follows; 1. Modified Barthel Index average mark was $63.77{\pm}33.60$ points and MBI score distribution according to characteristics of injury is as following. 1) A patient who had long duration of injury, small injury region, incomplete paralysis in paralysis degree, paraplegia in paralysis type got high MBI score as statistical and significantly(p<0.05). 2. Society adaptation state by characteristics of spinal cord injured is an following. 1) After lapse of time of disease, a patient who is injured for a long term present surrounding environmental problem, a patient who is injured for a short term shows psychological problem. In society activity, as lapse of time of disease is long, patient did many hobby activity and same private club, on the other hand as lapse of time of diseases is short, the others appeared high and significantly as statistical(p<0.01). 2) In society activity by injury region, cervical injury and thoracic injury did more hobby activity than lumbar injury and in lumbar injury same private club or religion life appeared higher than thoracic injury of cervical injury significantly as statistical(p<0.01). 3) In walk method by paralysis degree Complete paralysis had more wheelchair life than incomplete paralysis(p<0.01). 4) In serious problem by paralysis type psychological problem in quadriplegia and surrounding environmental problem in paraplegia appeared high and significantly as statistical(p<0.01). 3. In society adaptation state by MBI score difference between variables appeared but it wasn't significantly.

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