• Physical Therapy Korea
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• v.11 no.4
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• pp.19-29
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• 2004

Many muscles of the trunk and hip are capable of contributing to the stabilization and protection of the lumbar spine. To have optimal effectiveness, a training program should include dynamic back/stomach/hip exercises. This study was designed to assess the L5 level paraspinal, external abdominal oblique, and gluteus maximus muscle activities during various low back stabilization exercises. Participants were 26 healthy adults (13 males, 13 Females), aged 21 to 28 years. The surface electromyography (EMG) was recorded from the L5 level paraspinal, external abdominal oblique, and gluteus maximus muscles. The recorded signal was averaged and normalized to the maximal electromyographic amplitude obtained during the maximal voluntary contraction. The measurements were taken during 3 low back stabilization exercises. One-way analysis of variance with repeated measures was used to examine the difference, and a post hoc test was performed with least significant difference. A level of significance was set at p<.05. The significance of difference between men and women, and between the electromyographic recording sites was evaluated by an independent t-test. The EMG activity for the externus oblique and gluteus maximus muscles had significant differences among 3 exercises (p<.05). In males, the EMG activity for the external abdominal oblique muscle had significantly increased differences during exercises 1 and exercise 2 (p<.05). The gluteus maximus muscle had significantly increased differences during exercise 2 and exercise 3 (p<.05). In females, the multifidus muscle had significantly increased difference during exercise 3 (p<.05), the external abdominal oblique muscle had significantly increased difference during exercise 1 (p<.05). and the gluteus maximus muscle had significantly decreased difference during exercise 3 (p<.05). The results were that the external abdominal oblique muscle was apparently activated during the curl-up exercise in females and males, and the multifidus muscle was apparently activated during the bridging exercise in females and during the sling exercise in males and females.1)In comparison of the %MVC between males and females, exercise 2 and exercise 3 apparently activated of the multifidus and gluteus maximus muscles in both males and females (p<.05). The EMG activity of the gluteus maximus muscle of the males significantly increased during exercise 2 and exercise 3 (p<.05). The EMG activity the multifidus muscle of the females was significantly increased during exercise 2 and exercise 3 (p<.05). More research is needed to understand the nature of motor control problems in the deep muscles in patients with low back pain.

• Physical Therapy Korea
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• v.4 no.2
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• pp.18-35
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• 1997

The purpose of this study were to determine causes of low back pain in bus drivers who usually work in prolonged sitting position and to find the relationship of back pain with general characteristics and work environmental characteristics, stress symptoms, to com맹re lordosis angle of habitual driving posture and resting posture in low back pain group and non-low back pain group, and to use this result as a basis for improvement of work environment and comprehensive rehabilitative management of low back pain. Ninety-eight bus drivers were selected from the membership of an urban transit union in Seoul. These informations were collected from May 1, 1997 to May 25, 1997 by means of structured questionnaires and X-ray findings. These data were analyzed by $x^2$ test, t-test, logistic regression using SAS. The major results were as follows: 1. Of the respondents, 66.3% of bus drivers were found to be experiencing back pain. 2. Of the respondents of low back pain groups, 78.5% reported that major cause of low back pain was due to prolonged sitting. 3. The group with experiences of frequent or continuous vibration had more low back pain (p<0.05). There were no significant differences among other work environmental factors. 4. Average stress score was significantly higher in the group with low back pain than in the group without low back pain (p<0.05). 5. The results of the logistic regression analyses were statistically significant vibration from seat and stress score among the risk factors (p<0.05). 6. Averaged lordosis angle of habitual driving posture was $7.6{\pm}14.9$ degrees in low back pain group, $16.5{\pm}8.7$ degrees in non-low back pain and averaged lordosis angle of resting sitting posture was $10.8{\pm}13.7$ degrees in low back pain, $18.9{\pm}9.6$ degrees in non-low back pain group but the difference in mean lordosis angles of two groups was not statistically significant. The results of this study indicate that professional drivers developed chronicity of low back pain due to unfit seat, poor habitual posture and stress from vibration or other risk factors. Therefore, there is need to improve work environment, i.e. enough resting, to set a seat to support lumbar spine properly and to provide comprehensive rehabilitation program including early diagnosis, proper treatment and education for self help management.

• Journal of Physiology & Pathology in Korean Medicine
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• v.18 no.6
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• pp.1918-1926
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• 2004

Osteoporosis is defined as a progressive systemic skeletal disorder characterized by low bone mineral density, microarchitectual deteriorations of bone and susceptibility to fracture. numerous methods have been used for quantitative assessment of the skeleton in osteoporosis. QCT has been shown to measure changes in trabecular mineral content in the spine with great sensitivity and precision. To provide the normal reference values and changes of lumbar spinal bone mineral density in korean adult spinal bone mineral density was evaluated in 451 women (229 premenopausal and 222 postmenopausal women) and 206 men, aged 20 to 74 years old in Wonkwang hospital from 2000 to 2004, which was carried out by using QCT. women with oophorectomy, vertebral compression fracture, any history of endocrine disease and use of drugs that alter bone metabolism were excluded. According to the WHO definition, a patient is osteoporotic based on a bone mineral density(BMD) measurement that is 2.5 standard deviations (SDs) below typical peak bone mass of young healthy white women. This measurement of standard deviation from peak mass is called the T score. BMD values of normal women in their 20-24 years, 25-29 years, 30-34 years, 35-39 years, 40-44 years, 45-49 years, 50-54 years, 55-59 years, 60-64 years, 65-69 years, over 70 years were 168.95㎎/㏄ K₂PHO₄, 155.41㎎/㏄ K₂PHO₄, 166.87㎎/㏄ K₂PHO₄, 160.67㎎/㏄ K₂PHO₄, 154.06㎎/㏄ K₂PHO₄, 132.04㎎/㏄ K₂PHO₄, 114.05㎎/㏄ K₂PHO₄, 91.78㎎/㏄ K₂PHO₄, 78.61 ㎎/㏄ K₂PHO₄, 61.35㎎/㏄ K₂PHO₄, 50.53㎎/㏄ K₂PHO₄ Mean bone density of normal women was 115.77K₂PHO₄ K₂PHO₄. BMD values of normal men in their 20-24 years, 25-29 years, 30-34 years, 35-39 years, 40-44 years, 45-49 years, 50-54 years, 55-59 years, 60-64 years, 65-69 years, over 70 years were 171.46㎎/㏄ K₂PHO₄, 162.19㎎/㏄ K₂PHO₄, 155.62㎎/㏄ K₂PHO₄, 147.28㎎/㏄ K₂PHO₄, 137.56㎎/㏄ K₂PHO₄, 137.56㎎/㏄ K₂PHO₄, 101.25㎎/㏄ K₂PHO₄, 109.00㎎/㏄ K₂PHO₄, 103.32㎎/㏄ K₂PHO₄, 91.53㎎/㏄ K₂PHO₄, 88.35㎎/㏄ K₂PHO₄ Mean density of normal men was 115.77㎎/㏄ K₂PHO₄. Peak bone density of women and men was in the age group of 20-24 years and 168.95㎎/㏄ K₂PHO₄, 171.46㎎/㏄ K₂PHO₄, respectively. Bone loss was increased with aging and was accelerated in postmenopausal women than that of premenopausal women. The total loss of BMD for women and men was 70.09% and 48.47%, respectively. Postmenopausal women(mean BMD : 85.83㎎/㏄ K₂PHO₄) had significantly lower BMD than premenopausal women(meand BMD : 144.80㎎/㏄ K₂PHO₄)(p<0.001). The annual loss of BMD of women and men was 2.702㎎/㏄ K₂PHO₄ and 1.795㎎/㏄ K₂PHO₄, respectively. This study provided the BMD reference data for normal korean adult. further studies on BMD in healthy adult and comparison with published data are needed.

• Journal of Acupuncture Research
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• v.23 no.3
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• pp.207-214
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• 2006

Objectives : This study is designed in order to evaluate the therapeutic effect of Scalp Acupuncture and Do-ma Acupuncture related with Governer Vessel(Dok) and Bladder Meridian(Chok-taeyang) on acute low back pain Methods : We investigated 30 patients suffering from acute low back pain were admitted to Dunsan O.M.hospital from March. 1st 2005 to December. 30th 2005. We divided into two groups: one group was treated with Scalp acupunture, another group was treated with common acupuncture. 30 patients, were diagnosed only straightened curvature on lateral view of lumbar spine X -ray. Scalp acupunture related with Governer Vessel(Dok) and Bladder Meridian(Chok-taeyang) and Do-ma acupuncture. To estimate the efficacy of treatment that applied for two groups, we compared the visual analog scale(VAS), Oswestry disabiliby index(ODI) and Straight Leg Raising Test(SLRT) score of two groups statistically. Results : Both Scalp acupuncture related with Governer Vessel(Dok) and Bladder Meridian (Chok-taeyang) and Do-ma acupuncture therapy showed good effect on acute low back pain. It was proved by the difference between VAS, ODI and SLRT score checked before treatment and what checked after treatment on each groups. Conclusion: The therapeutic effect of Scalp Acupuncture and Do-ma Acupuncture on acute low back pain can be recommended as a useful therapy to treat acute low back pain.

• Journal of Nutrition and Health
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• v.35 no.7
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• pp.779-790
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• 2002

Nutritional factors affecting bone mineral density (BMD) in the different age groups of Korean women were investigated to obtain baseline data for maintaining bone health. Information on diet and anthropometry were collected in 80 elementary school children (height 127.2 cm, weight 27.3 kg), 84 high school students (height 161.6 cm, weight 52.4 kg), 100 adults aged 25 to 35 years (height 159.4 cm, weight 52.7 kg) and 120 elderly people over 60 years of age (height 150.9 cm, weight 55.6 kg). Data for nutrient intake were obtained by 24-hour recall method. BMDs of lumbar spine (L$_2$-L$_4$) and femoral neck were measured by dual energy x-ray absorptiometry. The relationship between BMD of femoral neck and nutritional factors were analyzed. The average BMD of femoral neck for females was 0.61 g/$\textrm{cm}^2$ in children, 0.88 g/$\textrm{cm}^2$ in adolescents, 0.90 g/$\textrm{cm}^2$ in adults, 0.64 g/$\textrm{cm}^2$ in elderly people. Among the adult subjects, 11.0% was classified as osteopenia in the femoral neck. For the elderly, the prevalence of osteopenia and osteoporosis were 34.2% and 47.5% of the subjects. It was shown the intake of energy, protein, plant protein, animal protein, fat, carbohydrate, Ca, P, Fe, vitamin A, thiamin, riboflavin, niacin, vitamin C, carbohydrate energy percent and fat energy percent influenced bone health status in all age groups. In the MAR on bone health status, children, adult and elderly subjects were significantly different among groups classified by bone health status and the MAR of the groups with good in bone health was higher. The RDA percent of each nutrient was influence factor on BMD. Nutrient intake of energy, protein, P, Fe, thiamin, niacin were lower BMD on below 75% of Korean RDA. Stepwise multiple regression analysis revealed that several dietary factors were influence on BMD. MAR on femoral neck BMD of children and elderly subjects was the highest influence factor. Beyond this, the most influential dietary factors on BMD were the vitamin A, total Ca and vegetable Ca. The above results have confirmed that dietary factors influence BMD in various age groups. Energy, protein, Ca, P, Fe, thiamin, riboflavin, niacin, vitamin C as well as MAR were important dietary factors influencing BMD. The results of this study revealed that people who received sufficient nutrients intake showed healthy bone status. The MAR mainly influenced the bone health status.

• Journal of Korean Neurosurgical Society
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• v.29 no.2
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• pp.240-248
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• 2000

Objective : Spontaneous intracranial hypotension is a rarely reported syndrome of spontaneous postural headache associated with low CSF pressure and has rarely been demonstrated radiographically or surgically. But recently, it is being recognized with increasing frequency. The purpose of this study was to characterize clinical and imaging features, etiologic factors, and outcome in the spontaneous intracranial hypotension. Patients and Methods : We reviewed our experience with documented cases of spontaneous intracranial hypotension in 5 consecutive patients with orthostatic headaches from April 1998 to April 1999. Results : The mean age was 41 years(from 35 to 49 years). All patients had postural headaches, which were completely alleviated by recumbency position. Nausea, neck pain, horizontal diplopia, photophobia, and blurred vision were noted in some of the patients. Brain MRI showed diffuse pachymeningeal gadolinium enhancement, subdural collections of fluid, and descent of the brain. The opening pressure from lumbar puncture was $4cmH_2O$ or less in three of five patients whereas the opening pressure was within normal range in two patients. All patients underwent radioisotope cisternography and computerized tomographic myelography. On radioisotope cisternography, CSF leakage was suspected at the level of cervical area(1 patient), upper thoracic area(2 patients), mid-thoracic area(1 patient). Computed tomography myelography revealed extraarachnoid accumulation of contrast media(compatible finding with CSF leakage) at the level of cervical or thoracic area. In all patients, the symptoms resolved in response to supportive measures or epidural blood patch(1 patient). Conclusion : Spontaneous spinal CSF leakage is increasingly recognized as a cause of spinal postural headache. Most CSF leaks are located at the cervicothoracic junction or in the thoracic spine and can be demonstrated by variable diagnostic method. The condition is usually self-limiting and its prognosis is typically good.

• Journal of Korean Neurosurgical Society
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• v.29 no.7
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• pp.935-939
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• 2000

Objective : Traumatic disc lesion is a lesion with tremendous controversies. The causal relationships of this lesion are not established along with pathogenesis, diagnostic criteria, methods of treatment and the outcome. However, a significant number of patients with back pain after a trauma underwent spinal operations under the diagnosis of traumatic disc lesions. Such an ill-directed operation eventually produce a person with an iatrogenic disability. We present two illustrative cases, and tried to make a preventive method. Methods : We examined the path from mild trauma after a road traffic accident into the iatrogenic disability in two illustrative cases, who requested disability assessment and medical appraisement. We evaluated the reason and background for such an unwanted outcome and tried to find a method to reduce or prevent it by a literature review. Results : These two patients were admitted to the hospital with the diagnosis of lumbar sprain after a road traffic accidents. They eventually underwent spinal surgery under another diagnosis such as traumatic disc herniation or internal disc disruption. They stayed at the hospital for more than six months and finally lost their jobs. They became the disabled at last. Although they complained back pain, they never insisted by themselves that their symptoms were due to the traumatic disc lesion. To prevent such an iatrogenic disability, the doctors should assist them to go-back to the workplace promptly instead of a reckless extension of the treatment period. It may be necessary to evaluate the certificates to extend the treatment period with an additional diagnosis by a medical expert. To reduce the unnecessary long-term admission, a new billing system such as a partial share for the high cost of the treatment by the patients may be needed. Conclusion : It is not the patient but the doctors, who has the responsibility to avoid the unnecessary operations. All treating doctors should try to reduce or prevent such an iatrogenic complication caused by ourselves before we are forced to do so.

• Korean Journal of Clinical Laboratory Science
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• v.48 no.4
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• pp.296-303
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• 2016

This study was performed to evaluate the effect of hemoglobin (Hb) on bone mineral density (BMD) in university students by performing a quantitative analysis. The subjects included healthy university students aged 20 to 30 years. Although osteoporosis has traditionally been considered as a disease of aging women, it is becoming an increasingly concerning male health problem. Diagnosis of osteoporosis is calculated with a quantitative assessment of BMD. Laboratory blood and urine tests are mainly used with low BMD or fragility fractures to identify any possible causes of bone metabolism disorders. In this study, there was no difference in BMD according to gender. The average red blood cell (RBC), Hb, and Hematocrit (HCT) were significantly higher in males (p<0.01). The correlation between lumbar spine, skeletal muscle mass (SMM), and basal metabolic rate (BMR) was statistically significant (p<0.01). Hb showed a 51.7% statistical influence on BMD by multiple regression analysis. These findings are useful to understand the relationship between BMD and Hb; lower Hb level is associated with lower BMD. The Hb level was the strongest predictor of abnormal BMD. In conclusion, this study showed that a low Hb value was significantly correlated with low bone mass, suggesting that a low Hb value is a risk factor for changes in bone turnover that leads to a decrease bone density.

• The Journal of the Korea Contents Association
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• v.15 no.3
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• pp.168-173
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• 2015

Use of forearm and hip joint bone density scan and find the clinical usefulness of the results that can be inferred as a result of any other region sites injured by a correction factor which if One part up. Groups of 60 patients, 10 patients by age 20-70 were composed of patients measured with the forearm and lumbar spine bone mineral density T-score and Z-score of the survey for each of the three factors that it was Find the correction factor to obtain the relationship. Bone mineral density of the correlation coefficient R = 0.8 correction factor is Y = 1.341X + 0.146. T-score of correlation coefficient R = 0.804 and the correction factor Y = 0.565X - 0.327 is Z-score of the correlation coefficient R = 0.637 correction factor Y = 0.539X - 0.225. It is regarded that there will be a clinical availability which can analogize the result of a part by using the result of the other part. It will be able to determine an auxiliary role in the clinical diagnosis. Correction factor to the equation Y = 1.341X + 0.146 is recommended.

• Journal of Nutrition and Health
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• v.39 no.5
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• pp.451-459
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• 2006

The purpose of our study was to evaluate an association between milk consumption and bone mineral density (BMD) of female college students in Korea. The dietary data of 1,410 Korean college students living in the vicinity of Seoul area were collected through the Food Frequency Questionnaire. The mean age, height, weight and 8MI of the subjects were 20.4 years, 162.1 cm, 52.7 kg, and $20.0\;kg/m^2$ respectively. The mean intakes of energy, protein, and phosphorus were 2,398.7 kcal, 95.2 g, and 1,302.9 mg respectively, which were above their EER or Recommended Intake (RI), but the mean intake of calcium was 657.8 mg which was below its RI, and 44.0% of the subjects did not meet Estimated Average Requirement (EAR) of calcium. The daily milk consumption was 131.1 g, and the total consumption of milk and dairy product was 228.7 g. Forty five percent of the subjects consumed $50{\sim}200\;g$ of milk or dairy products. After the analysis of their dietary intakes, the subjects were divided into quintiles of total consumption of milk and dairy product, which were considered as major source of dietary calcium. Ninety two subjects from the upper quintile (UQ) and 85 subjects from the lower quintile (LQ) were selected and their bone mineral densities (BMD) of lumbar spine (L1-L4) and the femur were examined by the dual energy X-ray absorptiometry. The BMD $(g/cm^2)$of L1, L2, L3, and average of femur were 1.065, 1.150, 1.187, and 0.988 for the UQ subjects, which were significantly higher than those of the LQ subjects, 1.010, 1.090, 1.146, and 0.942 respectively. Moreover, the T-scores of the UQ were significantly higher than those of the LQ. The prevalence rates of osteopenia classified according to WHO's criterion were 12.0% in the UQ. and 20.0% in the LQ group which showed non significant. Blood levels of calcium, and phosphorus of UQ and LQ group were both within the normal range, and were not significantly different. Our results showed that UQ group presented the better status of bone mineral density and bone health. Therfore our results suggest that continuous consumption of more than one and a half cups of milk per day, which corresponds to the least amount of UQ group's consumption, would affect positively on the bone health of Korean adults.