• The Journal of Korean Physical Therapy
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• 제23권5호
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• pp.15-21
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• 2011

Purpose: The purpose of this study was to describe the influence of respiration on the segmental motion of the lumbar spine in the lying position. Methods: Twelve healthy females without a history of low back pain participated. Lumbosacral lordosis, intervertebral body angles, intervertebral body displacements, and anterior heights of the intervertebral disc of the lumbar spine were measured at inspiration, expiration and forced expiration in the supine and prone positions via fluoroscopy. Results: The results of lumbar kinematic analysis in the supine position according to respiration pattern were as follows. The L4/5 intervertebral body angle was significantly higher at forced expiration than at expiration (p<0.05). The L3/4 anterior height of the intervertebral disc was significantly higher at expiration than at forced inspiration and the L5/S1 anterior height of the intervertebral disc was significantly higher at inspiration than at forced expiration (p<0.05). There were no significant differences in the intervertebral body displacements and lumbosacral lordosis in the supine position (p>0.05). The results of lumbar kinematic analysis in the prone position according to respiration pattern were as follows. The L5/S1 anterior height of the intervertebral disc was significantly higher at inspiration than at forced expiration (p<0.05). However, there was no significant difference in the intervertebral body angle, the intervertebral body displacements, and the lumbosacral lordosis (p>0.05). Conclusion: These findings suggested that respiration can affect the intervertebral body angle and anterior height of the intervertebral disc in some segments. The results from this study serve as a step in the development of guidelines for lumbar kinematic analysis for lumbar breathing training.

• 대한정형도수물리치료학회지
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• 제22권2호
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• pp.9-14
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• 2016

Purpose: Many people are suffering from Low back pain due to HIVD and muscular problems, lack of joint functions on lumbar spine. In this study we compared the change of the herniation index, Oswestry LBP disability index (OLDI), visual analog scale (VAS), lumbar flexion range of motion (ROM) between the pre-experiment and after 4 weeks treatment by maitland manual therapy. Method: we selected and managed both the 15 people. They are $46.80{\pm}15.46$ years old people with HIVD and Stenosis. We treated for the people with HIVD and Stenosis by manual therapy(maitland manipulation method) during 4 weeks. And then we compared with pre-experiment and after 12 weeks through measuring the herniation index change by using computor themograpy (CT), LBP OLDI, VAS, lumbar flexion ROM. Results: The changes in the herniation index, Oswestry lumbar Disability Index, VAS, lumbar flexion ROM between the pre-experiment and after 4 weeks treatment by maitland manual therapy, there was a statistically significant difference. Although there was a significant difference after 4 weeks in OLDI, VAS, lumbar flexion ROM. But disc herniation index was no significant difference. Conclusion: Manual therapy is very effective for Lumbago due to the HIVD and spinap stenosis patients. OLDI, VAS and lumbar flexion ROM were increased. But disc herniation index was no significant difference. We suggest the combination treatment between manual exercise and spinal traction.

• 대한정형도수물리치료학회지
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• 제10권2호
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• pp.33-43
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• 2004

The purpose of this study was to compare the lumbar extensor strength between before exercise and after 8 weeks exercise in the elderly. To evaluate lumbar extensor strength of total 18 patients (above 59 age) with low back pain or have experienced surgical operation. Lumbar extensor strength was measured in 8 male patients and 10 female patients (9 op group and 9 non-op group) by Medx lumbar extension machine. The data were analyzed with paired t-test compared to muscle strength, with repeated measured ANOVA compared to amount increase of muscle strength, using SPSS ver. 10.0 program. The results of this study were as follows: 1. There were significantly increased total lumbar extension strength was appear $6918.7{\pm}2802.77$ft-lbs in before exercise, $10432.83{\pm}2802.773397.1$ft-lbs in after 8 weeks exercise (p<. 05). 2. There were significantly increased total lumbar extension strength was increased to compared before exercise with after 8 weeks exercise in sex (p<. 05), op/non-op group (p<. 05).

• 국제물리치료학회지
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• 제10권1호
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• pp.1746-1749
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• 2019

Background: Surgery has been known as an inefficient approach to reduce back pain in patients with lumbar spinal stenosis; therefore, non-surgical treatments are necessary. However, there has been little research to analyze the effect of non-surgical treatments on lumbar spinal stenosis pain. Objective: To identify the effectiveness of 2 physiotherapeutic treatment approaches to relieve pain due to lumbar spinal stenosis. Design: Randomized controlled trial Methods: The participants were 36 lumbar spinal stenosis patients who were randomized in the joint mobilization group (JMG) and transcutaneous electrical nerve stimulation group (TENSG). Joint mobilization (JM) was conducted at the posteroanterior joint in the spinous process of the lumbar spine with stenosis. Transcutaneous electrical nerve stimulation (TENS) was applied on the lumbar spine with stenosis at a high frequency and intensity. Results: Visual analog scale (VAS) pain score significantly decreased in both groups, and the VAS value decreased more after JMG than that after TENSG. The pain thresholds of both groups also significantly increased, and that of JMG increased more compared to TENSG. In both the groups, significant improvements in VAS and pain thresholds were found, and JMG showed better results than TENSG. Conclusions: JM and TENS showed significant relief in both pain threshold and painpain, and JM showed more advanced relief compared to TENS.

• Journal of Korean Neurosurgical Society
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• 제58권4호
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• pp.346-349
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• 2015

Objective : To investigate the value of lumbar bone mineral density (BMD) in fracture risk assessment (FRAX) tool. Methods : One hundred and ten patients aged over 60 years were enrolled and divided into 2 groups as non-osteoporotic vertebral fracture (OVF) and OVF groups. The 10-year-risk of major osteoporotic vertebral fracture of each group was calculated by FRAX tool with femoral and lumbar spine BMDs to compare the usefulness of lumbar spine BMD in prediction of OVF. The blood level of osteocalcin and C-terminal telopeptide (CTX) as markers of activities of osteoblast and osteoclast, respectively were analyzed using the institutional database. Results : In the OVF group, the ratio of patients with previous fracture history or use of glucocorticoid was higher than those in non-OVF group (p=0.000 and 0.030, respectively). The levels of T-score of femur neck and lumbar spine in OVF group were significantly lower than those in non-OVF group (p=0.001 and 0.000, respectively). The risk of OVF in FRAX using femur BMD in non-OVF and OVF groups was $6.7{\pm}6.13$ and $11.4{\pm}10.06$, respectively (p=0.007). The risk of using lumbar BMD in the 2 groups was $6.9{\pm}8.91$ and $15.1{\pm}15.08$, respectively (p=0.002). The areas under the receiver operator characteristic curve in the FRAX risk with lumbar and femur neck BMD were 0.726 and 0.684, respectively. The comparison of osteocalcin and CTX was not significant (p=0.162 and 0.369, respectively). Conclusion : In our study, the 10-year risk of major osteoporotic fracture in the OVF group of our study was lower than the recommended threshold of intervention for osteoporosis. Hence, a lower threshold for the treatment of osteoporosis may be set for the Korean population to prevent OVF. In the prediction of symptomatic OVF, FRAX tool using lumbar spine BMD may be more useful than that using femur neck BMD.

• 척추신경추나의학회지
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• 제5권2호
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• pp.33-41
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• 2010

Objectives : This study is designed to find out the relationship of scoliotic curve, cervical lordosis, lumbar lordosis and Ferguson's angle. Method : The study was composed of 46 scoliosis patients who had single curvature(Group I) on their lumbar spine(Group I-A) or thoracic spine(Group I-B) and 38 patients who had double curvature(Group II) on their lumbar and thoracic spine. The patients were evaluated with X-ray findings of full spine AP and Lateral views and statistically analyzed. Results : 1. Group II showed a significant increase in scoliotic curve angle as compared with Group I(P<0.05). 2. Scoliotic curve has a negative relationship with cervical lordosis in group II. Conclusion : 1. The patients who has double curvature of spine had higher scoliotic curve angle compared with who has single curvature. 2. The Scoliotic curve and cervical lordosis was statistically concerned on patients who has double curvature of spine.

• Journal of Korean Neurosurgical Society
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• 제62권4호
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• pp.442-449
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• 2019

Objective : Bone mineral density (BMD) is an important consideration during fusion surgery. Although dual X-ray absorptiometry is considered as the gold standard for assessing BMD, quantitative computed tomography (QCT) provides more accurate data in spine osteoporosis. However, QCT has the disadvantage of additional radiation hazard and cost. The present study was to demonstrate the utility of artificial intelligence and machine learning algorithm for assessing osteoporosis using Hounsfield units (HU) of preoperative lumbar CT coupling with data of QCT. Methods : We reviewed 70 patients undergoing both QCT and conventional lumbar CT for spine surgery. The T-scores of 198 lumbar vertebra was assessed in QCT and the HU of vertebral body at the same level were measured in conventional CT by the picture archiving and communication system (PACS) system. A multiple regression algorithm was applied to predict the T-score using three independent variables (age, sex, and HU of vertebral body on conventional CT) coupling with T-score of QCT. Next, a logistic regression algorithm was applied to predict osteoporotic or non-osteoporotic vertebra. The Tensor flow and Python were used as the machine learning tools. The Tensor flow user interface developed in our institute was used for easy code generation. Results : The predictive model with multiple regression algorithm estimated similar T-scores with data of QCT. HU demonstrates the similar results as QCT without the discordance in only one non-osteoporotic vertebra that indicated osteoporosis. From the training set, the predictive model classified the lumbar vertebra into two groups (osteoporotic vs. non-osteoporotic spine) with 88.0% accuracy. In a test set of 40 vertebrae, classification accuracy was 92.5% when the learning rate was 0.0001 (precision, 0.939; recall, 0.969; F1 score, 0.954; area under the curve, 0.900). Conclusion : This study is a simple machine learning model applicable in the spine research field. The machine learning model can predict the T-score and osteoporotic vertebrae solely by measuring the HU of conventional CT, and this would help spine surgeons not to under-estimate the osteoporotic spine preoperatively. If applied to a bigger data set, we believe the predictive accuracy of our model will further increase. We propose that machine learning is an important modality of the medical research field.

• 척추신경추나의학회지
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• 제8권1호
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• pp.15-26
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• 2013

Objectives: The purpose of this study is to find out the relationship between lumbar lordotic angle and low back pain patterns. Methods: We randomly selected the 1191 patients (595 males, 596 females) who have visited Bu-Chun Jaseng Hospital of Korean Medicine with low back pain. We have taken lumbar x-ray films and measured their lumbar lordotic angle, the angle formed between L1 superior margin and S1 superior margin. We investigated 1191 patients' low back pain patterns(date of occurence, existence of radiating pain, trend of increasing pain with lumbar extention and flexion, trend of increasing pain with standing and sitting positions) and analysed the relationship between lumbar lordotic angle and low back pain patterns. Results: 1. The lumbar lordotic angle of the acute phase patient is more straight than the chronic one. 2. The lumbar lordotic angle of the patients with radiating pain is more straight than the patients without radiating pain. 3. At acute phase, the lumbar lordotic angle of the patients with increasing pain from lumbar extention is more straight than those with increasing pain from lumbar flexion. 4. At chronic phase, the lumbar lordotic angle of the patients with increasing pain from lumbar flexion is more straight than those with increasing pain from lumbar extention. Conclusions: There was a significant correlation between lumbar lordotic angle and low back pain.

• 척추신경추나의학회지
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• 제2권2호
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• pp.17-32
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• 2007

Objectives : The lumbosacral joint is unstable area from an anatomical viewpoint, while it is also a very mobile area in ordinary life, so that clinically major causes of low back pain originate in this joint. The purpose of this study is to assess the difference of the Ferguson's angles, Lumbar gravity lines, Lumbar lordotic angles among Herniated of Intervertebral Disc(HIVD) patients. Methods : We analyzed the lateral view of lumbar spine checked at erect position on 88 patients who had been diagnosed as HIVD by Magnetic Resonance Imaging(MRI). We investigated the Ferguson's angle, Lumbar gravity line, Lumbar lordotic angle on X-ray film. Results and Conclusions : In the acute lumbago group the Ferguson's angle had a tendency to decrease, while in the chronic group it had a tendency to increase. In the acute lumbago group the Lumbar gravity line fell in front of the normal range(sacrum), while in the chronic group it fell behind the normal range(sacrum). In the acute lumbago group the Lumbar lordotic angle usually decreased, while in the chronic group it increased. The Ferguson's angle and the Lumbar gravity line, the Ferguson's angle and the Lumbar lordotic angle, the Lumbar gravity line and Lumbar lordotic angle each had a positive realtionship. The Ferguson's angle, the Lumbar gravity line and the Lumbar lordotic angle was less influenced by the level of HIVD and was more influenced by how long the patient had the pain. The correlationship between each factor was less in the chronic lumbago group than the acute group. In the chronic lumbago group the instability of the lumbosacral joint increased, while in the acute group the compression of the weight on the sacrum increased.

• The Journal of Korean Physical Therapy
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• 제15권3호
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• pp.346-360
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• 2003

The purpose of this study was to evaluate effects of education and stabilization exercise of lumbar neutral zone is range of motion and pain of lumbar spine on the with non-specific low back pain. And the randomly selected each twenty patients out of the forty non-specific low back pain patients were classified as an stabilization exercise group and the other the patients were in a control group. stabilization exercise group in non-specific low back pain patients participated in exercise program of Richardson & Jull (1995) four week from October 1st, 2002 to February 28st, 2003 in Daegu 00 hospital. The conclusion were as follows: 1. After 4 weeks of therapy, Visual analogue scale in stabilization exercise group and control group with non-specific low back pain patients were not significantly decreased(p>.05). 2. Remodified Schober test in range of motion lumbar spine of stabilization exercise group and control group with non-specific low back pain patients were significantly increased(p<.05). 3. Finger-to-Floor test in range of motion whole spine of stabilization exercise group and control group with non-specific low back pain patients were not significantly increased(p>.05). 4. Visual analogue scale, Remodified Schober test and Finger-to-Floor test in pre and post treatment of stabilization exercise group and control group with non-specific low back pain patients were significant different(p<.05). 5. Visual analogue scale, Remodified Schober test and Finger-to-Floor test in stabilization exercise group and control group with non-specific low back pain patients were not significant different(p>.05).