• Journal of International Academy of Physical Therapy Research
• /
• v.4 no.2
• /
• pp.573-587
• /
• 2013

The purpose of this study was conducted in order to analyze the effects of the manual intervention and self-corrective exercise models of general coordinative manipulation(GCM) on the balance restoration of spine & extremities joints with distortions and mal-alignment areas. The subjects were the members who visited GCM Musculoskeletal Prevent Exercise Center from March 1 2012 to December 31 2013 because of spine & extremities joints distortion and mal-alignments, poor posture, and body type correction. All subjects were diagnosed with the four types of the GBT diagnosis. And according to the standards of the mobility vs stability types of the upper & lower body, they were classified into Group 1(40 persons) and Group 2(24 persons). For every other day for three times a week, GCM intervention models were applied to all subjects for four weeks, adding up to 12 times in total. Then the balance restoration effects were re-evaluated with the same methods. The results are as follows. 1) Balance restoration effects of VASdp(Visual analysis scale pain & discomfort) and ER(Equilibrium reaction: ER) came out higher in GCM body type(GBT) II III IV of Group 1. 2) In case of balance restoration effects in Moire and postural evaluation areas, Group 1 was higher and cervical and scapular girdle were higher in Group 2. The balance restoration of the four GBT types was significant in all regions(p<.05), and the scapular girdle came out as high in the order of GBTII IV I. 3) In case of thoracic-lumbar scoliosis and head rotation facial asymmetric cervical scoliosis ribcage forward, the balance restoration effects of the upper body postural evaluation areas came out the highest in Group 1 and Group 2, respectively. The balance restoration effects of the four GBT types were significant in all regions(p<.05), and came out the highest in lumbar scoliosis GBTIII I, ribcage forward and thoracic scoliosis GBTII IV. 4) The balance restoration effects of the lower body postural evaluation areas came out higher in Group 1 and Group 2 for pelvis girdle deviation patella high umbilicus tilt and hallux valgus foot longitudinal arch: FLA patella direction, respectively. The balance restoration effects of the four GBT types were significant in all regions(p<.05), and came out the highest in pelvis girdle deviation GBTIII I and patella high-direction GBTIV II I. 5) The balance restoration effects between the same GBT came out significant (p<.05) in all evaluation areas and items. The conclusions of this study was the manual intervention and self-corrective exercise models of the GCM about the mal-alignment of the spine & extremities joints across the whole body indicated high balance restoration effects(p<.05) in spine & extremities joints in all evaluation areas.

• The Journal of Korean Physical Therapy
• /
• v.17 no.4
• /
• pp.505-517
• /
• 2005

The Purposes of this study were to find complementary connectible new factors that analyzed correlation relate of Sasang Constitution and GCM Body Type in Static Posture and Dynamic Hyper/Hypo-mobility Pattern. Method of this study was asymtomatic volunteers 232(unmarried man and women), conducted from September 1 to December 31. In this main study progressing step diagnosised first, Constitution of Sasang medicine after being classified into four groups of Soyangin, Taeumin, Soeumin, Taeyangin diagnosis of GCM Body Type and progressed that related Static Posture and Dynamic Hyper/Hypo mobility Pattern. The results are as follows. Distribution of Sasang Medicine Constitution proved to be Taeyangin 13, Soyangin 66, Taeumin 67, Soeumin 86 respectively. Distribution of GCM Body Type proved I Body Type 72(31.0%), II Body Type 54(23.3%), III Body Type 89(38.4%), IV Body Type 17(7.3%). The distribution of Sasang Constitution according to GCM Body Type was that; I Body Type was distributed in the order Soeumin 34.7%(25), Taeumin 31.9%(23), Soyangin 30.6%(22), Soeumin 34.7%(25) is the most people. II Body Type was distribution of in the order Soeumin 42.6%(23), Soyangin 5.9%(14), Taeumin 24.1%(13), Soeumin 42.6%(23) is the most people. III Body Type was distribution of in the order Soeumin 37.1%(33), Taeumin 30.3%(27), Soyangin 28.1%(25), Soeumin 37.1% is the most people. IV Body Type proved high distribution each of Soeumin 29.4%(5) and Soyangin 29.4%(5). In case of main left side posture character of spine and limbs about I Body Type 72 persons with left scapular and ilium forward tilted pattern proved in the order high distribution iliac crest thigh and scapular high 70(97.2%), gluteal fold high and scapular abduction 69(95.8%), lumbar scoliosis 65(90.3%). Also, in case of right side posture character proved in the order high distribution deep gluteal fold 69(95.8%), umbilical deviation 68(94.4%). Incase of main left side posture character of spine and limbs about n Body Type 54 persons proved in the: order high distribution knee hyperextension 50(92.6%), shoulder deviation 49(90.7%) etc. Also, in case of right side posture character proved in the order high distribution pelvic deviation 53(98.1%), iliac crest thigh 52(96.3%), hip flexion and ankle inversion 51(94.4%) etc. In case of main left side posture character of spine and limbs about III Body Type 89 persons proved in the order high distribution shoulder deviation 87(97.8%), scapular abduction 86(96.6%), scapular high 85(95.5%) etc. And in case of right side posture character proved in the order high distribution pelvic deviation and iliac crest thigh 86(96.6%) etc. In case of main left side posture character of spine and limbs about IV Body Type 17 persons proved in the order high distribution pelvic deviation, lumbar sciliosis and lumbar lordosis increase 15(88.2%) etc. Also, in case of right side posture character proved in the order high distribution wrist dorsiflexion 16(94.1%), thickened achilles tendon etc.

• The Journal of Korean Physical Therapy
• /
• v.23 no.6
• /
• pp.9-14
• /
• 2011

Purpose: The pelvic tilting exercise is a well recognized rehabilitation maneuver. However, little information is available on the changes of lumbar segmental motion during pelvic tilting. This study was conducted to measure the kinematics of the pelvic tilting exercise on the supine and prone positions via fluoroscopy. Methods: A total of 10 female subjects were enrolled. During anterior, neutral, and posterior pelvic tilting, radiographs were taken in each exercise via fluoroscopy (ARCADIS Orbic, Siemens, USA). Images were sent to the picture archiving communication system (PACS), and the digitized images were analyzed using LabVIEW software (National Instruments, USA). Lumbosacral lordosis and the intervertebral body angle, intervertebral disc angle, and intervertebral displacement were analyzed. Results: The results of lumbar kinematic analysis during three tilting postures in the supine and prone positions demonstrated that lumbosacral lordosis and the intervertebral body angle and intervertebral disc angle were significantly higher when the pelvis was tilted anteriorly (p>0.05). However, there was no significant difference between anterior and neutral tilting in the intervertebral disc angle at the L3/4 level in the prone position (p>0.05), and there was no significant difference among tilting positions in intervertebral body displacement in the prone position (p>0.05). Conclusion: This study provides scientific evidence about the pelvic tilting exercise in lumbosacral segmental motion. Depending on the pelvic tilting exercise, kinematic changes were demonstrated in both positions, especially in the supine position. It is suggested that the supine position is effective for mobility, but it should be used carefully for the LBP (Low back pain) patient with hypermobility.

• Tuberculosis and Respiratory Diseases
• /
• v.54 no.4
• /
• pp.395-402
• /
• 2003

Background : Patients with chronic obstructive pulmonary disease (COPD) are at increased risk for osteoporosis, which has implications for mobility and even mortality. The goal of this pilot study was to evaluate bone mineral density (BMD) and risk factors for osteoporosis in a limited number of men with COPD. Methods : We checked BMD, $FEV_1$(% of predicted) and investigated risk factors for osteoporosis in 44 male patients with COPD who visited our hospital from January to August 2002. Results : Mean(${\pm}$) age was $69{\pm}9$ yrs, body mass index(BMI) $21{\pm}3kg/m^2$, $FEV_1$ $50{\pm}18%$ of predicted, lumbar spine T-score $-3.0{\pm}1.2$, lumbar spine Z-score $-2.0{\pm}1.2$, and lumbar spine BMD $0.76{\pm}0.13g/cm^2$. Osteoporosis(T-score below -2.5) was present in 27 patients(61.4%) and osteopenia(T-score between -1 and -2.5) in 17(38.6%). None of the patients had normal BMD. There was no relationship between BMD and $FEV_1$(% of predicted). There were significant differences in smoking, alcohol consumption, exercise, cumulative steroid dose, BMI and BMD among the three groups according to $FEV_1$(% of predicted) (group1 : ${\geq}65%$, group2 : 50-64%, group3 : ${\leq}49%$), except age. However, there were no significant differences in these variables between the osteopenia and osteoporosis groups, except BMI. Linear Regression(Stepwise) analysis showed that lumbar BMD was correlated with BMI & exercise. Conclusion : BMD is significantly reduced in men with COPD. There was no relationship between BMD and pulmonary function.

• Journal of Biomedical Engineering Research
• /
• v.38 no.1
• /
• pp.9-15
• /
• 2017

Recently, flexible cages have been introduced in an attempt to absorb and reduce the abnormal load transfer along the anterior parts of the spine. They are designed to be used with the pedicle screw systems to allow some mobility at the index level while containing ROM at the adjacent level. In this study, a finite element (FE) study was performed to assess biomechanical efficacies of the flexible cage when combined with pedicle screws with flexible rods. The post-operated models were constructed by modifying the L4-5 of a previously-validated 3-D FE model of the intact lumbar spine (L2-S1): (1) Type 1, flexible cage only; (2) Type 2, pedicle screws with flexible rods; (3) Type 3, interbody fusion cage plus pedicle screws with rigid rods; (4) Type 4, interbody fusion cage plus Type 2; (5) Type 5, Type 1 plus Type 2. Flexion/extension of 10 Nm with a compressive follower load of 400N was applied. As compared to the Type 3 (62~65%) and Type 4 (59~62%), Type 5 (53~55%) was able to limit the motion at the operated level effectively, despite moderate reduction at the adjacent level. It was also able to shift the load back to the anterior portions of the spine thus relieving excessively high posterior load transfer and to reduce stress on the endplate by absorbing the load with its flexible shape design features. The likelihood of component failure of flexble cage remained less than 30% regardless of loading conditions when combined with pedicle screws with flexible rods. Our study demonstrated that flexible cages when combined with posterior dynamic system may help reduce subsidence of cage and degeneration process at the adjacent levels while effectively providing stability at the operated level.

• Physical Therapy Korea
• /
• v.27 no.3
• /
• pp.171-177
• /
• 2020

Background: The flexion-relaxation phenomenon (FRP) refers to a sudden onset of activity in the erector spinae muscles that recedes or fades during full forward flexion of the trunk. Lumbar spine and hip flexion are associated with many daily physical activities that also impact trunk flexion. Shorter hamstring muscles result in a reduction of pelvic mobility that eventually culminates in low back pain (LBP). Many studies have explored the FRP in relation to LBP. However, few studies have investigated the influence of hamstring muscle length on the FRP in relation to the erector spinae muscles during trunk flexion. Objects: This study aimed to investigate the influence of hamstring muscle length on the FRP in relation to the erector spinae muscles during trunk flexion. Methods: Thirty subjects were divided into three groups according to hamstring length measured through an active knee extension test. The 30 participants consisted of 10 subjects who had a popliteal angle of 20° or less (Group 1), 10 subjects who had a popliteal angle of 21°-39° (Group 2), and 10 subjects who had a popliteal angle of 40° or more (Group 3). A one-way analysis of variance was used to compare the difference in muscle activity of the erector spinae muscles during trunk flexion. Results: The subjects with a shorter hamstring length had significantly higher muscle activity in their erector spinae muscles during trunk flexion and full trunk flexion (p < 0.05). The subjects with a shorter hamstring length also had a significantly higher flexion-relaxation ratio (p < 0.05). Conclusion: The results of this study demonstrate that differences in hamstring muscle length can influence the FRP in relation to the erector spinae muscles. This finding suggests that the shortening of the hamstring might be associated with LBP.

• Journal of Korean Medical Science
• /
• v.33 no.48
• /
• pp.316.1-316.10
• /
• 2018

Background: Water pressure and muscle contraction may influence bone mineral density (BMD) in a positive way. However, divers experience weightlessness, which has a negative effect on BMD. The present study investigated BMD difference in normal controls and woman free-divers with vertebral fracture and with no fracture. Methods: Between January 2010 and December 2014, traditional woman divers (known as Haenyeo in Korean), and non-diving women were investigated. The study population was divided into osteoporotic vertebral fracture and non-fracture groups. The BMD of the lumbar spine and femoral neck was measured. The radiological parameters for global spinal sagittal balance were measured. Results: Thirty free-diving women and thirty-three non-diving women were enrolled in this study. The mean age of the divers was $72.1{\pm}4.7$ years and that of the controls was $72.7{\pm}4.0$ years (P = 0.61). There was no statistical difference in BMD between the divers and controls. In divers, cervical lordosis and pelvic tilt were significantly increased in the fracture subgroup compared to the non-fracture subgroup (P = 0.028 and P = 0.008, respectively). Sagittal vertical axis was statistically significantly correlated with cervical lordosis (Spearman's rho R = 0.41, P = 0.03), and pelvic tilt (Spearman's rho R = 0.46, P = 0.01) in divers. Conclusion: BMD did not differ significantly between divers and controls during their postmenopausal period. When osteoporotic spinal fractures develop, compensation mechanisms, such as increased cervical lordosis and pelvic tilt, was more evident in traditional woman divers. This may be due to the superior back muscle strength and spinal mobility of this group of women.