• Journal of the Korean Orthopaedic Association
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• v.54 no.4
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• pp.336-342
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• 2019

Purpose: To examine the relationship between the progression of a kyphotic deformity and the magnetic resonance imaging (MRI) findings in conservatively treated osteoporotic thoracolumbar compression fracture patients. Materials and Methods: This study categorized the patients who underwent conservative treatment among those patients who underwent treatment under the suspicion of a thoracolumbar compression fracture from January 2007 to March 2016. Among them, this retrospective study included eighty-nine patients with osteoporosis and osteopenia with a bone density of less than -2.0 and single vertebral body fracture. This study examined the MRI of anterior longitudinal ligament or posterior longitudinal ligament injury, superior or inferior endplate disruption, superior of inferior intravertebral disc injury, the presence of low signal intensity on T2-weighted images, and bone edema of intravertebral bodies in fractured intravertebral bodies. Results: In cases where the superior endplate was disrupted or the level of bone edema of the intravertebral bodies was high, the kyphotic angle, wedge angle, and anterior vertebral compression showed remarkably progression. In the case of damage to the anterior longitudinal ligament or the superior disc, only the kyphotic angle was markedly prominent. On the T2-weighted images, low signal intensity lesions showed a high wedge angle and high anterior vertebral compression. On the other hand, there were no significant correlations among the posterior longitudinal ligament injury, inferior endplate disruption, inferior disc injury, and the progression of kyphotic deformity and vertebral compression. The risk factors that increase the kyphotic angle by more than 5° include the presence of injuries to the anterior longitudinal ligament, superior endplate disruption, and superior disc injury, and the risk factors were 21.3, 5.1, and 8.5 times higher than those of the uninjured case, and the risk differed according to the level of bone edema. Conclusion: An osteoporotic thoracolumbar compression fracture in osteoporotic or osteopenic patients, anterior longitudinal ligament injury, superior endplate and intravertebral disc injury, and high level of edema in the MRI were critical factors that increases the risk of kyphotic deformity.

• Physical Therapy Korea
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• v.23 no.1
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• pp.80-86
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• 2016

Background: Prone hip extension (PHE) can be performed to measure the lumbopelvic motor patterns and motions. Imbalances in lumbopelvic muscle activity and muscle weakness can result in instability including pain in lumbopelvic region. The posterior oblique sling (POS) muscles contribute to dynamic lumbopelvic stability. In addition, POS are anatomically aligned with the trapezius muscle group according to shoulder positions. Objects: This study compared the electromyography (EMG) activity of POS and pelvic compensations during PHE with and without pre-activation of lower trapezius muscle (lowT). Methods: Sixteen healthy males were recruited. PHE was performed in randomized order: PHE with and without lowT pre-activation. Surface EMG signals were recorded for biceps femoris (BF), gluteus maximus (GM) (ipsilateral), lumbar multifidus (MF) (bilateral), and the lowT (contralateral). An electromagnetic tracking motion analysis was used to measure the angle of pelvic rotation and anterior tilting. Results: The ipsilateral GM and bilateral MF EMG amplitudes were greater during PHE with lowT pre-activation compared to PHE without lowT pre-activation (p<.05). The BF amplitude during PHE without lowT pre-activation was significantly greater than that during PHE with lowT pre-activation (p<.05). The angles of pelvic rotation and anterior tilting during PHE with lowT pre-activation were significantly smaller compared to PHE without lowT pre-activation (p<.05). Conclusion: PHE with lowT pre-activation, which is aligned with the POS, showed more increased MF and GM muscular activity with smaller lumbopelvic compensations in rotation and anterior tilting compared to PHE without lowT pre-activation.

• The Journal of Korean Physical Therapy
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• v.13 no.2
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• pp.265-272
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• 2001

The object of this thesis is to study the correlation between scoliosis and foot in a theoretical and empirical method. My research process was investigated for 34 students on the forward bending test, foot printer test, feedoscope test, X-ray test and so on. The main results of this study were as follows: 1. There was statistical significance on the correlation between foot length and spine length. 2. Scoliosis angle is the smallest on the pes plannus group and the biggest on the pes cavus group without statistical significance. 3. Left lumbar curve is the smallest, and right thoracic spine curve is the biggest on the left foot pattern group with statistical significance. 4. On the foot weightbearing groups, there was statistical significance both of between left and right foot groups. 5. There was no statistical significance on the t-test analysis between left foot area and right foot area according to scoliosis typology.

• Journal of Korean Neurosurgical Society
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• v.42 no.5
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• pp.363-366
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• 2007

Objective : Kyphoplasty performed in the middle thoracic spine presents technical challenges that differ from those in the lower thoracic or lumbar region due to small pedicle size and angular severity for thoracic kyphosis. The purpose of this study was to evaluate the efficacy of balloon kyphoplasty through extrapedicular approach for the treatment of intractable osteoporotic compression fractures in the middle thoracic spine. Methods : The patients who were performed with one level balloon kyphoplasty through extrapedicular approach due to painful osteoporotic compression fractures at T5-T8 from June 2003 to July 2005 were retrospectively analyzed. Imaging and clinical features were analyzed including involved vertebrae level, vertebral height, Injected cement volume, clinical outcome and complications. Results : Eighteen female patients (age ranged from 60 to 77 years old) were included in this study. The average amount of the implanted cement was $4.2{\pm}1.5\;cc$. The mean cobb angle and compression rate were improved from $12.1{\pm}6.5^{\circ}$ to $8.5{\pm}7.2^{\circ}$ and from 30% to 15%, respectively. The mean pain score (visual analogue scale) prior to kyphoplasty was 7.9 and it decreased to 3.0 after the procedure. Cement leakage to the adjacent disc (2 cases) and paravertebral soft tissues (1 case) were seen but there were no major complications such as pneumothorax, segmental arte 이 Injury, pulmonary embolism, or epidural leakage. Conclusion : Balloon kyphoplasty through extrapedicular approach is considered as a safe and effective in treating the middle thoracic regions with low complication rate.

• Journal of Korean Neurosurgical Society
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• v.41 no.1
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• pp.1-6
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• 2007

Objective : The purpose of this study is to determine the factors that have effects on the neurological deficit in the patients with thoracolumbar fracture. Methods : Forty-eight patients were included. Cause of injury, type of injury, time interval, combined injury, kyphotic angle, spinal canal compromise, sagittal diameter, the most narrow sagittal diameter, transverse diameter, the most narrow transverse diameter, and remained height of vertebra body were concerned as the factors. The patients with American Spinal Injury Association[ASIA] impairment scale grade A to D were considered as having neurology while others with ASIA grade E were considered to be without neurology. The patients with ASIA grade A were classified to paraplegia group and the patients with ASIA grade B to E were not thought to be paraplegia. Statistical analysis for these groups were performed. Results : Spinal canal compromise [P<0.001] have correlation with neurological deficit. The most narrow sagittal diameter was smaller in the group with deficit than that in the group without deficit [P<0.004]. Also, combined injury have correlation with neurology [P=0.028]. Spinal canal compromise [P<0.001], sagittal diameter [P=0.032], the most narrow sagittal diameter [P=0.025], and Denis type [P<0.001] also have correlation with paraplegia. Conclusion : The factors of percentage of spinal canal compromise, the most narrow sagittal diameter, and combined injury are predictive of neurological deficit. The patients with paraplegia may be predicted by the factors such as type of injury, spinal canal compromise, sagittal diameter, the most narrow sagittal diameter, and Denis type.

• Journal of Korean Neurosurgical Society
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• v.42 no.4
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• pp.271-275
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• 2007

Objective : Although a significant correction of local kyphosis has been reported previously, only a few studies have investigated whether this correction leads to an improved overall sagittal alignment. The study objective was to determine whether an improvement in the local kyphotic angle improves the overall sagittal alignment. We examined and compared the effects of thoracic and lumbar level kyphoplasty procedures on local versus overall sagittal alignment of the spine. Methods : Thirty-eight patients with osteoporotic vertebral compression fractures who showed poor response to conventional, palliative medical therapy underwent single-level kyphoplasty. The pertinent clinical data of these patients, from June 2006 to November 2006, were reviewed retrospectively. We measured preoperative and postoperative vertebral body heights, which were classified as anterior, middle, or posterior fractured vertebral body heights. Furthermore, the local and overall sagittal angles after polymethylmethacrylate deposition were measured. Results : More height was gained at the thoracic level, and the middle vertebral height regained the most. A significant local kyphosis correction was observed at the fractured level, and the correction at larger spanning segments decreased with the distance from the fractured level. Conclusion : The inflatable balloon kyphoplasty procedure was the most effective in regaining the height of the thoracic fractured vertebra in the middle vertebral body. The kyphosis correction by kyphoplasty was mainly achieved in the fractured vertebral body. Sagittal angular correction decreased with an increase in the distance from the fractured vertebra. No significant improvement was observed in the overall sagittal alignment after kyphoplasty. Further studies in a larger population are required to clarify this issue.

• Physical Therapy Korea
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• v.24 no.4
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• pp.1-10
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• 2017

Background: Flexion-relaxation phenomenon (FRP) was a term which refers to a sudden onset of myoelectric silence in the erector spinae muscles of the back during standing full forward flexion. Hamstring muscle length may be related to specific pelvic and trunk movements. Many studies have been done on the FRP of the erector spinae muscles. However, no studies have yet investigated the influence of hamstring muscle flexibility on the FRP of the hamstring muscle and lumbopelvic kinematics during forward bending. Objects: The purpose of this study was to examine the flexion-relaxation ratio (FRR) of the hamstring muscles and lumbopelvic kinematics and compare them during forward bending in subjects with different hamstring muscle flexibility. Methods: The subjects of two different groups were recruited using the active knee extension test. Group 1-consisted of 13 subjects who had a popliteal angle under $30^{\circ}$; Group 2-consisted of 13 subjects who had a popliteal angel above $50^{\circ}$. The kinematic parameters during the trunk bending task were recorded using a motion analysis system and the FRRs of the hamstring muscles were calculated. Differences between the groups were identified with an independent t-test. Results: The subjects with greater hamstring length had significantly less lumbar spine flexion movement and more pelvic flexion movement. The subjects with greater pelvic flexion movement had a higher rate of flexion relaxation during full trunk bending (p<.05). Conclusion: The results of this study suggest that differences in hamstring muscle flexibility might cause changes in people's hamstring muscle activity and lumbopelvic kinematics.

• The Journal of Korean Physical Therapy
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• v.18 no.1
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• pp.65-73
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• 2006

Purpose: The purpose of this study was to identify the effect of electroacupuncture(EA) and transcutaneous electric nerve stimulation(TENS) after sciatic nerve crush injury in rats. Methods: The EA for experimental group I (Exp I, n=15) and TENS for experimental group II (Exp II, n=15) was applied from post-injury day(PD) 1 to PD 14 after sciatic nerve injury using low frequency stimulator that gave electrical stimulation(15min/60Hz). In order observe the effect of EA and TENS, this study examined GAP-43 expression in rat lumbar spinal cord at the PD 1, PD 7 and PD 14. In addition, the stride length(SL) and toe out angle(TOA) were measured at the PD 7 and PD 4. Results; Exp I and Exp II had higher GAP-43 immunoreactivity than control group(PD 1, 7, 14). The SL of Exp I and Exp II were significantly higher than control group(PD 7, 14). The TOA of Exp I and Exp II were significantly lower than control group(PD 7, 14). Conclusion: EA and TENS application increased motor nerve recovery and expression of GAP-43 immunoreactivity after sciatic nerve crush injury. Therefore effect of TENS and EA had similar effect on nerve regeneration and functional recovery.

• Korean Journal of Applied Biomechanics
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• v.19 no.3
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• pp.567-580
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• 2009

The purpose of this study was to find out how the combined exercise program has an influence on the physical recovery of the patients suffering from work-related back problems. Research objects consist of 43 patients suffering from back problems due to workplace accidents. The result of the study shows that the combined exercise program increased muscular strength and endurance significantly and worked positively in lumbar recovery of the patients. It also increased the lowered flexibility caused by back pain to the level of normal state. In addition, the program was effective on the correction of the bad pose of body and scoliosis. Moreover, it helped improve on lifting, social life and reduce in the duration and the frequency of outbreak of pain. Finally, according to the result of this study, the combined exercise program was shown to be effective and appropriate for the patients suffering from work-related back problems.

• Physical Therapy Rehabilitation Science
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• v.9 no.1
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• pp.36-42
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• 2020

Objective: Many caregivers often carry infants using baby carriers until they are approximately 36 months old. The purpose of this study was to compare the muscular activity of the trunk and lower leg muscles during trunk flexion-extension movements in correspondence to various wearing methods of a baby carrier blanket. Design: Cross-sectional study. Methods: Sixteen healthy adult women were to wear baby carrier blankets in five different ways in terms of direction and height, followed by flexion-extension of the trunk. Erector spinae (ES), rectus abdominis, rectus femoris (RF), biceps femoris (BF) muscle activities and triaxial acceleration of trunk were investigated. Results: The front-wearing method of the baby carrier blanket increased the muscular activity of the ES muscle, and wearing the baby carrier blanket at waist height in the same direction was significantly higher than wearing it at pelvic height (p<0.05). As the angle of flexion increased during trunk flexion-extension, the muscle activity of the ES, BF, and the RF increased. There was a greater increase in muscle activity of the ES and the BF during extension compared to flexion (p<0.05). Conclusions: If it is difficult to wear a baby carrier blanket due to lumbar pain, it is recommended to lower the wearing height of the baby carrier to the pelvic level so that the external load can be transferred to the lower extremity. In addition, it appears to be necessary to hold the baby and distribute the load onto the waist through proper body control when performing flexion-extension movements of the trunk. More objective and scientific research that includes various daily tasks and evaluation methods are needed.