• Physical Therapy Korea
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• v.21 no.4
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• pp.49-55
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• 2014

Excessive lumbar flexion during sit-to-stand (STS) is a risk factor for lower back pain. Postural taping can prevent unwanted flexion of the lumbar spine. This study aimed to demonstrate the effect of taping the lower back on the lumbopelvic region and hip joint kinematics during STS. Sixteen healthy subjects participated. All subjects performed the STS with and without taping of the lower back. A three-dimensional motion analysis system was used to measure the kinematics of the lumbar spine, pelvis, and hip joint during STS. The angle of the peak lumbar flexion, pelvic anterior tilting, and hip flexion and angular displacement of the lumbar spine between starting position and maximal lumbar flexion were collected. Paired t-tests, or Wilcoxon's rank-sum test for non-parametric distribution, were used to assess differences in the measurements with and without taping. A p-value <.05 was taken to indicate a significant difference. Significant differences were observed in the angle of the peak lumbar flexion, pelvic anterior tilting, hip flexion and angular displacement of the lumbar spine (p<.05). Taping was associated with a significant decrease in the angle of peak lumbar flexion and angular displacement of the lumbar spine between the starting position and maximal lumbar spine flexion. In addition, the peak angle of pelvic anterior tilting and hip flexion were significantly increased with taping. The findings of this study suggest that taping the lower back can decrease excessive lumbar flexion, and increase the pelvic anterior tilting and hip flexion motion during STS.

• Physical Therapy Rehabilitation Science
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• v.10 no.4
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• pp.450-456
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• 2021

Objective: Studies confirming the lumber spine kinematics of direct or indirect segmental mobility under the application of joint mobilization, which induces passive force on the spine, are insufficient.Therefore, this study aims to obtain the underlying clinical data by identifying direct or indirect segmental mobility produced by Maitland's PA mobilization technique. Design: Randomized controlled trial design. Methods: Thirty subjects with no back pain participated in this study. X-ray testing equipment (SIG-40-525, Ecoray Inc., Korea) was used to verify the segmented movement of their lumbar. Joint mobilization was performed by physiotherapists with more than 10 years of experience in prescription therapy, and radiography was performed once without PA joint mobilization and once without the mobilization for comparing the lumbar vertebrae before and after the mobilization. The radiographs taken were analyzed using the picture archiving and communication system (PACS) program to measure the spinal displacement, intervertebral height, intervertebral angle, and lumbar lordosis angle. Results: Significant differences were observed in the lumbar displacement, intervertebral angle, and lumbar lordosis angle in all lumbar vertebrae before and after the mobilization. The intervertebral height indicated significant differences in all ventral vertebrae and only in L3-L4 and L4-L5 in dorsal vertebrae. Conclusions: This study suggests that the segmental mobility produced through indirect approaches plays an important role in inducing therapeutic effects in patients with back pain.

• Physical Therapy Korea
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• v.22 no.1
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• pp.93-102
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• 2015

Prolonged sitting can contribute to low back pain. The lumbar taping can be applied to correct the sitting posture. This study aimed to investigate the effect of lumbar taping on lumbar kinematics and the muscle activities of multifidus (MF) and internal oblique in the individuals with nonspecific chronic low back pain (NSCLBP) as they type for 30 minutes. Nineteen subjects with NSCLBP (9 people in non taping group and 10 people in taping group) were recruited. Lumbar taping was applied to the taping group before typing. Both groups started typing in a neutral sitting position with their feet on the floor. The change of posture and S2 posterior tilting (S2P) were measured to investigate kinematic data. Three sensors were attached on T12, L3, and S2 to identify the change of posture. Surface electromyography was used to measure the muscle activities. Palpation meter was used to standardize the angle of pelvic tilt in sagittal plane before typing. All instruments were used to measure each data before and after typing. Independent t-test was used to compare the changing values of lumbar kinematics and muscle activities before and after typing between both groups. The changing values of S2P and change of posture of L3 and S2 were significantly smaller in the taping group compared to the non taping group (p<.05). The changing value of muscle activities of MF between before and after typing was significantly smaller in the taping group compared to the non taping group (p<.05). In conclusion, the lumbar taping during the 30-minute typing task can be applied to maintain correct sitting posture in the lumbar and pelvis and to maintain activation of MF.

• Journal of the Korean Society for Precision Engineering
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• v.25 no.11
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• pp.107-118
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• 2008

In this study, lower extremity joint kinematics and kinetics and lumbar lordosis were investigated for two different symmetrical lifting techniques(squat and stoop) using the three-dimensional motion analysis. Twenty-six male volunteers lifted boxes weighing 5, 10 and 15kg by both squat and stoop lifting techniques. There were not significant differences in maximum lumbar joint moments between the two techniques. The hip and ankle contributed the most part of the support moments during squat lifting, and the knee flexion moment played an important role in stoop lifting. The hip, ankle and lumbar joints generated power and only the khee joint absorbed power in the squat lifting. The knee and ankle joints absorbed power, the hip and lumbar joints generated power in the stoop lifting. The bi-articular antagonist muscles' co-contraction around the knee joint during the squat lifting and the eccentric co-contraction of the gastrocnemius and semitendinosus were found to be important for straightening up during the stoop lifting. At the time of lordotic curvature appearance in the squat lifting, there were significant correlations in all three lower extremity joint moments with the lumbar joint. Differently, only the hip moment had significant correlation with the lumbar joint in the stoop lifting. In conclusion, the knee extension which is prominent kinematics during the squat tilling was produced by the contributions of the kinetic factors from the hip and ankle joints(extensor moment and power generation) and the lumbar extension which is prominent kinematics during the stoop lifting could be produced by the contributions of the knee joint kinetic factors(flexor moment, power absorption, bi-articular muscle function).

• Physical Therapy Korea
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• v.20 no.1
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• pp.10-17
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• 2013

The purpose of this study was to assess the influence of the duration of smartphone usage on cervical and lumbar spine flexion angles and reposition error in the cervical spine. The study included 18 healthy smartphone users (7 males and 11 females). We measured the kinematics of the upper and lower cervical and lumbar spine flexion angles and the reposition error of the upper and lower cervical spine after 3 s and 300 s smartphone use in sitting. A paired t-test was used to compare the effects of the duration of smartphone usage on the kinematics of cervical and lumbar spine flexion angles and reposition error. The flexion angles of the lower cervical and lumbar spine and the reposition error in the upper and lower cervical spine were significantly increased after 300 s smartphone of use (p<.05). However, the flexion angle of the upper cervical spine was not significantly different between the 3 s and 300 s smartphone of use (p>.05). These findings suggest that prolonged use of smartphones can induce changes in cervical and lumbar spine posture and proprioception in the cervical spine.

• The Journal of Korean Physical Therapy
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• v.23 no.5
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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.

• Journal of Biomedical Engineering Research
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• v.29 no.2
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• pp.139-145
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• 2008

Many recent studies suggest that the posterior dynamic stabilization(PDS) can be a more physiologically-relevant alternative to the rigid fixation for the patients suffering from low back pain. However, its biomechanical effects or clinically proven efficacies still remain unknown. In this study, we evaluated kinematic behaviors of the lower lumbar spine with the PDS system and then compared to those of the rigid fixation system using finite element (FE) analysis. A validated FE model of intact lumbar spine(L2-L5) was developed. The implanted model was then constructed after modification from the intact to simulate two kinds of pedicle screw systems (PDS and the rigid fixation). Hybrid protocol was used to flex, extend, laterally bend and axially rotate the FE model. Results showed that the PDS systems are more flexible than rigid fixation systems, yet not flexible enough to preserve motion. PDS system allowed $16.2{\sim}42.2%$ more intersegmental rotation than the rigid fixation at the implanted level. One the other hand, at the adjacent level it allowed more range of motion ($2.0%{\sim}8.3%$) than the rigid fixation. The center of rotation of the PDS model remained closer to that of the intact spine. These results suggest that the PDS system could be able to prevent excessive motion at the adjacent levels and restore the spinal kinematics.

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

• Journal of Biomedical Engineering Research
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• v.27 no.5
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• pp.210-217
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• 2006

Many types of interspinous distraction devices (IDDs) have been recently developed as an alternative surgical treatment to laminectomy and fusion with pedicle screws for the treatment of the lumbar spinal stenosis (LSS). They are intended to keep the lumbar spine in a slightly flexed posture to relieve pain caused by narrowing of the spinal canal and vertebral foramen. However, their biomechanical efficacies are not well known. In this study, we evaluated the kinematic behaviors and changes in intradiscal pressure (IDP) of the porcine lumbar spine implanted with IDD. For kinematics analysis, five porcine lumbar spines (L2-L6) were used and the IDD was inserted at L4-L5. Three markers (${\phi}{\le}0.8mm$) were attached on each vertebra to define a rigid body motion for stereophotogrammetric assessment of the spinal motion in 3-D. A moment of 7.5Nm in flexion-extension, lateral bending, and axial rotation were imparted with a compressive force of 700N. Then, IDD was implanted at L3-L4. IDPs were measured using pressure transducer under compression (700N) and additional extension moment (700N+7.5Nm). In kinematic behaviors, insertion of IDD resulted in statistically significant decrease 42.8% at the implanted level in extension. There were considerable changes in ROM at the adjacent levels, but statistically insignificant. In other motions, there were no significant changes in ROM as well regardless of levels. IDPs at the surgical level (L3-L4) under compression and extension moment decreased by 12.9% and 18.8% respectively after surgery (p<0.05). At the superiorly adjacent levels, IDPs increased by 19.4% and 12.9% under compression and extension, respectively (p<0.05). Corresponding changes at the inferiorly adjacent levels were 29.4% and 6.9%, but they were statistically insignificant (p>0.05). The magnitude of pressure changes due to IDD, both at the operated and adjacent levels, were far less than the previously reported values with conventional fusion techniques. Our experimental results demonstrated the IDDs can be very effective in limiting the extension motion that may cause narrowing of the spinal canal and vertebral foramens while maintaining kinematic behaviors and disc pressures at the adjacent levels.

• Journal of Biomedical Engineering Research
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• v.32 no.3
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• pp.230-236
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• 2011

The aim of this study was to investigate the alteration of lumbar spine and trunk postures on different load-carrying types and amounts under static loading. Two load-carrying types(unilateral carrying: UC vs. bilateral carrying: BC) and four different loads(0, 5, 10, and 15 kg) were randomly tested in this study. Carrying a heavy bag would affect human body posture, specifically lumbar spine curvature, which is considered as one of sources of back problems. Previous studies have not paid attention to the approach of the multisegment model of the lumbar spine and trunk. This study separated two compartments of trunk segment(the lumbar and thorax) in the analysis. The multisegment model of the lumbar spine in addition to Helen-Hayes marker set was used. Eight motion analysis cameras and a force plate were utilized. Ten male subjects(mean mass, $70.6{\pm}3.97$ kg; mean height, $178{\pm}4.18$ m) having no musculoskeletal disease participated in this study. We analyzed trunk angles in three anatomical planes and the spinal curvature in sagittal and frontal planes. Increased loading in both UC and BC significantly resulted in increases in trunk forward lean but only UC induced increases in trunk lateral lean. In addition, increased loading in BC produced flatten lumbar curvature in sagittal plane. As far as coupling motion, subjects tended to use axial rotation of the lumbar spine in transverse plane in response to increased UC loading. Finally, it is concluded that the increased static loading in UC rather than in BC tends to causes combined alterations of the spinal postures(sagittal and transverse planes together), which would be vulnerable to improper mechanical stresses on the spine.