• Proceedings of the Korean Society of Precision Engineering Conference
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• 2004.10a
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• pp.1207-1210
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• 2004

As many humans age, degenerative lumbar spinal stenosis (DLSS) becomes a major cause of lower limb discomfort and disability. By surgical treatment method of DLSS, the existing surgical treatment methods using internal fixation have showed degeneration changes of an adjacent vertebrae and loss of lumbar spine lordosis-kyphosis due to eliminating a motion. For solving the problems of internal fixation, a novel interspinous spacer has been developed to treat DLSS by surgical treatment method. In this study, we evaluated the biomechanical effects of the interspinous spacer on the kinematics of the porcine lumbar spine before and after insertion of the implant. For this purpose, a device that is capable of measuring 3-D motions were built based on direct linear transformation (DLT) algorithm written with MATLAB program. Results showed that in extension, a change of the mean angle between the intact and the implanted specimens at L4-L5 was 1.87 degree difference and the implant reduced the extension range of motion of the L4-L5 (p＆lt;0.05). But the range of motion in flexion, axial rotation and lateral bending at the adjacent segments was not statistically affected by the implant. In conclusion, we thought that interspinous spacer may have remedical value for DLSS by flexing human lumbar spine.

• 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.

• Annals of Rehabilitation Medicine
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• v.42 no.6
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• pp.888-888
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• 2018

• Journal of Korean Neurosurgical Society
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• v.58 no.5
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• pp.412-418
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• 2015

Objective : To investigate the effects of posterior implant rigidity on spinal kinematics at adjacent levels by utilizing a cadaveric spine model with simulated physiological loading. Methods : Five human lumbar spinal specimens (L3 to S1) were obtained and checked for abnormalities. The fresh specimens were stripped of muscle tissue, with care taken to preserve the spinal ligaments and facet joints. Pedicle screws were implanted in the L4 and L5 vertebrae of each specimen. Specimens were tested under 0 N and 400 N axial loading. Five different posterior rods of various elastic moduli (intact, rubber, low-density polyethylene, aluminum, and titanium) were tested. Segmental range of motion (ROM), center of rotation (COR) and intervertebral disc pressure were investigated. Results : As the rigidity of the posterior rods increased, both the segmental ROM and disc pressure at L4-5 decreased, while those values increased at adjacent levels. Implant stiffness saturation was evident, as the ROM and disc pressure were only marginally increased beyond an implant stiffness of aluminum. Since the disc pressures of adjacent levels were increased by the axial loading, it was shown that the rigidity of the implants influenced the load sharing between the implant and the spinal column. The segmental CORs at the adjacent disc levels translated anteriorly and inferiorly as rigidity of the device increased. Conclusion : These biomechanical findings indicate that the rigidity of the dynamic stabilization implant and physiological loading play significant roles on spinal kinematics at adjacent disc levels, and will aid in further device development.

• Journal of Biomedical Engineering Research
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• v.26 no.3
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• pp.151-155
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• 2005

Interspinous spacers have been developed as an alternative surgical treatment for laminectomy or fusion with pedicle screws and rods for the treatment of lumbar spinal stenosis. However, its biomedical efficacies are well not known. In this study, we evaluated kinematic behaviors of the surgical and the adjacent levels before and after inserting interspinous spacers. Three porcine lumbar spines were prepared. On each specimen, an interspinous spacer was inserted at the L4-L5. Flexion-extension moments (0, 2.5, 5.0, 7.5, 10Nm) were applied. A stereophotogrammetric set-up with DLT algorithm was used to assess the three-dimensional motions of the specimen where three markers $({\square}0.8mm)$ were attached to each vertebra. Results showed that extension motion decreased by $15-24\%$ at the surgical level (L4-L5) after insertion of interspinous spacer. At the adjacent levels, the range of motion remained unchanged. In flexion, no significant changes in motion were observed regardless of levels. Therefore, our experimental results demonstrated the interspinous spacer is very effective in limiting the extension motion that may cause narrowing of the spinal canal and vertebral foramen while maintaining kinematic behaviors at the adjacent levels. Further, these results suggested that the use of interspinous spacer may be able to prevent lower back pain at the surgical level and to lower the incidence of degenerative changes at the adjacent levels.

• Physical Therapy Korea
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• v.31 no.1
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• pp.79-88
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• 2024

Background: The abdominal drawing-in maneuver (ADIM), a method of lumbar stabilization training, is an effective neuromuscular intervention for lumbar instability associated with low back pain (LBP). Objects: The purpose of this study was to compare the effect of a 2-week period of the ADIM and tensor fasciae latae-iliotibial band (TFL-ITB) self-stretching on lumbopelvic rotation angle, lumbopelvic rotation movement onset, TFL-ITB length, and pain intensity during active prone hip lateral rotation. Methods: Twenty-two subjects with lumbar extension rotation syndrome accompanying shortened TFL-ITB (16 males and 6 females) were recruited for this study. The subjects were instructed how to perform ADIM training or ADIM training plus TFL-ITB self-stretching program at home for a 2-week period. A 3-dimensional ultrasonic motion analysis system was used to measure the lumbopelvic rotation angle and lumbopelvic rotation movement onset. An independent t-test was used to determine between-group differences for each outcome measure (lumbopelvic rotation angle, lumbopelvic rotation movement onset, TFL-ITB length, and pain intensity). Results: The results showed that ADIM training plus TFL-ITB self-stretching decreased the lumbopelvic rotation angle, delayed the lumbopelvic rotation movement onset, and elongated the TFL-ITB significantly more than did ADIM training alone. Pain intensity was lower in the ADIM training plus TFL-ITB self-stretching group than the ADIM training alone group; however, the difference was not significant. Conclusion: ADIM training plus TFL-ITB self-stretching performed for a 2-week period at home may be an effective treatment for modifying lumbopelvic motion and reducing LBP.

• Korean Journal of Applied Biomechanics
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• v.12 no.1
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• pp.125-133
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• 2002

The purpose of this study was to develop a method for estimating 3-D coordinates of lower trunk muscles using orientation angles during a motion. Traditional 3-D motion analysis system with DLT technique was used to track down the locations of eight reference markers which were attached on the back of the subject. In order to estimate the orientations of individual lumbar vertebrae and musculoskeletal parameters of the lower trunk muscle, the rotation matrix of the middle trunk reference frame relative to the lower trunk reference frame was determined and the angular locations of individual lumbar vertebrae were estimated by partitioning the orientation angles (Cardan angles) that represent the relative angles between the rotations of the middle and lower trunks. When the orientation angles of individual intervertebral joints were known at a given instant, the instantaneous coordinates of the origin and insertion for all selected muscles relative to the L5 local reference frame were obtained by applying the transformation matrix to the original coordinates which were relative to a local reference frame (S1, L4, L3, L2, or L1) in a rotation sequence about the Z-, X- and Y-axes. The multiplication of transformation matrices was performed to estimate the geometry and kinematics of all selected muscles. The time histories of the 3-D coordinates of the origin and insertion of all selected muscles relative to the center of the L4-L5 motion segment were determined for each trial.

• Transactions of the Korean Society of Mechanical Engineers B
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• v.36 no.11
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• pp.1105-1110
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• 2012

The spine is one of the most important skeletal joints, and it strongly affects the health of the musculoskeletal system. A normal spine has an S-shape, and it is very important to maintain this shape. Recently, spinal diseases such as low back pain have increased rapidly, especially among the elderly. Some of these diseases are caused by congenital spinal disorders and sporting and accident injuries as well as by bad postures. Improper spinal postures could generate excessive disc pressure, which is related to degeneration and pain. Therefore, in this study, we investigated the three-dimensional kinematic parameters of the thoraco-lumbar joint in several bad postures using a motion capture analysis technique. Different bad postures created a significant amount of flexion/extension, side bending, and axial rotation angle compared with neutral postures. Further study is necessary to investigate the disc pressure and ligament force due to the increase in joint rotation from the bad postures.

• Korean Journal of Applied Biomechanics
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• v.23 no.4
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• pp.369-376
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• 2013

The purposes of this study were to assess dynamic stability toward pelvis-spine column distortion during running and to compare the typical three-dimensional angular kinematics of the trunk motion; cervical, thoracic, lumbar segment spine and the pelvis from the multi-segmental spine model between exercise group and non-exercise group. Subjects were recruited as exercise healthy women on regular basis (group A, n=10) and non-exercise idiopathic scoliosis women (group B, n=10). Data was collected by using a vicon motion capture system (MX-T40, UK). The pelvis, spine segments column and lower limbs analysiaed through the 3D kinematic angular ROM pattern. There were significant differences in the time-space variables, the rotation motion of knee joint in lower limbs and the pelvis variables; obliquity in side bending, inter/outer rotation in twisting during running leg movement. There were significant differences in the spinal column that is lower-lumbar, upper-lumbar, upper-thoracic, mid-upper thoracic, mid-lower thoracic, lower thoracic and cervical spine at inclination, lateral bending and twist rotation between group A and group B (<.05, <.01 and <.001). As a results, group B had more restrictive motion than group A in the spinal column and leg movement behaved like a 'shock absorber". And the number of asymmetry index (AI) showed that group B was much lager unbalance than group A. In conclusion, non-exercise group was known to much more influence the dynamic stability of equilibrium for bilateral balance. These finding suggested that dynamic stability aimed at increasing balance of the trunk ROM must involve methods and strategies intended to reduce left/right asymmetry and the exercise injury.

• Journal of Korean Institute of Industrial Engineers
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• v.25 no.3
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• pp.393-403
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• 1999

In this research, a reach posture prediction based on a two-segment trunk model was made. Recently, reach posture prediction models have used inverse kinematics to provide a single posture that a person naturally takes, with a single segment trunk model that had some shortcomings. A two-segment trunk model was first developed with two links; pelvis link and lumbar-thoracic link. The former refers to the link from the hip joint to L5/S1 joint while the latter does the link from L5/S1 to the shoulder joint. Second, a reach prediction model was developed using the two-segment trunk model. As a result, more reliable equations for two-segment trunk motion were obtained, and the lean direction which refers to the movement direction of the trunk was not found to have a significant effect on the two-segment trunk motion. The results also showed that the hip joint is more preferred over L5/S1 to serve as a reference point for trunk models and the reach prediction model being developed predicted the real posture accurately.