• 대한물리치료과학회지
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• 제18권2호
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• pp.1-8
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• 2011

Background: The purpose of this study was to systematic review the effect of exercise programs for chronic low back pain patients. We needs systematic development of low back pain exercise program to reduce economic cost further doing great service to public health promotion. Methods: We searched to the effects of exercise programs for chronic low back pain patients by Dankook University electronic library databases of DBPIA, KSI KISS, CINAHL, MEDLINE and PEDro combined with a hand search of papers published in relevant journals. Any type of study relevant to the topic published during time period from 1970 to 2007 was included. Results: The literature search identified 30 studies. 1.Performing the flexion exercise increased abdominal muscle activity but acute herniated intervertebral disc should be avoided. 2.The general lumbar extension exercise used lumbar extension machine and the muscle power increases, significant probability the change. 3.The spinal segments exercise for the patients offered significant efficacy and appeared to be a reasonable therapeutic option. 4.Spinal stabilization exercises appear to improve trunk endurance and balance to patients with chronic low back pain. This exercise programs had effective decrease pain and disability. Conclusion: The review suggests that although the exercise programs for chronic low back pain patients, and we expected the efficacy of the exercise programs for chronic low back pain patients used in this study should be further investigated in a long period study and objective outcomes.

• 대한물리의학회지
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• 제9권1호
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• pp.125-132
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• 2014

PURPOSE: This study aims to determine the optimal knee joint angle and hip joint angle for minimizing the cervical muscle tension and maximizing the muscle activity of the trunk during the bridging exercise for trunk stabilization. METHODS: The bridging exercise in this study included seven forms of exercise: having a knee joint flexion angle of $120^{\circ}$, $90^{\circ}$, $60^{\circ}$, $45^{\circ}$ and hip joint abduction angle of $15^{\circ}$, $10^{\circ}$, $5^{\circ}$. The posture of the bridging exercise was as follows. To prevent the increase of hyper lumbar lordosis during the bridging exercise, the exercise was practiced after maintaining the lumbar neutral position through the pelvic posterior tilting exercise. RESULTS: The abduction angles did not result in statistically significant effects on the cervical erector, external oblique, rectus abdominis and erector spinae muscles. However, in relation to the knee joint angles, during the bridging exercise, statistically significant results were exhibited. CONCLUSION: The knee joint angle affected the muscle activity of the neck muscle. The greater the knee joint angle, the lower the load placed on the neck muscle. In contrast, the load increased as the knee joint angle decreased. In addition, the muscle activity of the neck muscle and trunk muscle increased as the knee joint angle decreased.

• Journal of Korean Neurosurgical Society
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• 제38권3호
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• pp.206-210
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• 2005

Objective : Our aim is to evaluate the early changes of biologic markers such as white blood cell[WBC] count, erythrocyte sedimentation rate[ESR] and C-reactive protein[CRP] in early diagnosis of postoperative infection and to differentiate infection from inflammatory reaction in lumbar spine surgery. Methods : We reviewed 330patients who had undergone spinal operations between May 1999 and October 2001. For this study, the patients were classified into two groups, which include a group that underwent spinal decompressive surgery without instrumentation[SD], and the other group that underwent fusion surgery with spinal instrumentation[SI]. And each group was also subdivided into two groups respectively, one with infection and the other without infection. We retrospectively analyzed the WBC count, ESR and CRP preoperatively and postoperatively, according to their operation type and postoperative infection history. Results : Inflammatory indices were physiologically affected by instrumentation itself. But ESR and CRP elevations were more prolonged and sustained under infection. In SD patients without infection, ESR and CRP were stabilized 5 days after surgery. In SI patients without infection, CRP was stabilized about 7days after surgery, but ESR showed sustained and variously elevated. In both SD and SI groups, the stabilization of CRP was the most reliable behavior of surgery without infection. Conclusion : C-reactive protein is most sensitive parameter for postoperative spine infection. The knowledge of the inflammatory indices and their relatively uniform patterns with or without infection offers surgeons the ability to infer the state of surgical wound.

• 한국융합학회논문지
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• 제10권2호
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• pp.309-313
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• 2019

본 연구는 여러 형태의 복부 운동(crunch, spine V-up, prone V-up on ball, prone V-up on slide board, prone V-up on TRX, and prone V-up power wheel)을 하는 동안 URA, LRA, IO, EO and RF의 EMG 반응을 조사했다. 대상자들은 이러한 운동을 수행하는 동안 복근의 isometric contraction을 수행했다. 테스트 결과 EO, URA, LRA는 어떠한 운동 간에도 통계학적으로 유의한 차이가 없었다. 하지만, IO를 검사 시에, 양와위 V-up운동은 slide운동 시 보다 유의하게 더 큰 근활성도를 보여주었다. 또한, crunch동안 EMG활성도는 다른5가지 어떠한 운동보다 현저히 적었다. 이러한 결과들은 등척성 복근 운동 시행 시에 장비가 없는 기반 운동이 장비 기반 운동과 유사하게 자극을 준다는 것을 나타낸다. 코어 강화는 오래 동안 운동 컨디셔닝과 수행능력의 핵심 구성 요소로 알려져 왔다. 복부 근육 조직은 개인의 코어를 구성하는 5가지 중 하나의 구성요소로 여겨진다. 복부 근육은 또한 요추의 적정한 기능을 보장한다. 모든 복부 근육이 요추 안정화에 기여하지만, TA & IO가 주요한 안정화(stabilizers)를 하는 것으로 보여주었다.

• Journal of Korean Neurosurgical Society
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• 제29권11호
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• pp.1484-1490
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• 2000

Objectives : In spinal metastasis and myeloma, percutaneous vertebroplasty could be an effective treatment method to provide spinal stabilization and to relief pain for early rehabilitation. The authors report twenty-five cases the clinical results of percutaneous vertebroplasty for twenty-five cases of spinal metastasis and myeloma. Materials and Methods : From September 1998 to December 1999, seventy percutaneous vertebroplasties(PVP) were performed for spinal metastases and myeloma in 25 patients, sixteen women and nine men ranging in age from 34 to 74. The primary malignancies were 6 multiple myelomas, and in metastatic tumore from various origin. All patients complained of severe pain and had osteolytic vertebral body destructions without spinal cord compression. To evaluate clinical improvement, suObjective verbal analogue pain score(VAS) and Karnofsky performance scale(KPS) were used. Thin sliced(2mm-thickness) sectional computed tomography(CT) was performed before and after PVP. Plain X-ray film was followed up every 1 month to assess the vertebral column stability. Results : In 25 patients, a total of seventy PVPS were performed successfully : 6 cervical, 33 thoracic and 31 lumbar vertebrae. Most patients had clear improvement of pain after PVP ; mean as score was 8.1 and 2.9 before and after PVP, respectively. Improvement was maintained in most patients. No further collapse of treated vertebrae was observed(mean follow-up, 7 months). Leakage of PMMA was notod in the spinal canal(13 levels), neural foramen (2 levels), adjacent disk(15 levels), paravertebral soft tissue(14 levels) and vein(8 levels). Pulmonary embolism was detected in three patients after the procedure, but was not associated with clinical symptoms. Conclusion : These results indicate that percutaneous vertebroplasty can be valuable treatment method in osteolytic spinal metastasis and myeloma, providing immediate pain relief and spinal stabilization and contributing to early rehabilitation.

• 한국전문물리치료학회지
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• 제14권4호
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• pp.21-27
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• 2007

The purposes of this study were to compare core muscle activities with and without the use of Pilates resistive equipment during bridging exercises and to investigate the efficacy of a Pilates device. Fourteen healthy individuals (6 males, 8 females) between 20 to 26 years of age were examined. They were engaged in a bridging exercise with and without a magic circle. Three consecutive repetitions of each exercise were performed. Surface electromyography (sEMG) was used to measure the electrical activities of the right side internal oblique, the adductor longus, the multifidus, and the gluteus maximus muscles. Normalized EMG activities were compared using a paired t-test and the level of significance was set at =.05. The results showed that the EMG activities of the internal oblique (p=.0078), the adductor longus (p=.0007), and the gluteus maximus (p=.0001) muscles were significantly higher when using the magic circle during the Pilates bridging exercise. Also, statistically significant change existed in the multifidus muscle (p=.0106). The bridging exercise, combined with hip adduction using the magic circle, may enhance core stabilization. Therefore, using a magic circle during hip adduction combined with bridging exercise may be recommended usefully for individuals wanting to strength the core muscles. Further research is needed to access the nature of motor control of the Pilates mat exercises and to deliver exercise intervention for lower back pain patients.

• The Journal of Korean Physical Therapy
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• 제33권5호
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• pp.238-244
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• 2021

Purpose: Menstruation is associated with menstrual symptoms like pain and balance problems which have an impact on the quality of life. Pilates increases pelvic stability and reduces menstrual pain by inducing abdominal muscle contraction. This study was done to evaluate the effects of Pilates on menstrual pain, symptoms, balance, and quality of life when compared to aerobic exercise. Methods: Thirty-nine women with menstrual pain were randomly divided into the Pilates group (n=13), aerobics group (n=13), and control group (n=13). The Pilates group performed lumbar-pelvic stabilization exercises, while the aerobic group ran on a treadmill. The control group did not undergo any intervention. The experimental groups exercised for four weeks (12 sessions) and did not exercise during menstruation. The Y-balance test was performed on the second day of menstruation to evaluate dynamic balance. The questionnaires administered immediately after menstruation were the visual analog scale (VAS), Korea Oswestry Disability Index (ODI), and the modified Menstrual Distress Questionnaire (MDQ). The paired t-test was used to compare the effect of exercise within the three groups and a oneway analysis of variance was used to compare between groups. Results: VAS and MEDI-Q scores significantly decreased in the Pilates group after 4 weeks compared with those in the aerobic and control groups. Moreover, ODI and Y-balance scores increased in the Pilates group compared with those in the aerobic and control groups (p<0.05). Conclusion: The Pilates stabilization exercises are effective and help in improving menstrual pain, balance and other menstrual symptoms assessed through ODI, and MEDI-Q, compared to aerobic exercises.

• Journal of Korean Neurosurgical Society
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• 제62권2호
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• pp.209-216
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• 2019

Objective : Hydatid cyst disease is caused by the parasite Echinococcus granulosus. It is rarely seen in the vertebral system, occurring at a rate of 0.2-1%. The aim of this study is to present 12 spinal hydatid cyst cases, and propose a new type of drainage of the cyst. Methods : Twelve cases of spinal hydatid cysts, surgical operations, multiple operations, chronic recurrences, and spinal hydatic cyst excision methods are discussed in the context of the literature. Patients are operated between 2005 and 2016. All the patients are kept under routine follow up. Patient demographic data and clinicopathologic characteristics are examined. Results : Six male and six female patients with a median age of 38.6 at the time of surgery were included in the study. Spinal cyst hydatid infection sites were one odontoid, one cervical, five thoracic, two lumbar, and three sacral. In all cases, surgery was performed, with the aim of total excision of the cyst, decompression of the spinal cord, and if necessary, stabilization of the spinal column. Mean follow up was 61.3 months (10-156). All the patients were prescribed Albendazole. Three patients had secondary hydatid cyst infection (one lung and two hepatic). Conclusion : The two-way drainage catheter placed inside a cyst provides post-operative chlorhexidine washing inside the cavity. Although a spinal hydatid cyst is a benign pathology and seen rarely, it is extremely difficult to achieve a real cure for patients with this disease. Treatment modalities should be aggressive and include total excision of cyst without rupture, decompression of spinal cord, flushing of the area with scolicidal drugs, and ensuring spinal stabilization. After the operation the patients should be kept under routine follow up. Radiological and clinical examinations are useful in spotting a recurrence.

• Journal of Korean Neurosurgical Society
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• 제60권2호
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• pp.225-231
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• 2017

Objective : Solid bone fusion is an essential process in spinal stabilization surgery. Recently, as several minimally invasive spinal surgeries have developed, a need of artificial bone substitutes such as demineralized bone matrix (DBM), has arisen. We investigated the in vivo bone growth rate of DBM as a bone void filler compared to a local autologous bone grafts. Methods : From April 2014 to August 2015, 20 patients with a one or two-level spinal stenosis were included. A posterior lumbar interbody fusion using two cages and pedicle screw fixation was performed for every patient, and each cage was packed with autologous local bone and DBM. Clinical outcomes were assessed using the Numeric Rating Scale (NRS) of leg pain and back pain and the Korean Oswestry Disability Index (K-ODI). Clinical outcome parameters and range of motion (ROM) of the operated level were collected preoperatively and at 3 months, 6 months, and 1 year postoperatively. Computed tomography was performed 1 year after fusion surgery and bone growth of the autologous bone grafts and DBM were analyzed by ImageJ software. Results : Eighteen patients completed 1 year of follow-up, including 10 men and 8 women, and the mean age was 56.4 (32-71). The operated level ranged from L3/4 to L5/S1. Eleven patients had single level and 7 patients had two-level repairs. The mean back pain NRS improved from 4.61 to 2.78 (p=0.003) and the leg pain NRS improved from 6.89 to 2.39 (p<0.001). The mean K-ODI score also improved from 27.33 to 13.83 (p<0.001). The ROM decreased below 2.0 degrees at the 3-month assessment, and remained less than 2 degrees through the 1 year postoperative assessment. Every local autologous bone graft and DBM packed cage showed bone bridge formation. On the quantitative analysis of bone growth, the autologous bone grafts showed significantly higher bone growth compared to DBM on both coronal and sagittal images (p<0.001 and p=0.028, respectively). Osteoporotic patients showed less bone growth on sagittal images. Conclusion : Though DBM alone can induce favorable bone bridging in lumbar interbody fusion, it is still inferior to autologous bone grafts. Therefore, DBM is recommended as a bone graft extender rather than bone void filler, particularly in patients with osteoporosis.

• Journal of Korean Neurosurgical Society
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• 제49권5호
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• pp.267-272
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• 2011

Objective : Although iliac crest autograft is the gold standard for lumbar fusion, the morbidity of donor site leads us to find an alternatives to replace autologous bone graft. Ceramic-based synthetic bone grafts such as hydroxyapatite (HA) and b-tricalcium phosphate (b-TCP) provide scaffolds similar to those of autologous bone, are plentiful and inexpensive, and are not associated with donor morbidity. The present report describes the use of Polybone$^{(R)}$ (Kyungwon Medical, Korea), a beta-tricalcium phosphate, for lumbar posterolateral fusion and assesses clinical and radiological efficacy as a graft material. Methods : This study retrospectively analyzed data from 32 patients (11 men, 21 women) who underwent posterolateral fusion (PLF) using PolyBone$^{(R)}$ from January to August, 2008. Back and leg pain were assessed using a Numeric Rating Scale (NRS), and clinical outcome was assessed using the Oswestry Disability Index (ODI). Serial radiological X-ray follow up were done at 1, 3, 6 12 month. A computed tomography (CT) scan was done in 12 month. Radiological fusion was assessed using simple anterior-posterior (AP) X-rays and computed tomography (CT). The changes of radiodensity of fusion mass showed on the X-ray image were analyzed into 4 stages to assess PLF status. Results : The mean NRS scores for leg pain and back pain decreased over 12 months postoperatively, from 8.0 to 1.0 and from 6.7 to 1.7, respectively. The mean ODI score also decreased from 60.5 to 17.7. X-rays and CT showed that 25 cases had stage IV fusion bridges at 12 months postoperatively (83.3% success). The radiodensity of fusion mass on X-ray AP image significantly changed at 1 and 6 months. Conclusion: The present results indicate that the use of a mixture of local autologous bone and PolyBone$^{(R)}$ results in fusion rates comparable to those using autologous bone and has the advantage of reduced morbidity. In addition, the graft radiodensity ratio significantly changed at postoperative 1 and 6 months, possibly reflecting the inflammatory response and stabilization.