• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.7 no.2
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• pp.23-39
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• 2001

Dysfunction of the anterior and dorsal muscles of the trunk have been studied in relation to low back pain of many years. Many muscles of the trunk are capable of contributing to the stabilization and protection of the lumbar spine, recent evidence has suggested that transversus abdominis may be critically involved and has been the focus of rehabilitation. The delay in onset of contraction of trunk muscles associated with movement of the upper or lower limb in patients with low back pain indicates a significant deficit in the automatic motor command for control of disturbance to the spine. The function of transversus abdominis has been largely ignored in the evaluation of spinal stabilization and protection. The most essential stabilizing muscles for the lumbar column are the transversus abdominis and the multifidus. Sling exercise therapy(SET) concept consists of a system of diagnosis and treatment. The system of diagnosis involves testing the muscle's tolerance through progressive loading in open and close kinetic chains. The SET system contains elements such as relaxation, increasing the range of movement, traction, training the stabilizing musculature, sensorimotor exercises, training in open and close kinetic chains, dynamic training of the mobilizing musculature, cardiovasc+ular exercises, group exercise, personal exercise at home. Sensorimotor training is an essential element of the SET concept. The emphasis is on closed kinetic chain exercises on an unstable surface, thereby achieving optimum stimulation of the sensorimotor apparatus.

• The Journal of the Korea Contents Association
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• v.12 no.3
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• pp.233-243
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• 2012

The purpose of this study was to examine the effects of lumbar stabilization exercise using the PNF techniques on the lumbar deep muscles thickness and functional activity in chronic low back pain patient. Group I(n=10): general physical therapy group; Group II(n=10): general lumbar stabilization exercise group; Group III(n=10): lumbar stabilization exercise using PNF techniques(stabilizing reversal, rhythmic stabilization, combination of isotonic) group. Change of pain was measured with visual analog scale(VAS). To observe muscle thickness changes, we measured transverse abdominis(TrA), external oblique(EO), multifidus with real time ultrasound scanning. The functional activity were measured with Oswestry Disability Questionnaire(ODQ) and Roland & Morris Disability Questionnaire(RMDQ). In VAS test, group III had more significantly decreased than before exercise. In muscle thickness test, group III had more significantly increased than before exercise in right/left TrA, EO, multifidus. In ODQ & RMDQ test, group III had more significantly decreased than before exercise. This study show that the PNF techniques is effective in improving the lumbar stability and functional activity in chronic low back pain patients.

• Journal of Korean Neurosurgical Society
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• v.51 no.6
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• pp.343-349
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• 2012

Objective : Pedicle-based dynamic stabilization systems, in which semi-rigid rods or cords are used to restrict or control spinal segmental motion, aim to reduce or eliminate the drawbacks associated with rigid fusion. In this study, we analyzed the two-year clinical outcomes of patients treated with the NFlex (Synthes Spine, Inc.), a pedicle-based dynamic stabilization system. Methods : Five sites participated in a retrospective study of 72 consecutive patients who underwent NFlex stabilization. Of these 72 patients, 65 were available for 2-year follow-up. Patients were included based on the presence of degenerative disc disease (29 patients), degenerative spondylolisthesis (16 patients), lumbar stenosis (9 patients), adjacent segment degeneration (6 patients), and degenerative lumbar scoliosis (5 patients). The clinical outcome measures at each assessment were Visual Analogue Scale (VAS) to measure back pain, and Oswestry Disability Index (ODI) to measure functional status. Radiographic assessments included evidence of instrumentation failure or screw loosening. Results : Sixty-five patients (26 men and 39 women) with a mean age of 54.5 years were included. Mean follow-up was 25.6 months. The mean VAS score improved from 8.1 preoperatively to 3.8 postoperatively, representing a 53% improvement, and the ODI score from 44.5 to 21.8, representing a 51% improvement. Improvements in pain and disability scores were statistically significant. Three implant-related complications were observed. Conclusion : Posterior pedicle-based dynamic stabilization using the NFlex system seems effective in improving pain and functional scores, with sustained clinical improvement after two years. With appropriate patient selection, it may be considered an effective alternative to rigid fusion.

• The Journal of Korea Robotics Society
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• v.18 no.2
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• pp.189-196
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• 2023

An abdominal brace is a recommended treatment for patients with lumbar spinal disorders. However, due to the nature of the static brace, it uniformly compresses the lumbar region, which can weaken the lumbar muscles or create a psychological dependence that worsens the condition of the spine when worn for an extended period of time. Due to these issues, doctors limit the wearing time when prescribing it to patients. In this paper, we propose a device that can dynamically provide abdominal pressure and support according to the lumbar motion. The proposed device is a wearable robot in the form of a brace, with actuators and a driving unit mounted on the brace. To enhance wearability and reduce the weight of the device, worm gears actuator and a multi-pulley mechanism were adopted. Based on the spinal motion of the wearer measured by the Inertia measurement unit sensors, the drives wire by driving pulley, which provide tension to the multi-pulley mechanism on both sides, dynamically tightening or loosening the device. Finally, the device can dynamically provide abdominal pressure and support. We describe the hardware and system configuration of the device and demonstrate its potential through basic control experiments.

• Journal of Korean Neurosurgical Society
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• v.46 no.5
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• pp.431-436
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• 2009

Objective : This study examines whether functional motion is present at one or more years after Bioflex System placement. BioFlex System is a flexible rod system which has been used to preserve motion at the area of implantation. There has not been a scientific study showing how much motion is preserved after implantation. Methods : A total of 12 consecutive patients underwent posterior dynamic stabilization using the BioFlex System. Six patients were treated using a L3-4-5 construct and other six patients using a L4-5-S1 construct. Follow-up ranged from 12 to 33 months and standing neutral lateral, extension, flexion and posteroanterior (PA) radiographs were obtained at 3, 6, 9, and 12 months and at more than 12 months postoperatively. Range of motion (ROM), whole lumbar lordosis, and ROMs of motion segments from L2 to S1 were determined. Results : Patients with a L3-4-5 construct demonstrated a decrease in mean ROM for whole lumbar decreased from 40.08 to 30.77. Mean ROM for L3-4 (6.12 to 2.20) and L4-5 (6.55 to 1.67) also decreased after one year. Patients with a L4-5-S1 construct demonstrated L4-5 (8.75 to 2.70) and L5-S1 (9.97 to 3.25) decrease of mean ROM at one year postoperatively. Lumbar lordosis was preservep at both L3-4-5 and L4-5-S1 constructs. Clinical results showed significant improvements in both study groups. Conclusion : The present study provides preliminary information regarding the BioFlex motion preservation system. We conclude that the BioFlex System preserves functional motion to some degree at instrumented levels. However, although total lumbar lordosis was preserved, ROMs at implantation segments were lower than preoperative values.

• Journal of The Korean Society of Integrative Medicine
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• v.8 no.2
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• pp.75-88
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• 2020

Purpose : Dysmenorrhea can be caused by misalignment of the pelvis. Since pilates stabilization exercise is a methods that affects pelvic alignment by inducing contraction of abdominal muscles, the purpose of this study is to determine whether dysmenorrhea is reduced when pilates stabilization exercise is applied. Methods : 47 dysmenorrhea patients were randomly divided into experimental (n=23) and control (n=24) groups. The experimental group performed pilates stabilization exercise three times a week for 12 weeks, and the control group did not perform any intervention. Abdominal muscle thickness, lumbar pelvic alignment, and dysmenorrhea were measured before intervention, 6 weeks, and 12 weeks after intervention to determine the mean change over time and the effect of group and factor interactions (repeated measured ANOVA and contrast test for each period). Results : In the experimental group, the thickness of the transverse abdominis, internal oblique, and external oblique muscles were increased significantly by group and period (p<.05). The pelvic torsion, lordosis and dysmenorrhea were also significantly decreased by group and period. But the control group did not change significantly in any of the variables. Conclusion : Applying pilates stabilization exercise to women with dysmenorrhea may be an effective intervention that contributes to relieving dysmenorrhea by correcting the stability and alignment of the lumbar pelvis.

• Science of Emotion and Sensibility
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• v.24 no.2
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• pp.81-92
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• 2021

In this study, we investigated the effects of five EMS lumbar back pressure belts produced on an anatomical basis on lumbar spine stabilization. Five core muscles were selected, including the urinal, vertebral column, endotracheal, external abdominal, and large back muscles, and patterns were designed using a conductive fabric considering the appropriate muscle shape and pain-causing points. We experimented with four motions to examine the effects of different EMS abdominal compression belts on lumbar spine stabilization. Five healthy men in their 20s were selected. The selection conditions include no back pain history for the past three months, no restricted movements through pre-inspection, and the muscular strength of the body should belong to the normal grade. Using SLR, the sequence of experimental actions was chosen from the following but not limited to left-hand, body-hand, and back-line forces. Resting between movements lasted for 2 min, and the experiments were conducted after wearing the EMS abdominal pressure belt. Electrical stimulation was applied for 10 min to increase blood flow and muscle activation. The statistics of the experimental results were analyzed for specific differences by conducting the Wilcoxon and Friedman tests with nonparametric tests. The ranking results of each pattern were successfully assessed in the order of 5, 4, 3, 1, 2 for the five patterns, and we could identify slightly more significant results for experimental behavior associated with each muscle movement. Patterns produced based on anatomy showed differentiated effects when electric stimulation was applied to each muscle in different shapes, which could improve the stabilization of the lumbar spine in everyday life or training to the public. Based on these results, subsequent research would focus on developing smart healthcare clothing that is practical in daily life by employing different anatomical mechanisms, depending on the back pain, to utilize trunk-type tights.

• Journal of the Korean Society of Physical Medicine
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• v.12 no.4
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• pp.123-132
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• 2017

PURPOSE: This study aimed to examine the effects of lumbar stabilization exercise during abdominal hollowing with conscious contraction of the pelvic floor muscles on trunk muscle in healthy twenties subjects. METHODS: The participants were randomly allocated to an experimental group (n=15) and a control group (n=15). The experimental group received lumbar stabilization exercise combined with conscious contraction of the pelvic floor muscles during abdominal hollowing. The control group received lumbar stabilization exercise with abdominal hollowing. Both groups trained with the respective exercise for 30 minutes a day, 3 times a week for 6 weeks. Muscle activation of the external oblique and erector spinae muscles, thickness of the transversus abdominis and multifidus, and contraction holding time of tranversus abdominis were measured before and after exercise. RESULTS: Activations of both the external oblique muscles were significantly decreased, and thickness of both the transversus abdominis and multifidus muscles, and contraction holding time of the transversus abdominis muscle were significantly increased in the experimental group (p<.05). The thickness of the left transversus abdominis and right multifidus muscles, and the contraction holding time of the transversus abdominis muscle significantly increased in the control group (p<.05). On comparing both groups, the activations of both external oblique muscles were significantly reduced and the contraction holding time of the transversus abdominis muscle was significantly increased in the experimental group (p<.05). CONCLUSION: These results suggest that lumbar stabilization exercise by abdominal hollowing and conscious contraction of the pelvic floor muscles is suitable and efficient for healthy twenties subjects.

• 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 the Korea Contents Association
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• v.9 no.7
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• pp.225-232
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• 2009

This study conducted the following experiment to examine effects of cardiovascular function on lumbar stabilization exercise(LSE) in floor or swiss ball. This experiment was conducted to compare heart rate, systolic blood pressure, diastolic blood pressure and peripheral vascular oxygen saturation effects by lumbar stabilization exercise in floor or swiss ball with 18 normal adult and it divided 9 subjects. experiment group (1) is applying LSE on floor group and (2) is applying LSE on swiss ball group. Heart rate was measured by portable heart rate manometer, blood pressure was measured by hemodynamometer, and peripheral vascular oxygen concentration was measured using a computerized NURYTEC measuring apparatus analysis. These result lead us to the conclusion that systolic blood pressure and peripheral vascular oxygen concentration were influenced by LSE. but there was not differential effect between each groups. These results suggest that LSE has the capability to improve heart rate, blood pressure, peripheral vascular oxygen concentration. Consequently, LSE would be lead to increment of cardiovascular function.