• PNF and Movement
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• 제21권3호
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• pp.367-376
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• 2023

Purpose: The purpose of this study was to compare changes in pediatric Cobb's angle resulting from using the modified scoliosis exercise method to promote proprioception. Methods: There were 32 participants in this study. Cobb's angle was measured automatically using a ZeTTA PACS Viewer through a digital computer program with whole-body x-ray anterior to posterior. Scoliosis was diagnosed by a Cobb's angle of 10° or higher. Modified scoliosis exercises were used as the program for the three-stage method used in the study: the preparation phase (warm-up), actual exercise phase (main exercise), and final clean-up phase (cool-down). In this study, exercises that can promote proprioception, including muscle strengthening, stretching, equilibrium, myofascial release, balance taping, and traction, were applied, and their effects before and after treatment were compared. After implementing the exercise methods once a week-15 times total for about 4 months-the changes in Cobb's angle were measured. Results: After having the pediatric scoliosis patients practice the modified scoliosis exercises for four months, it was found that the Cobb's angle of the spine significantly decreased. Conclusion: The results of this study show that the modified pediatric scoliosis exercise, which is capable of promoting proprioception, is also effective in improving Cobb's angle.

• Journal of Korean Neurosurgical Society
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• 제39권4호
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• pp.256-259
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• 2006

Objective : Having a reliable and reproducible measurement technique to measure the sagittal contour in vertebral fractures is paramount to clinical decision making. This study is designed to determine the most reliable measurement technique in osteoporotic vertebral compression fracture. Methods : Fifteen lateral radiographs of thoracic and lumbar fractures were selected and measured on two separate occasions by three spine surgeons using six different measurement techniques [Centroid, Harrison Posterior Tangent Methods and 4 different types of modified Cobb method]. The radiograph quality was assessed and the center beam location was determined. Statistical analysis including ANOVA for repeated measures was carried out using the SAS software [v 8.0]. Results : The inter and intraobserver variance of the Cobb method 4 and Harrison posterior tangent method were significantly lower than the other four methods. The intraobserver correlation coefficients were the most consistent using the Cobb method 4 [0.982]. which was followed by the Harrison posterior tangent [0.953] and Cobb methods 1 [0.874]. The intraobserver agreement [% of repeated measures within 5 degrees of the original measurement] ranged from 42% to 98% for each technique for all three observers, with the Cobb method 4 showing the best agreement [97.8%] followed by the Harrison posterior tangent method [937%]. Conclusion : The Cobb method-4 and Harrison posterior tangent methods, when applied to measuring the kyphosis, are reliable and have a similar small error range. The Cobb method 4 shows the best overall reliability. However, the centroid method and Cobb method using a fractured endplate do not produce an accurate result due to inter and intraobserver differences in determining the baseline.

• The Journal of Korean Physical Therapy
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• 제35권4호
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• pp.95-104
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• 2023

Purpose: This study was undertaken to identify the effects of apparatus Pilates exercise on Cobb's angle, angle of trunk rotation, and depression in female patients with idiopathic scoliosis. Methods: Participants included five patients with idiopathic scoliosis presenting with Cobb's angle of 10 degrees or more. Among the single-subject experimental research designs, the reversal (ABA) design was selected and performed. The apparatus Pilates exercise was performed for a total of 16 weeks, comprising 8 weeks between the baseline and intervention 1 period and 8 weeks between intervention 1 and intervention 2 periods. The patients were then followed up for 5 weeks. Results: In all subjects, compared to the baseline, Cobb's angle and the angle of trunk rotation decreased after application of the apparatus Pilates exercise. The follow-up period also showed a similar continuous decline. Following the apparatus Pilates exercise, the depression scale in subject 3 was increased during the intervention 1 period as compared to the baseline. However, the patient displayed a reduced depression scale in intervention 2 and follow-up periods. The depression scale in all other subjects was decreased for both intervention periods and the follow-up period. Conclusion: The application of apparatus Pilates exercise improves Cobb's angle and the angle of trunk rotation for female patients with idiopathic scoliosis in their 10s and 20s. Our results also indicate that this is potentially an effective intervention method to overcome depression.

• Journal of Korean Neurosurgical Society
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• 제60권5호
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• pp.577-583
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• 2017

Objective : Laminoplasty is an effective surgical method for treating cervical degenerative disease. However, postoperative complications such as kyphosis, restriction of neck motion, and instability are often reported. Despite sufficient preoperative lordosis, this procedure often aggravates the lordotic curve of the cervical spine and straightens cervical alignment. Hence, it is important to examine preoperative risk factors associated with postoperative kyphotic alignment changes. Our study aimed to investigate preoperative radiologic parameters associated with kyphotic deformity post laminoplasty. Methods : We retrospectively reviewed the medical records of 49 patients who underwent open door laminoplasty for cervical spondylotic myelopathy (CSM) or ossification of the posterior longitudinal ligament (OPLL) at Pusan National University Yangsan Hospital between January 2011 and December 2015. Inclusion criteria were as follows : 1) preoperative diagnosis of OPLL or CSM, 2) no previous history of cervical spinal surgery, cervical trauma, tumor, or infection, 3) minimum of one-year follow-up post laminoplasty with proper radiologic examinations performed in outpatient clinics, and 4) cases showing C7 and T1 vertebral body in the preoperative cervical sagittal plane. The radiologic parameters examined included C2-C7 Cobb angles, T1 slope, C2-C7 sagittal vertical axis (SVA), range of motion (ROM) from C2-C7, segmental instability, and T2 signal change observed on magnetic resonance imaging (MRI). Clinical factors examined included preoperative modified Japanese Orthopedic Association scores, disease classification, duration of symptoms, and the range of operation levels. Results : Mean preoperative sagittal alignment was $13.01^{\circ}$ lordotic; $6.94^{\circ}$ lordotic postoperatively. Percentage of postoperative kyphosis was 80%. Patients were subdivided into two groups according to postoperative Cobb angle change; a control group (n=22) and kyphotic group (n=27). The kyphotic group consisted of patients with more than $5^{\circ}$ kyphotic angle change postoperatively. There were no differences in age, sex, C2-C7 Cobb angle, T1 slope, C2-C7 SVA, ROM from C2-C7, segmental instability, or T2 signal change. Multiple regression analysis revealed T1 slope had a strong relationship with postoperative cervical kyphosis. Likewise, correlation analysis revealed there was a statistical significance between T1 slope and postoperative Cobb angle change (p=0.035), and that there was a statistically significant relationship between T1 slope and C2-C7 SVA (p=0.001). Patients with higher preoperative T1 slope demonstrated loss of lordotic curvature postoperatively. Conclusion : Laminoplasty has a high probability of aggravating sagittal balance of the cervical spine. T1 slope is a good predictor of postoperative kyphotic changes of the cervical spine. Similarly, T1 slope is strongly correlated with C2-C7 SVA.

• 대한물리의학회지
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• 제9권1호
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• pp.11-23
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• 2014

PURPOSE: The purpose of this study suggests the exercise programs for improving the function and structure by applying the Schroth exercise method and sling exercise method to the scoliosis patient. METHODS: The subjects were 16 patients who were diagnosed with scoliosis. They were randomly assigned either to a Schroth exercise group (n=8) that received Schroth exercise program or to a sling exercise group (n=8) that received sling exercise program. Flexibility, static balance, dynamic balance, and spinal angles were measured by using the modified sit and reach test, one leg standing with closed eyes, functional reach test, and Cobb's angle, respectively. The chest expansion were calculated using differences of chest circumference between maximum inspiration and maximum expiration measured under armpits, at the junction between the sternum and xiphoid process, and at the waist. RESULT: Schroth group before and after the intervention there was a difference in the static balance, spine angle, chest expansion (p<.05). sling group before and after the intervention there was a difference in the flexibility, static balance, spine angle, chest expansion (p<.05). There were significantly differences between the both groups for chest expansion thoracic level inspiratory variables at post-exercise. CONCLUSION: These results revealed that two exercise program improved flexibility, static standing balance, spine angle, chest expansion level and ability used as scoliosis management and intervention. Therefore, it is expected to be used as a method for the treatment and prevention in the process of rehabilitation of patients with scoliosis.

• Journal of Korean Neurosurgical Society
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• 제52권4호
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• pp.346-352
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• 2012

Objective : We compared the radiological and clinical outcomes between patients who underwent posterior fixation alone and supplemented with fusion following the onset of thoracolumbar burst fractures. In addition, we also evaluated the necessity of posterolateral fusion for patients treated with posterior pedicle screw fixation. Methods : From January 2007 to December 2009, 46 consecutive patients with thoracolumbar burst fracture were included in this study. On the basis of posterolateral fusion, we divided our patients into the non-fusion group and the fusion group. The radiological assessment was performed according to the Cobb's method, and results were obtained at immediately, 3, 6, 12 months after surgery. The clinical outcomes were evaluated using the modified Mcnab criteria at the final follow-up. Results : The demographic data and the mean follow-up period were similar between the two groups. Patients of both groups achieved satisfactory clinical outcomes. The mean loss of kyphosis correction showed that patients of both groups experienced loss of correction with no respect to whether they underwent the posterolateral fusion. There was no significant difference in the degree of loss of correction at any time points of the follow-up between the two groups. In addition, we also compared the effect of fixed levels (i.e., short versus long segment) on loss of correction between the two groups and there was no significant difference. There were no major complications postoperatively and during follow-up period. Conclusion : We suggest that posterolateral fusion may be unnecessary for patients with thoracolumbar burst fractures who underwent posterior pedicle screw fixation.