• Journal of Korean Neurosurgical Society
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• 제61권2호
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• pp.167-179
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• 2018

The prevalence of patients with adult spinal deformity (ASD) has been reported as high as 68%. ASD often leads to significant pain and disability. Recent emphasis has been placed on sagittal plane balance and restoring normal sagittal alignment with regards to the three dimensional deformity of ASD. Optimal sagittal alignment has been known to increase spinal biomechanical efficiency, reduce energy expenditure by maintaining a stable posture with improved load absorption, influence better bony union, and help to decelerate adjacent segment deterioration. Increasingly positive sagittal imbalance has been shown to correlate with poor functional outcome and poor self-image along with poor psychological function. Compensatory mechanisms attempt to maintain sagittal balance through pelvic rotation, alterations in lumbar lordosis as well as knee and ankle flexion at the cost of increased energy expenditure. Restoring normal spinopelvic alignment is paramount to the treatment of complex spinal deformity with sagittal imbalance. Posterior osteotomies including posterior column osteotomies, pedicle subtraction osteotomies, and posterior vertebral column resection, as well anterior column support are well known to improve sagittal alignment. Understanding of whole spinal alignment and dynamics of spinopelvic alignment is essential to restore sagittal balance while minimizing the risk of developing sagittal decompensation after surgical intervention.

• 국제물리치료학회지
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• 제10권2호
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• pp.1797-1802
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• 2019

Background: Breathing is the essential step of Pilates exercise and can be used to activate core muscles. Although the effects of breathing exercise on pain, breathing muscles, and cervical posture have been extensively studied, little is known about the impact of Pilates breathing on spinal posture and alignment. Purpose: To determine the effect of 3D-Pilates breathing exercise on spinal curvature and alignment of healthy adults during corrected to normal alignment. Design: One group pre-post test design Methods: Eighteen participants were given a 3D-pilates breathing exercise twice a week (20 minutes per session) for three weeks and warmed up for 10 minutes before each exercise session. To examine spinal curvature and alignment of each subject, this study used radiation free rasterstereography (Formetric III, Germany). Paired t-test and Wilcoxon signed rank test were performed to determine the difference between pre and post exercise. Results: There were statistically significant differences in height (p<.001), kyphosis angle (p<.05), trunk imbalance (p<.05), kyphotic apex (p<.01), cervical fleche (p<.05), pelvic tilt (p<.01), and lateral deviation (p<.05) between before and after 3D Pilates breathing exercise. However, there was no significant difference in lordosis angle. Conclusions: The study results indicated that three week 3D-pilates breathing exercise program could be presented as an effective rehabilitation method for improving spinal curvature and alignment.

• Journal of Korean Neurosurgical Society
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• 제42권6호
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• pp.495-498
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• 2007

Fractures of lumbo-sacral junction involving bilateral sacral wings are rare. Posterior lumbo-sacral fixation does not always provide with sufficient stability in such cases. Various augmentation techniques including divergent sacral ala screws, S2 pedicle screws and Galveston rods have been reported to improve lumbo-sacral stabilization. Galveston technique using iliac bones would be the best surgical approach especially in patients with bilateral comminuted sacral fractures. However, original Galveston surgery is technically demanding and bending rods into the appropriate alignment is time consuming. We present a patient with unstable lumbo-sacral junction fractures and comminuted U-shaped sacral fractures treated by lumbo-sacro-pelvic fixation using iliac screws and discuss about the advantages of the iliac screws over the rod system of Galveston technique.

• The Journal of Korean Physical Therapy
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• 제30권1호
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• pp.14-22
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• 2018

Purpose: This study examined the effects of the lower limb alignment on the pelvis, hip, and knee kinematics in people with genu varum during stair walking. Methods: Forty subjects were enrolled in this study. People who had intercondylar distance ${\geq}4cm$ were classified in the genu varum group, and people who had intercondylar distance <4cm and intermalleolar distance <4cm were placed in the control group. 3D motion analysis was used to collect the pelvis, hip, and knee kinematic data while subjects were walking stairs with three steps. Results: During stair ascent, the genu varum group had decreased pelvic lateral tilt and hip adduction at the early stance phase and decreased pelvic lateral tilt at the swing phase compared to the control group. At the same time, they had decreased minimal hip adduction ROM at the early stance and decreased maximum pelvic lateral tilt ROM and minimum hip rotation ROM at the swing phase. During stair descent, the genu varum group had decreased pelvic lateral tilt at the early stance and decreased pelvic lateral tilt and pelvic rotation at the swing phase. In addition, they had decreased pelvic frontal ROM during single limb support and increased knee sagittal ROM during the whole gait cycle. Conclusion: This study suggests that a genu varum deformity could affect the pelvis, hip and knee kinematics. In addition, the biomechanical risk factors that could result in the articular impairments by the excessive loads from lower limb malalignment were identified.

• The Journal of Korean Physical Therapy
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• 제29권4호
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• pp.175-180
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• 2017

Purpose: This study examined the effects of fast walking training on a treadmill on the spinal alignment and muscle thickness of normal adults. Methods: A total of 36 college students in their twenties participated in the study for eight weeks, and they were divided into the normal walking, fast walking, and speed change groups. All the groups were measured in a pre-test before training. The subjects performed exercise three times per week for six weeks. A post-test was conducted six weeks after training began, and a follow-up test was done two weeks after the training ended.Trunk and pelvic tilts were measured in Formetric 4D for the spinal alignment of the subjects. The muscle thickness was examined in the trunk with an ultrasound test. Repeated-measures ANOVA was conducted to test the main effects and interactions among the measurement variables according to time and group. Results: Significant differences were observed in the pelvic tilt according to time. There were significant differences in the external oblique, internal oblique, transverse abdominal muscle according to time. The post-test results showed significant differences in the left external oblique, internal oblique muscles between before training, six weeks into training, and two weeks after the completion of training. There were significant interactions in the left oblique muscles according to the time and group. Conclusion: These findings have some value for patient rehabilitation and clinical applications and interventions through walking training.

• 대한물리의학회지
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• 제9권1호
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• pp.1-10
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• 2014

PURPOSE: The purpose of this study was to investigate the effects of flexible derotator of femur orthosis (FDO) during treadmill gait training on the quadriceps-angle (Q-angle), lateral pelvic tilt, gait speed, and number of steps in children with cerebral palsy. METHODS: Seven children with cerebral palsy who had rotational deformity of the lower extremities participated in this study. We used single group repeated measure design. The procedure consisted of baseline phase, intervention phase, and post-intervention phase. The baseline phase consisted of stretching and strengthening exercise and treadmill gait training without FDO. The treatment phase not only included the same procedures as those for baseline, but also included FDO during treadmill gait training. Postural alignment of the lower extremities was assessed with the Q-angle, and lateral pelvic tilt using the Dartfish software program. A 10-m walk test was used to evaluate gait speed and number of steps. RESULTS: For postural alignment, there was significant differences after the application of FDO (p<.05). For gait ability, there was significant differences in all phases (p<.01). CONCLUSION: These finding suggest that the application of FDO during treadmill gait training had a positive effect on the improvement of postural alignment and gait ability in children with cerebral palsy having rotational deformity.

• 한국산학기술학회논문지
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• 제18권9호
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• pp.347-355
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• 2017

본 연구의 목적은 골반 교정이 중년 여성의 만성 요통과 척추 골반 지표들에 미치는 영향을 규명하는데 있다. 이를 위하여 만성 요통이 있는 중년 여성 38명을 실험군(20명)과 무처치 대조군(18명)에 무선 할당하여 실험군에게는 골반 교정을 주 4회, 8주 간 시술하였다. 시술 전과 8주 후에 요통은 시각적 상사 척도와 Oswestry 요통 장애 지수로 측정하였고, 그 외 요부 유연성, 염증인자인 혈중 C-reactive protein (CRP) 및 척추 골반 지표들을 평가하였다. 처치 8주 후 대조군에 비하여 골반 교정군에서 요통 강도, 요통 장애 지수 및 요부 유연성 모두가 유의하게 향상되었으며, 혈중 CRP의 유의한 변화는 없었다. 척추 골반 지표들을 분석한 결과 골반 교정군에서 대조군에 비해 요추전만각, 천골경사 및 골반균형지표는 유의하게 변화된 반면, 골반입사각의 변화가 뚜렷하지 않았다. 따라서 골반 교정은 요통 환자의 통증 경감과 기능 향상에 효과적일 것이며, 척추 골반 정렬의 변화의 결과일 것이다.

• Journal of Korean Neurosurgical Society
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• 제66권6호
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• pp.611-617
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• 2023

The cervical spine plays a critical role in supporting the skull, maintaining horizontal gaze, and facilitating walking. Its unique characteristics, including the widest range of motion among spinal segments, have led to extensive research on cervical sagittal alignment. Various parameters have been proposed to evaluate cervical alignment, with studies investigating their clinical significance, correlation with symptoms, and implications for surgical interventions. Recent findings suggest that cervical sagittal alignment not only impacts the cervical spine but also influences global spine-pelvic alignment through compensatory mechanisms. This comprehensive review examines classical and new parameters of cervical sagittal alignment and considers the dynamic and muscular factors associated with it.

• 대한통합의학회지
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• 제7권1호
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• pp.81-88
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• 2019

Purpose : The purpose of this study was to examine if there is any correlation between pelvic tilt angle and trunk motion and trunk extensor during trunk forward flexion and to measure trunk motion, onset time of trunk motion, and onset time of trunk extensor activation. Methods : The subjects of this study were 42 healthy adults. The subjects had no back pain due to neurological disease and no experience of back surgery. After pelvic tilt angle was measured, each trunk forward flexion was performed three times. Trunk motion and onset time of trunk motion were measured using Myomotion. Four sensors were used, with one located at the upper thoracic (below $C_7$), the lower thoracic ($T_{12}-L_1$), the sacrum ($S_1$), and at the center of the anterior femur. Onset time of trunk extensors (spinalis, longissimus, gluteus medius, gluteus maximus, biceps femoris, and gastrocnemius) activation was measured using a wireless surface EMG. The EMG amplitude was normalized by using the reference voluntary contraction (RVC). The statistical significance of the results were evaluated using Pearson's correlation test. Results : The correlation between pelvic tilt angle and lumbar motion, onset time of pelvis motion, and onset time of gluteus medius activation was statistically significant in a positive direction (p<.05). The correlation between pelvic tilt angle with pelvis motion, onset time of lumbar motion, and onset time of longissimus activation showed a statistically significant negative correlation (p<.05). Conclusion : The study results provide a significant contribution to our understanding of the lumbar load at the initial stage of trunk flexion. Therefore, it may be possible to provide basic data for evaluation and treatment, such as orthodontic treatment for alignment of the spine and back pain. In addition, it is necessary to focus on normal exercise pattern reeducation as well as pelvic correction during exercise in daily life or in industrial fields.

• 국제물리치료학회지
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• 제11권3호
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• pp.2102-2106
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• 2020

Background: Static hamstring stretching exercises have been widely used to improve flexibility of the hamstring muscles. However, few studies have examined the influence of standing static hamstring stretching (e.g., jack-knife stretching) on movements of the lumbopelvic-hip complex. Objectives: To examine the short-term effects of jack-knife stretching on movements of the lumbopelvic-hip complex. Design: Case series. Methods: Fourteen participants with hamstring tightness (8 male, 6 female) were recruited. Participants performed jack-knife stretching for 150 s. Before and after stretching, participants performed the finger-to-floor distance (FFD), sit and reach (SRT), active knee extension (AKE), passive straight leg raising (PSLA), and active straight leg raising (ASLR) tests as well as pelvic tilt while standing to identify the effects of stretching. Results: There were significant improvements in the FFD, SRT, AKE, PSLA, and ASLR tests after stretching. However, pelvic tilt angle while standing did not significantly change. Conclusion: Jack-knife stretching can be a useful exercise to improve flexibility of the hamstring muscles, but not pelvic alignment while standing.