Background: The purpose of this clinical case report is to confirm sacroiliac joint misalignment effects on the gait. Methods: A healthy women volunteered to participate in this case report. Measurement of the subject was performed two categories. One is physical examination of the pelvic by inspection, palpation, movement based tests and pain provocation tests. The other one is gait performance measurement by 3 dimentional motion analysis. Results: Diagnosis by physical examination of the subject was Lt. ilium posterior rotation. Pelvic, hip, knee and ankle in the 3 dimensional kinematic data, the most notable result was the ankle. Conclusion: To confirm the effect of the misalignment of the sacroiliac joint on the gait function, it must be evaluated by integrating the movement to the ankle from the lumbar.
Lee, Jeong Moon;Yoon, Sun Jung;Park, Myung Sik;Song, Kyung Jin
Journal of Trauma and Injury
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제29권1호
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pp.22-27
/
2016
Purpose: The optimal method of fixation of symphysis pubis (SP) diastasis in pelvic ring injuries is still controversial. In this study, we investigated the radiological and the clinical results of a precontoured 4.5-mm symphysis pubis (SP) plate with tension band wiring (TBW) after an anterior pelvic injury in pelvic fractures. Methods: We treated 25 patients with traumatic SP diastasis by open reduction and internal fixation with plates and wires. We used a four-hole 4.5-mm precontoured SP plate with a tension band wiring. Results: Patients with a SP with TBW fixation achieved excellent or good results at final follow-up. Post-operative complications included two (8%) patients with metal work movement. The mean symphyseal width was smaller in 4.5 mm SP plate with TBW during 1-year follow up period. Conclusion: A precontoured symphysis pubis plate (4.5 mm) with figure-of-eight fashion tension band wiring shows favorable radiological results, excellent or good clinical outcome, and a lower complication (hardware failure and revision surgery).
Purpose: This study was conducted in order to suggest an effective method of daily life movement training for stroke patients by comparison and analysis of the biomechanic characteristics of sitting up from a lying posture in stroke patients and healthy elderly participants. Methods: Fifteen stroke patients and 15 age-matched elderly participants were included in the study. The movement of sitting up from a lying posture was divided into three stages, and the differences in muscle activity in the sternocleidomastoid (SCM), rectus abdominis (RA), external oblique (EO), and rectus femoris (RF) during the movement were analyzed. Results: Subjects in the experimental group showed slower speed than those in the control group. In the neck joint, the change of angle in movement showed a larger decrease at all stages in the experimental group than in the control group; the movement also decreased in stages I and II in the upper trunk joint. The movement also showed a statistically significant decrease in stage II in the lower trunk, pelvic, and hip joints. The SCM showed higher activity in the control group than in the experimental group, showing a statistically significant difference; the RA showed high activity in the experimental group. The RF showed higher activity in the control group than in the experimental group, showing a statistically significant difference. Conclusion: From the results obtained above, increasing movements in the neck, pelvic, and hip joints and strengthening of lower body muscles are required in order to improve the ability for getting up from a lying posture in stroke patients.
Purpose: The purpose of this study was to investigate the effects of Pilates exercise on the back pain index, pelvic tilt angle, and physical fitness of pregnant women with low back pain. Methods: All study participants, all of whom had pregnancy-induced back pain, were randomly assigned to either a Pilates exercise group (PG, n = 8) or control group (CG, n = 7). The PG performed a Pilates exercise for 50 minutes three times a week for eight weeks. The back pain scale and pelvic tilt angle were measured using a visual analogue scale and angulometer, respectively. Cardiopulmonary endurance, flexibility, and grip strength were measured to examine the physical fitness. The variables were analyzed using two-way repeated-measures ANOVA with the Holm-Sidak post hoc procedure. Results: Back pain in the PG significantly decreased from 4.69 ± 1.28 to 1.06 ± 0.94, whereas the CG showed significantly increased back pain from 2.63 ± 2.20 to 4.71 ± 2.56. The left pelvic angle in the PG showed a significant decrease from 13.94 ± 3.70° to 12.29 ± 2.95°, while the CG showed a non-significant difference from 13.07 ± 4.42° to 17.37 ± 3.13°. The right pelvic angle in the PG showed a significant decrease from 13.50 ± 4.47° to 10.34 ± 3.66°, while a non-significant difference in the CG from 44 ± 4.98° to 15.30 ± 3.61° was found. These results showed that the regular participation in Pilates exercise was effective in reducing the pelvic tilt angle. In terms of physical fitness, the PG showed a significant increase in cardiopulmonary endurance, flexibility, and grip strength. However, the CG showed any significance increase in those variables. Conclusion: Eight weeks of Pilates exercise was associated with a decrease in lower back pain, a maintained or reduced pelvic tilt angle, and increased cardiopulmonary endurance, grip strength, and flexibility in pregnant woman with lumbar pain.
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.
Kim, Si-Hyun;Park, Kyue-Nam;Kwon, Oh-Yun;Choi, Houng-Sik
한국전문물리치료학회지
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제21권4호
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pp.49-55
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2014
Excessive lumbar flexion during sit-to-stand (STS) is a risk factor for lower back pain. Postural taping can prevent unwanted flexion of the lumbar spine. This study aimed to demonstrate the effect of taping the lower back on the lumbopelvic region and hip joint kinematics during STS. Sixteen healthy subjects participated. All subjects performed the STS with and without taping of the lower back. A three-dimensional motion analysis system was used to measure the kinematics of the lumbar spine, pelvis, and hip joint during STS. The angle of the peak lumbar flexion, pelvic anterior tilting, and hip flexion and angular displacement of the lumbar spine between starting position and maximal lumbar flexion were collected. Paired t-tests, or Wilcoxon's rank-sum test for non-parametric distribution, were used to assess differences in the measurements with and without taping. A p-value <.05 was taken to indicate a significant difference. Significant differences were observed in the angle of the peak lumbar flexion, pelvic anterior tilting, hip flexion and angular displacement of the lumbar spine (p<.05). Taping was associated with a significant decrease in the angle of peak lumbar flexion and angular displacement of the lumbar spine between the starting position and maximal lumbar spine flexion. In addition, the peak angle of pelvic anterior tilting and hip flexion were significantly increased with taping. The findings of this study suggest that taping the lower back can decrease excessive lumbar flexion, and increase the pelvic anterior tilting and hip flexion motion during STS.
PURPOSE: This study was conducted to determine the effects of therapeutic exercise on range of motion (ROM), the manual muscle test (MMT), functional movement screen (FMS) and radiological evaluation in a youth football player with football-specific anterior pelvic tilt (APT). METHODS: The subject of this case report was a 12-year-old youth football player, who presented with football-specific APT. Therapeutic exercise consisted of hamstring stretch, prone hip extension, abdominal crunch, bridging with isometric hip abduction, plank exercise with posterior tilt and posterior pelvic tilting exercise using a swiss-ball for 40 min/day, twice a week for 8-weeks. ROM, MMT, FMS (deep squat, hurdle step, inline lunge, shoulder mobility, active straight-leg raise, rotary stability and trunk stability push-up) and radiographs (lumbar lordotic and sacral horizontal angle) were analyzed before and after week 8 of therapeutic exercise. RESULTS: The ROM, MMT, and FMS increased and the lumbar lordotic angle and sacral horizontal angle improved after 8-weeks of therapeutic exercise. CONCLUSION: The results of this case report suggest that therapeutic exercise improves ROM, MMT and radiography associated parameters in youth football players with football-specific APT. These findings have clinical implications for therapeutic exercise in youth football players with football-specific APT.
Background: Lower back pain (LBP) is a major cause of disability and a common musculoskeletal disorder encountered at some point in life. Dysfunction of the lumbar vertebrae has been associated with decreased flexibility of the hamstrings, which exhibited a strong positive correlation with LBP. Hamstring tension affects lumbar pelvic rhythm. We aimed to activate pelvic stability with compression by Active Therapeutic Movement (ATM), muscle energy technique (MET) was applied to increase the flexibility of the hamstring. Objects: In this study, we aimed to investigate the effects of MET with ATM and general MET were applied to the hamstring of adults, who were in their twenties with nor without LBP, on their pelvic inclination and the length of their hamstring. Methods: A total of 32 subjects were briefed about the purpose of this study and agreed to participate voluntarily. Before the experiment, all subjects were pre-examined, and they were divided into an LBP group and a no lower back pain group accordingly. Thereafter, all subjects participated in both in a crossover manner. After at least one week, they switched to another group and participated in the same experiment. Results: The study results revealed that both groups demonstrated significant results in the modified active knee extension test (p < 0.01) and the sit and reach test (p < 0.01) performed to assess the hamstring flexibility; an interaction (p < 0.05) was noted. Moreover, a more significant difference was observed between the MET with ATM and the general MET. Although significant results were obtained for the pelvic inclination (p < 0.01), interaction was not noted. Conclusion: Conclusively, in this study, when the MET with ATM was applied to the two groups, there was a significant difference compared to the general MET for hamstring flexibility, but it was confirmed that there was no significant difference for the pelvic inclination.
Purpose: This study was conducted in order to determine the effect of visual and tactile feedback on muscle activity of the gluteus maximus (Gmax) and abdominal muscles and the motion of pelvic rotation during performance of clam exercise (CE). Methods: Thirteen subjects without low back pain were recruited for this study. Each subject was instructed to perform the CE without and with feedback. The subjects were instructed to keep pelvic from rotating backwards by palpating the ASIS and monitoring the pelvic movement by themselves during performance of CE with feedback. The electromyographic (EMG) activities of Gmax and abdominal muscles were collected using surface EMG. Angles of pelvic rotation were measured using a 3-dimensional motion-analysis system. Paired t-tests were used for comparison of EMG activities in each muscle and the angle of pelvic rotation. Results: The EMG activities of all abdominal muscles were not significant between CM without and CM with feedback (p>0.05). The EMG activity of Gmax was significantly greater in CM with feedback compared with CM without feedback (without vs. with feedback; 14.2% vs. 20.7%MVIC) (p<0.05). The angle of pelvic rotation was significantly less in CM with feedback compared with CM without feedback (without vs. with feedback; $15.3^{\circ}$ vs. $10.8^{\circ}$ ) (p<0.05). Conclusion: Therefore, these findings suggest that CM with the visual and tactile feedback is effective in activation of the Gmax and correcting of the uncontrolled lumbopelvic rotation during CE.
The purpose of this study was to analyze the effects of three different pelvic tilts on a sit-to-stand (STS) and to suggest a new assessment approach based on biomechanical analysis. The three difrent pelvic tilts were: (1) comfortable pelvic tilt sit-to-stand (CPT STS), (2) posterior pelvic tilt sit-to-stand (PPT STS) and (3) anterior pelvic tilt sit-to-stand (APT STS). To determine the onset time of muscle contraction surface electrodes were applied to the rectus femoris muscle (RF), vastus lateralis muscle (VL), biceps femoris muscle (BF), tibialis anterior muscle (TA), gastrocnemius muscle (GCM), and soleus muscle (SOL). The ICC was used for functional linkage analysis. The findings of this study were as follows. First, significant differences were found in kinematic variables and in muscle activation pattern among the three activities. Second, the results of functional integrated analysis revealed that recruited muscle activation patterns changed when the thigh-off was viewed as a reference point. Third, there were independent functional units between the thigh-off and the VL and between the thigh-off and the RF in the functional linkage analysis. The VL and RF acted as prime mover muscles, and more postural adjustment muscle recruitment was required as the demand of postural muscle control increased (PPT STS, APT STS, and CPT STS in order). In conclusion, the findings of this study suggest the following evaluative and therapeutic approach for STS activity. APT STS can be introduced for movement efficiency and functional advantage when abnormal STS is treated. However, excessive APT would change the muscle activation patterns of BF and SOL and require additional postural muscle control to cause abnormal control patterns.
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