• Journal of Korean Neurosurgical Society
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• 제46권4호
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• pp.292-299
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• 2009

Objective : Clinical and radiological results of posterior dynamic stabilization using interspinous U (ISU, $Coflex^{TM}$, Paradigm Spine $Inc.^{(R)}$, NY, USA) were analyzed in comparison with posterior lumbar interbody fusion (PLIF) in degenerative lumbar spinal stenosis (LSS). Methods : A retrospective study was conducted for a consecutive series of 61 patients with degenerative LSS between May 2003 and December 2005. We included only the patients completed minimum 24 months follow up evaluation. Among them, 30 patients were treated with implantation of ISU after decompressive laminectomy (Group ISU) and 31 patients were treated with wide decompressive laminectomy and posterior lumbar interbody fusion (PLIF; Group PLIF). We evaluated visual analogue scale (VAS) and Oswestry Disability Index (ODI) for clinical outcomes (VAS, ODI), disc height ratio disc height (DH), disc height/vertebral body length ${\times}100$), static vertebral slip (VS) and depth of maximal radiolucent gap between ISU and spinous process) in preoperative, immediate postoperative and last follow up. Results : The mean age of group ISU ($66.2{\pm}6.7$ years) was 6.2 years older than the mean age of group PLIF ($60.4{\pm}8.1$ years; p=0.003). In both groups, clinical measures improved significantly than preoperative values (p<0.001). Operation time and blood loss was significantly shorter and lower in group ISU than group PLIF (p<0.001). In group ISU, the DH increased transiently in immediate postoperative period ($15.7{\pm}4.5%{\rightarrow}18.6{\pm}5.9%$), however decreased significantly in last follow up ($13.8{\pm}6.6%$, p=0.027). Vertebral slip (VS) of spondylolisthesis in group ISU increased during postoperative follow-up ($2.3{\pm}3.3{\rightarrow}8.7{\pm}6.2$, p=0.040). Meanwhile, the postoperatively improved DH and VS was maintained in group PLIF in last follow up. Conclusion : According to our result, implantation of ISU after decompressive laminectomy in degenerative LSS is less invasive and provides similar clinical outcome in comparison with the instrumented fusion. However, the device has only transient effect on the postoperative restoration of disc height and reduction of slip in spondylolisthesis. Therefore, in the biomechanical standpoint, it is hard to expect that use of Interspinous U in decompressive laminectomy for degenerative LSS had long term beneficial effect.

• 한국전문물리치료학회지
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• 제18권3호
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• pp.49-58
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• 2011

The purpose of this study was to evaluate the effects of bridging stabilization exercise on balance ability and gait performance in elderly women. The subjects of this study were thirty-one elderly women over 65 years old in HongSung-Gun Senior Citizen Welfare Hall. The subjects were randomly assigned into one of three groups (trunk stabilization exercise on the mat, whole body vibration, and Swiss ball) and participated in each exercise program three times a week for 4 weeks. Each exercise began in the bridging position. The dynamic balance and gait were measured by limit of stability area using force plate, Berg Balance Scale (BBS), and Timed Up and Go Test (TUG). The results were as follows: 1) The limit of stability in three groups increased significantly in anterior-posterior and medial-lateral lean after 4-weeks intervention (p<.05). 2) There were no significant differences in the limit of stability among three groups after 4-weeks intervention (p>.05). 3) The BBS and TUG in three groups increased significantly after 4-weeks intervention (p<.05). 4) There were significant differences among three groups in BBS. Post-hoc test showed that Swiss ball exercise group was significantly higher than the mat and whole body vibration groups. 5) There were no significant differences TUG among three groups after 4-weeks intervention (p>.05). In conclusion, this study suggested that 4 weeks of the bridging stabilization exercises were effective on balance and gait in all three groups. Particularly Swiss ball exercise group showed higher improvement than two other exercise groups (mat, whole body vibration group).

• Physical Therapy Rehabilitation Science
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• 제10권1호
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• pp.1-9
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• 2021

Objective: Joint mobilization for arthrokinematics altered by the positional fault of chronic ankle instability (CAI) is an effective intervention for stabilization. In this study, we compared the effects of ankle dorsi flexion range of motion (DFROM) and dynamic balance ability (DBA) in CAI patients via passive joint mobilization (PJM), a method traditionally performed in previous studies, and active joint mobilization (AJM), a method that can have a greater effect on cortical excitability with spontaneous movements. Design: Single-blind two-arm randomized controlled trial Methods: A total of 30 participants were registered: 15 each to the PJM and AJM groups. Each participant received a total of 10 intervention sessions, 10 minutes per session, 5 times a week for 2 weeks. PJM used Maitland's mobilization method to apply joint mobilization with talus in the posterior direction and AJM used an angular joint motion to induce patient's voluntary motion of medial malleolus anterior gliding and lateral malleolus posterior gliding, respectively. DFROM of the ankle was measured by using tape and DBA was evaluated by using the balance system. Results: Significant improvement was observed after intervention in both the PJM and AJM groups except for the DBA-anterior and DBA-right variables of the PJM group. There were statistically significant differences between the AJM and PJM groups in the DFROM, DBA-anterior, DBA-posterior, and DBA-right variables. Conclusions: The overall improvement of DFROM and DBA was found to be more effective in joint mobilization including voluntary movement. When it is accompanied by voluntary movement, it further affects the neuromuscular system of the ankle.

• 대한치과보철학회지
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• 제51권3호
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• pp.199-207
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• 2013

연구 목적: 저작 및 하악 운동시 발생되는 치아접촉은 치열의 보존, 하악의 안정과 보철 수복과정에 있어서 중요하다. 이에 한국인의 20-30대 성인을 대상으로 최대교두감합위에서의 치아접촉점의 위치 및 교합유도양상과 교합유도치의 분포를 분석하여 알아보고자 한다. 연구 대상 및 방법: 29명의 성인을 대상으로 하악의 최대교두감합위에서의 치아접촉점의 위치와 분포 및 전방운동시 교합접촉양상을 shimstock foil (Whaledent, Langenau, Germany), T-Scan III (Tekscan Inc., Boston, MA, USA), polyvinylsiloxane registration material (Genie Bite, Sultan Healthcare, Hackensack, NJ, USA)을 이용하여 측정하였다. 측정시 자세는 직립위로 Frankfurt horizontal plane과 지면이 수평이 되도록 앉게 하였으며 접촉이 재현될 때까지 수 차례 반복한 후 3회씩 측정하였다. 최대교두감합위에서 세가지 방법 간의 통계적 유의성을 비교하기 Fisher's Exact Test (R-General Public License, ver. 2.14.1)를 이용하였고, 전방 운동시 Pearson's Test를 통해 통계 검증하였다(${\alpha}=.05$). 결과: 최대교두감합위에서의 치아 접촉 양상을 shimstock foil, T-Scan III, polyvinylsiloxane registration material로 측정시 전치부, 소구치부, 구치부 모두에서 접촉하는 경우가 대부분이었으며, shimstock 사용시 약51%의 최대교두감합위는 전치부 접촉에서 일어났다. Shimstock foil과 T-Scan III를 사용하여 전방운동 측정시 중절치의 접촉이 가장 많이 일어났다. 결론: 최대교두감합위에서 실제 모든 치아의 접촉이 이루어지지 않는 경우가 있었으며 따라서 구치부에서 전치부를 보호해 주고 있음을 확인할 수 있었다. 또한, 전방운동 시 전치부의 치아접촉은 과도한 구치부의 치아접촉을 방지해 전치부가 구치부를 보호해 주고 있었다. 따라서 교합 재구성 시에는 이러한 상호 보호 교합에 대한 고려가 필요하다.