• Title/Summary/Keyword: Sacroiliac Joint

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Effects of a Pelvic Belt on Hip Muscle Forces and Abdominal Muscle Activities During Isometric Hip Adduction and Abduction (등척성 엉덩관절 모음 및 벌림 시 골반 벨트가 엉덩관절 근육의 근력과 복부 근육 근 활성도에 미치는 영향)

  • Kang, Min-hyeok;Oh, Jae-seop
    • Physical Therapy Korea
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    • v.24 no.2
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    • pp.19-26
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    • 2017
  • Background: To improve lumbo-pelvic stability, passive support devices (i.e., a pelvic belt) are recommended clinically. Nevertheless, to understand the influence of passive support on lumbo-pelvic stability, it is necessary to examine the influence of a pelvic belt on the abdominal and hip abductor muscles. Objects: To examine the effects of a pelvic belt on the forces of the hip adductor and abductor muscles and activity of the abdominal muscles during isometric hip adduction and abduction. Methods: This study recruited 14 healthy men. All subjects performed isometric hip adduction and abduction with and without a pelvic belt in a neutral hip position. Load cells, wrapped with a non-elastic belt, were placed above the medial and lateral malleoli of the dominant leg to measure the muscle forces of the hip adductors and abductors, respectively. The forces of the hip adductors and abductors were measured using a load cell during isometric hip adduction and abduction, while the electromyographic activities of the bilateral rectus abdominis, internal oblique, and external oblique muscles were measured. Results: The forces generated by the hip adductors and abductors were significantly greater with the pelvic belt than without (p<.05). No significant differences in abdominal muscle activities between the two conditions were found (p>.05). Conclusion: These findings suggest that use of a pelvic belt could lead to effective strengthening exercise of hip muscles in individuals with sacroiliac joint pain.

The Effect of Gait Exercise Using a Mirror on Gait for Normal Adult in Virtual Reality Environment: Gait Characteristics Analysis (가상현실환경에서 정상성인의 거울보행이 보행특성에 미치는 영향)

  • Lee, Jae-Ho
    • Journal of The Korean Society of Integrative Medicine
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    • v.10 no.3
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    • pp.233-246
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    • 2022
  • Purpose : The study aims to determine the effects of virtual and non-virtual realities in a normal person's mirror walk on gait characteristics. Methods : Twenty male adults (Age: 27.8 ± 5.8 years) participated in the study. Reflection markers were attached to the subjects for motion analysis, and they walked in virtual reality environments with mirrors by wearing goggles that showed them the virtual environments. After walking in virtual environments, the subjects walked in non-virtual environments with mirrors a certain distance away after taking a 5 min break. To prevent the order effect caused by the experiential difference of gait order, the subjects were randomly classified into groups of 10 and the order was differentiated. During each walk, an infrared camera was used to detect motion and the marker positions were saved in real time. Results : Comparison between the virtual and non-virtual reality mirror walks showed that the movable range of the leg joints (ankle, knee, and hip joints), body joints (sacroiliac and atlantoaxial joints), and arm joints (shoulder and wrist joints) significantly differed. Temporal characteristics showed that compared to non-virtual gaits, the virtual gaits were slower and the cycle time and double limb support time of virtual gaits were longer. Furthermore, spacial characteristics showed that compared to non-virtual gaits, virtual gaits had shorter steps and stride lengths and longer stride width and horizontally longer center of movement. Conclusion : The reduction in the joint movement in virtual reality compared to that in non-virtual reality is due to adverse effects on balance and efficiency during walking. Moreover, the spatiotemporal characteristics change based on the gait mechanisms for balance, exhibiting that virtual walks are more demanding than non-virtual walks. However, note that the subject group is a normal group with no abnormalities in gait and balance and it is unclear whether the decrease in performance is due to the environment or fear. Therefore, the effects of the subject group's improvement and fear on the results need to be analyzed in future studies.

Comparison of the Effects of Pelvic Compression Using Instruments on Trunk Muscle Endurance and Balance Ability in Subjects in Their Twenties With or Without Low Back Pain (기구를 이용한 골반 압박이 20대의 요통 경험자와 비경험자의 체간 근지구력과 균형 능력에 미치는 영향 비교)

  • Chung, Suh-young;Kim, Suhn-yeop
    • Physical Therapy Korea
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    • v.29 no.2
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    • pp.156-164
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    • 2022
  • Background: Low back pain (LBP) is a representative disease, and LBP is characterized by muscle dysfunction that provides stability to the lumbar spine. This causes physical functional problems such as decreased posture control ability by reducing the muscular endurance and balance of the lumbar spine. Pelvic compression using instruments, which has been used during recent stabilization exercises, focuses on the anterior superior iliac spine of the pelvis and puts pressure on the sacroiliac joint during exercise, making the pelvis more symmetrical and stable. Currently, research has been actively conducted on the use of pelvic compression belts and non-elastic pelvic belts; however, few studies have conducted research on the application effect of pelvic compression using instruments. Objects: This study aimed to investigate whether there is a difference in trunk muscular endurance and dynamic and static balance ability levels by applying pelvic stabilization through a pelvic compression device between the LBP group and the non-LBP group. Methods: Thirty-nine subjects currently enrolled in Daejeon University were divided into 20 subjects with LBP group and 19 subjects without LBP (NLBP group), and the groups were compared with and without pelvic compression. The trunk muscular endurance test was performed with 4 movements, the dynamic balance test was performed using a Y-balance test, and the static balance test was performed using a Wii balance board. Results: There was a significant difference the LBP group and the NLBP group after pelvic compression was applied to all tests (p < 0.05). In the static and dynamic balance ability test after pelvic compression was applied, there was a significant difference in the LBP group than in the NLBP group (p < 0.05). Conclusion: These results show that pelvic compression using instruments has a positive effect on both those with and without LBP and that it has a greater impact on balance ability when applied to those with LBP.

Evaluation of Usefulness of Portal Image Using Electronic Portal Imaging Device (EPID) in the Patients Who Received Pelvic Radiation Therapy (골반강 내 방사선 치료 환자에서 Electronic Portal Imaging Device(EPID)를 이용한 Portal Image의 유용성에 관한 연구)

  • Kim Woo Chul;Park Won;Kim Heon Jong;Park Seong Young;Cho Young Kap;Loh John J;Suh Chang Ok;Kim Gwi Eon
    • Radiation Oncology Journal
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    • v.16 no.4
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    • pp.497-504
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    • 1998
  • Purpose : To evaluate the usefulness of electronic portal imaging device through objective compare of the images acquired using an EPID and a conventional port film Materials and Methods : From Apr. to Oct. 1997, a total of 150 sets of images from 20 patients who received radiation therapy in the pelvis area were evaluated in the Inha University Hospital and Severance Hospital. A dual image recording technique was devised to obtain both electronic portal images and port film images simultaneously with one treatment course. We did not perform double exposure five to ten images were acquired from each patient. All images were acquired from posteroanterior (PA) view except images from two patients. A dose rate of 100-300 Mu/min and a 10-MV X-ray beam were used and 2-10 MUs were required to produce a verification image during treatment. Kodak diagnostic film with metal/film imaging cassette which was located on the top of the EPID detector was used for the port film. The source to detector distance was 140 cm. Eight anatomical landmarks (pelvic brim, sacrum, acetabulum. iliopectineal line, symphysis, ischium, obturator foramen, sacroiliac joint) were assessed. Four radiation oncologist joined to evaluate each image. The individual landmarks in the port film or in the EPID were rated - very clear (1), clear (2), visible (3), not clear (4), not visible (5). Results : Using an video camera based EPID system. there was no difference of image quality between no enhanced EPID images and port film images. However, when we provided some change with window level for the portal image, the visibility of the sacrum and obturator foramen was improved in the portal images than in the port film images. All anatomical landmarks were more visible in the portal images than in the port film when we applied the CLAHE mode enhancement. The images acquired using an matrix ion chamber type EPID were also improved image qualify after window level adjustment. Conclusion : The quality of image acquired using an electronic portal imaging device was comparable to that of the port film. When we used the enhance mode or window level adjustment. the image quality of the EPID was superior to that of the port film. EPID may replace the port film.

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Ultrasound-Guided Injections in the Lumbar and Sacral Spine (요추 및 천추부에 대한 초음파 유도하 중재 시술)

  • Ko, Kwang Pyo;Song, Jae Hwang;Kim, Whoan Jeang;Kim, Sang Bum;Min, Young Ki
    • Journal of Korean Society of Spine Surgery
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    • v.25 no.4
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    • pp.185-195
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    • 2018
  • Study Design: Literature review. Objective: Ultrasound-guided injections are a common clinical treatment for lower lumbosacral pain that are usually performed before surgical treatment if conservative treatment fails. The aim of this article was to review ultrasound-guided injections in the lumbar and sacral spine. Summary of Literature Review: Ultrasound-guided injections, unlike conventional interventions using computed tomography or C-arm fluoroscopy, can be performed under simultaneous observation of muscles, ligaments, vessels, and nerves. Additionally, they have no radiation exposure and do not require a large space for the installation of equipment, so they are increasingly selected as an alternative method. Materials and Methods: We searched for and reviewed studies related to the use of ultrasound-guided injections in the lumbar and sacral spine. Results: In order to perform accurate ultrasound-guided injections, it is necessary to understand the patient's posture during the intervention, the relevant anatomy, and normal and abnormal ultrasonographic findings. Facet joint intra-articular injections, medial branch block, epidural block, selective nerve root block, and sacroiliac joint injections can be effectively performed under ultrasound guidance. Conclusions: Ultrasound-guided injections in the lumbar and sacral spine are an efficient method for treating lumbosacral pain.

A study of variation level for each region changed in trunk at sagittal plane after Trunk Flexion-Extension Exercise (체간 굴곡-신전운동 후 체간 각 부위 별 시상면 높이변화에 대한 조사)

  • Kim, Keun-Jo;Lee, Cu-Rie;Jung, Byeong-Ok
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.14 no.2
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    • pp.1-15
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    • 2008
  • Purpose : This survey was to investigate on the effect of each region changed in trunk through sagittal plane after Trunk Flexion-Extension Exercise. Methods : 18 students of Gimcheon College participated in this study for the period of July 9-30, 2007. Analyzed factor were 1) degree of pain 2) presence of Gillet test and 3) difference of right-left for 7 landmark region in trunk applying I.B.S.-2000 after Trunk Flexion - Extension Exercise. We used the SPSS $PC^+$ program for classifying into analysis of frequency, $x^2$-test, t-test and Simple Linear Regression analysis test. Results: Followings are concluded For degree of pain, 13(72.2%) of students answered "No pain" after Trunk Flexion-Extension Exercise and in the result 4 more students decreased the pain. In the Gillet test, 14(77.8%) of students answered "positive" after Trunk Flexion-Extension Exercise and in the result 4 more students increased mobility of Sacroiliac joint. In the differences of right-left for 7 landmark region in trunk by B.M.I. scale, Slim type was decreased both Acromion(0.45mm), both Iliac crest(0.44mm), and both ASIS(0.31mm) to anterior plane, Normal type was decreased both inferior angle of Scapular(0.02mm), both L4-5(0.07mm), and both PSIS(0.09mm) to posterior plane Fatness type was decrease both Acromion(0.05mm), both ASIS(0.05mm) to anterior plane. In the differences of right-left for 7 landmark region in trunk for degree of pain No pain group was decreased both Acromion(0.17mm), both Nipple(0.25mm) to anterior plane and both PSIS(0.13mm) to posterior plane Pain group was decreased both Acromion(0.04mm), both Iliac creast(0.03mm) to anterior plane and both inferior angle of Scapular(0.18mm) both PSIS(0.13mm) to posterior plane. In the difference of right-left for 7 landmark region in trunk for each of the exercises, Both iliac crest(0.1mm), both ASIS(0.12mm) to anterior plane were decreased after Flexion Trunk Exercise. Both acromion(0.27mm) to anterior plane, both inferior angle of scapular(0.14mm) and both PSIS(0.12mm) to posterior plane were decreased after Extension Trunk Exercise. Each of the exercises, The both inferior angle of Scapular showed high scores($0.65{\pm}0.23$) at Trunk Extension Exercise group and there was statistical significance between Trunk Flexion Exercise group and Extension exercise group(t :-2.502, p < 0.05). 7. At Pre-exercise group, Both inferior angle of Scapular showed low scores($0.23{\pm}8.27$) at Trunk Extension Exercise group and there was statistical significance between Pre- Exercise group and Trunk Extension Exercise group(t :-2.5430, p<0.05). Conclusion : The simple linear regression analysis was presented at Acromion(-0.243), L4-5(-0.753), PSIS(0.576) and there was statistical significance in BMI scale(p<0.01).

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Retrospective Study on Surgical Repair of 31 Canine Pelvic Fracture Cases (골반 골절의 수술적 교정을 실시한 31두 개에서의 후향연구)

  • Lee, Seung-Hoon;Park, Sung-Su;Kang, Byung-Jae;Kim, Yong-Sun;Kim, Wan-Hee;Kweon, Oh-Kyeong
    • Journal of Veterinary Clinics
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    • v.29 no.1
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    • pp.8-11
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    • 2012
  • The results of surgical repair for pelvic factures in 31 dogs were reviewed. Lameness and weight bearing scores were used to evaluate functional recovery of the hind limbs. Simple fracture occurred in sacroiliac joint (n = 5) and ilium (n = 3). Pelvic fractures had acetabular (n = 7) and non-acetabular fractures (n = 23). Acetabular fracture cases were composed of additional surgical treatments with femoral head and neck ostectomy (FHNO) (n = 4) and only acetabular rim fixation (n = 3). Simple fractures had more rapid initial and complete recovery times than multiple fractures. Non-acetabular fracture cases (initial recovery time: 2.7 weeks, complete recovery time: 9.1 weeks) had more rapid initial and complete recovery times than acetabular fracture cases (8.4, 12.5 weeks) (p < 0.05). In addition, the cases of additional surgical treatment with FHNO (5.3, 7 weeks) had more rapid mean recovery times than surgical treatment without FHNO (11.1, 16.3 weeks). Surgical approach with FHNO in acetabular fracture was an alternative method to treat pelvic fractures in small breed dogs.

Suggestion of Optimal Radiation Fields in Rectal Cancer Patients after Surgical Resection for the Development of the Patterns of Care Study (Patterns of Care 연구 개발을 위한 직장암의 수술 후 방사선치료 시 적정 방사선치료 조사영역 제안)

  • Kim, Jong-Hoon;Park, Jin-Hong;Kim, Dae-Yong;Kim, Woo-Cheol;Seong, JinSil;Ahn, Yong-Chan;Ryu, Mi-Ryeong;Chun, Mison;Hong, Seong-Eon;Oh, Do-Hoon;Kim, Il-Han
    • Radiation Oncology Journal
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    • v.21 no.3
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    • pp.183-191
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    • 2003
  • Purpose: To suggest the optimal radiation fields after a surgical resection based on a nationwide survey on the principles of radiotherapy for rectal cancer in the Korean Patterns on Care Study. Materials and method: A consensus committee, composed of radiation oncologists from 18 hospitals in Seoul Metropolitan area, developed a survey format to analyze radiation oncologist's treatment principles for rectal cancer after a surgical resection. The survey format included 19 questions on the principles of defining field margins, and was sent to the radiation oncologists in charge of gastrointestinal malignancies in all korean hospitals (48 hospitals). Thirty three ($69\%$) oncologists replied. On the basis of the replies and literature review, the committee developed guidelines for the optimal radiation fields nor rectal cancer Results: The following guidelines were developed: superior border between the lower tip on the L5 vertebral body and upper sacroiliac joint; inferior border $2\~3$ cm distal to the anastomosis in patient whose sphincter was saved, and $2\~3$ cm distal to the perineal scar In patients whose anal sphincter was sacrificed; anterior margin at the posterior lip of the symphysis pubis or $2\~3$ cm anterior to the vertebral body, to include the internal iliac lymph node and posterior margin $1.5\~2$ cm posterior to the anterior surface of the surface, to include the presacral space with enough margin. Comparison with the guidelines, the replies on the superior margin coincided in 23 cases ($70\%$), the inferior margin after sphincter saving surgery in 13 ($39\%$), the inferior margin after adbominoperineal resection in 32 ($97\%$), the lateral margin in 32 ($97\%$), the posterior margins in 32 ($97\%$) and the anterior margin in 16 ($45\%$). Conclusion: These recommendations should be tailored to each patient according to the clinical characteristics such as tumor location, pathological and operative findings, for the optimal treatment. The adequacy of these guidelines should be proved be following the Korean Patterns of Care Study.

The Findings of $^{99m}Tc$-MDP Bone Scan in Primary Malignant Bone Tumors (원발성 악성 골종양의 $^{99m}Tc$-MDP 골스캔 소견)

  • Hyun, In-Young;Lee, Kung-Han;Lee, Dong-Soo;Chung, June-Key;Lee, Myung-Chul;Koh, Chang-Soon;Kang, Heung-Sik;Lee, Sang-Hoon;Lee, Han-Koo
    • The Korean Journal of Nuclear Medicine
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    • v.29 no.1
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    • pp.73-78
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    • 1995
  • [ $^{99m}Tc$ ]-MDP bone scan was performed in 31 patients with primary malignant bone tumors, 22 patients with osteogenic sarcoma, 5 patients with chondrosarcoma and 4 patients with Ewing's sarcoma. The findings were classified by isotope intensity of accumulation in tumor as grade 1 to 3, overall pattern of isotope distribution in tumor as grade 1 to 3, and distortion of bony outline as grade 1 to 3. Histologic classifications were cor related with scan findings in 22 patients with osteogenic sarcoma. The results were as follows 1) In 22 patients with osteogenic sarcoma, markedly increased isotope intensity higher than sacroiliac joint with patchy areas of decreased intensity and severe bony distortion were found in 16 patients. The correlations between histologic classification and scan findings were not discovered. 2) In 5 patients with chondrosarcoma, mildly increased isotope Intensity with patchy areas of increased intensity and mild bony distortion were found in 4 patients.. 3) In 4 patients with Ewing's sarcoma, markedly increased homogenous intensity with moderate bony distortion were found in 3 patients. Conclusively there were common findings in each 3 primary malignant bone tumors and $^{99m}Tc$-MDP bone scan was complemented with radiologic studies in differentiating primary malignant bone tumors.

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