• The Journal of Korean Physical Therapy
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• v.33 no.2
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• pp.76-83
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• 2021

Purpose: This study examined the effects of applying the Pilates reformer exercise to 17 adult women on the alignment of the standing posture. Methods: The subjects performed a Pilates reformer exercise for 60 minutes a day, three times a week, for a total of eight weeks. The Pilates reformer exercise consisted of five types: 1) lower and lift, 2) hundred, 3) plow, 4) airplane, and 5) twist. The standing posture alignment in the sagittal and frontal planes was measured using exbody 9100MOMI musculoskeletal analysis equipment. Results: A comparison of before and after the exercise using paired t-test revealed a significant decrease in the difference between the horizontal inclination and the vertical height that approached zero after the intervention in the frontal plane of anterior and posterior standing postures (p<0.05), and the lateral standing posture in the sagittal plane. In addition, the difference between the horizontal inclination and the vertical height decreased and approached zero after the intervention (p<0.05). Conclusion: The Pilates reformer exercise had a positive effect on the alignment of the standing posture.

• Journal of Korean Neurosurgical Society
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• v.60 no.5
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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.

• Physical Therapy Korea
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• v.9 no.1
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• pp.53-61
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• 2002

The purpose of this study was to compare the body alignment during standing on level and wedge board. Twenty healthy college students (8 females, 12 males) were evaluated in this study. Diagnostic contourline potographic imaging system (Model JTC-1, Jodang Trading Co.) was used to measure body alignment. Sagittal and frontal plane images were used to analyze the body alignment. The result showed that the cervical and lumbar lordotic curve significantly decreased during standing on wedge board when compared with standing on level. On the other hand, thoracic kyphosis significantly increased during standing on wedge board. There was no significant difference in body alignment according to gender, weight, and height. Clinically, patients with low back pain and severe lordosis may be affected by heel wedge. Further study is needed to identify whether the standing on wedge board can change the body alignment in patients with low back pain and spinal deformity.

• Korean Journal of Applied Biomechanics
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• v.31 no.3
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• pp.168-175
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• 2021

Objective: To investigate the static and dynamic analysis of ankle joint complex between subjects with chronic ankle instability (CAI) and healthy controls. Method: A total of 38 subjects and CAI group (N=19) and healthy control (N=19) participated in this first study. Variables that were measured in this study were as follows: 1) Subtalar joint axis inclination and deviation 2) Rearfoot angle 3) Navicular drop test 4) Heel alignment view in alignment analysis. Intra Correlation Coefficient (ICC) is used for reliability. A secondary 17 subjects are recruited including 9 of CAI and healthy for gait analysis between group. Lower extremity sagittal, frontal, and transverse kinematics were measured. All data were analyzed to ensemble curve analysis. Results: 1) There were statistically significant differences in standing rearfoot, navicular drop, heel alignment view, subtalar joint (STJ) inclination and deviation. 2) Only in sagittal, meaningful difference is showed during walking in gait analysis. Conclusion: Morphological problem can affect ankle sprain in aspect of structure with no relation to compensation of neuromuscular.

• Journal of Korean Neurosurgical Society
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• v.42 no.2
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• pp.112-117
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• 2007

Objective : Kyphoplasty and vertebroplasty are two minimally invasive procedures for osteoporotic vertebral compression fractures. The purpose of this retrospective study was to compare the radiological findings and clinical outcomes between two procedures. Methods : Osteoporotic vertebral fractures were treated in 76 vertebrae, using kyphoplasty (n=35 vertebrae) and using vertebroplasty (n=41 vertebrae). Fractured vertebral bodies were diagnosed by correlating the clinical symptoms with radiologic study. The responses of pain symptoms were measured by a self-reported Visual Analog Scale (VAS) score. Plain X-rays were checked preoperatively and postoperatively at admission and 6 months. The vertebral body height and kyphotic angle were measured to assess the reduction of the sagittal alignment. Results : The mean pain scores were decreased significantly for both procedures postoperatively, but there were no significant differences between two groups. Kyphoplasty led to a significant reduction of the vertebral body height and improvement of kyphotic angle. There were no neurological deficits after kyphoplasty, but one patient experienced paraparesis after vertebroplasty. During the 6 months follow-up both procedures provided stabilization of the sagittal alignment. Conclusion : Kyphoplasty and vertebroplasty are considered effective minimally invasive techniques for the stabilization of osteoporotic vertebral body fractures, leading to a statistically significant reduction in pain. Kyphoplasty significantly restore sagittal alignment. Also, complications and the incidence of bone cement leakage are significantly lesser than vertebroplasty. Therefore, kyphoplasty seems to be reasonable procedure for osteoporotic vertebral body compression fractures when medical treatment fail.

• Journal of Korean Neurosurgical Society
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• v.53 no.6
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• pp.356-369
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• 2013

Objective : We performed a retrospective analysis of medical records and radiographic images of patients who never underwent spinal treatment including diagnosis. The objective of this study is to explain the biomechanical and physiologic characteristics of cervical alignment related to thoracic inlet angle including T1 slope changes in each individual. Methods : We reviewed the cervical CT radiographs of 80 patients who visited ENT outpatient clinic without any symptom, diagnosis and treatment of cervical spine from January 2011 to September 2012. All targeted people were randomized without any prejudice. We assessed the data-T1 slope, Cobb's angle C2-7, neck tilt, sagittal vertical axis (SVA) C2-7 and thoracic inlet angle by the CT radiographs. Results : The relationships between each value were analyzed and we concluded that Cobb's angle C2-7 gets higher as the T1 slope gets higher, while the SVA C2-7 value decreases. Conclusion : We propose that the T1 slope is background information in deciding how much angle can be made in the cervical spinal angle of surgical lordotic curvature, especially severe cervical deformity.

• The Journal of Korean Physical Therapy
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• v.31 no.2
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• pp.122-128
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• 2019

Purpose: This study examined the effects of sagittal spinopelvic alignment on the clinical parameters, motor symptoms, and respiratory function in patients with mild to moderate Parkinson's disease (PD). Methods: This study was a prospective assessment of treated patients (n=28, Hoehn and Yahr (H&Y) stage 2-3) in a PD center. Twenty-eight subjects ($68.5{\pm}5.7yrs$) participated in this study. The clinical and demographic parameters, including age, sex, symptoms duration, treatment duration, and H&Y stage, were collected. Kinematic analysis was conducted in the upright standing posture with a motion capture system. A pulmonary function test (PFT) was performed in the sitting position using a spirometer. The motor symptoms were assessed on part III of the movement disorder society sponsored version of the unified Parkinson's disease rating scale (MDS-UPDRS). SPSS 18.0 was used to analyze the collected data. Results: The exceeding 12 degrees group of the lower trunk showed significantly higher on the clinical parameters than the below 12 degrees group. In addition, the exceeding 12 degrees group of the lower trunk showed a significantly lower forced expiratory volume at one second (FEV1) / forced vital capacity (FVC) (%) and 25-75% forced mid-expiratory flow (FEF) (L/s) than in the below group. On the other hand, there was no difference in the upper trunk and the cervical pelvis between the groups. Conclusion: These findings suggest that the sagittal balance in the lower trunk is related to the clinical parameters and respiratory function, but not the motor symptoms in patients with mild to moderate PD.

• Journal of Korean Neurosurgical Society
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• v.64 no.5
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• pp.677-692
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• 2021

Many studies have focused on pre-operative sagittal alignment parameters which could predict poor clinical or radiological outcomes after laminoplasty. However, the influx of too many new factors causes confusion. This study reviewed sagittal alignment parameters, predictive of clinical or radiological outcomes, in the literature. Preoperative kyphotic alignment was initially proposed as a predictor of clinical outcomes. The clinical significance of the K-line and K-line variants also has been studied. Sagittal vertical axis, T1 slope (T1s), T1s-cervical lordosis (CL), anterolisthesis, local kyphosis, the longitudinal distance index, and range of motion were proposed to have relationships with clinical outcomes. The relationship between loss of cervical lordosis (LCL) and T1s has been widely studied, but controversy remains. Extension function, the ratio of CL to T1s (CL/T1s), and Sharma classification were recently proposed as LCL predictors. In predicting postoperative kyphosis, T1s cannot predict postoperative kyphosis, but a low CL/T1s ratio was associated with postoperative kyphosis.

• Journal of International Academy of Physical Therapy Research
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• v.6 no.1
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• pp.809-814
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• 2015

This study was conducted to identify how a flexi-bar exercise influences body alignment and balance in adults who have asymmetry in their right or left body. In total, 20 participants were separated into the experimental group and the comparison group. Those in the experimental group participated in a flexi-bar exercise for 6 weeks and based on the coronal plane before and after exercise, their body alignment and balance were measured behind the body. The result was those who had participated in a flexi-bar exercise significantly improved their angle of acromion on both sides, the difference in the angle and height of the posterior superior iliac spine on both sides(p<.05), and the balance of the center sagittal plane(p<.05). Through this study, it could be said that participating in a flexi-bar exercise would improve postural alignment and balance of the shoulder and pelvis in adults with asymmetric posture.

• Korean Journal of Applied Biomechanics
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• v.28 no.2
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• pp.119-125
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• 2018

Objective: The purpose of this study was to compare the effect of different 12-week exercise programs for posture correction on postural alignment in elderly women. Method: The study included 36 elderly women who were randomly divided into 3 groups: Group A (core exercise, n=12), Group B (combined exercise, n=12), and Group C (Pilates exercise, n=12). Postural alignment was measured using 6 variables in frontal and sagittal planes. Two-way mixed analysis of variance was used to compare the effect of exercise program types on postural alignment and a paired t-test was used to compare differences in postural alignment after exercise. Results: The core exercise group showed statistically significant improvement (p<.05) in multiple upper and lower body postural alignment measurements. The combined exercise and Pilates exercise groups showed statistically significant improvement (p<.05) in upper body measurements alone. Conclusion: Core exercise, combined exercise, and Pilates exercise improved postural alignment in elderly woman through improvement in muscle strength and ligament flexibility around the spine and pelvis.