• 대한물리치료과학회지
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• 제13권4호
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• pp.7-16
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• 2006

The purpose of this study was designed to find out the effectiveness of vertebral segment instability, muscle fatigue response on lumbar spine after apply lumbosacral stabilization exercise program to 4 patients with chronic low back pain and for 12 weeks. In this study, the lumbar spine motion with blind by MedX test machine and the difference of instability to lumbar vertebra segments in flexion, extension test of standing position and spinal load test(Matthiass Test) by Spinal Mouse. The stabilization exercise program was applied 2 times a week for 12 weeks in hospital and 2 times a day for 20 minutes at home. The results of the present study were as follows: 1. Instability test of lumbar vertebra segment is 2 type differential angle test between vertebrae segment and loading test of spine(matthiass) by Spinal Mouse. It appeared to improve stability of segments in sagittal plane after program. So lumbar spine curve increased lordosis toward anterior and was improved of the lumbar spine flexibility in flexion and extension. Specially, in matthiass test, ( - ) value was increased between lumbar vertebra segment when was the load on spine. And so stability improved after program. 2. Fatigue response test(FRT) results, in male, was raised muscle fatigue rate during increase weight, on the other hand female appeared lower than male. As a results, lumbosacral stabilization exercise was aided to improvement of lumbar spine vertebra segments stabilization. Spine instability patients will have a risk when in lifting a load or working with slight flexion posture during the daily of living life and it is probably to increase recurrence rate. Thus, not only lumbar extension muscle strength but also stability of vertebra segments in lumbar spine may be very important.

• 대한정형도수물리치료학회지
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• 제16권2호
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• pp.28-33
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• 2010

Purpose : The purpose of this study is to find out the effects of Joint and Muscle Mobilization applied to the patients with Degenerative Disc Disease by measuring, assessing and analyzing the changes on pain and in flexibility before and after Joint and Muscle Mobilization. Method: Surveyed from June. 2008 to July. 2009 were 10 patients suffering from DDD. Joint and muscle Mobilization were applied for 15 minutes in total. After Joint Mobilization, the Oswestry Disability Index(ODI), Visual Analogue Scale (VAS) were used to measure the degree of the pain on the patients. After Joint and Muscle Mobilization, Spinal-$Mouse^{(R)}$ were used to measure the degree of the flexibility on the patients. Result: 1. There was significant decrease in the numerical values of the VAS & ODI after Joint and Muscle Mobilization (p<0.01). 2. There was significant decrease in the degree of the pain on the patients after Joint and Muscle Mobilization (p<0.01). 3. From the analysis into DDD in the degree the pain before and after Joint and Muscle Mobilization with Paired Sample T-test, It became evident that the longer the period of treatment was, the higher the pains decreases drastically, while significant difference was shown in the flexibility and the degree of the pain (p<0.01). Conclusion: Summed up, it can be generally concluded that Joint and Muscle Mobilization is an effective treatment to rid the patients with DDD of pains safely and promptly. It is, therefore, suggested to continue and expand the study on the cure of DDD and to motivate patients. Joint and Muscle Mobilization is considered as safest and most efficient pain remedy.

• 한국전문물리치료학회지
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• 제29권3호
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• pp.235-240
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• 2022

Background: A spinal extension and intensive rehabilitation program reduced the symptoms and pain of kyphosis, and improved function. Objects: This study aimed to demonstrate the effect of a spine extension device on the degree of thoracic kyphosis and extension angles, confirm reduction of the kyphosis angle and an increase in flexibility. Methods: Thirteen adults were enrolled in the experiment, using the spine extension device, which was set to passively extend the spine. The angle between the spinous process of the first thoracic vertebra and the spinous process of the twelfth thoracic vertebra was measured by dual inclinometer before and after using the spine extension device. Results: In the static posture, the thoracic kyphosis decreased after using the spine extension device in the thoracic extension posture, and there was a significant difference (p < 0.05); thoracic extension angle increased with statistical significance (p < 0.05). Conclusion: In this study, the thoracic kyphosis angle and thoracic extension angle of the subjects before and after using spine extension device was compared and analyzed, which proved that the spine extension device can effectively improve the mobility of spinal extension.

• 대한기계학회논문집A
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• 제30권12호
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• pp.1509-1517
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• 2006

The intervertebral fusion was reported to increase the degeneration of the neighboring region. Recently, a new technique of inserting an interspinous process fixator has been introduced to minimize the degenerative change in the lumbar spine. This study analyzed biomechanical effects of the fixator in the lumbar spine, and designed a new prototype to improve flexibility of the fixator with a reduced size. The evaluation was based on the displacement, stiffness and von-Mises stress obtained from the mechanical test and finite element analysis. A finite element lumbar model of L1 to L5 was constructed. The finite element model was used to analyze intervertebral fusion, insertion of a commercial fixator and a new prototype. The range of motion of intervertebral segments and pressures at vertebral discs were calculated from FEA. The results showed that the stiffness of the prototype was reduced by 32.9% than that of the commercial one.

• 복식
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• 제62권7호
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• pp.205-219
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• 2012

The purpose of this study is to develop comfortable patient gown for spinal surgery patients. The results of the survey confirmed inconveniences and problems with the current gown, and a new gown style was recommended. The recommended changes addressed design, pattern, and materials. The final experimental design for the top of the new patient gown is a wrap style that moves the center opening of the gown to the side and enables patients to control the length of the sleeves by attaching two snaps. The cutting line is aligned with the back brace location, and the issue of repeated bunching of the gown material by the brace was solved by substituting 100% knitted structure fiber. The sleeve length can be adjusted with snaps on the sleeve cap and hem. When lifting up the gown for treatment on specific areas of the body, doctors open the edge of the right side of the gown in order to lift up the top. The bottom of the new patient gown was made from 100% cotton knitted structure fiber, and it enables patients to control the length of pants by attaching two snaps on the side. The results of an on-site dressing suitability evaluation and a flexibility evaluation with respect to dressing/undressing indicated that the new patient gown was much better received than the existing gowns (A and B). Our hypothesis regarding new patient gowns was supported in both the fit and design categories.

• 대한정형도수물리치료학회지
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• 제4권1호
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• pp.7-20
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• 1998

Activity of the trunk muscles is essential for maintaining stability of the lumbar spine because of the unstable structure of that portion of the spine. The central nervous system deals with stabilization of the spine by contraction of the abdominal and multifidus muscles in anticipations of reactive forces produced by limb movement. Recent evidence indicates that the lumbar multifidus muscle and transversus abdominis muscle may be involved in controlling spinal stability. Stabilization training in neutral spine is an integrated approach of education in proper posture and body mechanics along with exercise to improve strength, flexibility, muscular and cardiovascular endurance, and coordination of movement.

• The Korean Journal of Pain
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• 제1권2호
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• pp.203-206
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• 1988

1) 통증치료 목적으로 실시한 308경막외 천자 중 원치 않는 경막천자를 일으킨 경우가 5회(1.6%)있었다. 2) 경막천자를 일으킨 5예 중 2예에서는 뇌척수액이 흡입되어 천자당시 알 수 있었으나 나머지 3예에서는 국소마취제 주사 후에 나타나는 척추마취 증상으로 경막천자를 추축할 수 있었다. 3) 뇌척수액이 흡입되지 않은 3예 중 1예에서는 추궁절제술 후 주위조직의 유착으로 인한 경막외강의 신축성 소실 또는 잠재공간의 감소를 일으켜 경막외 주사시의 압력에 의해 경막손상을 입었으리라는 추측이 가능하였고 1예에서는 조직편에 의한 주사침의 폐쇄로 실질적인 경막천자후 뇌척수액 흡입이 음성이었던 것으로 추출되었다. 나머지 1예에서는 경막천자를 의심할만한 이유가 없었으나 나타나는 증상에 의해 경막천자를 의심하였다. 이상의 결과로 보아 경막외 차단 중에는 숙련된 술자에 의해서도 원치않는 경막차단이 일어날 수 있고 특히 뇌척수액의 흡입이 음성인 경우에도 경막천자가 가능하므로 술자에게는 고위 및 전척추마취에 대한 충분한 예비지식 및 응급소생술을 포함한 대처방안이 미리 마련되어 있어야 하고 환자에게 시술전 그 가능성을 인지시켜야 하며 외래 환자의 경우 보호자와 동반 하지 않은 경우는 시술을 될 수록 피하는 것이 좋을 것으로 사료된다.

• Journal of Korean Neurosurgical Society
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• 제62권5호
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• pp.603-609
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• 2019

Objective : The purpose of this retrospective study was to determine which of the proximal adjacent segment disease (ASD) and distal ASD was more prevalent and what parameters is more related to ASD in proximal levels and distal levels after more than 2 levels fusions. Methods : The medical records were reviewed retrospectively for 856 cases. A total of 66 cases of ASD were enrolled. On preop magnetic resonance imaging, disc degeneration was measured at the upper and lower parts of surgically treated levels and confirmed by the commonly used Pfirrmann grade. Segmental flexibility in sagittal plane was embodied in segment range of motion (ROM) obtained through flexion and extension X-ray before surgery. Coronal angle was recorded as methods Cobb's angle including fusion levels preoperatively. For the comparison of categorical variables between two independent groups, the chi-square test and Fisher exact test were performed. Results : Proximal ASD and distal ASD were 37/856 (4.32%) and 29/856 (3.39%), respectively. The incidence of proximal ASD was relatively high but insignificant differences. In comparison between ASD group and non ASD group, proximal Pfirmman was higher in proximal ASD and distal Pfirmman was higher in distal ASD group (p=0.005, p<0.008, respectively). However, in the ROM, proximal ROM was higher in proximal ASD, but distal ROM was not different between the two groups (p<0.0001, p=0.995, respectively). Coronal angle was not quite different in both groups (p=0.846). Conclusion : In spite of higher frequency in ASD in proximal level in spinal fusion, it is not clear that incidence of ASD in proximal level is not higher than that of distal ASD group in more than 2 level thoracolumbar fusions. Not only Pfirrmann grade but also proximal segmental ROM is risk factor for predicting the occurrence of ASD in patients more than 2 level of thoracolumbar spine fusion operation excluding L5S1.

• 대한인간공학회지
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• 제19권2호
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• pp.87-99
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• 2000

This study aims to examine a fuzzy logic-based human expert EMG prediction model (FLHEPM) for predicting electromyographic responses of trunk muscles due to manual lifting based on two task (control) variables. The FLHEPM utilizes two variables as inputs and ten muscle activities as outputs. As the results, the lifting task variables could be represented with the fuzzy membership functions. This provides flexibility to combine different scales of model variables in order to design the EMG prediction system. In model development, it was possible to generate the initial fuzzy rules using the neural network, but not all the rules were appropriate (87% correct ratio). With regard to the model precision, the EMG signals could be predicted with reasonable accuracy that the model shows mean absolute error of 8.43% ranging from 4.97% to 13.16% and mean absolute difference of 6.4% ranging from 2.88% to 11.59%. However, the model prediction accuracy is limited by use of only two task variables which were available for this study (out of five proposed task variables). Ultimately, the neuro-fuzzy approach utilizing all five variables to predict either the EMG activities or the spinal loading due to dynamic lifting tasks should be developed.

• Journal of Korean Neurosurgical Society
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• 제57권1호
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• pp.61-64
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• 2015

A number of dynamic stabilization systems have been used to overcome the problems associated with spinal fusion with rigid fixation recently and the demand for an ideal dynamic stabilization system is greater for younger patients with multisegment disc degeneration. Nitinol, a shape memory alloy of nickel and titanium, is flexible at low temperatures and regains its original shape when heated, and the Nitinol shape memory loop (SML) implant has been used as a posterior tension band mostly in decompressive laminectomy cases because the Nitinol implant has various characteristics such as high elasticity and a tensile force, flexibility, and biological compatibility. The reported short-term outcomes of the application of SMLs as posterior column supporters in cervical and lumbar decompressive laminectomies seem to be positive, and complications are minimal except for the rare occurrence of pullout and fracture of the SML. However, there was no report of neurological complications related to neural compression in spite of the use of the loop of SML in the epidural space. The authors report a case of delayed development of radiating pain caused by subsidence of the SML resulting epidural compression.