• Journal of Korean Neurosurgical Society
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• v.62 no.4
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• pp.442-449
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• 2019

Objective : Bone mineral density (BMD) is an important consideration during fusion surgery. Although dual X-ray absorptiometry is considered as the gold standard for assessing BMD, quantitative computed tomography (QCT) provides more accurate data in spine osteoporosis. However, QCT has the disadvantage of additional radiation hazard and cost. The present study was to demonstrate the utility of artificial intelligence and machine learning algorithm for assessing osteoporosis using Hounsfield units (HU) of preoperative lumbar CT coupling with data of QCT. Methods : We reviewed 70 patients undergoing both QCT and conventional lumbar CT for spine surgery. The T-scores of 198 lumbar vertebra was assessed in QCT and the HU of vertebral body at the same level were measured in conventional CT by the picture archiving and communication system (PACS) system. A multiple regression algorithm was applied to predict the T-score using three independent variables (age, sex, and HU of vertebral body on conventional CT) coupling with T-score of QCT. Next, a logistic regression algorithm was applied to predict osteoporotic or non-osteoporotic vertebra. The Tensor flow and Python were used as the machine learning tools. The Tensor flow user interface developed in our institute was used for easy code generation. Results : The predictive model with multiple regression algorithm estimated similar T-scores with data of QCT. HU demonstrates the similar results as QCT without the discordance in only one non-osteoporotic vertebra that indicated osteoporosis. From the training set, the predictive model classified the lumbar vertebra into two groups (osteoporotic vs. non-osteoporotic spine) with 88.0% accuracy. In a test set of 40 vertebrae, classification accuracy was 92.5% when the learning rate was 0.0001 (precision, 0.939; recall, 0.969; F1 score, 0.954; area under the curve, 0.900). Conclusion : This study is a simple machine learning model applicable in the spine research field. The machine learning model can predict the T-score and osteoporotic vertebrae solely by measuring the HU of conventional CT, and this would help spine surgeons not to under-estimate the osteoporotic spine preoperatively. If applied to a bigger data set, we believe the predictive accuracy of our model will further increase. We propose that machine learning is an important modality of the medical research field.

• Journal of Korean Neurosurgical Society
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• v.51 no.6
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• pp.383-387
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• 2012

Spinal epidural abscess, if especially caused by Brucellosis is a very rare disease which is usually a consequence of spondylodiscitis. The spinal column can be affected at any joint; however, the lumbar spine is the most common region, especially at the level of the L4-5 and L5-S1. The frequency of spinal involvement usually seen at the lumbar, thoracic and cervical spine respectively. As an occupational disease in farmers, veterinaries, butchers, laboratory staff and shepherds, brucellosis can also occur by direct contact to animals and infected materials or ingestion of raw cheese, milk or unpasteurized milk products. In this study, we presented two cases with cervical spinal epidural abscess caused by brucella melitensis, which was successfully treated by surgical approach. Initial treatment was combined with antibiotic therapy after the surgery for 3 months.

• The Journal of Korean Physical Therapy
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• v.16 no.4
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• pp.246-263
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• 2004

Some Students have suffer from a back pain due to their situations. So, the respondents were asked about their demographic factors, the existence of a back pain and environment. Their muscles power and spine were estimated 'Digimax and spine mouse'. The data were analyzed by SPSSWIN. 1. The degree of a back pain before exercise correlated with time of class in school, time of sitting a day. 2. Weakness of back muscles have suffer from a back pain. 3. After MTT(Medical training therapy) exercise, back muscle power increase of 2kg and back pain decrease.

• The Journal of Korean Physical Therapy
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• v.30 no.1
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• pp.1-7
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• 2018

Objective: This study aimed to determine the efficacy of flexible pole training combined with lumbar stabilization in improving trunk muscle activities and to investigate the difference according to posture in young adults. Methods: Twenty-five participants were enrolled in this study. The subjects were randomly allocated into either the flexible pole group or the rigid pole group. Participants performed lumbar stabilization exercises on quadruped and curl-up, with the flexible pole or rigid pole. Electromyography was used to assess the percent maximal voluntary isometric contracion (%MVIC) of the rectus abdominis (RA), external oblique (EO), internal oblique (IO), and erector spine (ES) muscles. All participants completed one 30-minute session per day, 3 days per week, for 6 weeks. The evaluation was performed before and 6 weeks after the training, and follow-up. The data were analyzed using independent t-test and two-way repeated measure analysis of variance to determine the statistical significance. Results: The flexible pole in curl-up showed significant differences in EO and IO muscle activities compared with the rigid pole. The flexible pole in quadruped showed significant differences in IO and ES muscle activities compared with the rigid pole. The RA, EO, IO, and ES muscle activities of both groups were significantly higher after 6 weeks training. Conclusion: The flexible pole in curl-up and quadruped showed an improvement in trunk muscle activation. The flexible pole combined with lumbar stabilization will be useful as an exercise tool to improve activity of trunk muscles.

• Journal of Korean Neurosurgical Society
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• v.61 no.5
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• pp.568-573
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• 2018

Objective : Thoracic pedicles have special and specific properties. In particular, upper thoracic pedicles are positioned in craniocaudal plane. Therefore, manipulation of thoracic pedicle screws on the left side is difficult for right-handed surgeons. We recommend a new position to insert thoracic pedicle screw that will be much comfortable for spine surgeons. Methods : We retrospectively reviewed 33 patients who underwent upper thoracic pedicle screw instrumentation. In 15 patients, a total of 110 thoracic pedicle screws were inserted to the upper thoracic spine (T1-6) with classical position (anesthesiologist and monitor were placed near to patient's head. Surgeons were standing classically near to patient's body while patients were lying in prone position). In 18 patients, a total of 88 thoracic pedicle screws were inserted to the upper thoracic spine with the new standing position-surgeons stand by the head of the patient and the anesthesia monitor laterally and under patient's belt level. All the operations performed by the same senior spine surgeons with the help of C-arm. Postoperative computed tomography scans were obtained to assess the screw placement. The screw malposition and pedicle wall violations were divided and evaluated separately. Cortical penetration were measured and graded at either : 1-2 mm penetration, 2-4 mm penetration and >4 mm penetration. Results : Total 198 screws were inserted with two different standing positions. Of 198 screws 110 were in the classical positioning group and 88 were in the new positioning group. Incorrect screw placement was found in 33 screws (16.6%). The difference between total screw malposition by both standing positions were found to be statistically significant (p=0.011). The difference between total pedicle wall violations by both standing positions were found to be statistically significant (p=0.003). Conclusion : Right-handedness is a problem during the upper thoracic pedicle screw placement on the left side. Changing the surgeon's position standing near to patient's head could provide a much comfortable position to orient the craniocaudal plane of the thoracic pedicles.

• Journal of International Academy of Physical Therapy Research
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• v.9 no.4
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• pp.1657-1662
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• 2018

This epidemiological study aims to determine the incidence, areas, severity, and time of occurrence of sports injuries in elite female rowing athletes who were training at the Jincheon National Training Center for a 1-year period from January 1st to December 31st, 2017. According to the daily injury reports form of the IOC, sport events, weight division, injured area, and cause of injury were recorded, and the following results were found. Upon comparing the incidence of sports injuries, there was a significant difference in weight of double scull athletes. In terms of sports, there was a significant difference between pair and athletes who played double skull. Injuries occurred most commonly in the lower extremity (40.5%), followed by the trunk (35.1%), upper extremity (24.3%). for all athletes in rowing. The knee and lumbar spine/lower back were the most common injury sites. More than 60% of all injuries were Level III, and injuries occurred most frequently during training, followed by weight training and then competition.

• Journal of the Korean Society of Physical Medicine
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• v.17 no.4
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• pp.93-101
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• 2022

PURPOSE: This study sought to investigate the effects of treadmill gait training combined with a thoracic mobility exercise on gait and balance in patients with stroke. METHODS: In this single-blinded, randomized, controlled, comparative study, a total of 20 patients at a rehabilitation hospital who had suffered a hemiplegic stroke were randomly assigned to the experimental group (treadmill gait training combined with a thoracic mobility exercise, n = 11) or control group (treadmill gait training without the thoracic mobility exercise, n = 9). All the participants underwent comprehensive rehabilitation therapy (5 × /week for 4 weeks). Additionally, the experimental group underwent 20 min of treadmill gait training combined with 10 min of a thoracic mobility exercise (3 × / week for 4 weeks) and the control group underwent the former but not the latter. Gait and balance were measured before and after the 4-week training. RESULTS: Significant improvements were observed in the 10-m walking test (10 MWT), timed up-and-go (TUG) test, center of pressure (COP) velocity, and COP length in the experimental group (p < .05). This group also showed a larger decrease in the 10 MWT and COP velocity than the control group (10 MWT, -3.02 sec vs. -1.68 sec, p < .05; COP velocity, -.07 mm/sec vs. .08 mm/sec, p < .05). CONCLUSION: Treadmill gait training, combined with the thoracic mobility exercise, could be effective in improving the gait and balance of stroke patients. It could also be more effective in improving walking speed and static balance than the treadmill gait training alone.

• Journal of rehabilitation welfare engineering & assistive technology
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• v.9 no.1
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• pp.45-51
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• 2015

This study was to verify effect on muscle strength of trunk and body composition for elderly according to spinal stability exercise with three dimension. We recruited forty elderly participants(twenties as training group, the other twenties as control group) over sixty five aged. The participant performed muscle strength estimation to exercise of eight direction using spinal stability training system. Also, we estimated body composition in participants using inbody 720. Trining group performed direction exercise(F, FOR, R, BOR, B, BOL, L, FOL) and multiple exercise with band exercise, strengthening gym and walking during thirty minute. But control group only performed multiple exercise without direction exercise. All training progressed three days a week for eight weeks. The results showed that muscle strength of trunk in training group increased significantly from 79.9 point to 85.6 point with reducement of body weight, body fat and BMI. However, control group showed a few exercise effect with increasement of amount of muscles and reducement of body fat without muscle strength of trunk. These results means that spinal stability exercise could be helped to prevent obey and fall of elderly caused by muscle strengthening and improving body composition. This could be applied to develop rehabilitation program efficiently based these data.

• Journal of Nutrition and Health
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• v.48 no.2
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• pp.149-156
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• 2015

Purpose: This study examined the effects of combined intervention of isoflavones and exercise on bone mineral density, bone mineral content, and biochemical bone markers. Methods: Forty rats were divided into four groups; Control, Isoflavones (IF), Isoflavones + Running (IFR), and Isoflavones + Swimming (IFS). All of the rats in this study were fed an experimental diet and deionized water ad libitum for nine weeks. Bone mineral density (BMD) and bone mineral content (BMC) were estimated using PIXImus (GE Lunar Co, Wisconsin.) in spine and femur nine weeks after feeding or training. Results: The combined intervention did not affect weight gain, mean food intake, or food efficiency ratio. The serum concentrations of ALP and osteocalcin were not significantly different by combined intervention. The urinary DPD crosslinks values were not significantly different by combined intervention. There were no significant differences in serum PTH, calcitonin, and estradiol among all groups. Spine BMD, spine BMC and femur BMC were not significantly different by combined intervention. However, femur BMD was significantly higher in the IFR group than in the control group. Compared with the control group, spine BMD, spine BMC, and femur BMD per weight were markedly increased in the isoflavones supplementation and combined intervention group. In addition, femur BMC per weight was significantly higher in the IFS group than in the control group. Compared with the isoflavones supplemented group, BMD and BMC were not significantly different by combined intervention. Conclusion: It can be concluded that isoflavones supplementation or combined intervention of isoflavone and exercise had a beneficial effect on spine and femur peak bone mass in growing female rats.

• Journal of Korean Physical Therapy Science
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• v.13 no.1
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• pp.29-38
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• 2006

The purpose of this study lies in finding out the effect that variation of pain and body deflection posture has an influence on the static spinal stabilization after having performed spinal stabilization exercise making degenerative disc disease patients an object over 8 weeks using $CENTAUR^{(R)}$, 3-D spinal stabilization training implement. Subjects : 61 of DDD patients were made as an object of this study (mean age: 45.46 years, SD: ${\pm}12.78$, range: 16-68), their average height was 161.87cm, average weight 60.70kg, 12 males and 49 females were involved. Methods: 8 various investigations were performed and varied values were compared with reinvestigation done after having exercised 8 weeks using 3-D $CENTAUR^{(R)}$. We used VAS(Visual Analog Scale) in order to see the variation of pain intensity, MOS(Modified Oswestry Scale) in order to see activities of daily life. Results VAS was lessened from 7.50 to 2.71, limitation of routine life(MOS) from 20.26 to 9.32, there were remarkable differences statistically(p<0.05). As a result of muscular investigation for static spinal stabilization by 8 variations of body deflection, muscular strength were all increased and there were remarkable differences statistically(p<0.05). Conclusions : It has been turned out that pain and limitation of daily life was lessened as a result of making 61 of degenerative disc disease patients exercised 8 weeks using $CENTAUR^{(R)}$, 3-D spinal stabilization training implement, deep muscular power was increased. Thus it has been turned out that 3-D lumbar stabilization exercise has an effect on the spinal muscles strengthening and alleviation of their pain for degenerative disc disease.