• Physical Therapy Korea
• /
• v.4 no.2
• /
• pp.18-35
• /
• 1997

The purpose of this study were to determine causes of low back pain in bus drivers who usually work in prolonged sitting position and to find the relationship of back pain with general characteristics and work environmental characteristics, stress symptoms, to com맹re lordosis angle of habitual driving posture and resting posture in low back pain group and non-low back pain group, and to use this result as a basis for improvement of work environment and comprehensive rehabilitative management of low back pain. Ninety-eight bus drivers were selected from the membership of an urban transit union in Seoul. These informations were collected from May 1, 1997 to May 25, 1997 by means of structured questionnaires and X-ray findings. These data were analyzed by $x^2$ test, t-test, logistic regression using SAS. The major results were as follows: 1. Of the respondents, 66.3% of bus drivers were found to be experiencing back pain. 2. Of the respondents of low back pain groups, 78.5% reported that major cause of low back pain was due to prolonged sitting. 3. The group with experiences of frequent or continuous vibration had more low back pain (p<0.05). There were no significant differences among other work environmental factors. 4. Average stress score was significantly higher in the group with low back pain than in the group without low back pain (p<0.05). 5. The results of the logistic regression analyses were statistically significant vibration from seat and stress score among the risk factors (p<0.05). 6. Averaged lordosis angle of habitual driving posture was $7.6{\pm}14.9$ degrees in low back pain group, $16.5{\pm}8.7$ degrees in non-low back pain and averaged lordosis angle of resting sitting posture was $10.8{\pm}13.7$ degrees in low back pain, $18.9{\pm}9.6$ degrees in non-low back pain group but the difference in mean lordosis angles of two groups was not statistically significant. The results of this study indicate that professional drivers developed chronicity of low back pain due to unfit seat, poor habitual posture and stress from vibration or other risk factors. Therefore, there is need to improve work environment, i.e. enough resting, to set a seat to support lumbar spine properly and to provide comprehensive rehabilitation program including early diagnosis, proper treatment and education for self help management.

• The Journal of the Society of Korean Medicine Diagnostics
• /
• v.10 no.2
• /
• pp.121-131
• /
• 2006

Background : As each human has a look in the face of oneself, he or she has a look of him or herself in the shape of the body also. And for the shape of the body which gives a big clue in diagnosis in musculoskeletal disorders. Therefor many means are used and developed for diagnosis through body shape or posture analysis for musculoskeletal disorders. X-ray, CT, MRI has been used for diagnosis through image in this way to tell about the inside of the human body. On the other side, moire topography was used for information about the exterior of the human body, but yet only minimal information such as the number of contour lines in each side was available. Therefor there were a few studies to use moire topography or other methods to get information about the surface of the human body in numeric values. The instrument used in this study which is a laser projection moire, is another trial to get numeric data about the surface of the human body. The instrument is composed of laser projector and a computer software to recompose and analyse the image data into depth, height, angle and length. Objectives : The study was focused on whether the instrument is reliable for clinic use, and to seek the proper environment and posture for the examination, and among the data the software provides, which items are more reliable and useful. Methods : For reproductivity and repeatability, 4 testers tested 2 persons. And to how if the body shape changes according to the posture and which posture gives the most reliable data, the test was performed in 6 different positions. Results : Result, the instrument showed sufficient repeatability and reproductivity for clinical use. And among the items the software provides, the length of the back, the angle of the back in the sagittal and coronal plane showed reliable results. And there was difference in the results according to the posture, and Therefor, in following studies using this instrument or similar type of posture analysing instruments, the length of the back, the angle of the back in the sagittal and coronal plane could be reliable item to use.

• Journal of Korean Neurosurgical Society
• /
• v.65 no.1
• /
• pp.64-73
• /
• 2022

Objective : To evaluate the surgical outcomes of partial pedicle subtraction osteotomy (PPSO) in patients with thoracolumbar fractures and compare the outcomes of PPSO for burst fractures with those for posttraumatic kyphosis (PTK). Methods : From June 2013 to May 2019, 20 consecutive adult patients underwent PPSO for thoracolumbar fractures at the levels of T10 to L2. Of these patients, 10 underwent surgery for acute fractures (burst fractures), and 10 for sequelae of thoracolumbar fractures (PTK). Outcomes of PPSO were evaluated and compared between the groups. Results : Twenty patients (each 10 patients of burst fractures and PTK) with a mean age of 64.7±11.1 years were included. The mean follow-up period was 21.8±11.0 months. The mean correction of the thoracolumbar angle was -34.9°±18.1° (from 37.8°±20.5°preoperatively to 2.8°±15.2° postoperatively). The mean angular correction at the PPSO site was -38.4°±13.6° (from 35.5°±13.6° preoperatively to -2.9°±14.1° postoperatively). The mean preoperative sagittal vertical axis was 93.5±6.7 cm, which was improved to 37.6±35.0 cm postoperatively. The mean preoperative kyphotic angle at the PPSO site was significant greater in patients with PTK (44.8°±7.2°) than in patients with burst fractures (26.2°±12.2°, p=0.00). However, the mean postoperative PPSO angle did not differ between the two groups (-5.9°±15.7° in patients with burst fractures and 0.2°±12.4° in those with PTK, p=0.28). The mean angular correction at the PPSO site was significantly greater in patients with PTK (-44.6°±10.7°) than in those with burst fractures (-32.1°±13.7°, p=0.04). The mean operation time was 188.1±37.6 minutes, and the mean amount of surgical bleeding was 1030.0±533.2 mL. There were seven cases of perioperative complications occurred in five patients (25%), including one case (5%) of neurological deficit. The operation time, surgical bleeding, and complication rates did not differ between groups. Conclusion : In cases of burst fracture, PPSO provided enough spinal cord decompression without corpectomy and produced sagittal correction superior to that achieved with corpectomy. In case of PTK, PPSO achieved satisfactory curve correction comparable to that achieved with conventional PSO, with less surgical time, less blood loss, and lower complication rates. PPSO could be a viable surgical option for both burst fractures and PTK.

• Korean Journal of Radiology
• /
• v.23 no.6
• /
• pp.638-648
• /
• 2022

Objective: The study aimed to investigate the diurnal variation in cervical disc hydration and its relationship with cervical degeneration. Materials and Methods: C3-C7 discs of 86 prospectively enrolled participants (37 males, 49 females; mean age ± standard deviation, 23.5 ± 2.5 years) were assessed using T2 mapping in the morning and evening. All discs were stratified by Miyazaki grade or C2-C7 Cobb angle and T2 values (T2). The degree of diurnal T2 variation (T2-DDV), defined as (morning T2 - evening T2)/morning T2 x 100%, was measured for the entire disc, annulus fibrosus (AF), nucleus pulposus (NP), and endplate zones. Results: T2 of the entire disc decreased significantly after the daytime load (p < 0.001), with a T2-DDV of 13.3% for all discs and 16.0%, 12.2%, and 13.0% for healthy (grade I), mild degenerative (grade II), and advanced degenerative (grade III/IV) discs, respectively. T2 of regional NPs and AFs decreased significantly from morning to evening (p ≤ 0.049) except in the healthy anterior inner AF (p = 0.092). Compared with healthy discs, mild degenerative discs displayed lower T2 and T2-DDV in regional NPs (p < 0.001). Advanced degenerative discs showed higher T2-DDV in the anterior inner AF compared with healthy discs (p = 0.050). Significant diurnal T2 changes in the endplate zones were observed only in healthy discs (p = 0.013). Cervical discs in the low Cobb angle group showed higher T2-DDV in the anterior AFs and anterior NP and lower T2-DDV in the posterior AF than those in the high Cobb angle group (p ≤ 0.041). Conclusion: This study characterized the diurnal variation in hydration of the cervical discs as assessed using T2 mapping and revealed early chemo-mechanical coupling dysfunction in degenerating discs. Cervical sagittal alignment on MRI can affect the diurnal stress patterns of the cervical discs. T2 mapping is sensitive to disc biomechanical dysfunction and offers translational potential from biomechanical research to clinical application.

• Journal of rehabilitation welfare engineering & assistive technology
• /
• v.4 no.1
• /
• pp.53-61
• /
• 2010

In this paper, We investigated the characteristic analysis of flexibility and muscle strength for exercise to verify capacity in rehabilitation exercise of lumbar using lumbar strengthen exercise instrument. We have experiment in 20th years man and woman who are 20 subject with no medical history, we divided subjects into control group with no exercise and training group with lumbar strengthen exercise. We used Hi-Spine(Medicalscience.korea) also, provided exercise 40 minute a day, three days a week and progressed total four weeks. Moreover in our experiment, subjects exercised four postural position as lay down, sit, stand and stretch each ten minute. We measured trunk extension backward, trunk flexion forward, evaluation of based physical fitness and lumbar joint torque. The reults have shown that there more improved all for flexibility, based physical fitness and lumbar joint torque in training group than control group. We indicated that by rotating 3-D axis movement flatform of exercise instrument, muscle spindle in subject have been stimulated and these rotation direction and angle caused muscle tonus and contraction that makes muscle, flexibility and based physical fitness improve more. Our study can be used rehabilitation exercise program to aged people and patient with lumbar injury.

• Korean Journal of Applied Biomechanics
• /
• v.31 no.4
• /
• pp.308-313
• /
• 2021

Objective: The purpose of this study was to investigate the effect of different kettlebell mass (30%, 40%, and 50% of the body mass) on kinematics and kinetic variables of kettlebell swing. Method: Total of 16 healthy male who had at least 1 year of kettlebell training experience were participated in this study (age: 31.69 ± 3.46 yrd., height: 173.38 ± 4.84 cm, body mass: 74.53 ± 6.45 kg). In this study, a 13-segments whole-body model (upper trunk, lower trunk, pelvis, both side of forearm, upperarm, thigh, and shank) was used and 26 reflective markers were attached to the body to identify the segments during the movement. A 3-dimensional motion analysis with 8 infrared cameras and 4 channeled EMG was performed to find the effect of kettlebell mass on its swing. To verify the kettlebell mass effect, a one-way ANOVA with a repeated measure was used and the statistical significance level was set at 𝛼=.05. Results: Firstly, in all lower extremity joints and thoracic vertebrae, a statistically significant change in angle was shown according to an increase in kettlebell mass during kettlebell swing (p<.05). Secondly, in both the up-swing and down-swing phases, the knee joint and ankle joint ROM showed a statistically significant increase as the kettlebell mass increased (p<.05) but no statistically significant difference was found in the hip joint and thoracic spine (p>.05). Lastly, the hamstrings muscle activity was statistically significantly increased as the kettlebell mass increased during up-swing phases (p<.05). Also, as the kettlebell mass increased in P4 of the down swing phase, the gluteus maximus showed a statistically significantly increased muscle activation, whereas the rectus femoris showed a statistically significantly decreased muscle activation (p <.05). Conclusion: As a result of this study, hip extension decreased and knee extension increased at 40% and 50% of body mass, and the spine also failed to maintain neutrality and increased flexion. Also, when kettlebell swings are performed with 50% of body mass, synergistic muscle dominance appears over 30% and 40% of body mass, which is judged to have a risk of potential injury. Therefore, it is thought that for beginners who start kettlebell exercise, swing practice should be performed with 30% of body mass. In addition, even in the case of experienced seniors, as the weight increases, the potential injury risk may increase, so it is thought that caution should be exercised when performing swings with 40% and 50% of body mass. In conclusion, it is thought that increasing the weight after sufficiently training with 30% of the weight of all subjects performing kettlebell swing is a way to maximize the exercise effect as well as prevent injury.

• Journal of the Korea Academia-Industrial cooperation Society
• /
• v.21 no.12
• /
• pp.43-51
• /
• 2020

This study examined how the eight-week spinal stabilization exercise program affects the cervical disability index, postural balance ability, and body shape change. The exercise program performed 60 minutes of spinal stabilization exercise three times a week for eight weeks. Sixteen patients with chronic neck pain, who complained of neck pain for six months, were classified into exercise group (n=8 patients) and control group (n=8 patients). The results before and after the eight-week exercise program were observed. Significant differences were observed in the time, group, and interaction of the neck disability index (p<.05). The balance ability showed significant interaction effects between the groups and periods (p<.05). Significant differences were noted in the timing and interaction in the pelvic inclination angle in posture change (p<.05), and there were significant differences in the group, timing, group, and interaction in the cervical and shoulder position angles (p<.05). The above results showed that the spinal stabilization exercise significantly improved the cervical disability index, balance ability change, and body shape change in patients with chronic neck pain. Future studies will analyze the specific changes in spinal structure through radiographic imaging to increase the validity of spinal stabilization exercise.

• Journal of radiological science and technology
• /
• v.33 no.1
• /
• pp.19-24
• /
• 2010

The aim of this study was to evaluate the change of bone mineral density according to distal radius rotation and the correlations of the lowest BMD measured by DXA at the lumba versus distal radius. The eleven males were projected distal radius by DR X-ray and the measurement of BMD by DXA of the appropriate position of the forearm were performed on 21 males. The healthy 11 and 21 volunteers without any history of operations, anomalies, or trauma were enrolled. The experiment was performed by two methods. First, The DR X-ray was measured distal radius of 11 males in pronation and supination with three, six and nine degrees, including a neutral position. The ROI was measured by the m-view program on the PACS monitor. Second, The DXA was measured distal radius of 21 males in pronation and supination with five and ten degrees, including a neutral position to evaluate the changes of BMD according to the rotation. A correlation of the BMD in the distal radius with BMD that lumbar spine was performed, along with analysis of the data by SPSS 12.0v. The mean rotation angle of the distal radius about eleven males DR X-ray measured $7^{\circ}$ of pronation (82%, n = 9), $6^{\circ}$ of supination and $0^{\circ}$ of neutral of (9%, n = 1), The total average rotation angle in 11 male was $5.1^{\circ}$ of pronation. The rotation angle of the distal radius about twenty one males on DXA measured $7.2^{\circ}$ of pronation (43%, n = 9), $7^{\circ}$ of supination (24%, n = 5), and $0^{\circ}$ of neutral (33%, n = 7), The total average rotation angle in 21 people was $4.1^{\circ}$ of pronation. The correlation of the analysis of lumba and distal radius were r = 3.0, p = 0.18. consequently, The correlation was not significance. Because BMD of lumba was not coverd for BMD of the distal radius, with a neutral position, Pronation is needed for BMD in the distal radius with the rotation angle measuring at the lowest BMD. the rotation angle about five degrees of pronation of the distal radius is recommended.

• Journal of Acupuncture Research
• /
• v.17 no.4
• /
• pp.79-87
• /
• 2000

Objectives : To evaluate the findings useful for differential diagnosis and associated abnormaiities of isthmic spondylolisthesis and degenerative spondylolisthesis on CT. Materials and methods : We reviewed retrospectively the CT images of 65 patients who were diagnosed spondylolisthesis during 3 years period. Our technique was 5mm slices at 5mm intervals with gantry angle to parallel the interspaces. Also reformatted sagittal views were taken. 41 patients were isthmic spondylolisthesis and 24 patients were degenerative spondylolisthesis. Resuits : Isthmic spondylolisthesis. 1. Isthmic type was more common at L5-S1. 2. The degree of anterior displacement was grade I and II. 3. The plane of defect was more horizontal than the usual facet joint. 4. The defect had an irregular shape. 5. Medial aspect of bone just anterior to defect had a small round prominence. 6. Anteroposterior elongation of the spinal canal was common. 7. Pseudobulging disk was common. 8. The most common associated abnormality was a HNP at the upper level of the defect. Degenerative spondylolisthesis. 1. Degenerative type was more common at L4-5. 2. The degree of anterior disptacement was grade I and II. 3. The Plane of facet joint was oriented obliquely instead of horizontally. 4. The posterior facet(inferior facet of superior vertebra) was anteriorly displaced. 5. Bony spur of the posterior portion of anterior facet was seen. 6. The facet joints often contain gas(vaccum phenomenum). 7. The most common associated abnormality was a HNP at the level of the displacement. Conclusions : CT is a highly accurate and most sensitive technique for recognition, differential diagnosis of isthmic and degenerative types and the detection of associated abnormalities.

• Journal of Korean Neurosurgical Society
• /
• v.54 no.3
• /
• pp.194-200
• /
• 2013

Objective : Lumbar spine stenosis (LSS) can result in symptomatic compression of the neural elements, requiring surgical treatment if conservative management fails. Minimally invasive surgery has come to be more commonly used for the treatment of LSS. The current study describes outcomes of bilateral microdecompression by unilateral or bilateral laminotomy (BML) for degenerative LSS after a minimum follow-up period of 3 years and investigates factors that result in a poor outcome. Methods : Twenty-one patients who were followed-up for at least 3 years were included in this study. For clinical evaluation, the Japanese Orthopedic Association (JOA) scoring system for low back pain was used. The modified grading system of Finneson and Cooper was used for outcome assessment. Radiographic evaluation was also performed for spondylolisthesis, sagittal rotation angle, and disc height. Results : Twenty-one patients (10 men, 11 women) aged 53-82 years ($64.1{\pm}8.9$ years) were followed-up for a minimum of 3 years (36-69 months). During follow-up, two patients underwent reoperation. Average preoperative JOA score and clinical symptoms, except persistent low back pain, improved significantly at the latest follow-up. There were no significant differences in radiological findings preoperatively and postoperatively. Thirteen patients (61.9%) had excellent to fair outcomes. Conclusion : BML resulted in a favorable and persistent outcome for patients with degenerative LSS without radiological instability over a mid-term follow-up period. Persistent low back pain unrelated to postoperative instability adversely affects mid-term outcomes.