• Physical Therapy Korea
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• v.21 no.3
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• pp.73-79
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• 2014

The purposes of the current study were to (1) estimate the inter-rater agreement for visual assessment of scapular downward rotation (SDR), (2) develop the scapular downward rotation index (SDRI) as a method to measure SDR objectively and quantitatively, and (3) analyze the intra- and inter-rater reliability of the SDRI. Twenty subjects with scapular downward rotation syndrome (SDRS) were recruited for this study. The visual assessment and the measurement for the SDRI were conducted by two examiners in two sessions each. The SDRI [$(a-b){\div}a{\times}100$] is calculated with the measurement of two linear distances: One is a perpendicular distance from the root of the scapular spine to the thoracic mid-line (a), and the other is a perpendicular distance from the inferior angle of the scapula to the thoracic mid-line (b). Cohen's kappa coefficient was calculated to estimate the inter-rater agreement for visual assessment. Intra-class correlation coefficients (ICCs) with a 95% confidence interval (CI), the standard error of measurement, and minimal detectable differences were calculated to assess intra- and inter-rater reliability of SDR measurement using the SDRI. The results indicated that the kappa coefficient of inter-rater agreement for visual assessment was fair (${\kappa}=.21$). The intra-rater reliability of SDR measurement using the SDRI was excellent for examiner 1 (ICC=.92, 95% CI=.78~.97) and good for examiner 2 (ICC=.82, 95% CI=.55~.93). The inter-rater reliability was moderate (ICC=.73, 95% CI=.32~.89). These findings showed that SDR measurement using the SDRI for subjects with SDRS may be considered reliable and better than the visual assessment.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.12 no.2
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• pp.11-20
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• 2006

Low back pain is often experienced by many people who are in an activity flag. Their work and daily life are affected by low back pain. There are many causes of low back pain. Among those many causes, this study was focused on a relation between low back pain and the tightness of iliopsoas. The study was implemented by measuring the angles of the hip joints in subjects consisting of a 30 patients group, who had been selected from the outpatients at the Median Hospital, and a 30 people control group from the outpatients at the M Hospital and employee of M hospital. The patients group consists of the patients with low back pain who have intermittently or continuously experienced low back pain within the last 6 months. The group also had no symptom of spondylolysis or spondylolithesis and no muscular abnormality in terms of pathology without any experience of disc or spine fusion operation. The control group consisted out of persons who had never experienced lower back pain and had never been subjected to physical therapy due to lower back pain. The hip joint angles of the subjects of this study were measured by means of the modified Thomas test position. Data was analysed by independent sampling t-test using SPSS 11.0. The following results were obtained: 1. The measured angles of patient's both hip joints were significantly smaller than the control group's. 2. In the males group, The angles of patients' both hip joints were smaller than the controls'. In the females group, The angles of patients' both hip joints were smaller than the controls'. In conclusion, this study demonstrates that there is a significant difference in the tightness of the iliopsoas muscles when comparing the patient group with the control group. We should therefore pay more attention in releasing the muscle tightness of iliopsoas muscles when performing physical therapy with patients with lower back pain.

• Journal of Korean Neurosurgical Society
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• v.46 no.4
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• pp.285-291
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• 2009

Objective : This study examined the change of range of motion (ROM) at the segments within the dynamic posterior stabilization, segments above and below the system, the clinical course and analyzed the factors influencing them. Methods : This study included a consecutive 27 patients who underwent one-level to three-level dynamic stabilization with Bioflex system at our institute. All of these patients with degenerative disc disease underwent decompressive laminectomy with/without discectomy and dynamic stabilization with Bioflex system at the laminectomy level without fusion. Visual analogue scale (VAS) scores for back and leg pain, whole lumbar lordosis (from L1 to S1), ROMs from preoperative, immediate postoperative, 1.5, 3, 6, 12 months at whole lumbar (from L1 to S1), each instrumented levels, and one segment above and below this instrumentation were evaluated. Results : VAS scores for leg and back pain decreased significantly throughout the whole study period. Whole lumbar lordosis remained within preoperative range, ROM of whole lumbar and instrumented levels showed a significant decrease. ROM of one level upper and lower to the instrumentation increased, but statistically invalid. There were also 5 cases of complications related with the fixation system. Conclusion : Bioflex posterior dynamic stabilization system supports operation-induced unstable, destroyed segments and assists in physiological motion and stabilization at the instrumented level, decrease back and leg pain, maintain preoperative lumbar lordotic angle and reduce ROM of whole lumbar and instrumented segments. Prevention of adjacent segment degeneration and complication rates are something to be reconsidered through longer follow up period.

• Journal of The Korean Society of Integrative Medicine
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• v.7 no.4
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• pp.265-272
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• 2019

Purpose : Excessive computer use frequently results in musculoskeletal disorders of the neck and shoulder such as forward head posture (FHP). The purpose of this study was to investigate effects of neck and shoulder exercise program on spino-pelvic alignment and the correlation between change in head and neck posture and spino-pelvic alignment in FHP. Methods : The study included 44 participants with FHP. The participants performed the exercise for correction of FHP 2-3 times a week for 4 weeks. We examined whole spine X-ray images in the lateral standing position with both arms crossed. We measured anterior head translation distance (AHT), craniovertebral angle (CVA), cervical lordosis (CL), thoracic kyphosis (TK), lumbosacral lordosis (LSL), sacral slope (SS), pelvic tilt (PT), and pelvic incidence (PI) of the subjects. The association between change in AHT and each spino-pelvic parameter was also subjected to Pearson's correlation coefficient analysis. Results : There were statistically significant differences before and after exercise in the parameters of AHT, CVA, and SS (p<.05). Significant negative correlation was observed between the change in AHT and CVA (r=-.768, p<.001), and CL (r=-.388, p<.05). There was significant positive correlation between the change in AHT and SS (r=.328, p<.05), and PI (r=.333, p<.05). However, no significant correlation was observed in change in AHT with that of TK, LSL, and PT. Conclusion : Based on the above results, we conclude that there is a relationship between change in AHT, which is a parameter associated with forward displacement of the head, and that of CVA, CL, SS, and PI after exercise in cases of FHP.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.15 no.1
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• pp.32-40
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• 2009

Purpose: The purposes of this study were to determine the intertester and intratester reliabilities of the Lateral Scapular Slide Test (LSST) method, and to examine if significant differences existed in scapular positions among the pain groups (right-shoulder pain group, left-shoulder, pain group and both-shoulders pain group). 27 female subjects (mean age = 51.6, mean height = 157.7 cm, mean weight = 57.5 kg) with shoulder pain were recruited for this study. Methods: The bilateral distances between the root of the scapular spine and T3/4 (RSS), and between the inferior scapular angle and T7/8 (IA), were recorded. Subjects were tested at three positions: the with arms with abducted at 0, 45 and 90 degrees in the coronal plane. The LSST measurements were performed by two testers, selected randomly. Results: The results were as follows: Intraclass correlation coefficients (ICCs) for the intertester reliability were excellent (ICC 0.78-0.94). And the ICCs for the intratester reliability were excellent (ICC 0.83-0.99). In the right-shoulder and both-shoulders pain groups, the right-side RSS and IA values of right side were significantly greater than of the left-side RSS values left side for the arms abducted at 0 degrees of right shoulder pain group and both shoulder pain group (p<.05). However, the side-to-side difference was less than 1.5 cm. Conclusion: Our results suggest that the LSST is highly reliable in identifying the abnormal scapular position of patients with shoulder problems. Future research should be continued to clarify the clinical usefulness of this method.

• Journal of the Korea Society of Computer and Information
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• v.18 no.5
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• pp.53-60
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• 2013

This paper proposed visualization tool for motion of snowboarding using Skeleton data obtained by the Microsoft's Kinect sensor. The BBP(Balanced Body Position) posture is a most basic motion in the Snowboarding. This posture is the primary technology for stable turns. The implementation of visualization tool to analyse the BBP posture of snowboard. comparative analysis with standard postures to the ankles, knees, hips and spine angle of joints and body tracking using coordinate information obtained by the Kinect Sensor. Analysis of the final results of the screen through the OpenGL library. This research result could be used to analysis for turn postures of snowboarding.

• PNF and Movement
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• v.17 no.3
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• pp.471-480
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• 2019

Purpose: This study examined the correlations between a forward head posture and the endurance and maximal voluntary contraction of the deep neck flexor, neck pain, and the changed position of the mandible. Methods: The subjects of this study were 50 male and female adults who work at a desk for at least four hours a day. The head-spine angle was photographed with a camera, and the endurance and maximal voluntary contraction of the deep neck flexor and the changed position of the mandible were measured using pressure biofeedback. The Neck Disability Index was used to measure neck pain. To examine the correlations between a forward head posture and the endurance and maximal voluntary contraction of the deep neck flexor as well as the changed position of the mandible, a Spearman's correlation analysis was conducted. The statistical significance was set at 0.05. Results: A forward head posture and the endurance of the deep neck flexor showed a statistically significant positive correlation, and a forward head posture and neck pain showed a statistically significant negative correlation. In addition, the endurance of the deep neck flexor and neck pain showed a statistically significant negative correlation. Conclusion: The results of this study show that a forward head posture and the endurance of the deep neck flexor were correlated; in addition, a forward head posture and neck pain were correlated. Therefore, enhancing the endurance of the deep neck flexor can assist in correcting an imbalanced forward head posture, which can reduce neck pain.

• Physical Therapy Korea
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• v.13 no.1
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• pp.24-31
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• 2006

The purpose of this study was to identify the effect of the hip internal rotation on gluteal and erector spinae muscle electromyographic (EMG) activity during treadmill walking. Eleven healthy subjects were recruited. All subjects performed treadmill walking while maintaining the hip in neutral position (condition 1) and in internal rotation (condition 2). Surface EMG activity was recorded from four muscles (gluteus maximus (GM), gluteus medius (GMED), tensor fascia latae (TFL), and erector spinae (ES)) and the hip internal rotation angle was measured using a three dimensional motion analysis system. The gait cycle was determined with two foot switches, and stance phase was normalized as 100% stance phase (SP) for each condition using the MatLab 7.0 program. The normalized EMG activities according to the hip rotation (neutral or internal rotation) were compared using a paired t-test. During the entire SP of treadmill walking, the EMG activities of GM in condition 1 were significantly greater than in condition 2 (p<.05). The EMG activities of TFL and ES in condition 2 were significantly greater than in condition 1 (p<.05). The EMG activities of the GMED in condition 1 were significantly greater than in condition 1 (p>.05) except for 80~100% SP. Further studies need randomized control trials regarding the effect of hip internal rotation on the hip and lumbar spine muscle activity. Kinetic variables during gait or going up and down stairs are also needed.

• The Korean Journal of Pain
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• v.25 no.2
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• pp.81-88
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• 2012

Background: In discography performed during percutaneous endoscopic lumbar discectomy (PELD) via the posterolateral approach, it is difficult to create a fluoroscopic tunnel view because a long needle is required for discography and the guide-wire used for consecutive PELD interrupts rotation of fluoroscope. A stereotactic system was designed to facilitate the determination of the needle entry point, and the feasibility of this system was evaluated during interventional spine procedures. Methods: A newly designed stereotactic guidance system underwent a field test application for PELD. Sixty patients who underwent single-level PELD at L4-L5 were randomly divided into conventional or stereotactic groups. PELD was performed via the posterolateral approach using the entry point on the skin determined by premeasured distance from the midline and angles according to preoperative magnetic resonance imaging (MRI) findings. Needle entry accuracy provided by the two groups was determined by comparing the distance and angle measured by postoperative computed tomography with those measured by preoperative MRI. The duration and radiation exposure for determining the entry point were measured in the groups. Results: The new stereotactic guidance system and the conventional method provided similarly accurate entry points for discography and consecutive PELD. However, the new stereotactic guidance system lowered the duration and radiation exposure for determining the entry point. Conclusions: The new stereotactic guidance system under fluoroscopy provided a reliable needle entry point for discography and consecutive PELD. Furthermore, it reduced the duration and radiation exposure associated with determining needle entry.

• Journal of Korean Neurosurgical Society
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• v.38 no.6
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• pp.435-441
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• 2005

Objective : Expandable cage used for spinal reconstruction after corpectomy has several advantages over nonexpendable cages. Here we present our clinical experience with the use of this cage after anterior column corpectomy with an average of one year follow up. Methods : Ten patients underwent expandable cage reconstruction of the anterior column after single-level or multilevel corpectomy for various cervical spinal disorders. Anterior plating with or without additional posterior instrumentation were performed in all patients. Functional outcomes, complications, and radiographic outcomes were determined. Results : There was no cage-related complication. Functionally, neurological examination revealed improvement in 7 of 10 patients and no patient had neurological deterioration after the surgery. Immediate stability was achieved and maintained throughout the period of follow-up. There was minimal subsidence [<2mm] noticeable in three of the cases that underwent a two-level corpectomy. Subsidence was noted in osteoporotic patients and patients undergoing multi-level corpectomies. Average pre-operative kyphotic angle was 9 degrees. This was corrected to an average of 5.4 degrees in lordosis postoperatively. Conclusion : In conclusion, expandable cages are safe and effective devices for vertebral body replacement after cervical corpectomy when used in combination with anterior plating with or without additional posterior stabilization. The advantages of using expandable cages include its ability to easily accommodate itself into the corpectomy defect, its ability to tightly purchase into the end plates after expansion and thus minimizing the potential for migration, and finally, its ability to correct kyphosis deformity via its in vivo expansion properties.