• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.17 no.2
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• pp.57-63
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• 2011

Background: To investigate the effect of various intervention application on idiopathic scoliosis patient. Methods: One 20-years-old female subject underwent various intervention 3 times per week for 7 weeks. Modality physical therapy, muscle energy technique, combined pelvic tilt exercise and self exercise was performed for 50minutes. Degree of pain, axial trunk rotation, Cobb's angle, kyphotic angle, lumbar lordotic angle, and sacral angle were measured. Results: The subject decreased in degree of pan, axial trunk rotation, Cobb's angle, thoracic kyphotic angle, lumbar lordotic angle and sacral angle. Conclusions: The various interventions for scoliosis patients are effective in the pain and the improvement of angle on radiograph. However, any method is difficult to determine effective interventions.

• Journal of Korean Neurosurgical Society
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• v.41 no.3
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• pp.166-170
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• 2007

Objective : The purpose of this study is to evaluate the clinical outcome of the two-stage operation for thoracic tuberculous spondylitis. Methods : Eleven patients [4 male, 7 female] with thoracic tuberculous spondylitis were treated with two-stage operation. First stage consisted of anterior debridement and interbody fusion using rib graft and second with posterior instrumentation with fusion. Mean age was 46 years, and mean follow-up period was 18 months. All patients were treated with 12 months of antituberculotic medication postoperatively, and evaluated before and after surgery with respect to pain level, neurological status, associated lesions, hematological parameters and change of kyphotic angle. Results : The associated lesions were pulmonary tuberculosis in 4 cases. There were no recurrences of infection and bone union was obtained within 6 months of the operation in all cases. Changes in the pain severity, neurological status, and hematological parameters demonstrated significant clinical improvement in all patients. The mean kyphotic angle was corrected from $17.8^{\circ}$ to $9.8^{\circ}$ after surgery. The most recent follow-up of the mean kyphotic angle was $12.3^{\circ}$, with a loss of correction of $2.5^{\circ}$. The preoperative VAS averaged to be 7.18 [range, 4-10]. It decreased significantly an average of 1.45 [p <0001]. Conclusion : These results indicate that two-stage surgical treatment for thoracic tuberculous spondylitis provid safe and satisfactory results. Spine instability and kyphosis can be also prevented by two-stage operation.

• Physical Therapy Korea
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• v.29 no.3
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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.

• Physical Therapy Korea
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• v.26 no.2
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• pp.1-7
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• 2019

Background: In previous studies, changes in postural alignment were found when the slope was changed during walking. Downhill walking straightens the trunk by shifting the line of gravity backward. Objects: This study investigated the effect of the downhill treadmill walking exercise (DTWE) on thoracic angle and thoracic erector spinae (TES) activation in subjects with thoracic kyphosis. Methods: A total of 20 subjects with thoracic kyphosis were recruited for this study. All the subjects performed the DTWE for 30 minutes. A surface EMG and 3D motion capture system were used to measure TES activation and thoracic angle before and after the DTWE. Paired t-tests were used to confirm the effect of the DTWE (p<.05). Results: Both the thoracic angle and TES activation had significantly increased after the DTWE compared to the baseline (p<.05). An increase in the thoracic angle indicates a decrease in kyphosis. Conclusion: The DTWE is effective for thoracic kyphosis patients as it decreases their kyphotic posture and increases the TES activation. Future longitudinal studies are required to investigate the long-term effects of the DTWE.

• Journal of Korean Neurosurgical Society
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• v.39 no.4
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• pp.256-259
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• 2006

Objective : Having a reliable and reproducible measurement technique to measure the sagittal contour in vertebral fractures is paramount to clinical decision making. This study is designed to determine the most reliable measurement technique in osteoporotic vertebral compression fracture. Methods : Fifteen lateral radiographs of thoracic and lumbar fractures were selected and measured on two separate occasions by three spine surgeons using six different measurement techniques [Centroid, Harrison Posterior Tangent Methods and 4 different types of modified Cobb method]. The radiograph quality was assessed and the center beam location was determined. Statistical analysis including ANOVA for repeated measures was carried out using the SAS software [v 8.0]. Results : The inter and intraobserver variance of the Cobb method 4 and Harrison posterior tangent method were significantly lower than the other four methods. The intraobserver correlation coefficients were the most consistent using the Cobb method 4 [0.982]. which was followed by the Harrison posterior tangent [0.953] and Cobb methods 1 [0.874]. The intraobserver agreement [% of repeated measures within 5 degrees of the original measurement] ranged from 42% to 98% for each technique for all three observers, with the Cobb method 4 showing the best agreement [97.8%] followed by the Harrison posterior tangent method [937%]. Conclusion : The Cobb method-4 and Harrison posterior tangent methods, when applied to measuring the kyphosis, are reliable and have a similar small error range. The Cobb method 4 shows the best overall reliability. However, the centroid method and Cobb method using a fractured endplate do not produce an accurate result due to inter and intraobserver differences in determining the baseline.

• Physical Therapy Rehabilitation Science
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• v.5 no.1
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• pp.22-28
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• 2016

Objective: The Back Mapper is one type of Rasterstereography and it can be used in the clinic without radiation exposure. The purpose of our study was to prove the reliability and validity of the Back Mapper and to compare it with the Spinal Mouse, which is an assessment tool for spinal curvatures using a wheeled mouse, and the Cobb angle by X-ray. Design: Cross-sectional study. Methods: Twenty healthy adults participated in the test to investigate for the inter-rater reliability, intra-rater reliability, and concurrent validity. The tests were performed with assessment devices for scoliosis such as the Back Mapper, Spinal Mouse and Cobb's angle. Data was analyzed by an intraclass correlation coefficient (ICC) value and a standard error of measurement for reliability and correlation analysis for validity. Results: Intra-rater reliability of the Back Mapper was good (Cronbach's ${\alpha}$=0.821-0.984, ICC=0.696-0.969) except for assessing the lordotic angle. Inter-rater reliability was good (Cronbach's ${\alpha}$=0.870-0.958, ICC=0.770-0.919) in assessment for trunk imbalance, rotation of scapulae, thoracic angle, lumbar angle, and kyphotic angle. The kyphotic angle in the Spinal Mouse had a significant correlation icompared with the Back Mapper (r=0.510, p<0.05), and the Cobb's angle from an X-ray had a significant correlation with trunk inclination (r=0.532, p<0.05). Conclusions: These findings provide good intra-reliability of the Back Mapper in healthy subjects, but the Back Mapper requires more experienced practice to have good inter-reliability. Also, the variables of the Back Mapper does not seem as appropriate compared with the Cobb angle by X-ray.

• The Journal of Korean Physical Therapy
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• v.26 no.3
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• pp.169-174
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• 2014

Purpose: This study demonstrated a postural alignment exercise as conservative management strategy for a woman with excessive thoracic kyphosis presenting decreased chest function, and reports its results. Methods: A 21-year-old woman with thoracic kyphosis presenting limited chest function. The exercise program underwent for 30 min in the intervention phase, which consisted of exercises to improve the strength of back extensor and to stretch anterior chest region. Outcome measures comprised the severity of thoracic kyphosis and chest function (vital capacity [VC], forced expiratory volume in a second [FEV1], and chest expansion length). Results: The thoracic kyphotic angle decreased by 23.6% ($9.38^{\circ}$) and 25.4% ($10.58^{\circ}$) in the intervention and follow-up phases respectively. Also, chest function was improved in the intervention (VC: 3.7% [$0.10{\ell}$], FEV1: 17.1% [$0.39{\ell}$], and chest expansion length: 17.1% [0.96 cm]), and the improvement was maintained during the follow-up phase (VC: 4.8% [$0.13{\ell}$], FEV1: 17.1% [$0.39{\ell}$], and chest expansion length: 64.3% [1.81 cm]). Conclusion: These findings suggest that the postural alignment exercise was favorable for improving chest function of a woman with thoracic kyphosis.

• Journal of Korean Medicine Rehabilitation
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• v.23 no.4
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• pp.195-202
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• 2013

Objectives This study was designed to investigate the correlation between the forward head posture and the spinal alignment. Methods We examined the whole spine x-rays of the 144 student sample. We measured the Craniovertebral angle (CVA), Cervical angle (CA), Thoracic kyphotic angle (TKA), lumbar lordosis angle (LLA) and Ferguson's angle (FA) of the students. We then analyzed the relationship between these angles. Results CVA had correlation with CA, but it was weak. There was significant correlation between CVA and TKA. There were no significant correlation among CVA, LLA and FA. Conclusions According to above results, there is a negative relationship between the CVA and the TKA - in that higher CVAs yielded lower TKAs. But CVA had no significant correlation with LLA or FA.

• The Journal of Churna Manual Medicine for Spine and Nerves
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• v.2 no.2
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• pp.1-16
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• 2007

Objectives : The purpose of this study was to identify spinal curvatures, plantar pressure and foot angles in a walking. Methods : 19 outpatients under 19 years old were included. Plantar pressure and foot angle in a walking were measured by using Gaitview AFA-50. Spinal curvatures were measured by using radiograph. Results : The cervical lordotic angle is significantly difference with left and right plantar pressure(p=0.027). The thoracic kyphotic angle is significantly difference with left and right plantar pressure(p=0.026). Cobb's angle is significantly difference with left and right plantar pressure(p=0.027). The other plantar pressure were no difference from spinal curvatures and foot angle in a walking. Conclusion : There were no correlation between plantar pressure, spinal curvatures and foot angle. We consider that needed more additional study.

• Journal of the Korean Orthopaedic Association
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• v.54 no.4
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• pp.336-342
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• 2019

Purpose: To examine the relationship between the progression of a kyphotic deformity and the magnetic resonance imaging (MRI) findings in conservatively treated osteoporotic thoracolumbar compression fracture patients. Materials and Methods: This study categorized the patients who underwent conservative treatment among those patients who underwent treatment under the suspicion of a thoracolumbar compression fracture from January 2007 to March 2016. Among them, this retrospective study included eighty-nine patients with osteoporosis and osteopenia with a bone density of less than -2.0 and single vertebral body fracture. This study examined the MRI of anterior longitudinal ligament or posterior longitudinal ligament injury, superior or inferior endplate disruption, superior of inferior intravertebral disc injury, the presence of low signal intensity on T2-weighted images, and bone edema of intravertebral bodies in fractured intravertebral bodies. Results: In cases where the superior endplate was disrupted or the level of bone edema of the intravertebral bodies was high, the kyphotic angle, wedge angle, and anterior vertebral compression showed remarkably progression. In the case of damage to the anterior longitudinal ligament or the superior disc, only the kyphotic angle was markedly prominent. On the T2-weighted images, low signal intensity lesions showed a high wedge angle and high anterior vertebral compression. On the other hand, there were no significant correlations among the posterior longitudinal ligament injury, inferior endplate disruption, inferior disc injury, and the progression of kyphotic deformity and vertebral compression. The risk factors that increase the kyphotic angle by more than 5° include the presence of injuries to the anterior longitudinal ligament, superior endplate disruption, and superior disc injury, and the risk factors were 21.3, 5.1, and 8.5 times higher than those of the uninjured case, and the risk differed according to the level of bone edema. Conclusion: An osteoporotic thoracolumbar compression fracture in osteoporotic or osteopenic patients, anterior longitudinal ligament injury, superior endplate and intravertebral disc injury, and high level of edema in the MRI were critical factors that increases the risk of kyphotic deformity.