• Physical Therapy Korea
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• v.23 no.3
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• pp.48-56
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• 2016

Background: Recently, there has been an emphasis on the use of interventions with biofeedback information for the maintenance or correction of posture. Objects: This study assessed the change of trunk posture and trunk muscle activation when people exhibiting postural kyphosis performed visual display terminal work with or without a contact feedback device (CFD). Methods: Eighteen right-handed individuals were recruited. Thoracic angle and right thoracic erector spinae (TES) muscle amplitude were analyzed. There were two sessions in these experiments. The control session involved 16 minutes of typing without a CFD, and the CFD session involved 16 minutes of typing with a CFD. The visual analog scale score was analyzed with a paired t-test, and the kinematic and electromyography data were analyzed through two-way repeated analysis of variance. Results: The paired t-tests revealed that subjects had significantly less pain after the CFD sessions than after the control sessions (p<.05). Significant main effects by session and by time were observed in the thoracic kyphosis angle (p<.05). There was a significant session${\times}$time interaction for TES amplitude (p<.05), along with significant main effects by session and by time (p<.05). Conclusion: The CFD caused people with postural kyphosis to straighten and to activate their TES continuously, even though they were habituated to bend their bodies forward. Therefore, the CFD was a beneficial treatment tool.

• The Journal of Korean Physical Therapy
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• v.26 no.5
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• pp.358-364
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• 2014

Purpose: Flexed posture commonly increases with age in older women and is characterized by an excessive curvature in the thoracic spine (kyphosis), forward head posture, and decline in height. This study was conducted in order to determine the relationship between flexed posture, physical performance, and psychosocial factors in community dwelling elderly women in Korea. Methods: Fifty-two subjects with thoracic kyphosis of $40^{\circ}C$ or greater participated in this study. Flexed posture was measured using kyphosis angle (KA), forward head posture (FHP), and round shoulder (RS), and physical performance was evaluated using the short physical performance battery (SPPB), grip strength, and static and dynamic balance. Psychosocial factors were measured using depression and the quality of life (QOL). All data were analyzed using SPSS 18.0 software for windows. Results: KA showed significant correlation with SPPB score (r=-0.447) and dynamic balance (r=0.426) (p<0.05) depression (r=0.405) and QOL (r=-0.464) but not with grip strength and static balance in elderly individuals. FHP and RS showed significant correlation with SPPB score (r=0.002, r=-0341) and dynamic balance (r=-0.278, r=0.346) (p<0.05) but not with psychosocial factors. Conclusion: These findings suggest that flexed posture provides meaningful information about physical performance and psychosocial factors in elderly women. Our data suggest that the flexed posture may need to be addressed as part of the health management process for elderly women.

• Journal of Korean Neurosurgical Society
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• v.29 no.9
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• pp.1262-1266
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• 2000

Objective : Flat back syndrome constitutes a syndrome complex characterized by the loss of normal lumbar lordosis. Various techniques of correction for flat back syndrome have been reported. Posterior extension osteotomy has certain drawbacks. Forceful hyperextension of the spine may result in vascular complications such as rupture of the aorta or the inferior vena cava and stretching of superior mesenteric artery, and pseudoarthrosis. We describe a rationale and technique of transvertebral posterior extension osteotomy to avoid complications of posterior extension osteotomy and to achieve an correction of 30 degrees of flat back syndrome. Method : A 63-year-old woman with degenerative lumbar kyphosis presented with low back pain, thigh pain, knee pain and walking difficulty. Transpedicular fixation from L1 vertebra to S1 vertebra was accomplished for lumbar degenerative kyphosis. After 6 months, the patient presented with flat back syndrome. A second operation was performed with transvertebral posterior extension osteotomy. Result : With short segemental fusion, early bone fusion and correction of 30 degrees were achieved. Conclusion : Transvertebral posterior extension osteotomy provide an 30-60 degrees of correction of flat back syndrome. This technique is considered to be good method for the revision of lumbar degenerative kyphosis.

• Journal of Korean Neurosurgical Society
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• v.60 no.2
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• pp.174-180
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• 2017

Objective : Proximal junctional kyphosis (PJK) is radiologic finding, and is defined as kyphosis of >$10^{\circ}$ at the proximal end of a construct. The aim of this study is to identify factors associated with PJK after segmental spinal instrumented fusion in adults with spinal deformity with a minimum follow-up of 2 years. Methods : A total of 49 cases of adult spinal deformity treated by segmental spinal instrumented fusion at two university hospitals from 2004 to 2011 were enrolled in this study. All enrolled cases included at least 4 or more levels from L5 or the sacral level. The patients were divided into two groups based on the presence of PJK during follow-up, and these two groups were compared to identify factors related to PJK. Results : PJK was observed in 16 of the 49 cases. Age, sex and mean follow-up duration were not statistically different between two groups. However, mean bone marrow density (BMD) and mean back muscle volume at the T10 to L2 level was significantly lower in the PJK group. Preoperatively, the distance between the C7 plumb line and uppermost instrumented vertebra (UIV) were no different in the two groups, but at final follow-up a significant intergroup difference was observed. Interestingly, spinal instrumentation factors, such as, receipt of a revision operation, the use of a cross-link, and screw fracture were no different in the two groups at final follow-up. Conclusion : Preoperative BMD, sagittal imbalance at UIV, and thoracolumbar muscle volume were found to be strongly associated with the presence of PJK.

• The Journal of Churna Manual Medicine for Spine and Nerves
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• v.12 no.1
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• pp.57-70
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• 2017

Objectives : The purpose of this study is to find out the factors affecting the cervical angle with kyphosis. Methods : We investigated 340 cases of patients who had cervical kyphosis. We used cervical angle, flexion malposition angle, odontoid process cline angle, axis-atlas cline angle, odontoid process-atlas cline angle and occiput-atlas cline angle. Correlations between cervical angle and flexion malposition angle, odontoid process cline angle, axis-atlas cline angle, odontoid process-atlas cline angle, occiput-atlas cline angle were analyzed by pearson correlation analysis. Results : The correlation between cervical angle and flexion malposition angle was p-value 0.007, and odontoid process cline angle was p-value 0.002, and axis-atlas cline angle was p-value 0.000, and odontoid process-atlas cline angle was p-value 0.000, and occiput-atlas cline angle was p-value 0.012. Conclusions : Flexion malposition angle, odontoid process cline angle are inversely proportional to cervical angle. And correlation is statistically significant(p<0.01). Axis-atlas cline angle, odontoid process-atlas cline angle are proportional to cervical angle. And correlation is statistically significant(p<0.01). Occiput-atlas cline angle is proportional to cervical angle. And correlation is statistically significant(p<0.05).

• Korean Journal of Applied Biomechanics
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• v.24 no.2
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• pp.103-109
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• 2014

The study aimed to examine the effect of a corrective exercise on Cobb's angle and static and dynamic foot pressure in patients with kyphosis. Patients with kyphosis participated in a 12 weeks of corrective exercise program. Participants were randomly assigned to a corrective exercise group (n=17) and a control group (n=17), and corrective exercise for 60 minutes are executed every 3 times a week. All data were analyzed by two-way repeated measured ANOVA. Statistical level was set up as a=.05. As a result, Cobb's angle had significantly effects according to time and groups. Anterior and posterior part of static foot pressure showed significant effects by time but not by groups. Whereas left and right part of static foot pressure showed no significant effects. And dynamic foot pressure showed significant effects by time but not by group also. In conclusion, it is approved that this exercise was helpful on abnormal posture arrangement and improvement of unbalanced muscle capability.

• Journal of Korean Neurosurgical Society
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• v.64 no.5
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• pp.677-692
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• 2021

Many studies have focused on pre-operative sagittal alignment parameters which could predict poor clinical or radiological outcomes after laminoplasty. However, the influx of too many new factors causes confusion. This study reviewed sagittal alignment parameters, predictive of clinical or radiological outcomes, in the literature. Preoperative kyphotic alignment was initially proposed as a predictor of clinical outcomes. The clinical significance of the K-line and K-line variants also has been studied. Sagittal vertical axis, T1 slope (T1s), T1s-cervical lordosis (CL), anterolisthesis, local kyphosis, the longitudinal distance index, and range of motion were proposed to have relationships with clinical outcomes. The relationship between loss of cervical lordosis (LCL) and T1s has been widely studied, but controversy remains. Extension function, the ratio of CL to T1s (CL/T1s), and Sharma classification were recently proposed as LCL predictors. In predicting postoperative kyphosis, T1s cannot predict postoperative kyphosis, but a low CL/T1s ratio was associated with postoperative kyphosis.

• Journal of the Korean Society of Physical Medicine
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• v.9 no.1
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• pp.115-123
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• 2014

PURPOSE: This study was to investigate of pain and spine shape in elementary school students. The aim of this study was to prevent pain and spinal misalignment is to provide basic data and the need for regular screening for elementary school students. METHODS: This study had a survey research about pain and spine shape by using questionnaires and Formetric 4D. Subjects were 301 Elementary School Students RESULTS: In the presence or absence of pain and the presence of pain was in a high proportion and many of them indicated the back as a pain area, As a result of the spine shape contour, pelvic tilt was normal and trunk inclination was asymmetric as well as thoracic kyphosis and lumbar lordosis were diminished. There was a significant difference in relationship of trunk inclination according to pain CONCLUSION: The asymmetric of trunk inclination influenced the pain, In contrast, the pain did not influence thoracic kyphosis and lumbar lordosis in diminished. but, the diminution in thoracic kyphosis and lumbar lordosis are potential sources of pain. Regular checkups are necessary to prevent elementary school students from a change of spine shape and a pain, Moreover, education of maintaining normal posture should be followed.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.23 no.1
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• pp.73-78
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• 2017

Background: The purpose of this study was to identify the effects of morphological Change of cervical spine to apply to neck retraction and extension regarding the straight deformity of cervical spine. Methods: A 40-year male subject with straight deformity of cervical spine participated in this study. The study subject underwent a cervical lateral radiography on the static position, neck retraction and neck extension on standing. Measurement method were using computer-based digital radiogram on a picture achieving computer system forthe centroid method, Cobb's angle and Jackson's angle. Results: Neck retraction was increased kyphosis on the C2-4 with lordosis on the C5-7. Neck extension was increased lordosis on the C2-7. Conclusions: These findings suggest that neck retraction was increased kyphosis and neck extension was increased lordosis based on the straight deformity of cervical spine. Therefore, we should be consider that neck extension exercise when increased lordosis for the patients of straight deformity of cervical spine.

• Journal of the Korean Society for Precision Engineering
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• v.26 no.10
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• pp.116-121
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• 2009

It is important to consider lumbar lordotic angle for setup of training program in field of sports and rehabilitaton to prevent unexpected posture deviation and back pain. The purpose of this study was to analyze the biomechanical impact of the level of lumbar lordosis angle during isokinetic exercise through dynamic analysis using a 3-dimensional musculoskeletal model. We made each models for normal lordosis, excessive lordosis, lumbar kyphosis, and hypo-lordosis according to lordotic angle and inputted experimental data as initial values to perform inverse dynamic analysis. Comparing the joint torques, the largest torque of excessive lordosis was 16.6% larger and lumbar kyphosis was 11.7% less than normal lordosis. There existed no significant difference in the compressive intervertebral forces of each lumbar joint (p>0.05), but statistically significant difference in the anterioposterior shear force (p<0.05). For system energy lumbar kyphosis required the least and most energy during flexion and extension respectively. Therefore during the rehabilitation process, more efficient training will be possible by taking into consideration not simply weight and height but biomechanical effects on the skeletal muscle system according to lumbar lordosis angles.