• Physical Therapy Korea
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• v.30 no.2
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• pp.110-119
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• 2023

Background: Osteoarthritis is a common condition with an increasing prevalence and is a common cause of disability. Osteoarthritic pain decreases the quality of life, and simple gait training is used to alleviate it. Knee osteoarthritis limits joint motion in the sagittal and lateral directions. Although many recent studies have activated orthotic research to increase knee joint stabilization, no study has used patellar tendon straps to treat knee osteoarthritis. Objects: This study aimed to determine the effects of patellar tendon straps on kinematic, mechanical, and electromyographic activation in patients with knee osteoarthritis. Methods: Patients with knee osteoarthritis were selected. After creating the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), leg length difference, Q-angle, and thumb side flexion angle of the foot were measured. Kinematic, kinetic, and muscle activation data during walking before and after wearing the orthosis were viewed. Results: After wearing the patellar tendon straps, hip adduction from the terminal stance phase, knee flexion from the terminal swing phase, and ankle plantar flexion angle increased during the pre-swing and initial swing phases. The cadence of spatiotemporal parameters and velocity increased, and step time, stride time, and foot force duration decreased. Conclusion: Based on the results of this study, the increase in plantar flexion after strap wearing is inferred by an increase due to neurological mechanisms, and adduction at the hip joint is inferred by an increase in adduction due to increased velocity. The increase in cadence and velocity and the decrease in gait speed and foot pressure duration may be due to joint stabilization. It can be inferred that joint stabilization is increased by wearing knee straps. Thus, wearing a patellar tendon strap during gait in patients with knee osteoarthritis influences kinematic changes in the sagittal plane of the joint.

• Journal of Korean Neurosurgical Society
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• v.56 no.6
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• pp.469-474
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• 2014

Objective : The use of direct lumbar interbody fusion (DLIF) has gradually increased; however, no studies have directly compared DLIF and transforaminal lumbar interbody fusion (TLIF). We compared DLIF and TLIF on the basis of clinical and radiological outcomes. Methods : A retrospective review was performed on the medical records and radiographs of 98 and 81 patients who underwent TLIF and DLIF between January 2011 and December 2012. Clinical outcomes were compared with a visual analog scale (VAS) and the Oswestry disability index (ODI). The preoperative and postoperative disc heights, segmental sagittal/coronal angles, and lumbar lordosis were measured on radiographs. Fusion rates, operative time, estimated blood loss (EBL), length of hospital stay, and complications were assessed. Results : DLIF was superior to TLIF regarding its ability to restore disc height, foraminal height, and coronal balance (p<0.001). As the extent of surgical level increased, DLIF displayed significant advantages over TLIF considering the operative time and EBL. However, fusion rates at 12 months post-operation were lower for DLIF (87.8%) than for TLIF (98.1%) (p=0.007). The changes of VAS and ODI between the TLIF and DLIF were not significantly different (p>0.05). Conclusion : Both DLIF and TLIF are less invasive and thus good surgical options for treating degenerative lumber diseases. DLIF has higher potential in increasing neural foramina and correcting coronal balance, and involves a shorter operative time and reduced EBL, in comparison with TLIF. However, DLIF displayed a lower fusion rate than TLIF, and caused complications related to the transpsoas approach.

• Journal of the Institute of Convergence Signal Processing
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• v.14 no.4
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• pp.235-242
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• 2013

In this paper, the system which can translate sign language through motion recognition of Kinect camera system is developed for the communication between hearing-impaired person or language disability, and normal person. The proposed algorithm which can translate sign language is developed by using core function of Kinect, and two ways such as length normalization and elbow normalization are introduced to improve accuracy of translating sign langauge for various sign language users. After that the sign language data is compared by chart in order to know how effective these ways of normalization. The accuracy of this program is demonstrated by entering 10 databases and translating sign languages ranging from simple signs to complex signs. In addition, the reliability of translating sign language is improved by applying this program to people who have various body shapes and fixing measure errors in body shapes.

• Journal of the Korea Institute of Information and Communication Engineering
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• v.23 no.5
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• pp.555-567
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• 2019

Speech recognition rate is lowered even in a noisy environment, and it is difficult for a person with a speech disability or an inconvenient language to use it in a social life. In addition to improving the inconvenience of using the language, 280 words were selected using the word selection method which was improved when the word was selected considering the pronunciation characteristics of the language impaired. The MEMS development device used in the experiment was made considering material, lead wire type, length and direction. We improved the speech recognition rate by using the developed word selection method and the MEMS device developed to improve the speech recognition rate due to incorrect pronunciation and severe noise. The new method of selecting words and the mems device were improved and the results were included.

• Physical Therapy Korea
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• v.29 no.1
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• pp.37-47
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• 2022

Background: Lower back pain (LBP) is a major cause of disability and a common musculoskeletal disorder encountered at some point in life. Dysfunction of the lumbar vertebrae has been associated with decreased flexibility of the hamstrings, which exhibited a strong positive correlation with LBP. Hamstring tension affects lumbar pelvic rhythm. We aimed to activate pelvic stability with compression by Active Therapeutic Movement (ATM), muscle energy technique (MET) was applied to increase the flexibility of the hamstring. Objects: In this study, we aimed to investigate the effects of MET with ATM and general MET were applied to the hamstring of adults, who were in their twenties with nor without LBP, on their pelvic inclination and the length of their hamstring. Methods: A total of 32 subjects were briefed about the purpose of this study and agreed to participate voluntarily. Before the experiment, all subjects were pre-examined, and they were divided into an LBP group and a no lower back pain group accordingly. Thereafter, all subjects participated in both in a crossover manner. After at least one week, they switched to another group and participated in the same experiment. Results: The study results revealed that both groups demonstrated significant results in the modified active knee extension test (p < 0.01) and the sit and reach test (p < 0.01) performed to assess the hamstring flexibility; an interaction (p < 0.05) was noted. Moreover, a more significant difference was observed between the MET with ATM and the general MET. Although significant results were obtained for the pelvic inclination (p < 0.01), interaction was not noted. Conclusion: Conclusively, in this study, when the MET with ATM was applied to the two groups, there was a significant difference compared to the general MET for hamstring flexibility, but it was confirmed that there was no significant difference for the pelvic inclination.

• Journal of Acupuncture Research
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• v.33 no.3
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• pp.89-99
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• 2016

Objectives : This study was performed to develop objective methods for evaluating facial palsy sequelae using a 3D Facial Scanning System. Methods : Fifty-eight patients with facial palsy sequelae were selected. Their medical records were reviewed to collect demographic data, facial palsy sequelae evaluation, Facial Disability Index questionnaire, and test results (3D Facial Scanning System). Five different facial expressions (at rest, eye closure, eyebrow elevation, smiling, and whistling) were photographed. Sunnybrook Scale was associated with distances between predetermined facial points. Results : The average Sunnybrook composite score was $58.88{\pm}17.31$. Secondary movements (mouth to eye synkinesis, contracture of eye, and contracture of mouth) showed significant difference according to the Sunnybrook Scale. In voluntary movements, eyebrow height at eyebrow elevation, length between mouth angle and central line while whistling, and eyelid width at maximum eye opening showed significant difference. Facial palsy Sequelae Index (FSI) was correlated with Sunnybrook sub-scales (resting symmetry, voluntary movement, and synkinesis). Conclusion : These results demonstrate that a 3D Facial Scanning System is useful for evaluating facial palsy sequelae. This method may facilitate objective evaluation for facial palsy sequelae and it could be applied in clinical trials.

• Journal of Acupuncture Research
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• v.33 no.1
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• pp.103-116
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• 2016

Objectives : This study was performed to assess the effectiveness of conservative Korean traditional medical treatment on lumbar intervertebral disc herniation in 12 adolescents. Methods : Data were collected from adolescent patients diagnosed with lumbar intervertebral herniation by MRI, hospitalized at Jaseng Korean Medicine Hospital from January 1, 2014 to December 31, 2015. A total of 12 patients were included in the study. Patients were treated by acupuncture, pharmacopuncture, electroacupuncture, herbal medicine, chuna manual therapy, physical therapy during hospitalization period. To measure treatment outcomes, a verbal numerical rating scale (VNRS), Oswestry disability index (ODI), range of motion (ROM), Straight leg raising test (SLR), and EQ-5D were used. Results : The average age of the participants was $16.05{\pm}1.62$. The average of duration of symptom was $19.25{\pm}26.83(weeks)$ and the average length of hospitalization was $23.8{\pm}16.4(days)$. 2 patients (17 %) suffered from only lumbar pain, while 10 patients (83 %) suffered from lumbar and leg pain. No participant suffered from only leg pain. 8 patients (67 %) were diagnosed with disc herniation in one segment, and 4 patients (33 %) were diagnosed with disc herniation in multiple segments. A total of 17 disc segments (28 %) were herniated. The most herniated lumbar level was L4-5. 3 segments were diagnosed with bulging (17 %), 6 with protrusion (35 %), and 8 with extrusion (47 %). Extrusion was the most frequent herniated type. After treatment, the average VNRS of lumbar pain significantly decreased from $5.58{\pm}1.62$ to $2.91{\pm}1.56$ (p<0.001) and the average VNRS of leg pain significantly decreased from $5.16{\pm}2.51$ to $3.08{\pm}1.8$ (p<0.001). ODI significantly decreased from $48.87{\pm}18.72$ to $28.57{\pm}15.05$ (p<0.05), and EQ-5D significantly increased $0.58{\pm}0.31$ to $0.80{\pm}0.12$ (p<0.05). Range of flexion significantly improved from $61.25{\pm}32.62$ to $68.33{\pm}26.22$ (p<0.05). Conclusion : Conservative Korean Traditional Medical Treatment may be effective in the treatment of lumbar intervertebral disc herniation in adolescence. However, more case reports and clinical research are needed.

• Journal of Korean Neurosurgical Society
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• v.64 no.4
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• pp.575-584
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• 2021

Objective : Cervical expansive laminoplasty is an effective surgical method to address multilevel cervical spinal stenosis. During surgery, the spinous processes of C2 and C7 are usually preserved to keep the insertion points of the cervical musculature and nuchal ligament intact. In this regard, dome-like laminectomy (undercutting of C7 lamina) instead of laminoplasty is performed on C7 in selected cases. However, resection of the lamina can weaken the C7 lamina, and stress fractures may occur, but this complication has not been characterized in the literature. The objective of the present study was to investigate the incidence and risk factors for C7 laminar fracture after C7 dome-like laminectomy and its impact on clinical and radiological outcomes. Methods : Patients who underwent cervical open-door laminoplasty combined with C7 dome-like laminectomy (n=123) were classified according to the presence of C7 laminar fracture. Clinical parameters (neck/arm pain score and neck disability index) and radiologic parameters (C2-7 angle, C2-7 sagittal vertical axis, and C7-T1 angle) were compared between the groups preoperatively and at postoperatively at 3, 6, 12, and 24 months. Risk factors for complications were evaluated, and a formula estimating C7 fracture risk was suggested. Results : C7 lamina fracture occurred in 32/123 (26%) patients and occurred at the bilateral isthmus in 29 patients and at the spinolaminar junction in three patients. All fractures appeared on X-ray within 3 months postoperatively, but patients did not present any neurological deterioration. The fracture spontaneously healed in 27/32 (84%) patients at 1 year and in 29/32 (91%) at 2 years. During follow-up, clinical outcomes were not significantly different between the groups. However, patients with C7 fractures showed a more lordotic C2-7 angle and kyphotic C7-T1 angle than patients without C7 fractures. C7 fracture was significantly associated with the extent of bone removal. By incorporating significant factors, the probability of C7 laminar fracture could be assessed with the formula 'Risk score = 1.08 × depth (%) + 1.03 × length (%, of the posterior height of C7 vertebral body)', and a cut-off value of 167.9% demonstrated a sensitivity of 90.3% and a specificity of 65.1% (area under the curve, 0.81). Conclusion : C7 laminar fracture can occur after C7 dome-like laminectomy when a substantial amount of lamina is resected. Although C7 fractures may not cause deleterious clinical outcomes, they can lead to an unharmonized cervical curvature. The chance of C7 fracture should be discussed in the shared decision-making process.

• Journal of Korean Neurosurgical Society
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• v.46 no.4
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• pp.292-299
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• 2009

Objective : Clinical and radiological results of posterior dynamic stabilization using interspinous U (ISU, $Coflex^{TM}$, Paradigm Spine $Inc.^{(R)}$, NY, USA) were analyzed in comparison with posterior lumbar interbody fusion (PLIF) in degenerative lumbar spinal stenosis (LSS). Methods : A retrospective study was conducted for a consecutive series of 61 patients with degenerative LSS between May 2003 and December 2005. We included only the patients completed minimum 24 months follow up evaluation. Among them, 30 patients were treated with implantation of ISU after decompressive laminectomy (Group ISU) and 31 patients were treated with wide decompressive laminectomy and posterior lumbar interbody fusion (PLIF; Group PLIF). We evaluated visual analogue scale (VAS) and Oswestry Disability Index (ODI) for clinical outcomes (VAS, ODI), disc height ratio disc height (DH), disc height/vertebral body length ${\times}100$), static vertebral slip (VS) and depth of maximal radiolucent gap between ISU and spinous process) in preoperative, immediate postoperative and last follow up. Results : The mean age of group ISU ($66.2{\pm}6.7$ years) was 6.2 years older than the mean age of group PLIF ($60.4{\pm}8.1$ years; p=0.003). In both groups, clinical measures improved significantly than preoperative values (p<0.001). Operation time and blood loss was significantly shorter and lower in group ISU than group PLIF (p<0.001). In group ISU, the DH increased transiently in immediate postoperative period ($15.7{\pm}4.5%{\rightarrow}18.6{\pm}5.9%$), however decreased significantly in last follow up ($13.8{\pm}6.6%$, p=0.027). Vertebral slip (VS) of spondylolisthesis in group ISU increased during postoperative follow-up ($2.3{\pm}3.3{\rightarrow}8.7{\pm}6.2$, p=0.040). Meanwhile, the postoperatively improved DH and VS was maintained in group PLIF in last follow up. Conclusion : According to our result, implantation of ISU after decompressive laminectomy in degenerative LSS is less invasive and provides similar clinical outcome in comparison with the instrumented fusion. However, the device has only transient effect on the postoperative restoration of disc height and reduction of slip in spondylolisthesis. Therefore, in the biomechanical standpoint, it is hard to expect that use of Interspinous U in decompressive laminectomy for degenerative LSS had long term beneficial effect.

• Journal of Korean Neurosurgical Society
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• v.51 no.1
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• pp.14-19
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• 2012

Objective : The authors performed a retrospective study to assess the clinical and radiological outcome in symptomatic lumbar spondylolysis patients who underwent a direct pars repair surgery using two different surgical methods; pedicle screw with universal hook system (PSUH) and direct pars screw fixation (DPSF), and compared the results between two different treated groups. Methods : Forty-seven consecutive patients (PSUH; 23, DPSF; 15) with symptomatic lumbar spondylolysis who underwent a direct pars repair surgery were included. The average follow-up period was 37 months in the PSUH group, and 28 months in the DPSF group. The clinical outcome was measured using visual analogue pain scale (VAS) and Oswestry disability index (ODI). The length of operation time, the amount of blood loss, the duration of hospital stay, surgical complications, and fusion status were also assessed. Results : When compared to the DPSF group, the average preoperative VAS and ODI score of the PSUH group were less decreased at the last follow-up; (the PSUH group; back VAS : 4.9 vs. 3.0, leg VAS : 6.8 vs. 2.2, ODI : 50.6% vs. 24.6%, the DPSF group; back VAS : 5.7 vs. 1.1, leg VAS : 6.1 vs. 1.2, ODI : 57.4% vs. 18.2%). The average operation time was 174.9 minutes in the PSUH group, and 141.7 minutes in the DPSF group. The average blood loss during operation was 468.8 cc in the PSUH group, and 298.8 cc in the DPSF group. The average hospital stay after operation was 8.9 days in the PSUH group, and 7 days in the DPSF group. In the PSUH group, there was one case of a screw misplacement requiring revision surgery. In the DPSF group, one patient suffered from transient leg pain. The successful bone fusion rate was 78.3% in the PSUH group, and 93.3% in the DPSF group. Conclusion : The present study suggests that the technique using direct pars screw would be more effective than the method using pedicle screw with lamina hook system, in terms of decreased operation time, amount of blood loss, hospital stay, and increased fusion success rate, as well as better clinical outcome.