• Journal of Korea Association of Health Promotion
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• v.2 no.2
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• pp.137-148
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• 2004

Objective : To identify the risk factors for postmenopausal osteoporosis in Korea Materials and methods : Bone mineral density (BMD) at the lumbar spine and femoral neck was measured by dual energy X-ray absorptiometry in 808 apparently normal postmenopausal Korean women. Questions about life style, demographic parameters, medical history and social habits etc. were asked on these women; 2ll women with normal bone mineral density, and 597 women with osteopenia or osteoporosis. Results 'Age of >50 years, low body mass index (BMI; <18.5 kg/m2), long duration of menopause(>10 years), and previous history of fracture were associated with increased prevalence of osteopenia or osteoporosis. Women without the outside activity also showed a higher frequency of low bone mass, Risk for osteopenia or osteoporosis was low in women with high BMI (>23 kg/m2) and women with job. The prevalence of low bone mass appeared to be independent of the following parameters: socioeconomic status, familial history, smoking, drinking, exercise, previous use of oral contraceptive, coffee or milk consumption, and degree of sunlight exposure. Conclusion 'Age, BMI, duration of menopause, previous history of fracture and degree of outside activity are the risk factors for postmenopausal osteoporosis in Korea.

• The Journal of Korean Physical Therapy
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• v.31 no.2
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• pp.82-87
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• 2019

Purpose: The purpose of this study was to examine the effects of plank exercises with resistance of one-sided hip adduction on abdominal muscle thickness. Methods: Thirty subjects were divided into a group that underwent plank exercises with one-sided hip adduction resistance (n=15) and a group that underwent plank exercises only (n=15). Their changes in abdominal muscle thickness before the experiment (n=15) and three and six weeks after the experiment were analyzed using a two-way repeated analysis of variance at a statistical significance level of ${\alpha}=0.05$. When there was any interaction between the time of measurement and each group, post hoc t-tests were conducted at a statistical significance level of ${\alpha}=0.01$. Results: The results of the experiment showed statistically significant differences in the thickness of the rectus abdominis, internal oblique muscle, and transversus abdominis, depending on the time of measurement and the interaction between the time of measurement and each group (p<0.05). Statistically significant differences were observed in the thickness of the external oblique, depending on the time of measurement, the interaction between the time of measurement and each group, and variances between the groups (p<0.05). Conclusion: The results of this study indicated that plank exercises with resistance of one-sided adduction are effective for increasing abdominal muscle thickness. The study's overall findings will likely be used as basic data for lumbar stabilization exercises and rehabilitation treatment.

• Journal of International Academy of Physical Therapy Research
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• v.11 no.4
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• pp.2178-2183
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• 2020

Background: Trunk flexor-extensor muscles' co-activation and upright posture are important for spinal stability. Abdominal bracing and maximal expiration are being used as exercises to excel torso co-contraction. However, no study has on comparison of the effect of this exercise on multifidus in the upright sitting posture. Objectives: This study aims to verify the effectiveness of abdominal bracing and expiration maneuvers in lumbo-pelvic upright sitting. Design: Cross-sectional study. Methods: Eighteen healthy women were recruited for this study. The multifidus muscle thickness of all subjects was measured in three sitting conditions (lumbo-pelvic upright sitting, lumbo-pelvic upright sitting with abdominal bracing, and lumbo-pelvic upright sitting with maximum expiration) using ultrasound. One-way repeated measure analysis of variance was used for the evaluation. Results: Compared to lumbo-pelvic upright sitting, lumbo-pelvic upright sitting with abdominal bracing and lumbo-pelvic upright sitting with maximum expiration were associated with significantly increment of muscle thickness. There was no significant difference in muscle thickness between lumbo-pelvic upright sitting with abdominal bracing and lumbo-pelvic upright sitting with maximum expiration. Conclusion: Abdominal bracing and maximum expiration could be beneficial to increasing lumbar multifidus thickness in lumbo-pelvic upright sitting.

• Journal of Acupuncture Research
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• v.19 no.3
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• pp.107-114
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• 2002

Objective : This study was designed to find the most effective and safest way to overcome Lumbago due to blood stasis and sprain involved in a few Meridian Tendino-musculatures by evaluating the effect of two kinds of Dong-gi(Dong-qi) Acupuncture(DGA) and by reporting their side effects. Material : 97 patients of out and admission patients were selected, who were diagnosed with lumbar sprain caused by repetitive bending, heavy weight lifting, unsuitable posture, concussion and falling down and whose Lumbago due to blood stasis and sprain in the concept of oriental medicine. Methods : 97 patients were divided into three groups. One is exclusive DGA group to which DGA and the method retaining needles on the acupoints for about 20 minutes were applied, the other is DGA combined active exercise group in which patients stretched their Meridian Tendino-muscuIatures with their hips moving up and downward repeatedly during DGA, the third is DGA combined passive exercise group in which patients were made to flex or extend their bodies on the auto flexion-distraction table in a prone position, from 10 to 20 degree, during DGA. In each group, bed rest, physical therapy and herbal medicine were used according to symptoms, in addition to DGA. In DGA method, "Su(Shu)" points of the meridian related to the involved Meridian Tendino-musculature were mainly chosen, that is, Sokkol(Shugu, B65), Hugye(Houxi, SI3), ChungJo(Zhongzhu, TE3) were used, for most LBP belonged to Bladder and Gallbladder Meridian Tendino-musculature disorders. Pyong-Bo-Pyong-Sa(Ping-Bu-Ping-Xie) such as Dong-Gi and Yeom-Jeon(Nian-Zhuan) was applied as Bo-Sa method. For evaluation of effectiveness, new score system was devised by severity of pain and range of movement. the score was given twice at patients' first and last visit and the difference between first and last score was regarded as a evaluation scale, the effectiveness was classified into four grade by evaluation scale.(scale : 12-15; excellent, 8-11; good, 4-7; fair, 0-3; bad) Results : 1. Exclusive DGA, DGA combined active exercise and DGA combined passive exercise group showed 97, 87 and 89% in effectiveness. 2. Exclusive DGA, DGA combined active exercise and DGA combined passive exercise group showed no aggravation of pain, range of movement. 3. In blood test of 34 patients, only one patient showed abnormal rise of sGOT, sGPT and $\gamma$-GTP at his first visit and the others didn't show any detrimental change. DGA had no bad influence upon BUN and creatinine of patients. Conclusion : For complex theraphy combining DGA, exercise, physical therapy and Herbal medicine proved to be highly effective on treating lumbago due to blood stasis and sprain, this is expected to be available for clinical use.

• Journal of Korean Academy of Nursing Administration
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• v.7 no.2
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• pp.265-284
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• 2001

The case management has been applied to improve the quality of care and the cost-effectiveness in the most health care institutions. In a way of case management, the critical pathway(CP) has been executed in many acute care settings, focused on the diagnoses with high cost, high volume, and high risk. This study was conducted to develop a case management program using CP as an intervention of patients with lumbar spinal stenosis for the surgery of posterolateral fusion, and to find out the effects of the critical pathway on the quality of nursing care, patient satisfaction as an outcome of care, length of stay and medical charge, and nurses' job satisfaction. At the same time, patients' functional states were checked with the Oswestry Low Back Pain Index, to show that the CP would not decrease the patients' function compared to the control group. The subjects were 25 control patients with a usual operation of lumbar fusion and 25 experimental patients with CP. They were all female, aged $50s{\sim}70s$, admitted in the Orthopedic surgery ward of a university hospital. Also nurses on the floor using CP were asked to respond to measurement tool of job satisfaction before and after the application of CP, and compared with other nurses on the different wards. Data were analyzed with t-test for continuous variables and chi-square for non-parametric variables in addition to the reliability test of the measurement tools. The results of this study were as followings: 1. Patients' functional states The differences in Oswestry scores of the experimental and control groups assessed at preoperation and at discharge were not statistically significant. The change in scores of the experimental group measured at preoperation and at discharge was larger than that of the control group, however the difference was not statistically significant. The results indicate that the CP did not decrease the patients' functional status. 2. The quality of nursing care The total of quality of nursing care given to the experimental group was better than that of the control group(P=.000). In addition, the experimental group showed better scores of quality of every item of care than the control group(P=.000 -.004). 3. Patient satisfaction Patients of the experimental group were not more satisfied with general care than the control group. But they were more satisfied with discharge care of 'explanation about medication, body posture, and brace application' and 'explanation about the adjustment of daily living and exercise during recovery'(P= .047, P=.028). 4. Nurses' job satisfaction Nurses working with the CP showed more job satisfaction than before the CP introduction(P=.048). But the control group of nurses on a different floor showed no change in job satisfaction at the same period of time. 5. Length of stay and medical charge The mean length of stay of the experimental group was shorter than that of the control group without statistical significance. The charge of medication and treatment of the experimental group were smaller than that of the control group(P=.011, P=.000). The results of the study support that the case management using critical pathway enables to improve the quality of care and job satisfaction, to reduce the medical charge, and consequently to increase satisfaction with care. However, the case management should be instituted focusing on the quality improvement of nursing and the client satisfaction, not just for the purpose of cost-effectiveness of health care facilities.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.19 no.5
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• pp.346-356
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• 2018

Overweight and abdominal obesity caused by sedentary lifestyle may induce deconditioned and atrophied extensor musculature of the lumbar spine and be a potential risk factor for low back pain (LBP). Therefore, this study was conducted to evaluate the validity of high intensity circuit training (HICT) on weight loss and subsequent alleviation of spine curvature (SC) and visual analog scale (VAS) among middle aged men with abdominal obesity. The training program (1 exercise session for 30 minutes, three times a week for 12 weeks) consisted of 12 different functional exercises based on core strengthening multiple joint circuit training. Portions of the obesity index related to body composition were positively changed, which improved the angles of thoracic kyposis and lumbar lordosis, which appeared to effectively reduce lower back pain. Taken together, HICT specifically designed for LBP effectively decreased obesity related body composition and was superior to other treatments for decreasing aggravation of the spine curvature and LBP caused by abdominal obesity; however, weight loss should be the primary treatment target for LBP patients.

• Journal of Nutrition and Health
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• v.27 no.10
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• pp.1025-1036
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• 1994

This study was designed to investigate the effects of Ca and/or vitamin D supplementation for 53 weeks on bone metabolism in postmenopausal women. The subjects were healthy 18 women aged from 59 to 69 years old. They were divided into three groups : placebo, Ca(1000mg/day) supplementation and Ca(1000mg/day) with vitamin D(12.5$\mu\textrm{g}$/day) supplementation. During the experimental periods except for metabolic studies, the subjects ate their usual diets and the use of drugs as well as excessive exercise was prohibited. Metabolic studies were conducted in the 1st week and in the 53rd week of the experimental periods. The subjects ate experimental diets which consisted of 1787.3kcal, 69.6g of protein, 561.5mg of Ca and 1078.6mg of P daily during both of the metabolic study periods. The results were summarized as follows; 1) Bone density of the second lumbar spine and trochanter measured after treatment decreased significantly in control group as compared with pre-experimental level(p<0.05). On the contrary, bone density of femoral neck and Ward's triangle in Ca group and the second lumbar spine in Ca.Vit D group increased significantly after treatment. 2) Serum PTH and calcitonin levels did not show any significant differences among groups before and after treatment. But serum PTH level increased significantly in all groups after treatment(P<0.05). 3) Serum Ca and P levels did not show any significant differences among groups before and after treatment. But serum Ca level increased significantly in all groups after treatment (P<0.05) and serum P level decreased significantly in Ca.Vit D group after treatment(P<0.05). 4) Mean 24-hours fecal Ca excretion of Ca group was the highest in the 1st week of treatment(P<0.01), and that of control group was the lowest in the 53rd week of treatment(P<0.01). Fecal Ca excretion increased significantly in control and Ca.Vit D group in the 53rd week of treatment(P<0.05). Urinary Ca excretion did not show any significant differences among groups in the 1st and 53rd week of treatment, but that of Ca.Vit D group was the highest the 1st week of treatment(P<0.01). In the 53rd week of treatment Ca and Ca.Vit D group showed positive Ca balance, but control group showed negative Ca balance. The above results showed that it will be difficult to prevent degenerative bone loss without Ca and/or vitamin D supplementation in postmenopausal women eating Korean usual diets.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.20 no.12
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• pp.224-229
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• 2019

This study was undertaken to provide correct posture guidance and reference material for sports injury and injury prevention programs, by analyzing body alignment and plantar pressure distribution in high school baseball players. Totally, 32 subjects were enrolled for the study. Body alignment was measured from the trunk imbalance, kyphotic angle, lordotic angle, pelvic tilt, and pelvic torsion. Foot pressure was measured from the left maximum pressure, right maximum pressure, left weight, and right weight. The mean and standard deviation of the measured factors were calculated and tabulated, and the correlation between body alignment and foot pressure distribution was analyzed using Pearson's correlation analysis. All statistical significance levels were set at 0.05. Body alignment and foot pressure distribution show a positive correlation between the lordotic angle of lumbar spine and the left maximum pressure. There was no correlation between trunk imbalance, kyphotic angle, lordotic angle, pelvic tilt, pelvic torsion, and the left·right weight distribution and the left·right maximum pressure of each foot. Results of this study determined that the increase of the lordotic angle of lumbar spine results in more force on one side of the foot, thereby increasing the maximum pressure. We believe our data could be a reference for exercise programs on physical alignment and plantar pressure distribution of athletes.

• Journal of Korean Neurosurgical Society
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• v.62 no.5
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• pp.561-566
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• 2019

Objective : Functional outcomes have traditionally been evaluated and compared using subjective surveys, such as visual analog scores (VAS), the Oswestry disability index (ODI), and Short Form-36 (SF-36), to assess symptoms and quality of life. However, these surveys are limited by their subjective natures and inherent bias caused by differences in patient perceptions of symptoms. The Fitbit $Charge^{(R)}$ (Fitbit Inc., San Francisco, CA, USA) provides accurate and objective measures of physical activity. The use of this device in patients after laminectomy would provide objective physical measures that define ambulatory function, activity level, and degree of recovery. Therefore, the present study was conducted to identify relationships between the number of steps taken by patients per day and VAS pain scores, prognoses, and postoperative functional outcomes. Methods : We prospectively investigated 22 consecutive patients that underwent laminectomy for spinal stenosis or a herniated lumbar disc between June 2015 and April 2016 by the same surgeon. When patients were admitted for surgery and first visited after surgery, preoperative and postoperative functional scores were recorded using VAS scores, ODI scores, and SF-36. The VAS scores and physical activities were recorded daily from postoperative day (POD) 1 to POD 7. The relationship between daily VAS scores and daily physical activities were investigated by simple correlation analysis and the relationship between mean number of steps taken and ODI scores after surgery was subjected to simple regression analysis. In addition, Wilcoxon's signed-rank test was used to investigate the significance of pre-to-postoperative differences in VAS, ODI, and SF-36 scores. Results : Pre-to-postoperative VAS (p<0.001), ODI (p<0.001), SF-36 mental composite scores (p=0.009), and SF-36 physical composite scores (p<0.001) scores were found to be significantly different. Numbers of steps taken from POD 1 to POD 7 were negatively correlated with daily VAS scores (r=-0.981, p<0.001). In addition, the mean number of steps from POD 3 to POD 7 and the decrease in ODI conducted one month after surgery were statistically significant (p=0.029). Conclusion : Wearable devices are not only being used increasingly by consumers as lifestyle devices, but are also progressively being used in the medical area. This is the first study to demonstrate the usefulness of a wearable device for checking patient physical activity and predicting pain and prognosis after laminectomy. Based on our experience, the wearable device used to provide measures of physical activity in the present study has the potential to provide objective information on pain severity and prognosis.

• Journal of Digital Convergence
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• v.18 no.2
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• pp.483-487
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• 2020

In this study, the effects of suspension training according to the types of ground. Fourteen healthy male college students measured for the characteristics of core muscle activity in suspension training on two different types of grounds, normal flat and unstable ground using a gym ball. EMG (Electromyography) was exploited to measure the activity of the core muscles according to the types of the ground. Muscle activity of the abdominal muscles, external oblique muscles, internal oblique muscles, and lower lumbar standing muscles was measured. The variables in analyses were measured by the means of % MVC method to standardize the EMG signal according to the ground type for each core muscle. In order to verify the differences in core muscles according to the type of ground the paired t-tests were performed at the significance level of 0.05 (p<.05). As a result of measuring the activity of the core muscles according to the various types of grounds, the difference between muscle characteristics obtained in two different grounds did not appear to be statistically significant. However, the result is an important clue to reconsider the notion that the training effect on the unstable ground is generally superior to the effect on the stable ground in the core muscle training. The type of ground in the core muscle training has been found not to significantly affect the muscle activation according to the results of this study. Regardless of the type of exercise program, hence, the difference in muscle activation will not be insignificant even with the standardized program strengthening core muscles.