• Title/Summary/Keyword: sacroiliac joint dysfunction

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Biomechanical changes in lower quadrant after manipulation of low back pain patients with sacroiliac joint dysfunction (요통환자의 엉치엉덩관절 기능부전에 대한 도수교정 후에 하지의 생체역학적인 변화)

  • Oh, Seung-Gil;Yoo, Seung-Hee
    • Journal of Korean Physical Therapy Science
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    • v.8 no.1
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    • pp.893-906
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    • 2001
  • The purposes of this study were to compare pelvic tilt. range of motion(ROM) of hip rotation, and leg length difference before and after manipulation and to investigate correlation between changes of each variables after manipulation of sacroiliac pint in 31 low back pain patients(11 males, 20 females) with sacroiliac pint dysfunction. The sacroiliac pint of patients was manipulated on the side of anterior pelvic tilt, using the technique described by Stoddard(1962) and Greenmann (1996). I used this technique because it usually eliminated sacroiliac Pint dysfunction in one treatment session. SPSS for window computer system was used to analyze the data. Also t-test was performed for comparison of the variables before and after manipulation, and Pearson product-moment correlation analysis and regression analysis were performed for changes of each variables after manipulation. The result were as follows: 1. The pelvic tilt after manipulation was significantly decreased(mean=$2.79^{\circ}$) compared with the pelvic tilt before manipulation(p=.001). 2. The PROM of hip internal rotation ipsilateral to anterior pelvic tilt after manipulation significantly decreased (mean = $1.88^{\circ}$) compared with hip internal rotation before manipulation (p=.008). The PROM of hip internal rotation ipsilateral to posterior pelvic tilt after manipulation significantly increased(mean = $1.29^{\circ}$) compared with hip internal rotation before manipulation (p=.029). 3. The PROM of hip external rotation ipsilateral to anterior pelvic tilt after manipulation significantly increased(mean=$2.42^{\circ}$) compared with the hip external rotation before manipulation(p=$2.42^{\circ}$) compared with the hip external rotation ipsilateral to posterior pelvic tilt after manipulation significantly decreased(mean = $1.84^{\circ}$) compared with the hip external rotation before manipulation (p=.008). 4. Leg length difference after manipulation significantly decreased(mean=2.15 mm) compared with leg length difference before manipulation (p=.008). Regression analysis revealed that a fair correlation was found between change in leg length difference and change in anterior pelvic tilt after manipulation(p=.009). 5. Pearson product-moment correlation coefficient was used to assess differences of the variables after manipulation. A fair correlation was found between change in leg length difference and change in anterior pelvic tilt after manipulation(r=.462, p<.01). A fair correlation was found between change in anterior pelvic tilt and change in hip internal rotation ipsilateral to anterior pelvic tilt(r=.397, p<.05) and between change in anterior pelvic tilt and change in hip external rotation ipsilateral to anterior pelvic tilt(r=.516, p<.01). A fair correlation was found between change in posterior pelvic tilt and changes in hip internal rotation ipsilateral to posterior pelvic tilt (r=.441, p<.05) and between change in posterior pelvic tilt and change in hip external rotation ipsilateral to posterior pelvic tilt(r=.361, p<.05). A fair correlation was found between change in hip internal rotation ipsilateral to anterior pelvic tilt and change in hip external rotation ipsilateral to posterior pelvic tilt(r=.388, p<.05) and between change in hip internal rotation ipsilateral to posterior pelvic tilt and change in hip internal rotation ipsilateral to anterior pelvic tilt(r=.426. p<.05).

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Integrated Biomechanics in the Lumbo-Pelvic-Hip Complex : Focus on Sacroiliac Joint Dysfunction (요부-골반-고관절 복합체의 생체역학 -천장관절 기능부전과 관련하여-)

  • Yoon, Hong-Il;Sim, Hyun-Po;Lee, Jun-Yong
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.19 no.1
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    • pp.69-77
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    • 2013
  • The pelvic girdle function as an integrated unit with all three bones moving at all three joints, are influenced by the lower extremities below and vertebral column and trunk above sacroiliac movements are caused by spinal motion, whereas iliosacral movements are caused by movements of the lower limbs. Concept of normal functional integration among the lumbar spine, pelvic and hip joint is basic to the understanding of dysfunction in this region and also functional movement of the lumbo-pelvic-hip region are part of the clinical examination, consequently the integrated biomechanics of these region need to be understood. The purpose of this review is to ascertain the integrated biomechanics among the lumbo-pelvic-hip complex by consideration of literature and to give sufficient information to be able to render accurate assessment and treatment for the syndromes described.

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Anatomy and Biomechanics of the Patellofemoral Joint (슬개대퇴관절의 해부학과 생체역학에 관한 문헌적 고찰)

  • Choi, Byung-Ok
    • Journal of Korean Physical Therapy Science
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    • v.8 no.2
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    • pp.935-944
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    • 2001
  • The patellofemoral pint is formed by the articulation of the patella and femoral condyles in the trochlear groove. The complexity of the patellofemoral pint is magnified by the fact that the tibiofemoral pint works in conjunction with the patellofemoral pint. Additionally, other pints such as the subtalar pint., hip and sacroiliac pints indirectly contribute to the function of the patellofemoral pint. This pint has little bony stability, Soft tissue surrounds the pint to increase stability. The patellofemoral pint increases the mechanical advantage of the quadriceps muscles and resists mechanical loading. In patellofemoral dysfunction, patellofemoral contact pattern is disrupted. leading to excessive compression at the pint. When you treat the patellofemoral dysfunction, you should evaluate anatomic and biomechanic components and find factors of patellofemoral dysfunction. Hamstring tightness. weakness of VMO and tightness of lateral retinaculum lead to flexed knee and abnormal patella tracking and patellofemoral pint reaction force and patellofemoral dysfunction. A through understanding of the anatomy and biomechanics may assist the clinician in the recognition and treatment of patients with patellofemoral pain. Therefore physical therapists should apply modality as well as therapeutic exercise, stretching and strengthening. In this paper, I will discuss the germane anatomical structures and biomechanics of the patellofemoral pint.

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Arthro Kinematic Approach (관절 운동학적 치료접근법)

  • Lim, Sung-Su;Oh, Seung-Kil;Kim, Ju-Sang
    • Journal of Korean Physical Therapy Science
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    • v.2 no.2
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    • pp.545-562
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    • 1995
  • The purpose of this paper was to provide the understanding of theory, technique, clinical use about arthro kinematic approach. Difference between AKA and Joint mobilization was seen through Table 1, and the relation between AKA and Athro kinematics was seen through Table 2. Examples of AKA techniques were as follow ; 1. Cervical intervertebral joint, left $C_{2/3}$ 2. Thoracic intervertebral joint, left $T_{5/6}$ 3. Sacroiliac joint, left (1) Nutation-upward gliding (2) Nutation-downward gliding (3) Superior distraction (4) Inferior distraction 4. 1st. costovertebral joint, left 5. 2nd. sternocostal joint, left 6. AKA-streching exercise 7. AKA - resistive exercise Symptoms, diagnosis, treatment were discribed for clinical use, and they were expected further that clinical application of AKA might clarify many of joint dysfunction.

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The Effect of External Pelvic Compression on Shoulder and Lumbopelvic Muscle sEMG and Strength of Trunk Extensor During Push Up Plus and Deadlift Exercise (푸쉬업플러스와 데드리프트 운동 시 골반압박이 견관절과 요골반부 주위근의 근활성도와 체간 신전근 근력에 미치는 영향)

  • Huang, Tian-zong;Kim, Suhn-yeop
    • Physical Therapy Korea
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    • v.25 no.3
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    • pp.1-11
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    • 2018
  • Background: Lumbopelvic stability is highly important for exercise therapy for patients with low back pain and shoulder dysfunction. It can be attained using a pelvic compression belt. Previous studies showed that external pelvic compression (EPC) enhances form closure by reducing sacroiliac joint laxity and selectively strengthens force closure and motor control by reducing the compensatory activity of the stabilizer. In addition, when the pelvic compression belt was placed directly on the anterior superior iliac spine, the laxity of the sacroiliac cephalic joint could be significantly reduced. Objects: This study aimed to compare the effects of EPC on lumbopelvic and shoulder muscle surface electromyography (EMG) activities during push-up plus (PUP) and deadlift (DL) exercise, trunk extensor strength during DL exercise. Methods: Thirty-eight subjects (21 men and 17 women) volunteered to participate in this study. The subjects were instructed to perform PUP and DL with and without the EPC. EMG data were collect from serratus anterior (SA), pectoralis major (PM), erector spinae (ES), and multifidus (MF). Trunk extensor strength were tested in DL exercise. The data were collected during 3 repetitions of all exercise and the mean of root mean square was used for analysis. Results: The EMG activities of the SA and PM were significantly increased in PUP with pelvic compression as compared with PUP without pelvic compression (p<.05). In DL exercise, a significant improvement in trunk extensor strength was observed during DL exercise with pelvic compression (p<.05). Conclusion: The results of this study indicate that lumbopelvic stabilization reinforced with external pelvic compression may be propitious to strengthen PUP in more-active SA and PM muscles. Applying EPC can improve the trunk extensor strength during DL exercise. Our study shows that EPC was beneficial to improve the PUP and DL exercise efficiency.

Four Cases of the Piriformis Syndrome Treated by Trigger Point Injection on the Piriformis Muscle (이상근 증후군 치험 4예)

  • Park, Jang-Soo;Song, Chan-Woo;Kim, Jung-Won;Shin, Dong-Yeop;Hong, Kee-Hyek
    • The Korean Journal of Pain
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    • v.8 no.2
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    • pp.341-346
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    • 1995
  • Piriformis Syndrome is characterized by pain of the low back, groin, perineum, buttock, hip, posterior thigh, leg and foot. Symptoms are aggravated by sitting, prolonged combination of hip flexion, adduction, the medial rotation, or by activity. In addition, patient may complain of painful swelling of the limb and sexual dysfunction-dyspareunia in female, and impotence in male. It currently appears that three specific conditions may contribute to the piriformis syndrome: (a) myofascial pain; (b) nerve and vascular entrapment; (c) dysfunction of the sacroiliac joint. The important keys of diagnosis are history and physical examination. There is no known objective diagnostic method. We described the clinical features of four cases of piriformis syndrome and reviewed foreign literature.

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Functional Taping Technique for Chronic Back Pain and Lower Extremity Pain - McConnell's Approach (만성 요통과 하지 통증에 대한 기능적 테이핑 기법 - McConnell 접근법 -)

  • Kim, Suhn-Yeop;Oh, Duck-Won;Kim, Taek-Yean
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.14 no.2
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    • pp.50-59
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    • 2008
  • Taping techniques have been usually used by physical therapists long time ago, which have been considered a useful adjunct to treatment programs for a variety of musculoskeletal disorders. Also, taping techniques may be employed as effective prophylactic methods in clinical setting because of ease application and cost effectiveness. The aims of this study were to describe background information for the management of some chronic low back pain patients with/without leg pain that don't respond to conservative treatment, to demonstrate McConnell taping as successful therapeutic strategies for treating these patients, and to provide detailed application methods of McConnell taping in order that physical therapists can readily use the taping in clinical setting. This study emphasized to illustrate biomechanical benefits of McConnell taping in controlling undesirable muscle activation by decreasing mechanical loads on specific muscles. McConnell taping may be helpful for the inhibition of overactive synergist or antagonists, the facilitation of inactive synergists, the promotion of proprioception, the optimization of joint alignment, pain reduction, and unloading of irritable neural tissue. This study provides taping examples of low back pain, sacroiliac joint dysfunction and lower extremity symptoms associated with these conditions, and discusses the possible mechanisms for their successful application.

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Comparison of the Effects of Pelvic Compression Using Instruments on Trunk Muscle Endurance and Balance Ability in Subjects in Their Twenties With or Without Low Back Pain (기구를 이용한 골반 압박이 20대의 요통 경험자와 비경험자의 체간 근지구력과 균형 능력에 미치는 영향 비교)

  • Chung, Suh-young;Kim, Suhn-yeop
    • Physical Therapy Korea
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    • v.29 no.2
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    • pp.156-164
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    • 2022
  • Background: Low back pain (LBP) is a representative disease, and LBP is characterized by muscle dysfunction that provides stability to the lumbar spine. This causes physical functional problems such as decreased posture control ability by reducing the muscular endurance and balance of the lumbar spine. Pelvic compression using instruments, which has been used during recent stabilization exercises, focuses on the anterior superior iliac spine of the pelvis and puts pressure on the sacroiliac joint during exercise, making the pelvis more symmetrical and stable. Currently, research has been actively conducted on the use of pelvic compression belts and non-elastic pelvic belts; however, few studies have conducted research on the application effect of pelvic compression using instruments. Objects: This study aimed to investigate whether there is a difference in trunk muscular endurance and dynamic and static balance ability levels by applying pelvic stabilization through a pelvic compression device between the LBP group and the non-LBP group. Methods: Thirty-nine subjects currently enrolled in Daejeon University were divided into 20 subjects with LBP group and 19 subjects without LBP (NLBP group), and the groups were compared with and without pelvic compression. The trunk muscular endurance test was performed with 4 movements, the dynamic balance test was performed using a Y-balance test, and the static balance test was performed using a Wii balance board. Results: There was a significant difference the LBP group and the NLBP group after pelvic compression was applied to all tests (p < 0.05). In the static and dynamic balance ability test after pelvic compression was applied, there was a significant difference in the LBP group than in the NLBP group (p < 0.05). Conclusion: These results show that pelvic compression using instruments has a positive effect on both those with and without LBP and that it has a greater impact on balance ability when applied to those with LBP.