• Journal of Korean Neurosurgical Society
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• v.42 no.4
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• pp.271-275
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• 2007

Objective : Although a significant correction of local kyphosis has been reported previously, only a few studies have investigated whether this correction leads to an improved overall sagittal alignment. The study objective was to determine whether an improvement in the local kyphotic angle improves the overall sagittal alignment. We examined and compared the effects of thoracic and lumbar level kyphoplasty procedures on local versus overall sagittal alignment of the spine. Methods : Thirty-eight patients with osteoporotic vertebral compression fractures who showed poor response to conventional, palliative medical therapy underwent single-level kyphoplasty. The pertinent clinical data of these patients, from June 2006 to November 2006, were reviewed retrospectively. We measured preoperative and postoperative vertebral body heights, which were classified as anterior, middle, or posterior fractured vertebral body heights. Furthermore, the local and overall sagittal angles after polymethylmethacrylate deposition were measured. Results : More height was gained at the thoracic level, and the middle vertebral height regained the most. A significant local kyphosis correction was observed at the fractured level, and the correction at larger spanning segments decreased with the distance from the fractured level. Conclusion : The inflatable balloon kyphoplasty procedure was the most effective in regaining the height of the thoracic fractured vertebra in the middle vertebral body. The kyphosis correction by kyphoplasty was mainly achieved in the fractured vertebral body. Sagittal angular correction decreased with an increase in the distance from the fractured vertebra. No significant improvement was observed in the overall sagittal alignment after kyphoplasty. Further studies in a larger population are required to clarify this issue.

• Journal of The Korean Society of Integrative Medicine
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• v.9 no.3
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• pp.193-201
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• 2021

Purpose : The purpose of this study was to compare the effect of pelvic exercise on the CVA and spinal curve in adults with forward head posture compared to the group using only neck exercise when pelvic exercise was performed in parallel with conventional neck exercise. Methods : GPS 400 and Formetric were used to identify craniovertebral angle (CVA), thoracic kyphosis, lumbar lordosis, and pelvic torsion and were measured by an experienced research manager. Forward head posture (FHP) was selected for people whose angle between the line connecting the ear ball and the seventh cervical spine and the horizontal line is 50 degrees or less. The 30 selected students were randomly divided into 15 experimental groups and 15 control groups. Mackenzie exercise and sling exercise were performed for neck exercise in both the experimental group and the control group, and pelvic exercise using a Swiss ball was additionally performed in the experimental group. All data collected in this study were analyzed using SPSS statistics 21.0. Cervical vetebral angle (CVA), thoracic kyphosis, lumbar lordosis, and pelvic torsion were compared at 0 weeks, 3 weeks, and 6 weeks for each measurement factor using ANOVA with repeated measures. For the statistical significance test, the significance level of α was set to .05. Results : The changes of pelvic torsion, thoracic kyphosis and CVA due to pelvic exercise using Swiss Ball and neck exercise were changed over time, but lumbar lordosis were not changed. And there were no significant differences among the groups. Conclusion : In conclusion, the pelvic correction exercise is considered to be an effective exercise for correcting the FHP and requires regular pelvic correction exercises. We expect the results to be used in clinical trials.

• Journal of Korean Neurosurgical Society
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• v.65 no.5
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• pp.719-729
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• 2022

Objective : The ossification of the ligamentum flavum (OLF) is one of the major causes of thoracic myelopathy. Surgical decompression with or without instrumented fusion is the mainstay of treatment. However, few studies have reported on the added effect of instrumented fusion. The objective of this study was to compare clinical and radiological outcomes between surgical decompression without instrumented fusion (D-group) and that with instrumented fusion (F-group). Methods : A retrospective review was performed on 28 patients (D-group, n=17; F-group, n=11) with thoracic myelopathy due to OLF. The clinical parameters compared included scores of the Japanese Orthopedic Association (JOA), the Visual analogue scale of the back and leg (VAS-B and VAS-L), and the Korean version of the Oswestry disability index (K-ODI). Radiological parameters included the sagittal vertical axis (SVA), the pelvic tilt (PT), the sacral slope (SS), the thoracic kyphosis angle (TKA), the segmental kyphosis angle (SKA) at the operated level, and the lumbar lordosis angle (LLA; a negative value implying lordosis). These parameters were measured preoperatively, 1 year postoperatively, and 2 years postoperatively, and were compared with a linear mixed model. Results : After surgery, all clinical parameters were significantly improved in both groups, while VAS-L was more improved in the F-group than in the D-group (-3.4±2.5 vs. -1.3±2.2, p=0.008). Radiological outcomes were significantly different in terms of changes in TKA, SKA, and LLA. Changes in TKA, SKA, and LLA were 2.3°±4.7°, -0.1°±1.4°, and -1.3°±5.6° in the F-group, which were significantly lower than 6.8°±6.1°, 3.0°±2.8°, and 2.2°±5.3° in the D-group, respectively (p=0.013, p<0.0001, and p=0.037). Symptomatic recurrence of OLF occurred in one patient of the D-group at postoperative 24 months. Conclusion : Clinical improvement was achieved after decompression surgery for OLF regardless of whether instrumented fusion was added. However, adding instrumented fusion resulted in better outcomes in terms of lessening the progression of local and regional kyphosis and improving leg pain. Decompression with instrumented fusion may be a better surgical option for thoracic OLF.

• Journal of the Korean Academy of Clinical Electrophysiology
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• v.10 no.2
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• pp.23-29
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• 2012

Purpose : Purpose of this study was to investigate whether cervicothoracic posture was associated with scapula orientation and muscle activity during shoulder abduction. Methods : Cervicothoracic junction angle and thoracic kyphosis angle were measured in health twenty subjects. Then, scapular resting orientation and range of motion (upward/downward rotation, internal/external rotation) and muscle activity (upper trapezius, lower trapezius, serratus anterior) was determined using motion capture system and surface electromyography while subjects performed shoulder abduction. Results : Cervicothoracic junction angle was significantly associated with range of motion of scapular internal/external rotation during shoulder abduction. Thoracic kyphosis angle was significantly associated with scapular resting orientation of upward/downward rotation and average IEMG of lower trapezius. Conclusion : The result of this study shows that poor cervicothoracic posture is relationship with altered scapular kinematics cause of shoulder dysfunction. These findings suggested that cervicothoracic posture may be considered in occupation and exercise including arm elevation over head as well as used as predict factor to estimate shoulder dysfunction.

• PNF and Movement
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• v.20 no.1
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• pp.51-58
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• 2022

Purpose: The purpose of this study was to investigate the effect of thoracic-lumbar dissociation motion and slump motion on thoracic-lumbar erector spinae and rectus abdominis muscle activity. Methods: Seventeen healthy adult volunteers participated in this study. All participants performed two motions (thoracic-lumbar dissociation motion, slump motion). Muscle activation during the two motions was measured using a surface electromyography device. The data from this were collected from the iliocostalis thoracis, iliocostalis lumborum, and rectus abdominis. The activities of these muscles before and after each motion were then compared. Results: The iliocostalis thoracis activation was significantly greater during the thoracic-lumbar dissociation motion than during the slump motion (p <0.05). The iliocostalis lumborum activation was greater during the slump motion than during the thoracic-lumbar dissociation motion (p <0.05). The rectus abdominis activation was lesser during the slump motion than during the thoracic-lumbar dissociation motion (p <0.05). Conclusion: This study confirmed that individual contraction of the erector spinae muscles is possible during thoracic-lumbar dissociation motion, which increases the stability of the thoracic spine. In addition, this motion could improve control of the rectus abdominis. Therefore, thoracic-lumbar dissociation motion should be considered for rehabilitation programs for patients with kyphosis and back pain.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.9 no.1
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• pp.29-38
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• 2003

The purpose of this study was to investigate relationship of lumbar extensor muscle power & spinal column curve for old female patients with LDK(Lumbar degenerative kyphosis). Subjects were composed of 37 old female with LDK. The subjects were tested in their spinal segment movement and spinal column curve with Spinal-$Mouse^{\leq}$ in $1^{st}$ loaded test and $2^{nd}$ loaded test and then tested lumbar extensor muscle power with $Medx^{\leq}$ lumbar extension machine. The results of this study, were as follow; There were statistically significant difference $1^{st}$ loaded test and $2^{nd}$ loaded test in upright position increase spinal column forwardly(p<0.01) and decrease lumbar lordosis angle(p<0.01), but no statistically significant difference $1^{st}$ loaded test and $2^{nd}$ loaded test thoracic and hip & sacrum curve angle. Their lumbar extensor muscle poser is very weakness, 61.4% of normal people.

• Physical Therapy Korea
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• v.9 no.1
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• pp.53-61
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• 2002

The purpose of this study was to compare the body alignment during standing on level and wedge board. Twenty healthy college students (8 females, 12 males) were evaluated in this study. Diagnostic contourline potographic imaging system (Model JTC-1, Jodang Trading Co.) was used to measure body alignment. Sagittal and frontal plane images were used to analyze the body alignment. The result showed that the cervical and lumbar lordotic curve significantly decreased during standing on wedge board when compared with standing on level. On the other hand, thoracic kyphosis significantly increased during standing on wedge board. There was no significant difference in body alignment according to gender, weight, and height. Clinically, patients with low back pain and severe lordosis may be affected by heel wedge. Further study is needed to identify whether the standing on wedge board can change the body alignment in patients with low back pain and spinal deformity.

• Journal of International Academy of Physical Therapy Research
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• v.11 no.2
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• pp.2065-2070
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• 2020

Background: Weakness of the abdominal and mid thoracic muscles the lead to thoracic kyphosis of stroke patients. The trunk muscles activity of stroke patients is significantly related to upper extremity. Objectives: To investigate the effect of seated exercise of thoracic and abdominal muscles on upper extremity function and trunk muscles activity in stroke patients. Design: One-group pretest-posttest design. Methods: A total of 27 stroke patients were recruited. All stroke patient were given seated abdominal exercise (posterior pelvic tilt exercises) and thoracic exercise (postural-correction exercise). All exercises were conducted for 30 minutes, three times a week for four weeks. The manual function test (MFT) and electromyography (EMG) were measured, and EMG electrodes were attached to thoracic paraspinal muscles and lower rectus abdominal muscles. EMG signal is expressed as %RVC (reference voluntary contraction). Results: Experimental group showed significant increases in abdominal muscles, paraspinal muscles activity and MFT total score, items of arm motion (forward elevation of the upper extremity, lateral elevation of the upper extremity, touch the occiput with the palm) in MFT after four weeks. Conclusion: These results suggest that, in stroke patients, seated exercise of thoracic and abdominal muscles contribute to improve trunk muscles activity and upper extremity function in stroke patients.

• Journal of The Korean Society of Integrative Medicine
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• v.8 no.2
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• pp.41-51
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• 2020

Purpose : The purpose of this study was to determine the effect of scapulothoracic exercise and thoracic mobilization on shoulder pain and function in individulas with shoulder partial- thickness rotator cuff tear. Methods : Forty-five subjects were recruited and randomly divided into 3 groups of 15 subjects each : Scapulothoracic exercise with Thoracic mobilization (STwTM), Scapulothoracic exercise (ST), and Thoracic mobilization (TM) groups. All subjects were assessed for pain and disability of shoulder, thoracic angle base on the Shoulder Pain and Disability Index (SPADI) and Thoracic kyphosis assessment (TKA) using Baseline Bubble Inclinometer. All groups performed 50 minutes of the intervention twice a week for a total of six weeks. These tests were evaluated Three times : prior to the start of the intervention, after three weeks and, after six weeks had passed. Results : The SPADI score showed that pain and dysfunction in the STwTM group decreased compared to those in the other two groups. The TKA score showed a decrease over time in the ST, TM, and STwTM groups, in increasing order. However, the TKA score decreased significantly in the STwTM group compared to that in the oher two groups. Conclusion : ST and TM are effective in improving pain and dysfunction in patients. However, STwTM may be more effective for patients.

• Journal of radiological science and technology
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• v.45 no.5
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• pp.391-396
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• 2022

The purpose of this study was to investigate the effect of cross arms and palms facing forward on spinopelvic parameters during the whole spine lateral radiography. In addition, we would like to present the usefulness of a posture with the palm facing forward during whole spine lateral radiography of the spine using EOS. The subjects of this study were images of a total of 50 patients (18 males, 32 females) who whole spine lateral radiography using the conventional method and the EOS method from October 2020 to March 2021. The posture used in this study was set as 'CAP' for cross arms and 'PUSH' for posture with palms facing forward. In this study, among the spinal stability factors, thoracic kyphosis (thoracic vertebrae 4 to 12), lumbar lordosis (lumbar vertebrae 1 to sacrum 1), sagittal vertical axis, sacral slope, and shoulder flexion angle were compared on average. The mean thoracic kyphosis was 34.52±12.46° for CAP and 28.46±10.81° for PUSH (p<0.01). The lumbar lordosis of CAP was 42.45±17.45°and that of PUSH was 40.56±16.14°(p>0.57). The sagittal vertical axis was 26.59±34.34 mm in CAP and 21.21±35.41 mm in PUSH (p>0.44). In CAP, the sacral slope was 30.96±10.29°, and in PUSH, it was 31.01±10.19° (p>0.98). shoulder flexion angle was 38.31±8.24° for CAP and 26,08±6.71° for PUSH(p<0.01). As a result of this study, the PUSH posture is considered to be a posture that can minimize the shoulder flexion angle and can perform a stable examination while minimizing changes in spino-pelvic parameter.