• 한국전문물리치료학회지
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• 제27권1호
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• pp.1-10
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• 2020

Background: Thoracic spine self-mobilization exercise is commonly used to manage patients with neck pain. However, no previous studies have investigated the effects of thoracic spine self-mobilization exercise alone in patients with chronic neck pain. Objects: The purpose of this study was to investigate the effects of thoracic self-mobilization using a tool on cervical range of motion (ROM), disability level, upper body posture, pain and fear-avoidance beliefs questionnaire (FABQ) in patients with chronic neck pain. Methods: The subjects were 49 patients (21 males, 28 females) with chronic neck pain. The subjects were randomly divided into an experimental group (EG, n = 23) and control group (CG, n = 26). For the EG, thoracic self-mobilization was applied. We placed a tool (made with 2 tennis balls) under 3 different vertebral levels (T1-4, T5-8, T9-12) of the thoracic spine and the subjects performed crunches, which included thoracic flexion and extension in supine position. Five times × 3 sets for each levels, twice a week, for 4 weeks. Cervical pain, disability, upper body posture, FABQ results, and ROM were evaluated at baseline, after 4 weeks of intervention, and at 8 weeks of follow-up. Assessments included the quadruple visual analogue scale (QVAS); Northwick Park neck pain questionnaire (NPQ); craniovertebral angles (CVA), forward shoulder angle (FSA) and kyphosis angle (KA) measurements for upper body posture; FABQ and cervical ROM testing. Results: The EG showed a statistically significant improvement after intervention in the QVAS (-51.16%); NPQ (-53.46%); flexion (20.95%), extension (25.32%), left rotation (14.04%), and right rotation (25.32%) in the ROM of the cervical joint; KA (-7.14%); CVA (9.82%); and FSA (-4.12%). Conclusion: These results suggest that, for patients with chronic neck pain, thoracic self-mobilization exercise using a tool (tennis balls) is effective to improve neck pain, disability level, the ROM, and upper body posture.

• Physical Therapy Rehabilitation Science
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• 제9권4호
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• pp.230-237
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• 2020

Objective: To investigate the physical appearance and therapeutic changes that occur with the performance of Schroth exercise in patients with scoliosis. Design: Randomized controlled trial. Methods: Fifteen subjects with maximum curvature of the lumbar who were diagnosed with idiopathic scoliosis had volunteered to participate in the study. Eight subjects were included in the experimental group where they performed the Schroth Therapeutic Exercise and the other seven were included in the control group. The experimental group underwent 2 hours of weekly treatment for 12 weeks, while the control group did not during the same period based on the decisions of patients or guardians. The Mann-Whitney rank test was carried out to compare the treatment results of the two groups, and the comparison within the group was done by Wilcoxon signed-rank test. The vertebral rotation angle (VRA) was by Scoliometer, and difference of rotated and curved portion volume (DV) between both sides on the major curvature portion measured by 3D human body scanning system. Results: In the experimental group, 12 weeks of Schroth exercise therapy has significant improved in correction rate (CR) in Cobb's angle (CA), VRA, and DV between both sides on the major curvature portion (p<0.05), while significant differences were not found between the groups regarding weight bearing difference in both feet (WD) and DV (p<0.05). Conclusions: Schroth exercise performance showed significant changes in the patient's therapeutic changes (CA, VRA), but the physical appearance (DV, WD) was not significant, indicating that external changes in the treatment goal setting are more difficult goals to achieve.

• 대한의용생체공학회:의공학회지
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• 제27권5호
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• pp.210-217
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• 2006

Many types of interspinous distraction devices (IDDs) have been recently developed as an alternative surgical treatment to laminectomy and fusion with pedicle screws for the treatment of the lumbar spinal stenosis (LSS). They are intended to keep the lumbar spine in a slightly flexed posture to relieve pain caused by narrowing of the spinal canal and vertebral foramen. However, their biomechanical efficacies are not well known. In this study, we evaluated the kinematic behaviors and changes in intradiscal pressure (IDP) of the porcine lumbar spine implanted with IDD. For kinematics analysis, five porcine lumbar spines (L2-L6) were used and the IDD was inserted at L4-L5. Three markers (${\phi}{\le}0.8mm$) were attached on each vertebra to define a rigid body motion for stereophotogrammetric assessment of the spinal motion in 3-D. A moment of 7.5Nm in flexion-extension, lateral bending, and axial rotation were imparted with a compressive force of 700N. Then, IDD was implanted at L3-L4. IDPs were measured using pressure transducer under compression (700N) and additional extension moment (700N+7.5Nm). In kinematic behaviors, insertion of IDD resulted in statistically significant decrease 42.8% at the implanted level in extension. There were considerable changes in ROM at the adjacent levels, but statistically insignificant. In other motions, there were no significant changes in ROM as well regardless of levels. IDPs at the surgical level (L3-L4) under compression and extension moment decreased by 12.9% and 18.8% respectively after surgery (p<0.05). At the superiorly adjacent levels, IDPs increased by 19.4% and 12.9% under compression and extension, respectively (p<0.05). Corresponding changes at the inferiorly adjacent levels were 29.4% and 6.9%, but they were statistically insignificant (p>0.05). The magnitude of pressure changes due to IDD, both at the operated and adjacent levels, were far less than the previously reported values with conventional fusion techniques. Our experimental results demonstrated the IDDs can be very effective in limiting the extension motion that may cause narrowing of the spinal canal and vertebral foramens while maintaining kinematic behaviors and disc pressures at the adjacent levels.

• Journal of Korean Neurosurgical Society
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• 제53권6호
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• pp.331-336
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• 2013

Objective : The offset connector can allow medial and lateral variability and facilitate intralaminar screw incorporation into the construct. The aim of this study was to compare the biomechanical characteristics of C7 intralaminar screw constructs with and without offset connector using a three dimensional finite element model of a C6-7 cervical spine segment. Methods : Finite element models representing C7 intralaminar screw constructs with and without the offset connector were developed. Range of motion (ROM) and maximum von Mises stresses in the vertebra for the two techniques were compared under pure moments in flexion, extension, lateral bending and axial rotation. Results : ROM for intralaminar screw construct with offset connector was less than the construct without the offset connector in the three principal directions. The maximum von Misses stress was observed in the C7 vertebra around the pedicle in both constructs. Maximum von Mises stress in the construct without offset connector was found to be 12-30% higher than the corresponding stresses in the construct with offset connector in the three principal directions. Conclusion : This study demonstrated that the intralaminar screw fixation with offset connector is better than the construct without offset connector in terms of biomechanical stability. Construct with the offset connector reduces the ROM of C6-7 segment more significantly compared to the construct without the offset connector and causes lower stresses around the C7 pedicle-vertebral body complex.

• 대한기계학회논문집A
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• 제36권1호
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• pp.29-35
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• 2012

척추관 협착증은 감압술과 융합술 그리고 인공추간판 치환술 등이 있으며, 2000년대 중반부터는 인공추간판 치환술이 널리 시술되고 있다. 인공추간판의 연구는 추간판의 자유도 및 추체의 굴곡-신전, 측굴전, 축회전에 대한 해석이 핵심기술이지만, 시술 후 수년이 경과하여 발생하는 피로파손이 새롭게 큰 문제점으로 대두되고 있다. 따라서 인공추간판 연구는 슬라이딩 코어의 피로특성 및 내구성 향상에 집중되어야 한다. 본 연구에서는 세계적으로 가장 많이 사용되는 인공추간판 제품(SB Charit$\acute{e}$ III)을 기초로 유한요소모델을 제작하고, 슬라이딩 코어의 곡률반경과 마찰계수의 변화가 von-Mises 응력과 접촉압력에 미치는 영향을 평가하였다. 이와 같은 결과를 바탕으로 새로운 인공추간판 모델들 (Model-I, -II, -III)을 제안하고 일정수명 후 발생할 수 있는 슬라이딩 코어의 피로파손 거동에 대해 SB Charit$\acute{e}$ III의 결과와 비교 평가하였다.