Background: It is well known that squat exercises are good for scoliosis patients. Especially wall facing squat (WS) is believed to be more effective than normal squat (NS). Objectives: In order to find out what effect the wall squat has on the rehabilitation exercise of patients with lumbar scoliosis compared to the conventional squat, the force between the lumbar segments was compared using a motion analysis system. Design: Quasi-experimental study. Methods: In this work, an attempt was made to provide a scientific basis for these experiences. Inverse dynamics simulations were performed for each of the 10 subjects with mild scoliosis during NS and WS using subject-specific 3D musculoskeletal models. Exercises with three sets of five cycle for NS or WS were performed. Muscle forces calculated from the simulations were compared with electromyography data for verification. Results: The imbalance of muscle forces between the right and left in erector spinae (ES) decreased with the progress of WS sets. The difference of 14.1% for the 1st set diminished to 1.8% during the 3rd set. Conclusion: The overall level of right and left ES muscle forces also increased from the 1st set to the 3rd set. The results of simulations indicated that WS was more effective than NS for scoliosis correction.

요통을 호소하는 환자에서의 자기공명영상 검사는 다른 영상 진단법에 비해 요추와 주변 조직에 대한 높은 대조도와 해상력, 다양한 영상면의 획득으로 해부학적 구조 파악과 다양한 척추 질환의 진단에 널리 활용되고 있다. 그러나 자기공명 영상 검사는 검사 시간이 길기 때문에 통증으로 협조가 되지 않는 환자들에게서 움직임에 의한 인공물을 유발하는 경우가 많아 검사 시간을 최소화하는 것이 중요하다. 이에 자기공명영상 검사 시간 단축을 위한 다양한 기법들이 개발되어 왔으며, 최근 높은 영상의 질을 유지하면서 검사 시간은 크게 줄이는 K-공간 기반 딥 러닝(K-space based Deep Learning, DL) 기법이 주목받고 있다. 본 연구는 요추 자기공명영상 검사에서 DL 기법의 유용성을 알아보기 위해 본원을 내원하여 척추 질환이 의심되는 환자를 대상으로 DL 기법 적용 전후 시상면 T2 강조 영상과 축상면 T2 강조 영상을 각각 획득하였으며, 신호대잡음비와 대조대잡음비, 영상 획득 시간, 전체적인 영상의 질 및 병변 진단 일치도를 비교 분석하였다. 연구 결과 영상의 질 향상과 검사 시간의 단축뿐만 아니라 빠른 영상 획득으로 움직임이나 호흡에 의한 인공물 또한 감소하는 것을 볼 수 있었다. 따라서 자기공명영상 검사에서 DL 기법 사용 시 진단적 가치가 보다 높은 영상을 제공하는 동시에 환자의 만족도를 높여 임상에서도 유용한 방법이 될 것으로 사료된다.

Background: Previous researchers have investigated the mechanical and neurophysiological effects of manual mobilization, however little research has been done on muscle tone and muscle stiffness. Objective: To compare the effects of posterior-anterior (PA) mobilization with weight bearing on sling and conventional PA mobilization on the bed. Design: Randomized controlled trial (single blind) Methods: The subjects were 16 male university students and randomized to sling mobilization group (SMG, n=8) or conventional mobilization group (CMG, n=8). SMG received PA mobilization using a sling and CMG received traditional mobilization on the bed during lumbar mobilization. Results: Both left and right muscle tones of SMG increased, but left muscle tone of SMG were increased and right muscle tone was decreased after intervention. In addition, both left and right muscle stiffness of SMG were also increased, however left muscle stiffness of SMG was increased and right muscle stiffness was decreased. The muscle tone and muscle stiffness of SMG were higher than those of DMG, especially the right side was statistically significantly higher. Extension of SMG, extension and flexion of CMG were increased statistically significantly except for Flexion of SMG (p<.05). There were no significant differences between the groups in Extension and Flexion. Conclusions: This study suggests that lumbar spine PA mobilization using sling is beneficial in improving muscle tone, muscle stiffness, and trunk movement.

The purpose of this study is to investigate the effect of pelvic, Lumbar spine and Cervical spine manipulation on the joint position sense in normal adults. Thirty normal adults were divided into an experimental group of 15 subjects and a control group of 15 subjects. The experimental group was treated with pelvic, Lumbar spine and Cervical spine manipulation with massage, whereas the control group received only massage. Both groups were evaluated in terms of joint position errors (JPEs) using a digital dual clinometer before and after the experiment. The comparison of the JPEs of the experimental group and the control group before and after the experiment showed that the experimental group’s cervical spine results were significantly different in the flexion, left lateral flexion, and right rotation (p < .05) and lumbar spine results were significantly different in the flexion and extension (p < .05), but the control group’s results were not statistically significant in all items (p > .05). The pelvic, lumbar spine and cervical spine manipulation makes an effect on the joint position sense in normal adults. The findings of this study suggest that the pelvis, lumbar spine and cervical spine manipulation improve the motor ability in people with low joint position sense.

The purpose of this study was to measure the mean peak mobilization forces to the lumbar spine 1-3 with grade III and grade IV of posteroanterior (PA) mobilization. Twenty subjects with no history of Lumbar back pain (LBP) (10 female, 10 male) with a mean age of 24.1 years (SD = 6.0) were recruited for the study and PA mobilization were performed in each spine and the therapist took approximately 2.5s to complete mobilization. In the results, applied grade IV force showed no different according to each segment in LS1, LS2, LS3, however, there are distinct differences between LS1 and LS2, LS1 and LS3 during mobilization with grade III force. This study suggested that the mean peak force of the grade III and grade IV mobilization in the L1-L3 was almost similar each other.

목적 및 배경 : 본 연구의 목적은 Lumbar Spine Routine 자기공명영상에서 ProSet(Principles of the selective excitation technique)기법이 유용한 검사임에도 임상에서 많이 사용되지 않으며 2D영상만 주로 사용하고 3D영상으로 잘 분석되지 않고 있다. 이에 ProSet기법의 3D영상의 중요성과 요추 자기공명영상에서의 ProSet기법의 유용성을 알리고자 한다. 대상 및 방법 : 본원을 내원하여 2011~2014년 요추 자기공명영상 검사를 시행한 환자를 대상으로 ProSet 2D영상과 3D영상을 분석하였다. 연구에 이용한 실험 장비는 Philips사의 Gyroscan Intera 1.5Tesla로 Spine Array coil을 사용하였다. 결 과 : 요추 자기공명영상 검사의 ProSet 2D영상과 3D영상을 영상의학과 전문의 3명에게 보여주었다. 2D영상보다는 3D영상에서의 신경근 압박(Nerve root compression)정도와 신경근의 부종 등이 잘 묘사되어 3D영상의 진단적 가치가 더 높았다. 결 론 : 요추(Lumbar spine) 자기공명영상에서 ProSet의 2D영상보다 3D영상의 신경근 압박 및 부종 등의 진단적 가치가 높았다

This study aimed to investigate the effect of the abdominal drawing-in maneuver (ADIM) and abdominal expansion maneuver (AEM) on trunk stabilization, as well as trunk muscle activities and differences in quadruple visual analogue scale, Korean Oswestry Disability Index, and Fear Avoidance Beliefs Questionnaire scores, in patients with chronic low back pain and lumbar spine instability. To increase intra-abdominal pressure during the trunk stabilization exercise, the technique of pushing the abdomen out using diaphragmatic abdominal breathing suggested by Pavel Koral was used, which we termed the AEM. Fifty patients who tested positive on more than three of the five lumbar spine instability tests were separated from 138 patients with chronic low back pain of these patients, 16 were placed in the control group (trunk stabilization exercise), 17 were placed in the ADIM group (trunk stabilization exercise with ADIM), and 17 were placed in the AEM group (trunk stabilization exercise with AEM). Each group participated in the study for 30 minutes three times weekly for 4 weeks. Surface electromyography was used to measure the trunk muscle activities during the kneeling forward and supine bridging positions, and one-way repeated analysis of variance was used to determine the statistical significance of the trunk muscle activities in the rectus abdominis, internal oblique (IO), erector spinae, and multifidus (MF) muscles. The ADIM and AEM groups showed relatively larger improvements in psychosocial and functional disability level than control group. There were significant changes among the three groups, those from the measured values of the AEM group was significantly higher than the other two groups in changes in IO and MF trunk muscle activities (p＜05). This finding demonstrates that trunk stabilization exercises with AEM is more effective than ADIM for increasing trunk deep muscle activity of chronic low back pain patients with lumbar spine instability.

This study investigated the effects of axillary crutch length on trunk muscle activity and lumbo-pelvic-hip complex movements during crutch gait. Eleven healthy men participated in this study. The participants performed a three-point gait with optimal, shorter, and longer crutch lengths. Weight-bearing (WB) side was determined as the dominant leg side. The electromyography (EMG) activity of the bilateral rectus abdominis (RA) and erector spinae (ES) muscles and lumbo-pelvic-hip complex movements were monitored using a three-dimensional motion system with wireless surface EMG. Differences in the EMG activity of RA and ES muscles and range of motion (ROM) of lumbar spine, pelvis, and hip among conditions were analyzed using one-way repeated-measures analysis of variance, and a Bonferroni correction was conducted. There was less RA muscle activity on the WB side under the optimal crutch length condition compared with shorter and longer crutch length conditions (p<.05). The EMG activity of the RA muscle on the non-WB side and ES muscle on the WB side were significantly decreased under the optimal crutch length condition compared with shorter crutch length condition (p<.05). No significant differences in the EMG activity of the ES muscle on the non-WB side and ROM of lumbo-pelvic-hip complex were found among conditions (p>.05). These findings indicate that the optimal crutch length improves the trunk muscle efficiency during crutch gait.

The purpose of this study was to assess the influence of the duration of smartphone usage on cervical and lumbar spine flexion angles and reposition error in the cervical spine. The study included 18 healthy smartphone users (7 males and 11 females). We measured the kinematics of the upper and lower cervical and lumbar spine flexion angles and the reposition error of the upper and lower cervical spine after 3 s and 300 s smartphone use in sitting. A paired t-test was used to compare the effects of the duration of smartphone usage on the kinematics of cervical and lumbar spine flexion angles and reposition error. The flexion angles of the lower cervical and lumbar spine and the reposition error in the upper and lower cervical spine were significantly increased after 300 s smartphone of use (p<.05). However, the flexion angle of the upper cervical spine was not significantly different between the 3 s and 300 s smartphone of use (p>.05). These findings suggest that prolonged use of smartphones can induce changes in cervical and lumbar spine posture and proprioception in the cervical spine.

The purpose of this study was to identify the effects of manual facilitation and a stick on lumbar and hip joint flexion angles in subject with lumbar flexion syndrome during forward bending from a sitting position. Fifteen subjects with lumbar flexion syndrome were recruited for this study. As a pretest, all subjects performed three repetitions of bending the trunk forward until the tips of their fingers touched the target bar. After this pretest, the subjects practiced the forward bending of the trunk 10 times, using either manual facilitation or a stick. Then, as a posttest, all subjects repeated the pretest procedure. The flexion angles of lumbar spine and hip joint during forward bending in a sitting position were measured using a three-dimensional motion analysis system. A paired t-test was used to determine the statistical differences between pre-test and post-test flexion angles and pre- and post-test flexion angle differences between forward bending with manual facilitation and forward bending with a stick. The level of statistical significance was set at p=.05. The results of the study showed that the angle of the lumbar flexion decreased significantly and the bilateral hip flexion angle increased significantly when performing forward bending with stick and manual facilitation. Furthermore, the angle of lumbar flexion decreased significantly and the angle of bilateral hip flexion increased significantly in forward bending with a stick compared to forward bending with manual facilitation. The findings of this study indicate that both forward bending with manual facilitation and sticks could be used to prevent excessive lumbar flexion and increase hip flexion, and that forward bending with a stick is more effective than forward bending with manual facilitation for inducing lumbar spine and hip joint angle changes.

Low back pain is a common phenomenon among the golfers. In an attempt to understand low back pain, the kinematic changes and golf swing motion analysis has been performed to focus on lumbar spine in pro. golfers. According to the swing pattern, significant variations of the lumbar joint forces and loads has related with muscles activities so the motion analysis of lumbar spine were discussed. The purpose of this study was to analyze motion of lumbar spine and it was to compare joint force during golf swing in pro. golfers. The swing motion of the subjects was tracked using a 3D motion analysis system by Motion Analysis Ltd. and SIMM software. The angle changes of lumbar spine rapidly in vx direction during the top back swing and the finish and in vy direction during the follow through and in vz direction during the down swing and the impact(Subject A). The angle changes of lumbar spine rapidly in vx direction during the top back swing and in vy direction during the down swing, the impact and the follow through and in vz direction during the down swing(Subject B). In conclusion, subject A and B both show sudden angle changes between 1st-3rd lumbar spine and 4th-5th lumbar spine during the stage from address to top back swing which caused by over upper body twisting.

In children with cerebral palsy, bone density is decreased by disturbance of bone remodelling due to lack of normal weight bearing and muscle contraction through physical activity. Loss of bone density cause fracture, delays treatment with immobilization, and leads to functional limitation. The purpose of this study was to investigate bone mineral density of lumbar spine in children with spastic quadriplegia and diplegia. Six spastic quadriplegia and 14 spastic diplegia were evaluated in this study. QDR 4500 X-ray densitometer was used to measure bone density at lumbar spine (L1~L4). Children with cerebral palsy showed lower bone density than that of normal children. Bone density in children with spastic quadriplegia and diplegia was , , respectively. However, there was no significant differences in bone density between children with spastic quadriplegia and diplegia. There was no significant difference in bone density relation to motor development level, height, and weight. Further study is needed to find the appropriate interventions for preventing loss of bone density in children with cerebral palsy.

골다공증은 골절의 위험도가 증가하는 질환으로, 본 연구에서는 이중에너지 엑스선 흡수계측법(DXA)을 이용하여 허리뼈의 회전과 기울기에 따른 골밀도를 비교 분석하였다. 실험 결과 허리뼈의 회전에 따른 골밀도는 감소하지만 허리뼈의 기울기 변화에서는 그 결과는 예측할 수 없었다. 이러한 이유는 허리뼈의 기울기 변화가 허리뼈 1번과 4번사이 일부분에서 겹침으로 인하여 뼈의 전체 면적과 골밀도가 변화한 결과로 판단되어진다. 즉, 방사선사는 정확한 골밀도 결과 값을 얻기 위하여 허리뼈의 회전방지와 기울기에 따른 겹침을 방지하기 위한 노력이 필요할 것으로 판단되어진다.

본 연구자는 척주 측만증 및 허리뼈 분쇄 골절된 환자의 수술 후 단순 엑스선 척주 측방향 촬영에서 두 개의 철심이 겹친 영상을 얻어내기 위해 엑스선관 및 인체팬톰의 각도를 변화시켜 영상을 얻었다. 영상 평가를 위해 대학병원 영상의학과에서 10년 이상 근무한 방사선사 5명에게 주관적 평가를 하였다. 측정 결과 척주 측만증 측방향 촬영은 정중 이마면을 IR면 중심에 일치되게 하고 일곱 번째 등뼈가 중앙이 되도록 자세를 조정한 후 엑스선관과 척주팬톰 자세를 각각 수직으로 촬영하면 척주 측방향 촬영에서 두 개의 겹쳐진 영상을 얻을 수 있었고 주관적 평가에서도 높은 점수를 얻었다. 또한 허리뼈 탈구 골절된 허리뼈 측방향 촬영은 이마면을 IR면 중심에 일치시키고 네번째 허리뼈가 중앙이 되도록 자세를 조정하여 엑스선관 각도를 수직되게 하고 척주 팬톰을 네번째 허리뼈를 수직하여 촬영 하게 되면 척주 측방향 촬영에서 두개의 철심이 겹치는 영상을 얻을 수 있었고 주관적 평가에서도 높은 점수를 얻었다.

Globally, as well as domestically, patients without risk factors for spontaneous spinal epidural hematoma (SSEH) have rarely been reported. SSEH often results from trauma, epidural catheter insertion for anesthesia and invasive spinal procedures. It could also occur in patients with risk factors such as hypertension, coagulopathy, pregnancy, and vascular anomaly. We encountered a case of a 51-year-old female without prior medical history or any risk factors. Magnetic resonance imaging (MRI) showed subacute SSEH at lumbar spine regions. The patient was treated successfully by surgical decompression. Therefore, we report this case with a review of the relevant literature.