본 연구는 최근 7년간 Google scholar, ProQuest에서 Adolescent Idiopathic Scoliosis(AIS), Cobb’s angle, Surgical, Conservative, In tervention을 핵심 키워드로 활용하여 청소년 특발성 척추측만증의 수술 적 중재 방법과 보존적 중재 방법이 Cobb’s angle에 미치는 영향을 조 사하였다. 중재 전ㆍ후 Cobb’s angle 차이를 JAMOVI를 이용하여 메타 회귀분석을 실시하였으며 청소년 특발성 척추측만증 환자에게 Cobb’s an gle 긍정적 변화에 효과적인 중재 방법은 수술적 중재 방법에는 Selectiv e thoracic fusion, Posterior spinal fusion, Anterior spinal fusion 이 있었으며, 보존적 중재 방법에는 Lumbar cheneau brace, Xinmiao treatment system(XTS), Cheneau brace+Schroth best practice(S BP), Core stabilization exercises가 있음을 확인하였다. 이러한 연구 결과를 통하여 청소년 특발성 척추측만증 연구 분야의 방향성 제공에 도 움을 주고 향후 어떠한 중재 방법이 효과적일지 판단할 수 있는 지표개발 을 요구하는 바이다.

본 연구는 최근 10년간 국내 청소년 특발성 척추측만증 보존적 중재법이 Cobb's angle의 변화에 어떠한 영향을 미치는지 알아보기 위하여 RISS(학술연구정 보서비스)에서 청소년 척추측만증, 특발성, 중재법을 핵심키워드로 검색하여 메타 회귀분석을 실시하였다. KCI등재후보지 이상 학술지만 선별하였으며, 참가자의 연 령 및 중재방법 등을 고려하여 총 11개의 논문이 선정되었다. 총 23개의 보존적 중재법은 크게 능동적 운동치료, 수동적 치료, 복합치료, 보조기로 나뉘었으며 신 뢰도95%에 해당하는 중재법은 능동적 운동치료 5가지와 보조기 1가지였다. 이는 능동적 운동치료의 형태의 보존적 중재법이 청소년 특발성 척추측만증 Cobb's angle변화에 가장 긍정적인 영향을 미치는 것으로 조사되었다.

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.

Background: Scoliosis can be caused by postural changes. The effects of Schroth exercises and Kinesio taping for scoliosis have been reported independently, but there are few studies on the effects of combining both methods. Objectives: To investigated the effects of Schroth exercises and kinesio taping on the Cobb angle and dynamic balance ability in patients with scoliosis. Design: Quaxi-experimental study. Methods: Participants were divided into the taping (n=3) and non-taping (n=3) groups. Pre-tests for the Cobb angle and dynamic balance were performed prior to the first intervention, and post-tests were performed after the intervention was completed. The non-taping group performed Schroth exercises for a total of 12 35-minute sessions thrice a week for 6 weeks. Meanwhile, in the taping group, Kinesio tape was attached before performing the same exercises and was maintained for 24 hours after the exercises were finished. Results: In the taping group, there was no significant change in the Cobb angle and dynamic balance ability pre- and post-intervention (P>.05). Similarly, there was no significant change in the Cobb angle and dynamic balance ability pre- and post-intervention (P>.05) in the non-taping group. Furthermore, there was no significant difference upon comparing the two groups (P>.05). Conclusion: Kinesio taping combined with Schroth exercises did not give additional benefits in terms of the Cobb angle and dynamic balance ability than that in the application of Schorth exercises alone.

Background: Although the Schroth exercise is widely used in idiopathic scoliosis, the Schroth exercise with kinesiotaping is not. And, little research has examined their effectiveness. Objectives: To investigate the effect of Schroth exercise with kinesiotaping on idiopathic scoliosis. Design: A randomized controlled trial. Methods: Participants with hamstring tightness were allocated into the Schroth exercise with kinesiotaping group (SETG, n=12) and the schroth exercise group (SEG, n=11). Participants groups performed Schroth exercise with kinesiotaping or Schroth exercise according to group assignment. To identify changes in spine alignment and balance were performed at pre- and postexercise. Results: Significant changes occurred in spine alignment, balance ability (X mean, LOS forward, LOS right) after exercise in SETG (P<.05). SETG was a significant difference in balance ability (LOS right) than SEG. Conclusion: Schroth exercise with kinesiotaping are effective in improving spine alignment and balance ability in idiopathic scoliosis.

Background: Although recent studies using virtual reality have been actively conducted, studies on exercise therapy interventions and changes in muscle characteristics in patients with scoliosis are limited. Objectives: To investigate the effects of trunk and pelvic exercises program using virtual reality on the characteristics of paraspinal muscles in patients with scoliosis. Design: A randomized controlled trial. Methods: Thirty college students with scoliosis were randomly assigned to the trunk and pelvic exercise program using virtual reality group (VRG; n=15) and the general stretching exercise group (SG; n=15). The intervention was conducted three times a week for 8 weeks for 30 min per session. The recorded variables were muscle tone (F), muscle stiffness (S), and muscle elasticity (D). The collected data were analyzed after statistical processing. Results: In the cervical vertebrae, F showed significant differences in the amount of inter-group variation in the VRG compared that in the SG on the right side. The VRG showed significant increases in intra-group variation on both the right and left sides. S showed significant differences in the amount of inter-group variation in the VRG compared to that in the SG on the right side. With regard to the intra-group variation of F in the thoracic vertebrae, the right muscle in the VRG demonstrated significantly increased after the experiment, while D significantly increased in the left muscle in the VRG. Conclusion: Pelvic and trunk exercises program using virtual reality may be applied a better therapeutic intervention for patients with scoliosis.

Background: Incorrect postures of adolescents caused by the use of smart devices have been noted as a factor causing spinal diseases. Objectives: To examine the effect of joint mobilization and stretching on Cobb’s angle and respiratory function in adolescent idiopathic scoliosis (AIS). Design: Cluster-randomized controlled trial. Methods: A total of 22 subjects with AIS were enrolled. They were allocated to two groups: the joint mobilization (n=11) and the stretching (n=11). All interventions were conducted for 30 minutes, three times a week for six weeks. Outcome measures were the Cobb’s angle and respiratory function. The Cobb’s angle and respiratory function measured using the X-ray and Micro- Quark. Results: Joint mobilization group showed significant differences in Cobb’s angle and respiratory function, but stretching group showed significant differences Cobb’s angle. The differences in peak expiratory flow (PEF) between the two groups were significant. Conclusion: This study proved that joint mobilization is a more effective intervention for AIS to improve Cobb’s angle and respiratory function, when compared to stretching.

Background: Effect of cervical and lumbar tractions on the reduction in the angle of curvature and the effect of a correction exercise or a general traction method on balance, muscle strength, pain, and body alignment, however insufficient research has been undertaken on self traction exercises targeting patients with scoliosis. Purpose: To determine the effect of cervical and lumbar tractions on the reduction in the angle of curvature and the effect of a correction exercise or a general traction method on balance, muscle strength, pain, and body alignment. Design: Randomized controlled clinical trial (single blinded) Methods: Twelve adults(20s) with scoliosis were included in this study and performed a traction program that was composed of a 5-min warm-up exercise, a 15-min main exercise, and a 5-min cool-down exercise (25 minutes in total), three times a week for four weeks. The Chiro traction machine was used for the self-traction exercise. Vertebral alignment, muscle strength, and flexibility were compared before and after the intervention using the paired T-test. Results: The scoliosis angle, pelvic torsion, and lumbar extensor were significantly changed by intervention; however, there was no significant difference in flexibility. Conclusion: The results revealed that self-traction exercise activated blood flow through the extension and contraction of muscles, effectively increasing the function of the muscles around the vertebrae.

The purpose of this study was to examine the effects of the thoracic spine manipulation on spinal alignment (Cobb angle), pain, and trunk range of motion (ROM) in a patient with mild thoracic scoliosis. The Cobb angle was 11.0° and there was a right deviation of the thoracic spine. The subject had thoracic and lumbar pain, and had felt stiffness during turning of the trunk for about 3 years. Thoracic manipulation was applied at the upper thoracic spine as a therapeutic intervention three times per week for 5 weeks. After intervention, the Cobb angle decreased from 11.0° to 5.5° and the pain score decreased from 4.0 to 1.5, and the trunk left rotation ROM increased from 30.0° to 41.5°, and trunk right rotation ROM increased from 26.0° to 39.0°. These results suggest that the thrust thoracic manipulation technique had a positive effect on the spinal alignment, pain and trunk rotation ROM in patients with mild scoliosis.

The purpose of this article was to investigate the effects of Maitland’s transverse movement on change of pain, trunk flexion movement and Cobb’s angle in patient with upper thoracic scoliosis. The subject are 37 years old with chronic low back pain participated in this study and has no experience surgery within the last six months due to back pain. 10 set was applied 10 times on the T3-T5 applied the transverse movement with grade Ⅳ to each segment by skilled physical therapist. Transverse movement was applied convex toward the concave side. Pressure pain threshold was reduced from 4/10 to 2/10. Trunk flexion range that is the distance between the middle finger and floor was increase from 7.3cm to 2cm. Cobb’s angle was decreased from degree 18 to 16. This result demonstrated that the Maitland’s transverse movement was benefit to reduce the pain and Cobb’s angle, and to increase the trunk flexion movement.

The purpose of this study was to compare the static balance in a sitting position between a group with adolescent idiopathic scoliosis (AIS) and a normal aged-matched group. Forty-nine subjects were included in this study. Thirty-one healthy subjects and eighteen AIS subjects were participated. Each group was tested with the Lumbar Trunk Muscle Endurance Test (LTMET) and Balance Performance Monitor (BPM). The parameters for static balance were sway area, sway path, mean balance, maximum velocity, anterior-posterior angle, and left-right angle of each group with eyes opened and closed. Results from the LTMET showed significantly more increase in the normal group than in the AIS group in the flexor and extensor endurance. The BPM tested showed significantly difference beteen the groups in parameters of sitting balance such as maximum velocity and anterior-posterior sway angle. For the AIS subjects, there were no significant differences in all parameters of sitting balance between eyes opened and eyes closed. In comparisons of the groups with eyes opened there were no significant differences in all parameters of sitting balance. In comparisons of the groups with eyes closed there were significant differences in the sway area, maximum velocity, anterior-posterior sway angle and left-right sway angle. These results suggest that the AIS group relies much more on proprioception than on vision, and develops compensatory passive postures of the spine. Further study is needed to measure many AIS patients with morphologic and electromyographic data for clinical application.

The purpose of this study was to compare the static balance of standing position between adolescent idiopathic scoliosis (AIS) and a normal group that were aged-matched. There were forty subjects included in this study. Twenty-seven healthy subjects (age, 13.9±1.2 yrs; height, 161.9±7.5 ㎝; weight, 52.2±7.7 ㎏) and thirteen AIS subjects (age, 14.2±2.2 yrs; height, 161.5±8.7 ㎝; weight, 48.1±8.1 ㎏) were participated in the study. The thirteen subjects in the AIS group had a major Cobb angle between 20.1° and 49°. Each group was tested with the Balance Performance Monitor (BPM). The parameters for static balance were sway area, sway path, max velocity, mean balance, anterior-posterior angle, and left-right angle of each group with their eyes opened and again with their eyes closed. Both sides of the forward reach test and the lateral reach test were also performed on each group. Results from the BPM tested showed significantly increases in all parameters of static balance with those patients with AIS under the conditions where eyes were opened and closed. In the right and left forward reach test, there was no significant difference between normal and AIS groups. However, in the lateral reach test with right and left direction, there were significant differences between normal and AIS groups. For the normal subjects, there were significant differences in the parameters with sway path and anterior-posterior sway angle between the eyes opened and closed. However, there were no significant differences in the all parameters between eyes opened and closed for the AIS subjects. These results suggest that, balance programs could be used in the rehabilitation setting for intervention of AIS and evaluation of AIS. Further study is needed to measure many patients with AIS and other functional balance scales for clinical application.

The objectives of this study were to investigate the effects of thoracic flexibility exercise on chest function and mobility and to provide the information of physical therapy for patients with idiopathic scoliosis. Forty female subjects who were diagnosed with scoliosis participated in this study and were divided into the experimental and control groups. The experimental group consisted of 20 patients who were treated with thoracic flexibility exercise program during the admission (10 days) ad one month after discharge. The control group consisted of 20 patients who were not treated with thoracic flexibility exercise program. Vital capacity was measured using a respirometer. The chest expansion were calculated using differences of chest circumference between maximum inspiration and maximum expiration measured under armpits, at the junction between the sternum and xyphoid process, and at the waist. All subjects were measured two times: before the admission and at one month after discharge. Data were compared by groups using independent t-test, Vital capacity and chest expansion values (the armpit, chest and waist values) were significantly higher for the experimental group compared to those of the control group (p<.05). The findings of this study show that thoracic flexibility exercise program can lead to an increase in vital capacity and chest expansion and has a positive effects in relieving symptoms and restoring thoracic mobility.

The present study was performed to investigate the prevalence rate of idiopathic scoliosis and to determine the effect of exercise training on scoliotic angle in elementary school children. In this study, two out of five elementary schools in Seosan city were chosen by random sampling. Seven hundred sixty four students (from four grade to the sixth grade student) were selected in two schools. Screening tests were conducted to find idiopathic scoliosis. Among the 764 individuals, 139 subjects who showed positive sign in physical examination took whole spine radiography. Thirty six subjects who had a curve of 10 or greater and consented to participate in the exercise program were selected for the exercise program. The exercise program was performed four times a week for 5 months. The results of this study were as follows: 1) One hundred thirty nine subjects showed positive sign in the scoliosis screening test. 2) The overall prevalence of curve of greater in X-ray finding was 8.15%. The prevalencies of curve of greater in male and female were 7.1% and 9.2%, respectively. 3) Scoliosis curves were observed at thoracic area (48.4%), at thoracolumbar area (27.4%) and at lumbar area(24.4%). 4) Right side curve was 59.7%, and left side curve was 40.3%. 5) After the 5 month exercise program for scoliosis, the Cobb's angle was significantly decreased. 6) There was no significant difference of Cobb's angle change respect to sex, grades, and scoliosis curve site. Results shown here indicates that an early detection and early exercise for scoliosis can result in decreased the Cobb's angle in elementary school children.

The purpose of this research is to identify traction effects for the treatment of scoliosis and compare the effects among patients as their own physical characters. In this research, the patients with scoliosis hospitalized for ten days have treated in the way of the static traction for twenty hours a day, and alternating lumbar and cervical traction for twenty minutes two times a day in the department of rehabilitaton of Yong-Dong Severance Hospital. The followings are the conclusions of this research: 1) The traction for the patients with scoliosis is effective treatment method to reduce the curved angle (p<0.001). 2) Statistically there is no significant difference of the reduced curved angle between male and female after the traction (P>0.05). 3) Statistically there is significant difference of the reduced curved angle among age groups after the traction (P<0.05). 4) Statistically there is significant difference of the reduced curved angle among curved angle groups after the traction (p<0.001). 5) Statistically there is no significant difference of the reduced curved angle among shapes of curved angle after the traction (P>0.05).

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.

본 논문에서는 척추측만증 환자의 진료를 위하여 필요한 Whole Spine Scanography 검사에서 촬영거리, 환자자세(전후⦁후전 방향), 흉부벽두께, 갈비뼈두께, 폐조직두께, 관전압, 고전압정류방식의 변화에 따른 유방의 입사선량의 차이에 대한 정량적인 자료를 제시하고자 하였다. 환자의 자세(전후방향과 후전방향)에 따른 유방 입사선량의 저감효과를 확인하기 위하여 관전압 90 kVp, 커마 0.1 mGy, 촬영거리 260 cm, 관전압의 리플율이 0인 인버터정류방식, 필터의 두께 3.5 mm, 환자의 흉벽의 두께 120 mm를 조건으로 Simulati on of X-ray Spectra program을 이용하여 시뮬레이션 하였다. 그 결과 알루미늄 필터 두께 3.5 mm에서 2.6배, 흉벽의 두께 120 mm에서 25.7배, 고 관전압에서 1.43배, 관전압 리플율 0에서 1.14배의 선량 저감효과가 있었다. 각각의 입사 선량저감효과의 총합은 약 109배이었다. RANDO phantom의 자세(전후방향과 후전방향) 에 따른 선량 저감효과를 확인하기 위하여 촬영거리 260 cm, 관전압 90 kVp, 관전류 270 mA, 촬영시간 0.31 sec, 관전압의 리플율이 0인 인버터정류방식, 필터의 두께 3.5 mm을 조건으로 측정한 결과 유방의 입사선량은 전후 방향에 비하여 후전방향이 평균 20.56배의 선량 저감효과가 있었다.

본 연구의 목적은 필라테스 운동이 척추 측만증 환자의 요추 Cobb's angle에 어떠한 영향을 미치는지의 효과를 알아보는데 있다. 이 운동의 효과를 검증하기 위하여 필라테스 자세교정운동(PCE), 척추스트레칭운동(SSE), 근육강화운동(MSE)등을 시행하였다. 자세교정운동은 불균형한 근육에너지를 바로잡아주며 척추스트레칭 운동은 척추주변의 과 긴장된 근육을 이완시키고 근육강화운동은 주동근과 길항근의 균형을 잡아주어 척추 주변 근육의 탄력성과 유연성을 회복시켜주게 된다. 연구방법은 필라테스 적용 전과 적용 후의 X-ray 촬영에 의한 요추의 Cobb's angle을 측정하여 검증하였다. X-ray 촬영을 통한 Cobb's angle 실험 전 후의 결과는 필라테스 실시 후 약 5도 정도에서 통계적으로 유의하게 감소하였다(p=0.005). 따라서 필라테스 운동이 척추 측만증에 완화에 도움이 되는 것으로 나타났다.

본 연구의 목적은 특발성 척추 측만증 환자를 대상으로 요가 운동 요법을 통하여 척추 측만각도 즉 요추 Cobb's angle의 정도를 분석하여 요가 운동 프로그램이 특발성 척추 측만연구에 어떠한 영향을 미치는지의 효과를 알아보는데 있다. 본 연구의 요가 운동 프로그램은 척추주변의 근육들의 지나친 긴장을 풀고 이완된 근육은 수축운동을통하여 유연성과 탄력을 회복하여 운동 시 주동근과 길항근의 균형을 맞추고 협력근과의 조화로운 상태가 척추측만에 도움될 것으로 판단하여 골반운동과 척추 비틀기 운동을 중심으로 실시하였다. 실험대상은 광주광역시 소재C병원에서 특발성 척추 측만증 진단을 받은 여자 중학생을 대상으로 하여, 요가 운동 프로그램으로 주5일, 1일 60분, 12주간 실시하여 요가 운동프로그램이 특발성 척추 측만증 변화에 미치는 영향을 알아보고자 실시하였다. 실험 전, 후 방사선을 통하여 요추의 Cobb's angle을 측정하여 효과를 검증하였다. 첫째, 요가 및 척추 전문가와함께 연구하여 동작을 추축하였다. 둘째, 개발된 척추측만증에 대한 요가 운동 프로그램을 특발성 척추 측만증을갖고 있는 여중생에게 12주간 실시하였다. 셋째, 특발성 척추 측만증에 대한 요가 운동 프로그램에 대한 타당성과효과를 검증하였다. 그 결과 운동 전보다 5도가 통계적으로 유의하게 감소하여 (p=0.006)특발성 척추 측만증이 개선되었다.