Does Discontinuing Teriparatide Treatment and Replacing It with Bisphosphonate Maintain the Volume of the Bone Fusion Mass after Lumbar Posterolateral Fusion in Women with Postmenopausal Osteoporosis?

Seiji Ohtori,Sumihisa Orita,Kazuyo Yamauchi,Yawara Eguchi,Yasuchika Aoki,Junichi Nakamura,Miyako Suzuki,Gou Kubota,Kazuhide Inage,Yasuhiro Shiga,Koki Abe,Kazuki Fujimoto,Hirohito Kanamoto,Masahiro Ino 대한척추외과학회 2017 Asian Spine Journal Vol.11 No.2

Study Design: Retrospective case series. Purpose: The purpose of this study was to determine whether discontinuing teriparatide treatment and replacing it with bisphosphonate treatment maintains the volume of the fusion mass after posterolateral fusion (PLF) in women with postmenopausal osteoporosis. Overview of Literature: Clinical data support the efficacy of parathyroid hormone (PTH) for lumbar PLF. However, the use of PTH is limited to 2 years. Methods: We treated 19 women diagnosed with osteoporosis and degenerative spondylolisthesis with teriparatide (20 μg daily subcutaneously). All patients underwent one-level instrumented PLF. Teriparatide was used during 2 months prior to surgery and more than 8 months after surgery. After discontinuing teriparatide treatment, all patients used bisphosphonate (17.5 mg risedronate weekly, oral administration). Area of the fusion mass across the transverse processes at one segment was determined on an anteroposterior radiograph at 1, 2, and 3 years after surgery. Results: We followed 19 patients for 3 years. The average duration of teriparatide treatment was 11.5 months. The bone union rate was 95%. The average area of the bone fusion mass was not significantly different between the right and left sides at 1, 2, or 3 years after surgery (p >0.05). Conclusions: This study showed that replacing teriparatide treatment with bisphosphonate maintained the bone fusion mass volume after PLF in women with postmenopausal osteoporosis.

Comparison of Test-retest Measurement Reliability of Iliopsoas Strength between Break and Make Test in Subjects with Lumbar Extension Syndrome

전인철 KEMA학회 2019 근골격계과학기술학회 Vol.3 No.2

ABSTRACT Background The strength of iliopsoas muscle is frequently measured to evaluate the performance of hip flexion in the clinical setting. However, little research into the test- retest reliability of iliopsoas muscle strength in subjects with lumbar extension syndrome (LES) in supine position has been reported. Purpose The purpose was to compare the test-retest reliability of iliopsoas strength measurement in supine position with break and make test in subjects with LES. The iliopsoas muscle is very important in the hip joint structures. The reliable measurement is essential to evaluate the performance of hip flexion. Study design Reliability study. Methods Twenty subjects were enrolled in this study. The strength of iliopsoas muscle was measured in supine position, with using a smart KEMA tensiometer system for make test, using a hand held dynamometer for break test. The intra class correlation coefficients (ICC 3, 1) were used to determine test-retest reliability of iliopsoas muscle strength. Results Test-retest reliability of iliopsoas muscle strength measurements in make test was significantly greater compared with break test (p<0.05). The value of ICC with make test was greater than make test (0.86 for make test, 0.71 for break test). Additionally, the coefficients of variation (4.5% for make test, 18.3% for break test) was better in the supine position with make test. Conclusions The measurement of iliopsoas muscle strength in make test can be more reliable than break test in subjects with LES in supine position. The make test in supine position can be recommended for reliable measurement of iliopsoas muscle in subjects with LES.

The Effects of Active Stretching Exercise on Passive Stiffness of Rectus Femoris Muscle and Low Back Pain in Patients with Lumbar Extension Rotation Syndrome

박규남 KEMA학회 2017 근골격계과학기술학회 Vol.1 No.1

ABSTRACT Background A previous literature suggested that increased passive stiffness of rectus femoris muscle (RF) can cause compensatory lumbopelvic motion in sagittal plane or transverse plane during active knee flexion in patients with lumbar extension rotation syndrome (L-ext & rot syn), resulting low back pain. Purpose The purpose of this study was to investigate the effects of active stretching exercise of RF during 6-week on passive muscle stiffness of RF and low back pain in patients with L-ext & rot syn. Study design Pre/post-test design. Methods Twenty patients with L-ext & rot syn were recruited for this study. Passive RF stiffness was measured in pre- and post-stretching period using specially designed motorized pulling machine. Subjective stretch sensation and intensity of low back pain were measured using numeric rating scale. The subjects performed the active RF stretching exercise during 6-week. The significance of the difference between pre- and post-stretching exercises was assessed using repeated one-way analysis of variance. Results Passive RF stiffness and stretch sensation after RF stretching exercise was significantly reduced in subjects with L-ext & rot syn. However, pain intensity of low back during daily activity showed no significant difference between before and after stretching exercise. Conclusions Active RF stretching exercise during 6-week can decrease RF stiffness, but failed to decrease pain intensity of low back during daily activity in patients with L-ext & rot syn.

The Effect of Stretching on Lumbar Muscle Flexibility, Isokinetic Parameters and Lower Extremity Function

이예원,유준호,이동엽,유재호,김진섭,김성길,남연교,홍지헌 대한물리치료학회 2024 대한물리치료학회지 Vol.36 No.4

Purpose: This study aimed to investigate the correlation of the flexibility of lumbar muscle fibers with the speed of the broad four- pronged muscle in healthy adult men and women. Methods: This study selected 36 healthy male and female college students. The subjects were randomly assigned to two groups (Group A; performing three stretches, and Group B; not engaging in any stretching) and measured for flexibility, functional evaluation, and bio- mechanical parameters (CSMI) as pre-experimental evaluation items. Flexibility was evaluated using 2 types of sit and reach tests and Schober’s test, while functional evaluation was assessed through the 3-hop test and the Sargent test. The knee extension angular veloci- ties of the biomechanical parameters were measured at 60°, 120°, 180°, and 240° to determine peak torque, work per repetition, and peak power. Results: Group A exhibited statistically significant improvements in both the before and after comparison of the sit and reach test and the difference in the quantum of change. There was a statistically significant improvement in the before and after comparison of the 3-hop jump test and the difference in the quantum of change. As for the isokinetic parameters, the peak torque of 60°, 120°, 180°, and 240° were only all significant in the experimental group. Conclusion: This study focused on assessing the role of the lower extremities with respect to lumbar flexibility. The results suggest that lumbar flexibility has a statistically significant and positive effect on lower extremity flexibility and its function.

Effects of Same-Sided and Cross-Body Load Carrying on the Activity of the Upper Trapezius and Erector Spinae Muscles

이원휘 KEMA학회 2017 근골격계과학기술학회 Vol.1 No.1

ABSTRACT Background The preference of the bag varies according to age, shoulder bag is mostly used by adults. Shoulder bag can result in an asymmetrical load that has negative impacts on the body. Purpose The purpose of this study was to investigate the effects of same-sided and cross-body carrying on the activity of the upper trapezius and erector spinae muscles in standing position. Study design Controlled laboratory study, with a pretest-posttest design. Methods 20 healthy students were asked to carry the shoulder bag, placing it either on a shoulder on the same side of the body as the bag (same-sided load) or in cross-body fashion in standing position. We used surface electromyography to measure the activities of both upper trapezius and erector spinae muscles. We analyzed the data by using paired t-test and compared muscle activity in two methods. The alpha level was set at 0.05. Results The activity of the right upper trapezius and left erector spinae muscles differed significantly between the two carrying methods (p<0.05), showing significantly less activity under the cross-body condition. The activity of the left trapezius and right erector spinae muscles did not differ significantly between the two carrying methods (p>0.05). Conclusions We suggest that proper carrying method for shoulder bag is needed to help prevent musculoskeletal pain caused by asymmetrical muscle activity.