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1 Full Spine Technique Dr.,PhD., Seungmo Yoo

2 법정비급여 실비의료보험적용 고지의무 제45조 ( 비급여진료비용등의고지 ) 비급여진료비용을환자또는환자보호자가쉽게알수있도록고지하여야한다 환자로부터징수하는제증명수수료의비용을게시 고지 게시한금액을초과하여징수할수없다

3 제 42 조의 2( 비급여진료비용등의고지 ) 1 법제45조제1항에따라의료기관개설자는비급여대상의항목 ( 행위 약제및치료재료를말한다. 이하이조에서같다 ) 과그가격을적은책자등을접수창구등환자또는환자의보호자가쉽게볼수있는장소에갖추어두어야한다. 이경우비급여대상의항목을묶어 1회비용으로정하여총액을표기할수있다. 2 법제45조제2항에따라의료기관개설자는진료기록부사본 진단서등제증명수수료의비용을접수창구등환자및환자의보호자가쉽게볼수있는장소에게시하여야한다. 3 인터넷홈페이지를운영하는병원급의료기관은제1항및제2항의사항을제1항및제2항의방법외에이용자가알아보기쉽도록인터넷홈페이지에따로표시하여야한다

4 Medical Care vs Chiropractic Care

5 Balance = 均衡 Mental Balance Physical Balance Chemical Balance

6 Health(Balance) vs Disease(Unbalance) Balance Unbalance

7 History of Chiropractic The roots of chiropractic care can be traced all the way back to the beginning of recorded time. Writings from China and Greece written in 2700 B.C. and 1500 B.C. mention spinal manipulation and the maneuvering of the lower extremities to ease low back pain.

8 History of Chiropractic Hippocrates the Greek physician, who lived from 460 to 357 B.C., also published texts detailing the importance of chiropractic care. In one of his writings he declares, "Get knowledge of the spine, for this is the requisite for many diseases".

9 History of Chiropractic D.D.Palmer began in 1895 when Daniel David Palmer of Iowa performed the first chiropractic adjustment on a partially deaf janitor, Harvey Lillard, who then mentioned a few days later to Palmer that his hearing seemed better. Palmer, D.D. (1910) The Science, Art and Philosophy of Chiropractic Portland, Oregon: Portland Printing House Company This led to Palmer opening a school of chiropractic two years later The word "chiropractic" was coined from Greek root words by Rev. Samel Weed. Chiropractic's early philosophy was rooted in vitalism, naturalism, magnetism, spiritualism and other constructs that were not amenable to the scientific method.

10 History of Chiropractic D.D.Palmer Chiropractic's founder, D.D. Palmer, attempted to merge science and metaphysics. Leach, Robert (2004). The Chiropractic Theories: A Textbook of Scientific Research. Lippincott, Williams and Wilkins. p. 15. In 1896, D.D. Palmer's first descriptions and underlying philosophy of chiropractic was strikingly similar to Andrew Still's principles of osteopathy established a decade earlier. Ernst E (2008). "Chiropractic: a critical evaluation". J Pain Symptom Manage 35 (5):

11 History of Chiropractic D.D.Palmer Palmer drew further distinctions by noting that he was the first to use short-lever HVLA manipulative techniques using the spinous process and transverse processes as mechanical levers. He described the effects of chiropractic spinal manipulation as being mediated primarily by the nervous system. D.D. Palmer's Lifeline

12 History of Chiropractic Chiropractic Milestones 1896 (January/April): Dr. D.D. Palmer administers two adjustments to the spine of Mr. Harvey Lillard in an effort to improve his hearing (Spring): Reverend Samuel Weed suggests Greek stems from which D.D. Palmer devises the term "chiropractic," meaning done by hand (July): D.D. Palmer obtains a corporate charter for the Palmer School of Magnetic Cure, wherein he teaches chiropractic; Leroy Baker is D.D. Palmer's first chiropractic student.30,36, : The Universal Chiropractors' Association (UCA) is founded in Davenport, Iowa, to provide legal protective services to chiropractors charged with the unlicensed practice of medicine; the UCA will gradually expand its services to educational and political actions : Shegetaro Morikubo, DC, a 1906 graduate of the Palmer School of Chiropractic, is the earliest known chiropractor to be acquitted of unlicensed practice - by a jury in LaCrosse, Wis. His legal defense will form the basis for future trials, "philosophy," and legislative efforts.22,32

13 History of Chiropractic Chiropractic Milestones 1910: D.D. Palmer releases his most important and best known book: The Chiropractor's Adjuster: The Science, Art & Philosophy of Chiropractic (April 20): Kansas passes the first chiropractic statute; however, formation of a Board of Chiropractic Examiners is delayed because the governor refuses to appoint members of the board on the grounds that all chiropractors had practiced illegally prior to passage of the statute.27, (Oct. 20): D.D. Palmer, founder of chiropractic, passes away at his home in Los Angeles. Death is due to typhoid fever, but son B.J. Palmer, DC, will be unfairly accused of patricide.12, : World War I ends and the U.S. government pays the tuition for returning veterans; chiropractic college enrollments skyrocket; the Palmer School of Chiropractic achieves a student body of 3,000.9,15, : The American Chiropractic Association (ACA) is first organized in opposition to Dr. B.J. Palmer and the Universal Chiropractors' Association (August): B.J. Palmer, DC, officially introduces the neuro-calometer.13,17

14 History of Chiropractic Chiropractic Milestones 1925: Wisconsin and Connecticut pass the first basic science statutes; these laws will eventually spread to 24 American states and a few Canadian provinces.10, (September): B.J. Palmer, DC, fails in his bid for re-election as secretary of the Universal Chiropractors' Association, and one week later, establishes the Chiropractic Health Bureau, later renamed the International Chiropractors Association (ICA).11, (September): The International Congress of Chiropractic Examining Boards is founded in Kansas City33; this federation will be reorganized as the Council of State Chiropractic Examining Boards in 1934, and renamed the Federation of Chiropractic Licensing Boards circa : The National Chiropractic Association (NCA) is organized by amalgamation of the UCA and the ACA.16,18, : Chittenden Turner authors The Rise of Chiropractic, an early history of the profession : Warren L. Sausser, DC, of New York City introduces the upright, 14-inch x 36-inch, full-spine X-ray to further Logan Basic Technique.28,38

15 History of Chiropractic Chiropractic Milestones 1940 (July 20): The Allied Chiropractic Educational Institutions (ACEI), which includes the Carver, Cleveland, Eastern, O'Neil-Ross, Palmer, Ratledge and Texas Colleges, issue an ultimatum to the National Chiropractic Association and its Committee on Education. The ACEI insists that instruction in physiotherapeutics and the lengthening of the chiropractic curriculum must cease. This marks the start of a vigorous, threedecade battle over chiropractic educational standards which will only be settled when the CCE is recognized by the U.S. Office of Education in : The NCA publishes the first edition of Chiropractic Education: Outline of a Standard Course, authored by former COSCEB president John J. Nugent, DC, who is newly appointed as NCA's director of education.21, : The Chiropractic Research Foundation (today's FCER) is established by the leadership of the National Chiropractic Association : World War II ends and returning veterans enjoy the educational benefits of the G.I. Bill; chiropractic college enrollments skyrocket.21

16 History of Chiropractic Chiropractic Milestones 1945 (December): The National Chiropractic Insurance Company (today's NCMIC Group, Inc.) is chartered by the board of directors of the National Chiropractic Association; it receives authorization to sell malpractice insurance from the Iowa Commissioner of Insurance in early (Aug. 4): At the urging of NCA Director of Education, John J. Nugent, DC, the NCA House of Delegates establishes the Council on Education, forerunner of today's Council on Chiropractic Education (May 27): B.J. Palmer, DC, PhC, dies in Sarasota, Fla.24 His passing gives hope that greater unity within the profession is possible, and thereby prompts the formation of the American Chiropractic Association three years later : The National Board of Chiropractic Examiners (NBCE) is founded and chartered by the officers of the Council of State Chiropractic Examining Boards (COSCEB) (November): The American Medical Association organizes its Committee on Quackery with the explicit intent to contain and subsequently eliminate the chiropractic profession.31,34

17 History of Chiropractic Chiropractic Milestones : The current American Chiropractic Association is founded through merger of the NCA and a splinter group from the ICA. 1965: William D. Harper, MS, DC, and Joseph Janse, DC, ND, testify in federal district court in Louisiana in the "England Case," an attempt to overturn the state's restrictive medical practice act which deems the practice of chiropractic as the practice of medicine; the case is lost and chiropractors will practice illegally until 1974, when a chiropractic statute is finally enacted.1, : National College of Chiropractic achieves federally recognized regional accreditation from the New York State Department of Education; the first chiropractic school to achieve this distinction. Regional accreditation makes National alumni license-eligible in the Empire State, and buttresses the efforts of the Council on Chiropractic Education to achieve recognition from the U.S. Office of Education as a specialty accrediting body.4,21

18 History of Chiropractic Chiropractic Milestones 1972: The U.S. Congress authorizes payments to chiropractors for services rendered to Medicare patients (Aug. 26): The Council on Chiropractic Education (CCE) is recognized by the U.S. Commissioner of Education as an accrediting agency for chiropractic schools.21, : Louisiana becomes the 50th American state to authorize the practice of chiropractic.8, (October): Chiropractors Chester A. Wilk, Patricia A. Arthur, James W. Bryden, Steven C. Lumsden and Michael D. Pedigo file suit against the AMA and several other defendant organizations and individuals for violations of the Sherman Antitrust Act. 2,6, (March): The first issue of the Journal of Manipulative & Physiological Therapeutics, the profession's pre-eminent scholarly and scientific periodical, is issued. The JMPT will be indexed in Index Medicus commencing in

19 History of Chiropractic Chiropractic Milestones 1980 (October): The Association for the History of Chiropractic is founded at Spears Chiropractic Hospital in Denver, and holds its first annual Conference on Chiropractic History the following year at the Smithsonian Institute in Washington, D.C (Aug. 27): Federal District Court Judge, Susan Getzendanner, finds in favor of the plaintiffs in Wilk, et al. v AMA, et al.; various appeals to higher courts sustain Getzendanner's ruling, which holds AMA, et al., in violation of the Sherman Antitrust Act.6, : Walter I. Wardwell, PhD, authors, and Mosby-Yearbook publishes, Chiropractic: History & Evolution of a New Profession, a scholarly textbook of chiropractic history.34

20 History of Chiropractic Chiropractic Milestones 1994: The U.S. Agency for Health Care Policy & Research issues its Clinical Practice Guidelines for Acute Low Back Problems in Adults, which recommends spinal manipulative therapy for low back pain : The chiropractic profession celebrates its centennial with festivities in Washington, D.C. and Davenport, Iowa. 1996: The Association of Chiropractic Colleges issues its "Paradigm" of chiropractic, which is widely endorsed by state, national and international chiropractic organizations.3

21 History of Chiropractic : Reference 1.Adams, Paul J. Trial of the England case. ACA Journal of Chiropractic 1965 (May);2(5):13,44. 2.AMA antitrust suit filed by chiropractors. Digest of Chiropractic Economics 1976 (Nov/Dec); 19(3): Association of Chiropractic Colleges. Position paper #1. JMPT 1996 (Nov/Dec);19(9): Beideman, Ronald P. In the Making of a Profession: The National College of Chiropractic, Lombard, IL: National College of Chiropractic, Bigos S, Bowyer O, Braen G, et al. Acute Low Back Problems in Adults. Clinical Practice Guideline No. 14. Rockville, MD: AHCPR Publication No , Chapman-Smith, David. The Wilk case. JMPT 1989 (Apr);12(2): Chiropractic historical society formed in Denver. Digest of Chiropractic Economics 1980 (Nov/Dec);23(3):4. 8.Espina, Michael A., Jr. Governor Edwards signs new law. Digest of Chiropractic Economics 1974 (July/Aug);17(1): Ferguson, Alana K., Wiese, Glenda C. How many chiropractic schools? An analysis of institutions that offered the DC degree. Chiropractic History 1988 (July);8(1): Gevitz, Norman. "A coarse sieve"; basic science boards and medical licensure in the United States. Journal of the History of Medicine & Allied Sciences 1988;43:36-63.

22 History of Chiropractic : Reference 11. Gibbons, Russell W. Vision to action: a history of ICA: the first 60 years. ICA Review 1986 (Mar/Apr);42(2):33-64 (Supplement). 12.Gibbons, Russell W. "With malice aforethought": revisiting the B.J. Palmer "patricide" controversy. Chiropractic History 1994 (June);14(1): Keating, Joseph C. Introducing the neurocalometer: a view from the Fountain Head. Journal of the Canadian Chiropractic Association 1991 (Sept);35(3): Keating, Joseph C. Toward a Philosophy of the Science of Chiropractic: A Primer for Clinicians. Stockton, CA: Stockton Foundation for Chiropractic Research, Keating, Joseph C. The influence of World War I upon the chiropractic profession. Journal of Chiropractic Humanities 1994;4: Keating, Joseph C. The short life and enduring influence of the American Chiropractic Association, Chiropractic History 1996 (June);16(1): Keating, Joseph C. B.J. of Davenport: The Early Years of Chiropractic. Davenport, IA: Association for the History of Chiropractic, Keating, Joseph C. Roots of the NCMIC: Loran M. Rogers & the National Chiropractic Association, Chiropractic History 2000 (June);20(1): Keating, Joseph C. Birth of the National Board of Chiropractic Examiners. Journal of Chiropractic Education 2003 (Fall);17(2): Keating, Joseph C., Green, Bart N., Johnson, Claire D. "Research" and "science" in the first half of the chiropractic century. JMPT 1995 (July/Aug);18(6):

23 History of Chiropractic : Reference 21.Keating, Joseph C., Callender, Alana K., Cleveland, Carl S. A History of Chiropractic Education in North America: Report to the Council on Chiropractic Education. Davenport, IA: Association for the History of Chiropractic, Keating, Joseph C., Sportelli, Louis, Siordia, Lawrence. We Take Care of Our Own: NCMIC and the Story of Malpractice Insurance in Chiropractic. Clive, IA: NCMIC Group, Inc., Lillard, Harvey. Deaf seventeen years. The Chiropractic 1897 (Jan);No. 17, p Luckey, William L. Dr. B.J. Palmer dies at age 79; called developer of chiropractic. Digest of Chiropractic Economics 1961 (May/June);3(6):21, Nugent, John J. Chiropractic Education: Outline of a Standard Course. Webster City, IA: National Chiropractic Association, Palmer, Daniel David. The Chiropractor's Adjuster: The Science, Art and Philosophy of Chiropractic. Portland, OR: Portland Printing House, Rehm, William S. Kansas coconuts: legalizing chiropractic in the first state, Chiropractic History 1995 (Dec);15(2): Sausser, Warren L. New spinographic technique: the full length X-ray plate is a success. The Chiropractic Journal (NCA) 1933 (July);1(7): Siordia, Lawrence, Keating, Joseph C. Laid to uneasy rest: D.D. Palmer, Chiropractic History 1999 (June);19(1): The Chiropractor 1906 (June);2(7):20.

24 History of Chiropractic : Reference 31.Trever, William. In the Public Interest. Los Angeles: Scriptures Unlimited, Troyanovich, Stephen J., Keating, Joseph C. Wisconsin versus chiropractic: the trials at La Crosse and the birth of a chiropractic champion. Chiropractic History 2005 (Summer);25(1): Turner, Chittenden. The Rise of Chiropractic. Los Angeles: Powell Publishing Company, Wardwell, Walter I. Chiropractic: History and Evolution of a New Profession. St. Louis: Mosby, Weed, Samuel. The Chiropractor 1905 (Apr);1(5): Wiese, Glenda. New questions: why did D.D. not use "chiropractic" in his 1896 charter? Chiropractic History 1986;6: Willis, John C. Notes from the editor. Chiropractic History 1996 (June);16(1):2. 38.Young, Kenneth J. Warren L. Sausser, DC: influence unrecognized. Chiropractic History 1997 (June);17(1): Zarbuck, Merwyn V. Chiropractic parallax. Part 3. IPSCA Journal of Chiropractic 1988c (Jul);9(3):4-6, 17-9.

25 History of Chiropractic Dr. Yoo In the year 1994, I started Chiropractic. Later, I teached chiropractic technique to many medical doctors in Suan Medical association and my Dr. Yoo biomechanic research institute. This is really my passion ~ studying the biophysics and many chiropractic techniques. The fruits of these efforts have resulted in Full Spine Technique. My Full Spine Technique(FST) is very easy to learn and very effective technique We developed a new seminar program called Full Spine Technique which combines our clinical experience -based technique together with patient and practice management procedures ~ Systems ~ to improve your patient care and your practice.

26 History of Chiropractic My Lecture In the Chosun medical university

27 History of Chiropractic Chiropractic: Why Choose Conservative Care First? Pain : Chiropractic can help

28 What is Full Spine Technique? Health = Balance of Mental, Chemical, Physical state 교정치료 = 均衡의治療 = Balance (= Hollistic therapy) Homeostasis

29 What is Full Spine Technique? Bases of Technique Dr. White & Panjabi-axis CBP( D.C Don Harrison) Deversified technqiue Gonstead technique Leander technique AMCT SOT( D.C De Janette ) Others

30 What is Full Spine Technique? Homeostasis (Live Blood Demonstration) 정상적인혈액상 교정치료전 교정치료후

31 The Merits of Full Spine Technique Easy to learn Easy to approach More Scientific technique Axis Base Very effective Case 1. HNP (L4~L5) Case 2. Scoliosis Non Insurance base

32 About the Founder Dr. Yoo In Korea Dr. Weber (CBP) Dr. Colemann (CBP) Dr. Pettibon (Pettibon technique) Dr. Donald Harrison and Deanne Harrison(CBP) Dr. Stillwagon(Pierce Stillwagon Technique) Dr. Leander(Leander technique) Dr. Nancy(Extremity) Principle of Axis ( Dr. White & Panjabi ) Clinical biomechanics of the spine Augustus A. White, Manohar M. Panjabi

33 About the Developer Dr. Yoo In USA Dr. Stillwagon Clinc (Pierce Stillwagon Technique) Dr. Weber Clinic(Diversified and CBP) : 3425 S Tacoma WayTacoma, WA (253) (Office) Dr. Vernon A. Weber Sr., DC Dr. Colemann Clinic (CBP) : 1344 E Main St. Othello, WA 99344, (509) (Office) (509) (Fax) Dr. Christopher J. Colloca Clinic (AMCT) : Neuromechanical Innovations, Intrnational Spine Research (INSPIRE) Foundation, Colloca Estate, Dr. Nancy : Extremity Live Blood demonstration Seminar

34 Co-workers & Instructors of FST Dr. Ph.D., Seungmo Yoo, President Dr. Kyungjin Kim, Vice President Dr. Manwoo Lee Dr. Kangho Kim Dr. Eul Choi Dr. Younghoon Kim

35 Principle of Full Spine Technique Subluxation ( 아탈구 ) Definition Past ; bone out of place Present ; 우리인체에생기는단지불편함을포함하여이상증후군, dis-ease, disease, symptom, abnormal sign (Mental level, Physical level, Chemical level)

36 Principle of Full Spine Technique Subluxation ( 아탈구 ) Kinds of Stress Mental stress Physical stress Chemical stress

37 Principle of Full Spine Technique

38 Principle of Full Spine Technique Pain Sensitivity

39 Principle of Full Spine Technique 손과접촉의관계 접촉수 ( Contact hand ) 또는교정수 ; 교정또는치료를위하여환자의몸에닿는의사의손을말한다. 보조수또는안정수 (Indifferent Hand or Stabilization Hand ) ; 접촉수로치료위치를접촉하여치료를할때보조수는환자의 setting 에서움직임을방지하기위하여사용한다

40 Principle of Full Spine Technique Axis (Translation) : Tz / Tx / Ty

41 Principle of Full Spine Technique Axis (Translation) : Tz / Tx / Ty 양의방향으로 head가 z-축에대하여전이가일어나있다면표기법은 +Tzh로표기한다

42 Principle of Full Spine Technique Axis (Rotation) : Rz / Rx / Ry

43 Principle of Full Spine Technique Axis (Rotation) : Rz / Rx / Ry 양의방향으로 head가 z-축에대하여회전변위가일어나있다면표기법은 +Rzh로표기한다

44 Principle of Full Spine Technique Affects of Reversible Change

45 Principle of Full Spine Technique Adjustment Set up Skin Pull High Speed Low amplitude LOC=Line of correction / LOD=Line of Drive Open Wedge -> Close

46 Effects of Full Spine Technique Pain relief Restoration of range of motion Relief of disability Return to activities of daily living Muscle strengthening Improved gait Improved posture

47 Article Immediate effects of thoracic manipulation in patients with neck pain: a randomized clinical trial Joshua A. Clelanda,b,, Maj. John D. Childsc, Meghann McRaed, Jessica A. Palmera, Thomas Stowell Abstract Mechanical neck pain is a common occurrence in the general population resulting in a considerable economic burden. Often physical therapists will incorporate manual therapies directed at the cervical spine including joint mobilization and manipulation into the management of patients with cervical pain. Although the effectiveness of mobilization and manipulation of the cervical spine has been well documented, the small inherent risks associated with these techniques has led clinicians to frequently utilize manipulation directed at the thoracic spine in this patient population. It is hypothesized that thoracic spine manipulation may elicit similar therapeutic benefits as cervical spine manipulation while minimizing the magnitude of risk associated with the cervical technique. The purpose of this randomized clinical trial was to investigate the immediate effects of thoracic spine manipulation on perceived pain levels in patients presenting with neck pain. The results suggest that thoracic spine manipulation results in immediate analgesic effects in patients with mechanical neck pain. Further studies are needed to determine the effects of thoracic spine manipulation in patients with neck pain on long-term outcomes including function and disability.

48 Indication of Full Spine Technique Neck, mid back and low back pain Chronic muscle pain and inflammation Acute and chronic muscle spasm Sciatica where disc bulges are contained less than 5 mm Failed back surgery Chronic occipital or tension headaches Decreased spinal range of motion Conditions where narcotic pain Chronic fibrositis Nerve entrapment Pseudo-sciatica relievers are of little benefit Traumatic torticollis RSD

49 Contraindication of Full Spine Technique Malignancy with metastasis to bone Tuberculosis of the bone Fractures Acute arthritis Acute gout Uncontrolled diabetic neuropathy Syphilitic articular or periarticular lesions Gonorrheal spinal arthritis Excessive spinal osteoporosis Evidence of cord or caudal compression by tumor, ankylosis and malacia bone disease.

50 Complications of Full Spine Technique 1. Vertebral basilar stroke 2. Pathologic fracture 3. Transverse ligament rupture 4. Increased instability 5. Permanent neurological deficits 6. Rib Fracture 7. Perforation of Tympanic Membrane Common cold Acute or Chronic Otitis Media

51 Full Spine Technique Protocol (Diagnosis) History Taking 자세한병력청취와기록은질병, 예후, 그리고적절한치료에대한귀중한정보제공

52 Full Spine Technique Protocol (Diagnosis) History Taking (PQRST Method for Pain Assessment) 1 2 P = Provokes ; What causes pain?, What makes it better?, Worse? Q = Quality ; What does it feel like?, Is it sharp?, Dull?, Stabbing?, Burning?, Crushing? ( Try to let patient describe the pain, sometimes they say what they think you would like to hear. ) 3 R = Radiates ; Where does the pain radiate?, Is it in one place?, Does it go anywhere else?, Did it start elsewhere and now localised to one spot? 4 S = Severity ; How severe is the pain on a scale of 1-10?, ( This is a difficult one as the rating will differ from patient to patient. ) 5 T = Time ; Time pain started?, How long did it last?

53 Full Spine Technique Protocol (Diagnosis) History Taking (SOAP) Subjective ; The subjective portion is evaluated by taking the patient's history Objective ; The objective portion is evaluated by observation and special tests that measure an objective component Assessment ; The assessment is based on the compilation of the subjective and objective findings and the examination Plan ; The plan may include further testing and/or treatment options

54 Full Spine Technique Protocol (Diagnosis) Range of Motion 보험청구 EX 773 월1회이상실시하더라도 1회만산정가능 너 773

55 Full Spine Technique Protocol (Diagnosis) Range of Motion Goniometer

56 Full Spine Technique Protocol (Diagnosis) Range of Motion

57 Full Spine Technique Protocol (Diagnosis) Range of Motion ( 참고문헌 ) Photographic Manual of Regional Orthopaedic and Neurologic Tests, Joseph J. Cipriano DC (Author) Musculoskeletal Assessment, Joint range of motion and manual muscle strength, Hazel M. Clarkson

58 Full Spine Technique Protocol (Diagnosis) Physical examination(topographical Landmarks) Anterior Landmarks 1. Hyoid bone : 3번경추의반대편 2. 갑상연골 : 4-5번경추의반대편에위치 3. Jugular notch : T2의반대편에위치 4. 검상돌기 : 흉추 10번의반대편에위치 5. 배꼽 : 요추 3번의반대편에위치 6. ASIS : anterior superior iliac spine

59 Full Spine Technique Protocol (Diagnosis) Physical examination(topographical Landmarks) Posterior Landmarks 1. EOP : 후두골의기저에서중앙선에위치 2. C1의 TP : Mastoid process의전방하방에위치 3. C2의 SP : EOP에서첫번째로현저하게융기된뼈. 4. C7의 SP : 하부경추의가장현저하게융기된뼈. 5. T1의 SP: 상부흉추중에서가장현저하게융기된뼈 6. T3의 SP : 견갑골의 spine의뿌리부근에점을찍고양측을잇는선이지나는중심선부근 7. T6의 SP : 엎드렸을때견갑골하각을잇는선이지나는곳의 SP 8. T7의 SP : 앉아있거나서있을때견갑골하각을잇는선이지나는중심부근 9. L4 의 SP : 장골능최상부에양측에점을찍고그점을잇는선이지나는중심부근 10. S2의결절 : 후상장골극의내방

60 Full Spine Technique Protocol (Diagnosis) Physical examination (Orthopaedic Test) Head and Neck Tests

61 Full Spine Technique Protocol (Diagnosis) Physical examination (Orthopaedic Test) Trunk and Abdomen Tests

62 Full Spine Technique Protocol (Diagnosis) Physical examination (Orthopaedic Test) Hip And Pelvis Tests

63 Full Spine Technique Protocol (Diagnosis) Posture analysis Anterior glabella, 인중, symphysis menti, episternal notch, 배꼽, symphysis pubis, both knee 사이가동일한 Y-축상에있는지 Lateral external auditory meatus, acromion의중앙, iliac crest의최상부, acetabulum의중앙, lateral knee, mid-ankle부위가일직선상에있는지

64 Full Spine Technique Protocol (Diagnosis) Posture analysis 머리기울기, 어깨높이, hip 의높이, 측면에서본귀와어깨, hip, 발목의위치등을파악

65 Full Spine Technique Protocol (Diagnosis) Leg Length Analysis 단족 = short leg 1. anatomical short leg ( 해부학적단족 ) : 선천적또는후천적으로골절이나수술로짧아진다리를말한다 functional short leg ( 기능적단족 ) = Pelvic deficiency : 실제다리길이는같지만인체를구성하고있는근육, 신경등의장애로인하여일시적으로또는영구적으로다리길이가짧아지는경우- 이런경우가수기요법의대상이된다.

66 Full Spine Technique Protocol (Diagnosis) Leg Length Analysis ( 단족의원인 ) Neuromuscular contraction 근육의불균형은 Bulboreticular formation의 imbalance의결과로야기된다. Bulboreticular formation의두종류 Facilitory area 근육수축» Reticular formation : Upper & Lateral portions of the medullar, Pons, Mescencephalon, Diencephalon» Vestibular nuclei Inhibitory area 근육이완» Basal ganglia» Cerebellum» Cerebral Cortex

67 Full Spine Technique Protocol (Diagnosis) Leg Length Analysis ( 단족의원인 ) Biomechanical malposition Gonstead 박사 방사선사진으로검사할때정상적인골반은대퇴두부 (femur head) 의높이를수평으로보여줄것이다. 뒤쪽으로혹은바깥쪽으로 malposition( 위치이상 ) 이된장골때문에대퇴두부 (femur head) 의한쪽은낮은위치가된다. 대퇴두부 (femur head) 는앞쪽으로혹은안쪽으로 malposition( 위치이상 ) 이된장골쪽으로올라갈것이다. 골반의양쪽으로 malposition( 위치이상 ) 이존재하는것처럼관찰되는단족의원인은이런 malposition( 위치이상 ) 의결합인것이다.

68 Full Spine Technique Protocol (Diagnosis) Leg Length Analysis 어떤다리가더짧은가를결정하기위해서신발 뒷굽의재봉선 (SIM) 을살펴본다

69 Full Spine Technique Protocol (Diagnosis) X-ray check ( 영상분석 ) 경추 (Cervical) : AP - Cervical Listing line 또는 Base Line 추체의 body 하단에서좌우의모서리에서각각의점을찍는다. 각각의점을연결하는가상의선을긋고이선을 listing line 이라고한다

70 Full Spine Technique Protocol (Diagnosis) X-ray check ( 영상분석 ) 경추 (Cervical) : Lateral - Cervical Foramen magnum line 후두과 ( occipital condyle) 의 후방면이두개골 (skull) 의하 벽 (floor) 과연결되는지점에점을찍는다. 후두골기저부의 squama 가 위로향하는지점에점을찍 는다. 1 과 2 의두점을연결하는선 을그린다. 이선을 foramen magnum line 이라고한다

71 Full Spine Technique Protocol (Diagnosis) X-ray check ( 영상분석 ) 경추 (Cervical) : Lateral - Cervical Atlas plane line atlas 의전방중앙에점을 찍는다. atlas 의후궁의가장좁은 곳의중앙에점을찍는다

72 Full Spine Technique Protocol (Diagnosis) X-ray check ( 영상분석 ) 경추 (Cervical) : Lateral - Cervical Odontoid line odontoid process (OD) 의상부에서 base 까지를 4등분하여위에서부터 1/4정도내려와그중앙에점을찍는다. OD 의기저부와경추 2 번추 체가만나는지점에서 OD 의 중앙에점을찍는다.

73 Full Spine Technique Protocol (Diagnosis) X-ray check ( 영상분석 ) 경추 (Cervical) : Lateral - Cervical Odontoid perpendicular line 그림에서와같이 Odontoid process의기저부에서약간밑으로하여 OD line과수직이되는선을긋고이선을 odontoid perpendicular line 이라고한다

74 Full Spine Technique Protocol (Diagnosis) X-ray check ( 영상분석 ) 경추 (Cervical) : Lateral - Cervical Disc plane lines 경추 2번부터흉추 1번까지각추체 (body) 하연의전방과후방에각각점을찍는다 각각의추체에찍은전방과후방의점을잇는가상의선을긋고이선들보다추체의길이에 1/4에해당하는위치로상향평행이동하여선을긋고이선을 disc plane line이라고한다

75 Full Spine Technique Protocol (Diagnosis) X-ray check ( 영상분석 ) 경추 (Cervical) : Lateral - Cervical Bite line 항상같은조건으로측방사진을얻기위한 요령으로지면과 bite 선이평행이되도록촬 영을하여야한다. 이런조건으로사진을찍어야우리가측정하 는경추에대한스트레스각도를해석하는 데있어서의미를갖게된다

76 Full Spine Technique Protocol (Diagnosis) X-ray check ( 영상분석 ) 경추 (Cervical) : Lateral - Cervical George s line 경추또는요추의추체후연의상, 하에점을찍고이점들을연결하는연속된선을긋는데바로이선을 George s line이라고한다. 이선이깨지면경추또는요 추에 Subluxation 을의심할 수있다

77 Full Spine Technique Protocol (Diagnosis) X-ray check ( 영상분석 ) 경추 (Cervical) : Lateral - Cervical Stress angle 그림과같이경추 2번의추체후연에각각점을찍는다. 두점을잇는선을그린다 Superior stress line 그림과같이경추 7번의추체후연에각각점을찍는다. 두점을잇는선을그린다. Inferior stress line 선이서로만나서이루는각도를스트레스각이라고한다

78 Full Spine Technique Protocol (Diagnosis) X-ray check ( 영상분석 ) 경추 (Cervical) : AP Open Mouth Transverse Condyle line 후두의좌우 Mastoid notch 에 점을각각찍는 다. 두점을잇는 선을긋는다

79 Full Spine Technique Protocol (Diagnosis) X-ray check ( 영상분석 ) 경추 (Cervical) : AP Open Mouth Transverse Atlas line 환추 ( 경추1번 ) 의횡돌기 ( transverse process ) 가환추의 lateral mass 와만나는하부에각각점을찍는다 두점을연결하는선을긋고이선을 Transverse atlas line이라고한다

80 Full Spine Technique Protocol (Diagnosis) X-ray check ( 영상분석 ) 경추 (Cervical) : AP Open Mouth Axis Plane Line 경추 2번의 Pedicle shadow의중앙에각각점을찍는다 두점을연결하는선을긋고이선을 Axis plane line이라고한다

81 Full Spine Technique Protocol (Diagnosis) X-ray check ( 영상분석 ) 요추 (Lumbar) Stress angle 요추의스트레스각을재기위하여 superior stress line 을작도할때 L1 이기준이고 inferior stress line 을작도할때 L5 가기준이다

82 Full Spine Technique Protocol (Diagnosis) X-ray check ( 영상분석 ) 요추 (Lumbar) Visual Posteriority 척추전반에걸쳐척추의하나또는일부가후방으로 translation 된상태를말하며아래사진에서는요추 4번과요추 5번에서요추 5번의위에있는요추 4번의추체가후방으로 translation 되어있는현상을말하며여기에서는요추 4번을 Posteriority 가있다고한다.

83 Full Spine Technique Protocol (Diagnosis) X-ray check ( 영상분석 ) 요추 (Lumbar) Disc Degeneration ( 디스크퇴행 ) 사진과같이디스크의공간이좁아져원래대로회복이되지않는상황을말한다. 이런현상이지속되면 foraminal enchroachment현상이일어난다. foraminal enchroachment 현상은 디스크퇴행의한현상으로볼수 있다

84 Full Spine Technique Protocol (Diagnosis) X-ray check ( 영상분석 ) 요추 (Lumbar) Eburnation End plates를따라불투과된방사선이아래사진에서와같이희게나타나는데이런현상을말하며디스크가 stress를받고있음을알수있다

85 Full Spine Technique Protocol (Diagnosis) X-ray check ( 영상분석 ) 요추 (Lumbar) Foraminal Enchroachment 디스크의퇴행성변화등으로인하여후관절부 위에서두개의인접척추가서로가까워지는현 상으로추간공의크기가감소하게된다

86 Full Spine Technique Protocol (Diagnosis) X-ray check ( 영상분석 ) 요추 (Lumbar) Vertebral Stacking 사진에서우리는정상요추만곡도가소실된것을관찰할수있다. 측방사진에서보면요추의만곡도가감소되어 military curve의형태를보이고있다. 이런현상이일어나면 Stack 의가장밑에있는분 절에위치한디스크가 stress 를많이받게되어문 제를유발할수있다

87 Full Spine Technique Protocol (Diagnosis) X-ray check ( 영상분석 ) 요추 (Lumbar) Stair stepping 사진에보이는것처럼계단식으로요추의추체들 이후방으로밀리는현상을보이는것을 stair stepping 이라한다

88 Full Spine Technique Protocol (Diagnosis) X-ray check ( 영상분석 ) 요추 (Lumbar) Thin Disc 정상적인디스크공간을확보하지못하고디스크 에 dehydration 현상이일어나디스크공간이협 소해진것을관찰할수있다. 퇴행성변화의한현상으로볼수있다

89 Full Spine Technique Protocol (Diagnosis) X-ray check ( 영상분석 ) 요추 (Lumbar) Hour Glassing 퇴행성으로골밀도가감소하면 서마치모래시계모양으로추체 가변하는것을말한다

90 Full Spine Technique Protocol (Diagnosis) X-ray check ( 영상분석 ) 요추 (Lumbar) Exostosis = bone spur 퇴행성으로 bone 에 골극이형성

91 Full Spine Technique Protocol (Diagnosis) X-ray check ( 영상분석 ) 요추 (Lumbar) Anterolisthesis 일반적으로척추의추체가전방으로하나이상 translation이일어나는것을말하며사진에서는요추 4번의추체가전방으로밀려나와있는것을보여주고있다

92 Full Spine Technique Protocol (Diagnosis) X-ray check ( 영상분석 ) 요추 (Lumbar) Retrolisthesis 일반적으로척추의추체가후방으로 translation되는현상을말하며측방사진에서요추 4번의추체가후방으로밀려있는것을보여주고있다

93 Full Spine Technique Protocol (Diagnosis) X-ray check ( 영상분석 ) 요추 (Lumbar) 척추분리증 (spondylolisthesis) 을분류하는방법 Meyerding's method - L5이척추분리증일때추체의후방에서천골방향으로선을긋는다. L5의하부분절인천골 (sacrum) 을백분율에서와유사한양상으로네개의부분으로나눈다. 이 line이네개로나뉘어진부분중어느곳을통과하는지를주의깊게분석한다. 이선이후방의 1/4에해당되는부분을통과하면등급 I 이라하며, 전방의 1/4 부위를통과하면등급 IV로분류한다.

94 Full Spine Technique Protocol (Diagnosis) X-ray check ( 영상분석 ) : 골반 (Pelvis) Femur head line 대퇴골두의양쪽최상부에사진과같이점을 찍는다

95 Full Spine Technique Protocol (Diagnosis) X-ray check ( 영상분석 ) : 골반 (Pelvis) Femur head line 두점을잇는선을긋고이선을 Femur head line 이라고한다

96 Full Spine Technique Protocol (Diagnosis) X-ray check ( 영상분석 ) : 골반 (Pelvis) Femur head line 무명골의길이를측정하기위하여먼저장골 능의양쪽최상부에각각점을찍는다

97 Full Spine Technique Protocol (Diagnosis) X-ray check ( 영상분석 ) : 골반 (Pelvis) Femur head line 그두점을지나는선을그리는데그요령은대퇴골두선과평행으로이동시켜각각 2인치정도의길이로긋고이선들을장골능선이라고한다

98 Full Spine Technique Protocol (Diagnosis) X-ray check ( 영상분석 ) : 골반 (Pelvis) Femur head line 좌골최하단의양측에각각점을찍는다

99 Full Spine Technique Protocol (Diagnosis) X-ray check ( 영상분석 ) : 골반 (Pelvis) Femur head line femur head line 과평행이되도록좌골최하 단의점까지자를이동시켜각각 2 인치정도 의선을긋는다

100 Full Spine Technique Protocol (Diagnosis) X-ray check ( 영상분석 ) : 골반 (Pelvis) Femur head line 선을그리고나서무명골의길이를재기위하여 a,b,c,d의길이를측정한다. ( a+b의길이와 c+d의길이를비교한다.) 만일 a+b < c+d 이면 a+b 쪽은 AS ilium 이고 c+d 쪽은 PI ilium이된다

101 Full Spine Technique Protocol (Diagnosis) X-ray check ( 영상분석 ) : 장골 (Ilium) 의분석 AS Ilium = + Rx 1. 무명골 (innominate) 과폐쇄공 (obturator foramen) 의수직높이감소. 2. 생리적장족 side가된다. PI Ilium= - Rx 1. 무명골과 obturator foramen의수직높이증가 2. 생리학적단족 side가된다.

102 Full Spine Technique Protocol (Diagnosis) X-ray check ( 영상분석 ) : 장골 (Ilium) 의분석 1 2 Ex Ilium 1 PSIS 와 PIIS 모두천골의중심에서멀어진다. 2 ilium의좌우폭이감소한다 IN Ilium 1 PSIS & PIIS가 dorsal S-I 관절부위에서안으로이동한다. 2 ilium 의좌우폭이넓어짐

103 Full Spine Technique Protocol (Diagnosis) Listing Systems Designation of the spatial orientation of one vertebra in relation to adjacent segments. Each segment is listed in relation to the segment below.

104 Full Spine Technique Protocol (Diagnosis) Listing Systems (Palmer-Gonstead) i. C2 through L5 Point of reference is always the spinous process a. First letter is always a P (for posterior slipped into extension) b. Second letter is either R or L (rotation) c. Third letter, if present, is either S or I (wedging) a. Hard to palpate b. Easily seen on x-ray

105 Full Spine Technique Protocol (Diagnosis) Listing Systems (Palmer-Gonstead) C2 through L5 Examples a. PR b. PL c. PRI d. PRS e. PLI f. PLS

106 Full Spine Technique Protocol (Diagnosis) Listing Systems (Palmer-Gonstead) ii. Ilium 1. Point of reference is the PSIS a. If the PSIS rocks back PI ilium b. If the PSIS rocks anterior AS ilium c. If the PSIS is medial IN ilium d. If the PSIS is lateral EX ilium

107 Full Spine Technique Protocol (Diagnosis) Listing Systems (Palmer-Gonstead) ii. Ilium Examples a. PI b. AS c. IN d. EX f. ASIN g. PIEX h. ASEX

108 Full Spine Technique Protocol (Diagnosis) Listing Systems (Palmer-Gonstead) iii. Sacrum 1. Point of reference is the base of the sacrum list the posterior portion of the base 2. Examples a. P-R (dash denotes a sacral listing) b. P-L c. PI-R d. PI-L e. Base Posterior f. Apex posterior

109 Full Spine Technique Protocol (Diagnosis) Listing Systems (Palmer-Gonstead) iv. Coccyx 1. Point of reference is the Apex of the coccyx 2. Examples a. A anterior b. AR anterior and right c. AL anterior and left

110 Full Spine Technique Protocol (Diagnosis) Listing Systems (Palmer-Gonstead) v. Atlas Point of reference is the anterior tubercle. First letter is always an A (anterior) Second letter is S or I (superior, inferior) taken from lateral view X-ray Third letter is R or L (translation side) Fourth letter is A or P (anterior or posterior) referring to the anteriority or posteriority of the side of laterality.

111 Full Spine Technique Protocol (Diagnosis) Listing Systems (Palmer-Gonstead) vi. Occiput Point of reference is mastoid process First two letters are either AS (hyperlordosis) or PS (military neck) Second two letters are either RS or LS denoting which side is superior Third two letters are either RA, RP, LA, or LP denoting if the superior side is anterior or posterior. Examples: a. AS b. PS c. ASRS d. ASLS e. PSRS f. PSLS g. ASRSRA h. ASRSRP i. ASLSLA j. ASLSLP

112 Full Spine Technique Protocol (Diagnosis) Listing Systems (National) i. C2 through L5 Point of reference is always the vertebral body First letter is either R or L (rotation) Second letter is always a P (posterior) Third letter, if present, is either S or I (wedging) Hard to palpate Easily seen on x-ray Examples a. LP b. RP c. LPI d. LPS e. RPI f. RPS

113 Full Spine Technique Protocol (Diagnosis) Listing Systems (National) ii. Ilium (Same as PG) Point of reference is the PSIS If the PSIS rocks back PI ilium If the PSIS rocks anterior AS ilium If the PSIS is medial IN ilium If the PSIS is lateral EX ilium Examples a. PI b. AS c. IN d. EX e. PIIN f. ASIN g. PIEX h. ASEX

114 Full Spine Technique Protocol (Diagnosis) Listing Systems (National) iii. Sacrum (Same as PG) Point of reference is the base of the sacrum; list the posterior portion of the base Examples a. P-R (dash denotes a sacral listing) b. P-L c. PI-R d. PI-L e. Base Posterior f. Apex posterior

115 Full Spine Technique Protocol (Diagnosis) Listing Systems (National) iv. Coccyx (Same as PG) 1. Point of reference is apex 2. Examples a. A anterior b. AR anterior right c. AL anterior left

116 Full Spine Technique Protocol (Diagnosis) Listing Systems (National) v. Atlas (Same as PG) Point of reference is the anterior tubercle. First letter is always an A (anterior) Second letter is S or I (superior, inferior) taken from lateral view X-ray Third letter is R or L (translation side) Fourth letter is A or P (anterior or posterior) referring to the anteriority or posteriority of the side of laterality.

117 Full Spine Technique Protocol (Diagnosis) Listing Systems (National) vi. Occiput (Same as PG) Point of reference is mastoid process First two letters are either AS (hyperlordosis) or PS (military neck) Second two letters are either RS or LS denoting which side is superior Third two letters are either RA, RP, LA, or LP denoting if the superior side is anterior or posterior. Examples: a. AS / b. PS / c. ASRS / d. ASLS / e. PSRS / f. PSLS g. ASRSRA / h. ASRSRP /i. ASLSLA / j. ASLSLP

118 Full Spine Technique Protocol (Diagnosis) Listing Systems (c. Medicare/Houston Conference) Flexion malposition Left lateral listhesis Extension malposition Left rotational malposition/left Right lateral flexion malposition lateral flexion malposition Left lateral flexion malposition Right rotational malposition/right Right rotation malposition lateral flexion malposition Left rotation malposition Left rotational malposition/right Anteriolisthesis lateral flexion malposition Retrolisthesis Right rotational malposition/left Right lateral listhesis lateral flexion malposition

119 Full Spine Technique Protocol (Diagnosis) Listing Systems (d. International (aka Right handed orthogonal)) Hints: + is clockwise. Right lateral flexion: +oz Left lateral flexion: -oz Right rotation: -oy Left rotation:+oy Flexion: +ox Extension: -ox Cephalad translation: +y Caudal translation: -y Right translation: -x Left translation:+x Anterior translation:+z Posterior translation: -z

120 Full Spine Technique Protocol (Diagnosis) Listing Systems (Simple Listing; Spinous 기준 )

121 Full Spine Technique Protocol (Diagnosis) Thermography 노 -776 (EZ776) 체온열검사 (Thermography) 인정비급여

122 Full Spine Technique Protocol (Diagnosis) Thermography 노 -776 (EZ776) 체온열검사 (Thermography) 인정비급여 임상적유용성 통증진단 치료효과판정과치료방향즉각적결정. 가병판별시유용. MRI 등의필요여부를알려주는 1 차적 Screening test 유용. 척추질환 : 급, 만성요통, 좌골신경통, 척추 추간판질환, 척추강협착증, 척추분리증, 척 추골전위증

123 Full Spine Technique Protocol (Diagnosis) 혈액학적검사 Complete Blood Count with Differential CRP RA ESR Uric acid Alkaline Phosphatase Calcium Vit D 25-OH

124 Full Spine Technique Protocol (Treatment Plan) 치료 Plan 평균치료기간 ; 20 회과정, 대개 5~6 회경부터호전을보임, 환자들이치료받는데도왜자꾸아프냐고호소함, 약 5~6 회는더아플수있다고안내하면됨 병증의정도에따라분류 Mild( 약 10 회 ~15 회 ) Moderate ( 약 15 회 ~20 회 ) Severe ( 약 20 회 ~30 회 ) VAS Scale

125 Full Spine Technique Protocol (Treatment Plan) Principle of Correction 1 LOC 2 skin pull 3 High speed 4 Low amplitude 5 Set up 6 open wedge side -> close ; CP

126 Full Spine Technique Protocol (Treatment Plan) Lumbar problem (Type I) 1 족지분석 2 골반교정 (PI, AS) ; drop AS (Anterior Superior) = + Rx ; ischium contact PI (Posterior Inferior) = - Rx ; PSIS contact 3 Posterior double thenar technique 4 TOS 5 Side posture ; AS -->PI = +Rx --> -Rx ; Ischium contact 6 Ant. thoracic adjustment 7 Side posture ; PI-->AS = -Rx --> +Rx ; PSIS contact

127 AS (Anterior Superior) = + Rx PI (-Rx) Ischium contact

128 PI (Posterior Inferior) = - Rx AS (+Rx) PSIS contact

129 Posterior double thenar technique

130 TOS

131 Side posture, AS-->PI Ischium contact

132 Ant. thoracic adjustment (T6~T8)

133 Side posture, PI (-Rx) --> AS (+Rx) PSIS contact

134 Full Spine Technique Protocol (Treatment Plan) Lumbar problem (Others) Lumbosacral Balance technique + Rz = Right Bending / - Rz = Left Bending

135 Full Spine Technique Protocol (Treatment Plan) Lumbar problem (Others) Lumbar Region (+ Rz / - Rz)

136 Full Spine Technique Protocol (Treatment Plan) Lumbar problem (Others) Lumbar Region (+ Tz / -Tz)

137 Full Spine Technique Protocol (Treatment Plan) Thoracic problem (Others) Cross Hand Technique

138 Full Spine Technique Protocol (Treatment Plan) Pelvis Problem (Others) Lt side Internal Rotation = + Ry

139 Full Spine Technique Protocol (Treatment Plan) Pelvis Problem (Others) Double AS = Double + Rx

140 Full Spine Technique Protocol (Treatment Plan) Pelvis Problem (Others) Double PI = Double - Rx

141 Full Spine Technique Protocol (Treatment Plan) Cervical Problem (Type II) 1 족지분석 2 골반교정 (PI, AS) ; drop AS (Anterior Superior) = + Rx ; ischium contact PI (Posterior Inferior) = - Rx ; PSIS contact Posterior double thenar technique TOS Side posture ; AS -->PI = +Rx --> -Rx ; Ischium contact Ant. thoracic adjustment Side posture ; PI-->AS = -Rx --> +Rx ; PSIS contact Supine Cervical Break

142 Supine Cervical Break Facet line Vertebrovascular Accidents ; Soft, Gentle

143 Full Spine Technique Protocol (Treatment Plan) Cervical Pproblem (Others) Drop technique

144 Full Spine Technique Protocol (Treatment Plan) Cervical Pproblem (Others) Thumb Technique

145 Full Spine Technique Protocol (Reassessment) History taking ROM Physical examination Topographical Landmarks Anterior Posterior Palpation Orthopaedic test 일반 X-ray 촬영 : Listing 체온열검사

146 Most Frequently Used Techniques(ACA) 1. Diversified 95.9% 2. Extremity manipulating/adjusting 95.5% 3. Activator Methods 62.8% 4. Gonstead 58.5% 5. Cox Flexion/Distraction 58.0% 6. Thompson 55.9% 7. Sacro Occipital Technique [SOT] 41.3% 9. NIMMO/Receptor Tonus 40.0% 10. Cranial 37.3% 11. Manipulative/Adjustive Instruments 34.5% 12. Palmer upper cervical [HIO] 28.8% 13. Logan Basic 28.7% 14. Meric 19.9% 15. Pierce-Stillwagon 17.1% 8. Applied Kinesiology 43.2%

147 Article review 교정치료의실제적용 ( 설문조사, 치료계획, 검사, 평가, 치료후설문조사 ) 저자명 : 주상연, 옥선명, 유승모 - Conclusions 교정치료후환자의전반적인효과및안전성, 효용성평가는의사, 환자, 그리고건강보혐평가하는실무자모두에게필요하다. 교정치료후효과판정은쉽게이용할수있는여러설문지를이용하여, 환자의기능적인평가, 통증변화, 운동범위변화, 환자만족도변화에대한기록으로이루어질수있겠다. 물론국내에서교정치료 ( 도수치료 ) 는비급여항목으로되어있다.

148 감사합니다