• Title/Summary/Keyword: 어깨 관절

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Study on 3D Printer Production of Auxiliary Device for Upper Limb for Medical Imaging Test (의료영상 검사를 위한 상지 보조기구의 3D 프린터 제작 연구)

  • Kim, Hyeong-Gyun;Yoon, Jae-Ho;Choi, Seong-Dae
    • Journal of radiological science and technology
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    • v.38 no.4
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    • pp.389-394
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    • 2015
  • There is a progressive development in the medical imaging technology, especially of descriptive capability for anatomical structure of human body thanks to advancement of information technology and medical devices. But however maintenance of correct posture is essential for the medical imaging checkup on the shoulder joint requiring rotation of the upper limb due to the complexity of human body. In the cases of MRI examination, long duration and fixed posture are critical, as failure to comply with them leads to minimal possibility of reproducibility only with the efforts of the examiner and will of the patient. Thus, this study aimed to develop an auxiliary device that enables rotation of the upper limb as well as fixing it at quantitative angles for medical imaging examination capable of providing diagnostic values. An auxiliary device has been developed based on the results of precedent studies, by designing a 3D model with the CATIA software, an engineering application, and producing it with the 3D printer. The printer is Objet350 Connex from Stratasys, and acrylonitrile- butadiene-styrene(ABS) is used as the material of the device. Dimensions are $120{\times}150{\times}190mm$, with the inner diameter of the handle being 125.9 mm. The auxiliary device has 4 components including the body (outside), handle (inside), fixture terminal and the connection part. The body and handle have the gap of 2.1 mm for smooth rotation, while the 360 degree of scales have been etched on the handle so that the angle required for observation may be recorded per patient for traceability and dual examination.

The Comparative Kinematic Analysis of a Volleyball Spike Serve (배구 스파이크 서브 동작의 운동학적 비교 분석)

  • Park, Jong-Chul;Back, Jin-Ho;Lee, Jin-Taek
    • Korean Journal of Applied Biomechanics
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    • v.19 no.4
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    • pp.671-680
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    • 2009
  • We performed a study to obtain kinematic data on the characteristics of spike serving techniques used by volleyball players, including other basic data that will be useful for in-field applications. We used three-dimensional videography to compare good tough serves and serve errors. The subjects were 3 left attackers whose spike serves were videographed (60 fileds/s). The three-dimensional coordinates were calculated using the direct linear transformation method and then analyzed using the Kwon 3D software program version 3.1. There was no difference in time elapsed. However, the vertical displacement of the center of body mass(CM) differed between the 2 types of serves: in successful serves, the CM tended to be lower, as did the maximum ball height at the time of hitting. Further, the higher the level of the hitting hand was at the moment of impact, the higher was the likelihood of scoring points. In good serves, the players tended to accelerate their CM movement just before jumping to hit the ball and descend rapidly at the moment of hitting. The hand speed along with ball velocity during the impact was proven to be higher in successful serves. Moreover, in successful serves, the shoulder angles increased to a greater extent while the elbow angles were maintained constant. This possibly resulted in faster and more precise serves. An important observation was that the angle of trunk inclination during the jump did not increase with the swing of the shoulders, muscle tendon complex.

Acute postoperative myelopathy caused by spontaneous developed cervical disc herniation: Case report & literature review (수술후 자연발생 경추간판탈출에 의한 척수병증: 증례보고 및 문헌고찰)

  • Lee, Jeong-Woo;Lee, Keun Hyeong;Lee, Ju-Hwan
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.20 no.10
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    • pp.303-308
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    • 2019
  • Non-traumatic acute myelopathy caused by cervical disc herniation is rare. To date, no case has been reported to be caused by extrusion cervical disc herniation, unrelated to patient posture during surgery. Here, we report the case of a 65-year-old male patient with cervical myelopathy who underwent subsequent arthroscopic rotator cuff surgery under general anesthesia; non-cervical spine surgery. Ed. Notes: I am unable to understand the insertion of the highlighted phrase. Please delete if not required, or revise the sentence appropriately. Patient showed acute postoperative tetraplegia in spite of optimal anesthetic management. He showed no limitation of neck movement at pre-operative airway evaluation, and had no history of trauma to the cervical spine. During surgery, there had been no overextension or twisting of the neck, including at the time of anesthetic induction by tracheal intubation. However, cervical disc herniation causing spinal canal cord compression was detected in the postoperative magnetic resonance imaging, which probably resulted in tetraplegia of the patient. Motor and sensory functions were recovered after 21 days of conservative treatment, including steroid pulse intravenous therapy without any surgical intervention. In this report, the disease is described after reviewing other reported cases; furthermore, we also discuss the pathophysiology of the disease. Based on our report, we propose that under general anesthesia, clinicians should pay attention to the possibility of pre-existing cervical disease, even in non-cervical spine surgeries of geriatric patients.

Effect of Integrative Korean Medicine on Acute Postoperative Pain after Arthroscopic Shoulder Surgery: A Retrospective Observational Study (한의 복합 치료가 어깨 관절경 수술 후 급성 통증에 미치는 영향: 후향적 관찰연구)

  • Ahn, Jonghyun;Ko, Junhyuk;Kim, Hyungsuk;Rhee, Sung-Min;Lee, Seung Hoon;Kim, Koh-Woon;Chung, Won-Seok;Song, Mi-Yeon;Chung, Seok-Hee;Lee, Jong-soo;Kim, Sung-soo;Cho, Jae-Heung
    • Journal of Korean Medicine Rehabilitation
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    • v.31 no.2
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    • pp.69-79
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    • 2021
  • Objectives The purpose of this study was to verify the effect of integrative Korean medicine on acute postoperative pain after arthroscopic shoulder surgery. Methods This study was conducted in a retrospective observational way. Patients who met the inclusion criteria were divided into integrative Korean medicine-treated group (IKM group) and no integrative Korean medicine treated-group (No IKM group). The primary outcome was the difference in the amount of change in pain intensity. The secondary outcome was the difference in pain intensity, opioid consumption over time, and the number of adverse events after surgery. Results The change of numerical rating scale for pain intensity from baseline to IKM group was 3.09±2.12, while 2.64±1.80 in no IKM group, and the difference of change between two groups was statistically significant (p<0.05). Difference in the use of opioid between two groups over time after surgery was also statistically significant (p=0.000). Conclusions The results of this study suggest that integrative Korean medicine can be effective for acute postoperative pain after arthroscopic shoulder surgery.

The Effect of Stellate Ganglion Block on Breast Cancer-Related Infectious Lymphedema (유방암 감염성 림프부종 환자에서 성상신경절 블록이 미치는 영향)

  • Lee, Youn Young;Park, Hahck Soo;Lee, Yeon Sil;Yoo, Seung Hee;Lee, Heeseung;Kim, Won Joong
    • Journal of Hospice and Palliative Care
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    • v.21 no.4
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    • pp.158-162
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    • 2018
  • Breast cancer related lymphedema (BCRL) is one of the most intractable complications after surgery. Patients suffer from physical impairment, as well as psychological depression. Moreover, a recent study revealed that cellulitis significantly increased the risk of BCRL, and cellulitis has been suggested as a risk factor of BCRL development. We describe a patient treated with stellate ganglion blocks (SGBs) without steroid for relief of symptoms and reduction of the arm circumference of breast cancer-related infectious lymphedema in a month. We measured the arm circumference at four locations; 10 cm and 5 cm above and below the elbow crease, numeric rating scale (NRS) score, lymphedema and breast cancer questionnaire (LBCQ) score on every visit to the pain clinic. A serial decrease of the arm circumference and pain score were observed after second injection. In the middle of the process, cellulitis recurred, we performed successive SGBs to treat infectious lymphedema. The patient was satisfied with the relieved pain and swelling, especially with improved shoulder range of motion as it contributes to better quality of life. This case describes the effects of SGB for infectious BCRL patients. SGB could be an alternative or ancillary treatment for infectious BCRL patients.

Effects of Sling Exercise With Vibration on Range of Motion, Muscle Strength, Pain, Disability in Patients With Shoulder Injuries (진동을 동반한 슬링 운동이 어깨 손상 환자의 관절가동범위, 근력, 통증, 기능장애 수준에 미치는 영향)

  • Chi, Chang-yeon;Kim, Suhn-yeop
    • Physical Therapy Korea
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    • v.26 no.3
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    • pp.11-22
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    • 2019
  • Background: Sling exercises are frequently used for the rehabilitation process of patients with shoulder joint injuries, but research on the significant frequency intensity and appropriate treatment duration for sling exercises with local vibration stimulation is lacking. Objects: The aim of this study was to investigate the effects of sling exercise with vibration on shoulder range of motion (ROM), muscle strength, pain, and dysfunction in patients with a medical diagnosis of shoulder joint injury. Methods: Twenty-two patients were randomly assigned to the experiment and control groups. Six sling exercises with and without 50 Hz vibrations were applied in the experiment and control groups, respectively. Each exercise consisted of 3 sets of 5 repetitions performed for 6 weeks. The assessment tools used included shoulder joint range of motion, muscle strength, pain level, and shoulder pain and disability index for functional disability. We conducted re-evaluations before and 3 and 6 weeks after intervention. The changes in the measurement variables were analyzed and compared between the two groups. Results: The ROM of the external rotation of the shoulder joint had a significant interaction between the group and the measurement point (F=3.652, p<.05). In both groups, we found a significant increase in external rotation angle between the measurement points (p<.05). The flexor strength of the shoulder joint significant interaction between the group and the measurement point (F=4.247, p<.05). Both the experiment (p<.01) and control groups (p<.05) showed a significant increase in shoulder flexor strength at the measurement points. After 6 weeks of the interventions, both the groups showed significantly improved VAS (p<.01), SPADI (p<.01), and orthopedic tests (p<.01). However, there was no significant difference between the group and the measurement point in terms of the clinical outcomes observed. Conclusion: The sling exercise with local vibration of 50 Hz affected the external rotation of the shoulder range of motion and improved shoulder flexor strength in the patients with shoulder injuries. Therefore, we propose the use of the sling exercise intervention with vibration in the exercise rehabilitation of patients with shoulder joint injuries.

The Kinematical Analysis of Straddle Jump to Push up Motion on Sports Aerobics (스포츠 에어로빅스 Straddle Jump to Push up 동작의 운동학적 분석)

  • Kim, Cha-Nam
    • Korean Journal of Applied Biomechanics
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    • v.12 no.2
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    • pp.77-90
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    • 2002
  • This study serves the purpose of understanding about correct jump and landing motion through Kinematical Analysis of Straddle Jump to Push up Motion at target by four elite sports aerobics athletes have more than four years career. And further more that make good assistance for coaches effective guidance through an offer basic data and correct diagnosis, evaluate of motions. It was picture-taked by two-video camera for Straddle Jump to Push up Motions. Camera speeds are 60 frame/sec. There are Kinematical Variation elements for analysis, the displacement of COG, each angle displacement left/right of shoulder-joint, each angle displacement left/right of knee-joint and each speed left/right of tip of the toes. Every each person accomplished severaly 3 times and we have acquired this conclusion. The conclusions were as follows; 1. Each situation for displacement of COG showed low height of COG by phase 1, 4, 5(79.05${\pm}9.07,\;46.41{\pm}3.65,\;18.66{\pm}0.54cm$) and It showed high height of COG by phase 2, 3($120.80{\pm}6.13,\;148.12{\pm}9.19cm$). 2. Each displacement left, right of shoulder-joint flexion by phase 1($91.07{\pm}8.30,\;90.77{\pm}5.72$deg/sec)and It showed maximal extension angles by phase 2($102.48{\pm}10.00,\;102.39{\pm}10.51$deg/sec). in part of phase 3, left of shoulder-joint angle($94.43{\pm}4.12$deg/sec) showed flexion phase 1, the other right shoulder-joint angle(88.38${\pm}$4.98deg/sec) showed more a little lower than phase 1, in last phase that showed most low by phase 4($70.58{\pm}13.72,\;54.24{\pm}11.58$deg/sec). 3. Each displacement left, right of hip joint showed maximal extent conditions by phase 2, 3($160.35{\pm}22.68,\;1534.77{\pm}5.40$deg/sec, $150.04{\pm}12.79,\;145.54{\pm}13.00$deg/sec) beside, ankle-joint showed minimal angle by phase 1, 4($93.59{\pm}18.92,\;85.37{\pm}13.23$deg/sec, $66.60{\pm}15.77,\;80.60{\pm}16.57$deg/sec). 4. Each displacement left, right of hip joint showed maximal extent conditions by phase 2($157.15{\pm}9.13,\;163.52{\pm}8.18$deg/sec), and right of hip joint showed minimal angle by phase 3($110.87{\pm}13.81,\;77.53{\pm}8.95$deg/sec) It showed alike condition of low angle by phase 1, 4($91.04{\pm}2.31,\;96.26{\pm}2.20$deg/sec). 5. Each displacement left, right of knee-joint showed maximal extent conditions by phase 1, 3, 4($173.46{\pm}2.95,\;171.51{\pm}5.44$deg/sec, $172.24{\pm}4.49,\;171.26{\pm}0.65$deg/sec, $162.78{\pm}2.13,\;164.10{\pm}5.97$deg/sec) but It showed flexion only left of knee-joint by phase 2($164.45{\pm}7.51,\;159.38{\pm}3.48$deg/sec). 6. Each speed left, right of the tip of the toes showed most fastest when someone jumped with lift up leges by phase 1, 2($321.32{\pm}67.91,\;316.90{\pm}41.97$cm/sec, $410.06{\pm}153.06,\;399.77{\pm}189.34$cm/sec), It showed more less speed than phase 1,2 by phase 3($169.74{\pm}67.17,\;150.00{\pm}63.80$cm/sec) and It showed most slow speed than phase 1,2,3 by phase 4($87.22{\pm}34.90,\;85.72{\pm}52.23$cm/sec).

Extracorporeal Shock-wave Therapy after Multiple Drilling as a Treatment for Chronic Calcific Tendinitis - An Analysis of Outcome Following Different Levels of Energy (만성 석회화 건염에 대한 다발성 천공술 후 추가적으로 시행한 체외 충격파 치료의 에너지 수준에 따른 결과분석)

  • Noh, Gyu Cheol;Jang, Keun Jong
    • The Journal of Korean Orthopaedic Ultrasound Society
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    • v.5 no.2
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    • pp.66-74
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    • 2012
  • Purpose: To compare the outcome of two methods of chronic calcific tendinitis (CCT) treatment, Multiple drilling alone versus combined drilling and extracorporeal shock-wave therapy (ESWT). Furthermore, to analyze the clinical and radiologic results of different energy level configurations of ESWT. Materials and Methods: Among the patients complaining shoulder pain who visited the clinic from June 2010 to August 2011, 98 were diagnosed with CCT of the supraspinatus and were divided into the following three groups. Multiple drilling alone (n=31), Multiple drilling followed by high-energy ESWT (n=31), Multiple drilling followed by low-energy ESWT (n=36). The study was conducted only with patients with chronic pain persisting longer than six months despite prolonged conservative therapy. Clinical evaluation was done before and after 12 weeks from treatment, in clinical terms using the ASES, KSS, CSS system reflecting performance and symptom improvement, and in radiologic terms by studying the change in size of the calcific nodules. Results: All of three groups showed effects for improvement of clinical function and decrease of calcification and clinical improvement was significantly high in comparison between the group fulfilled by only multiple needling (the third group) and the group fulfilled by additional ESWT (the first and second groups) and in the radiological evaluation, calcification size and the rate of calcification decrease showed significant improvement statistically. For the comparison among the groups, degree of clinical function improvement and rate of calcification decrease showed significant difference between high energy group (the first group) and multiple needling group (the third group) as well as low energy group (the second group) and multiple needling group (the third group). But, in comparison between high energy group (the first group) and low energy group (the second group), there was no significant difference for the degree of clinical function improvement and rate of calcification decrease. Conclusion: For the treatment of chronic calcific tendinitis, additional ESWT showed more superior effects on clinical function improvement and radiological improvement regardless of the energy standard rather than the exclusive fulfillment of needling. But, as the result of ESWT by the energy standard, there was no significant difference for the decrease of calcification and degree of clinical function improvement.

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Kinemetic analysis of a thumping security motion with an expandable barton (경호원의 삼단봉 머리치기 동작의 운동학적 분석)

  • Kim, Yong-Hak;Kim, Sin-Hye;Jung, Sung-Bae
    • Korean Security Journal
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    • no.36
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    • pp.93-109
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    • 2013
  • This research is mainly based on the experimental result due to seek different outcomes whena certain security motion with a paticular gear is applied in a plausible confrontational situation. For the purpose of this research an Expandable Baton, which is one of the most commonsecurity equipments, was chosen to be applied in a situation of hitting a person's head. Alsothe results will be studied in the view of Kinematic theory. To demonstrate, 10 students who were majeored in Escort Crane studies at 'H' university werechosen as testees. The participants were grouped into two-one is practiced with the 'expanadable baton use program' and the other is pre-practiced. In this report two groups abovewill be reffered as 'group A' and 'group B' for conveniency. There were a number of differences and changes between two groups. Group B took more timethan the other group did. Group A spent about 0.428sec in section 'e2' and 0.230sec in section'e3' while Group B took 0.435sec, 0.232sec in each sections.To add on, more distinctive results were out when it was more focused on physical movements. Two gropus presented considerable changes- in an 'left-right' moving displacement-Group A;$2.16{\pm}0.9cm$ (left side), $3.78{\pm}1.42cm$ (right side), total $5.94{\pm}2.03cm$. Group B; $2.97{\pm}1.01cm$ (left side),$4.56{\pm}1.57cm$ (right side), total $7.53{\pm}2.13cm$.Continuously, different outcomeswere shown between two groups in a 'back and forth' moving displacement-Group A;$32.48{\pm}3.86cm$, $35.21{\pm}4.64cm$, total $69.36{\pm}5.72$. Group B; $34.50{\pm}6.12cm$, $37.04{\pm}3.70cm$, total $71.46{\pm}7.17cm$. Furthermore, changes in an 'up and down' moving displacement were - GroupA; $5.62{\pm}2.41cm$, $4.54{\pm}1.87cm$, total $10.11{\pm}1.57cm$. Group B; $6.33{\pm}1.78cm$, $4.86{\pm}1.85cm$,total $10.68{\pm}1.81cm$. To continue, there were few modifications of degree on participants' joints, espcially on 'Wristjoint', 'Elbow joint' and 'Shoulder joint', depend on different sections -Wrist joint;Group A; e1 $114.62{\pm}7.13$, e2 $68.27{\pm}6.37$, e3 $131.64{\pm}6.27$. Group B; e1 $112.62{\pm}6.13$, e2 $66.28{\pm}7.38$, e3$137.42{\pm}4.28$ and Elbow joint ; Group A e1 $132.31{\pm}6.55$, e2 $117.92{\pm}8.42$, e3 $144.41{\pm}6.32$. Group B; e1 $133.58{\pm}8.56$, e2 $114.45{\pm}8.21$, e3 $139.89{\pm}4.38$. Lastly, degree changes ofshoulder joint were; Group A; e1 $13.55{\pm}3.85$, e2 $131.42{\pm}11.24$, e3 $78.32{\pm}6.28$. Group B; e1$9.45{\pm}1.23$, e2 $136.74{\pm}13.21$, e3 $79.75{\pm}4.24$.

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Association Between Temporomandibular Disorders and Cervical Muscle Pressure Pain (측두하악장애와 경부근육 압통 간의 상관성)

  • Im, Yeong-Gwan;Kim, Jae-Hyeong;Kim, Byung-Gook
    • Journal of Oral Medicine and Pain
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    • v.33 no.4
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    • pp.339-352
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    • 2008
  • Aims: The aims of this study were to identify the association between cervical muscle pain and TMD by pressure pain response, and to find cervical muscles showing moderate to severe pressure pain that are correlated with masticatory muscle pain. Methods: Patients(n=129, female 65.9%, mean age 28.8 years) answered a TMD questionnaire asking about headache, neck pain, emotional stress, sleep disturbance, parafunction habits, and pain intensity. A clinical examination of the masticatory system was performed. Of the neck muscles, (1) the upper sternocleidomastoid, (2) the middle sternocleidomastoid, (3) the upper trapezius, (4) the splenius capitis, (5) the semispinalis capitis, (6) the scalene medius, and (7) the levator scapulae muscles were examined by palpation. Pressure pain or tenderness of all palpation sites was scored from 0 to 3 according to the pain response. The variables of sum of pressure pain scores were calculated from pressure pain scores and were used for statistical analyses. Results: Eighty patients(62.0%) answered that they suffer from neck pain in the TMD questionnaire. More than 40% of sternocleidomastoid and upper trapezius examination sites showed moderate to severe tenderness in the cervical muscles, and 36% of middle masseter in the masticatory muscles. For the 129 patients, the sum of cervical muscle pain scores(mean=12.88, SD=8.06) and the sum of TMD pain scores(mean=5.36, SD=5.10) were moderately correlated($\rho$ = 0.502, P < 0.001). The sum of TMD pain scores tends to increase as the sum of cervical muscle pain scores increases(Y = 0.395${\cdot}$X, $R^2$ = 0.659, P < 0.001). In the patients with masticatory muscle disorders, the sum of sternocleidomastoid and upper trapezius pain scores(mean = 8.67, SD = 4.95) and the sum of temporalis and masseter pain scores(mean = 3.37, SD = 3.56) showed moderate correlation($\rho$ = 0.375, P < 0.001). Those two variables were in a proportionate relationship(Y = 0.359${\cdot}$X, $R^2$ = 0.538, P < 0.001). In a partial correlation analysis of the sum of unilateral pain scores, the sum of right cervical muscle pain scores and the sum of left cervical muscle pain scores showed the highest correlation(r = 0.802, P < 0.001). The sum of right TMD pain scores and the sum of left TMD pain scores were moderately correlated(r = 0.481, P < 0.001). For the twenty patients with unilateral TMD pain, the partial correlation coefficient between the sum of ipsilateral cervical muscle pain scores and the sum of contralateral cervical muscle pain scores was the largest(r = 0.597, P = 0.009). A partial correlation between the sum of primary TMD side pain scores and the sum of ipsilateral cervical muscle pain scores was 0.564(P = 0.015). Conclusions: TMD is associated with cervical muscle pain on condition of pressure pain response to palpation. Of the cervical muscles, sternocleidomastoid and upper trapezius frequently exhibit moderate to severe pressure pain, and they are closely related to the masticatory muscle pain. The characteristic of symmetric involvement of pain is prominent in cervical muscles; however, TMD can affect the level of cervical muscle pain to modify its symmetric nature.