• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.27 no.3
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• pp.69-78
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• 2021

Background: Approximately 30% of people suffer from chronic neck and shoulder pain. Chronic neck and shoulder pain arise due to the exposure to continuous low loading and monotonous work. This is a common musculoskeletal disorder in a society. As physical therapists, we should give appropriate treatment to these people. Methods: A total of 26 patients with chronic neck and shoulder myalgia were randomly allocated into two experimental groups. First, 13 patients received shoulder strength training, while the other 13 patients received cervical mobilization. Outcome measures included bilateral pressure pain threshold by using an algometer at upper trapezius, visual analogue scale (VAS) to express their pain scale, and muscle tension by using myoton pro device pre-intervention and after the final treatment. Results: The VAS and muscle tension in upper trapezius significantly decreased (p<.05) in both groups; however, no differences between two groups were observed (p>.05). The pressure pain threshold in upper trapezius significantly increased (p<.05) in both groups; yet, again, the differences between the groups did not reach statistical significance (p>.05). Conclusion: As methods of treatment, shoulder-specific strength training and cervical mobilization can be appropriate approaches to the treatment of neck and shoulder musculoskeletal disorder.

• Korean Journal of Acupuncture
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• v.25 no.2
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• pp.125-141
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• 2008

Objective : The aim of this study is to investigate the curative effect of Bee Venom Acupuncture Therapy for pain and limited R.O.M (range of motion) of shoulder in stroke patients. Methods : The subjects of this study were 6 patients with shoulder pain in stroke sequelae. Routine Oriental Medical programs (Acupunture, moxibustion, herbal medicine and physical therapy) were maintained for each subject throughout this study. Single subject ABABAB design was adopted. Each period was 4 days as a rule. Only during the treatment period, Bee Venom Acupuncture Therapy was provided as intervention at the acupoints of LI15(Gyeonu),　TE14(Gyeollyo), GB21(Gyeonjeong), LI14(Bino). The change of pain was measured with a Visual Analogue Scale(VAS). The pain threshold was measured using pressure algometer at the same acupoints where Bee Venom Acupuncture Therapy was provided. And the R.O.M of shoulder joint (flexion, extension, abduction, adduction, external rotation, internal rotation) was measured as well. Analysis was performed by Bayesian analysis using WinBUGS for the comparison of treatment(Bee Venom Acupuncture Therapy) and non-treatment. Results : The median overall improvement for difference in VAS was -2.219(-3.213, -1.175), for difference in external rotation of shoulder R.O.M was 9.992(-2.298, 18.49), for difference in tenderness score of LI14(Bino) by pressure algometer was 5.05(0.6283, 7.762). 95% credibility intervals being shown in brackets. However, the median overall improvement for difference in the other measurements was not significant. Conclusion : This study suggests that Bee Venom Therapy may be applicable to decrease pain and improve R.O.M of shoulder in hemiplegia patients with stroke. Further elaborated single subject designs need to be accumulated to confirm the effects of Bee Venom Acupunture Therapy on shoulder pain in patients with stroke sequelae.

• Journal of Acupuncture Research
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• v.23 no.1
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• pp.187-215
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• 2006

Objectives : To determine whether the pragmatic acupuncture treatment provides more effective pain relief than treatment using the same acupuncture point to the all patients. Methods : We randomly allocated participants to treatment group 1 and 2. The group 1 is the pragmatic treatment group and the group 2 is using the same acupuncture point to the all patients. Primary outcomes were measured by the Western Ontario and McMaster Universities Osteoarthritis index(WOMAC) pain and function scores at 4, 8, and 14 weeks. Secondary outcomes were measured by 100mm VAS(Visual Analog Scale), ROM(Range of Motion) using Goniometer, and pain threshold using pressure algometer. Results : When patients were extension of the knee, they were statistically significant in improvement of the ROM in 14 weeks. Whole body condition and pain rate through VAS measurement were improved significantly in 14 weeks. Also pain score and function score of WOMAC were improved significantly in 14 weeks. We could get difference in pain score of two acupuncture groups significantly in 14 weeks. But we could not get difference in whole score of two acupuncture groups significantly. Local temperature using T.C thermometer was changed significantly in 14 weeks. But we could not get difference in whole score of two acupuncture groups significantly. Excluding above item, DITI, pain threshold, and ROM of the knee flexion were no difference in before and after treatment.

• Korean Journal of Psychosomatic Medicine
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• v.21 no.2
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• pp.140-146
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• 2013

Objectives: We compared the characteristics of the pain threshold and pain experience between demented group and non-demented group. Methods: This study was part of Gangwon projects for early detection of dementia in 2010. We recruited 8302 local resident ages over 65 years old. Of theses, 1259 people who scored low MMSE were selected and 365 of them completed CERAD-K(Consortium to Establish a Registry for Alzheimer's disease). Finally, 90 in non-demented group and 57 in demented group(mild to moderate Alzheimer's disease) were analyzed. Pain threshold was experimentally measured by pressure algometer and we investigated the pain experience, by Brief pain inventory (BPI), a self-report test. Results: In the demographic characteristics, there are more female, higher ages, lower education in the demented group. There was no significant difference between the two groups in the pain threshold. On the BPI results, 'shoulder pain', 'the number of pain' and 'interference of working' were significantly more prevalent in non-demented group. However, there are no significant differences between the groups in the 'pain severity', 'prevalence of pain' and 'pain treatment'. Conclusions: Demented group report less pain experience but, still perceived pain. It support previous studies that patient with dementia have increased pain tolerance but preserved pain threshold. Thus, active pain assessment and treatment for patients with dementia is needed.

• Journal of Acupuncture Research
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• v.32 no.2
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• pp.87-96
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• 2015

Objectives : The purpose of this study was to investigate the clinical effects of Dong-qi acupuncture on piriformis for herniated intervertebral disc(HIVD) of lumbar spine patients with piriformis muscles tenderness. Methods : This research was carried out on the 60 inpatients who received treatment for their HIVD of lumbar spine from January 1 to May 31, 2014 in DaeJeon Jaseng Hospital of Korean Medicine. We divided them into two groups ; group A(n=30) : common treatment on HIVD of L-spine without Dong-qi acupuncture on piriformis(acupuncture, pharmacopuncture, herb medication, Chuna and physiotherapy), and group B(n=30) : common treatment on HIVD of L-spine with Dong-qi acupuncture on piriformis. We evaluated the treatment effect of each group on tenderness(checked by Algometer pressure), and with a numeric rating scale(NRS), and oswestry disability index(ODI). The evaluations of tenderness were performed 8 times : admission day, and on the 3rd, 6th, 9th, 12th, 15th, 18th and 21st day after admission. The evaluations of NRS and ODI were performed 3 times : admission day, and on the 12th and 21st day after admission. The statistical significance was evaluated by SPSS 18.0 for Windows. Results : In group B, tenderness was significantly decreased compared with group A. The difference of tenderness from admission day to the 12th day showed significant reduction compared with group A. Conclusions : Dong-qi acupuncture is more effective in reducing piriformis muscle tenderness in the early stages of treatment. We expect that patients who receive Dong-qi acupuncture will be satisfied with Korean medical treatment and trust their doctor.

• Korean Journal of Psychosomatic Medicine
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• v.6 no.1
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• pp.22-27
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• 1998

Thirteen female patients of somatization disorder, undifferentiated somatoform disorder and somatoform disorder, NOS, diagnosed by DSM-IV were studied for their pain threshold and serum testosterone and the results were compared with the respective data of 20 control females. The results are as follows : 1) The pain threshold as measured by Variable Weight Pressure Algometer was significantly lower in the patient group(153.8${\pm}$39.5 gm/$0.05mm^2$) as compared to the control group(197.5${\pm}$66.7 gm/$0.05mm^2$)(p<0.05). 2) There was no significant difference of serum testosterone between the patient(0.175${\pm}$0.081 ng/ml) and the control(0.174${\pm}$0.108 ng/ml) groups. 3) A significant positive correlation was noted between the pain threshold and serum testosterone in the patient group(r=0.632, p<0.05, two tailed, Pearson's correlation test), but not in the normal control group(r= -0.405). From these results, it was suggested that the role of testosterone in endogenous pain control system might be more important in somatoform disorders than normals.

• Journal of the Korean Society of Physical Medicine
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• v.9 no.4
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• pp.433-438
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• 2014

PURPOSE: The purpose of our study was to compare a 975-nm, 500-mW GaAlAs low-level laser therapy versus placebo low-level laser therapy with regard to the immediate changes on the myofascial trigger point of the dominant upper trapezius muscle in subjects with rounded shoulder posture. METHODS: Thirty-two male college students with rounded shoulder posture and shoulder pain consented to participate in the experiment. The subjects were randomly assigned to a 2-minute procedure with either an active GaAlAs low-level laser or a placebo GaAlAs low-level laser. The pressure-pain threshold and visual analog scale on tenderness at 3 kg were measured with an algometer before and after the laser treatments. RESULTS: The active GaAlAs low-level laser group showed significant changes in pressure-pain threshold and visual analog scale on tenderness at 3 kg (p<0.05). The placebo GaAlAs low-level laser group showed no significant changes in either pressure-pain threshold or visual analog scale on tenderness at 3 kg (p>0.05). CONCLUSION: An immediate effect was observed in pressure-pain threshold and visual analog scale on tenderness at 3 kg following a 2-minute application ($857.14J/cm^2$) of a 975-nm, 500-mW GaAlAs low-level laser to the myofascial trigger point of the dominant upper trapezius muscle in patients with rounded shoulder posture.

• PNF and Movement
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• v.20 no.3
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• pp.451-459
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• 2022

Purpose: Temporomandibular disorder (TMD) is a common musculoskeletal problem that causes pain in and disability of masticatory muscles, the temporo-mandibular joint (TMJ), and related structures. The purpose of this study was to compare pressure pain thresholds (PPTs) of masticatory muscles, cervical ranges of motion (ROM), and pelvic mobility during gait of subjects with or without TMD. Methods: In this study, pain thresholds and changes in the mobility of the cervical vertebrae and pelvis were measured in 25 patients with TMD and 25 healthy controls. Using a pressure algometer, the pressure pain thresholds (PPTs) of the masseter and temporalis muscles were measured in both groups. A gyroscope sensor with a mobile application was used to determine cervical ROM in the frontal and sagittal planes. A 3D-motion analysis system was used to evaluate pelvic mobility in the sagittal, frontal, and transverse planes during gait. Results: The TMD group showed significantly decreased PPTs of masseter and temporalis muscles compared with the control group (p < 0.05). Cervical ROM in flexion, extension, and lateral bending were significantly decreased in the TMD group compared with the control group (p < 0.05). In addition, antero-posterior pelvic tilt was significantly decreased in the TMD group (p < 0.05). Conclusion: The results of the current study suggest that there are close anatomical and functional relationships between TMD and muscle chains related to the cervical spine and pelvis. Therefore, more comprehensive body posture assessments, especially of painful areas, should be undertaken when studying TMD patients.

• The Journal of Korean Physical Therapy
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• v.26 no.6
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• pp.379-385
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• 2014

Purpose: This study was to determine the immediate effects of pulsed magnetic field (PMF) in subjects with upper trapezius (UT) trigger point (TrP). Methods: Fifteen subjects with UT TrP were recruited for the study's PMF group (pain threshold=$2.29kg/cm^2$), and 15 age-, weight-, and gender-matched subjects with UT TrP were recruited for control group (pain threshold=$2.25kg/cm^2$). Pressure algometer was used to measure pressure pain threshold on UT TrP and, cervical range of motion (ROM) inclinometer was used to measure cervical ROM. Surface electromyography was used to record UT, lower trapezius, and serratus anterior muscle activity and relative ratio during scapular plane abduction between pre- and post-treatment. Results: The PMF effectively improved pain threshold and concurrently increased ROM (rotation to the painful side, lateral flexion to the nonpainful side). In addition, the PMF may effectively deactivate UT activity during abduction and the muscle activity ratio between UT and serratus anterior. Conclusion: These findings provided empirical evidence that PMF can be an effective treatment method to reduce pain threshold, to increase cervical ROM, and deactivate UT activity in individuals with TrP.

• Journal of The Korean Society of Integrative Medicine
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• v.11 no.4
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• pp.147-155
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• 2023

Purpose: Headache is a very common disease experienced at least once in daily life, and tension-type headaches have a high and increasing prevalence. Chronic headaches can cause functional damage and huge socioeconomic impacts. This study aimed to compare the effects of myofascial release technique with manual therapy and self-myofascial release technique using a foam roller on the pain threshold and body schema in patients with chronic tension-type headaches. Methods: The study was conducted on 20 patients living in Busan with chronic tension headaches. Myofascial release technique with manual therapy was performed on the suboccipital, sternocleidomastoid, scalene, and upper trapezius muscles. The self -myofascial release technique using a foam roller was applied to the cervical and thoracic muscles. A laterality test was performed using a recognized neck application developed to evaluate body schema ability. A pressure-pain threshold test was performed using an electronic pressure algometer to compare the results before and after the myofascial release technique. Results: After applying myofascial release with manual therapy and a foam roller, the pressure-pain threshold values showed significant changes in both groups (p<.05). As a result of the laterality test, myofascial release with manual therapy and a foam roller were applied to the painful area. The values showed significant changes in both groups (p<.05), but only the group using the foam roller showed a significant difference (p<.05) in painless areas. Conclusion: The myofascial release technique with manual therapy can be the primary treatment technique for pain control in painful areas. The self-muscle release technique using a foam roller can be an effective method when there is no pain or when maintenance is needed after pain control.