• 한국전문물리치료학회지
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• 제26권1호
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• pp.8-18
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• 2019

Background: Numerous studies have used smartphone applications to measure the range of motion in different joints. In addition, studies measuring the active range of motion (AROM) of the craniocervical joint have revealed high reliability. However, the subjects in these studies were all healthy subjects. No study has yet been conducted to measure the inter-rater reliability for the AROM of the craniocervical joint in stroke patients. Objects: The purpose of this study was to investigate the inter-rater reliability of the AROM of the craniocervical joint using a smartphone. Methods: The participants included 21 subjects who had strokes (17 males and 4 females). Two raters evaluated six types of craniocervical AROM, including flexion, extension, lateral flexion to the hemiplegic side, lateral flexion to the non-hemiplegic side, rotation to the hemiplegic side, and rotation to the non-hemiplegic side, using a goniometer and a smartphone to investigate inter-rater reliability. The inter-rater reliability was analyzed by intraclass correlation coefficients (ICC). Results: The inter-rater reliability of the smartphone was good for extension, lateral flexion to the hemiplegic side, lateral flexion to the non-hemiplegic side, and rotation to the hemiplegic side [ICC(2,k)=.86~.88] and excellent for flexion [ICC(2,k)=.95]. The inter-rater reliability for rotation to the non-hemiplegic side was moderate [ICC(2,k)=.72]. Conclusion: These results suggest that the smartphone offers high inter-rater reliability for measurements of the craniocervical AROM in patients with stroke.

• Journal of Korean Neurosurgical Society
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• 제53권4호
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• pp.223-227
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• 2013

Objective : Although there is no consensus on the ideal treatment of the craniocervical instability, biomechanical stabilization and bone fusion can be induced through occipito-cervical fusion (OCF). The authors conducted this study to evaluate efficacy of OCF, as well as to explore methods in reducing complications. Methods : A total of 16 cases with craniocervical instability underwent OCF since the year 2002. The mean age of the patients was 51.5 years with a mean follow-up period of 34.9 months. The subjects were compared using lateral X-ray taken before the operation, after the operation, and during last follow-up. The Nurick score was used to assess neurological function pre and postoperatively. Results : All patients showed improvements in myelopathic symptoms after the operation. The mean preoperative Nurick score was 3.1. At the end of follow-up after surgery, the mean Nurick score was 2.0. After surgery, most patients' posterior occipito-cervical angle entered the normal range as the pre operation angle decresed from 121 to 114 degree. There were three cases with complications, such as, vertebral artery injury, occipital screw failure and wound infection. In two cases with cerebral palsy, occipital screw failures occurred. But, reoperation was performed in one case. Conclusion : OCF is an effective method in treating craniocervical instability. However, the complication rate can be quite high when performing OCF in patients with cerebral palsy, rheumatoid arthritis. Much precaution should be taken when performing this procedure on high risk patients.

• The Korean Journal of Pain
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• 제37권2호
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• pp.164-177
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• 2024

Background: Neck and jaw pain is common and is associated with jaw functional limitations, postural stability, muscular endurance, and proprioception. This study aimed to investigate the effect of jaw and neck pain on cranio-cervico-mandibular functions and postural stability in patients with temporomandibular joint disorders (TMJDs). Methods: Fifty-two patients with TMJDs were included and assessed using Fonseca's Questionnaire and the Helkimo Clinical Dysfunction Index. An isometric strength test was performed for the TMJ depressor and cervical muscles. The TMJ position sense (TMJPS) test and cervical joint position error test (CJPET) were employed for proprioception. Total sway degree was obtained for the assessment of postural stability. Deep neck flexor endurance (DNFE) was assessed using the craniocervical flexion test. The mandibular function impairment questionnaire (MFIQ) was employed to assess mandibular function, and the craniovertebral angle (CVA) was measured for forward head posture. Results: Jaw and neck pain negatively affected CVA (R² = 0.130), TMJPS (R² = 0.286), DNFE (R² = 0.355), TMJ depressor (R² = 0.145), cervical flexor (R² = 0.144), and extensor (R² = 0.148) muscle strength. Jaw and neck pain also positively affected CJPET for flexion (R² = 0.116) and extension (R² = 0.146), as well as total sway degree (R² = 0.128) and MFIQ (R² = 0.230). Conclusions: Patients with painful TMJDs, could have impaired muscle strength and proprioception of the TMJ and cervical region. The jaw and neck pain could also affect postural stability, and the endurance of deep neck flexors as well as mandibular functions in TMJDs.

• 한국방사선학회논문지
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• 제8권2호
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• pp.89-96
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• 2014

경추관절의 부정렬로 인한 두부전방자세를 가진 대상자에게 관절가동술을 적용 후 경추관절의 자세변화와 기능에 영향을 미치는지 알아보고자 한다. 대상자들은 경상북도 G대학 학생 39명 중 경부관절가동술그룹 20명, 가동술을 적용하지 않은 그룹 19명을 나누어서 실시하였으며, 대상자들은 방사선 사진 촬영을 한 후 그 중 경추전만각(cervical lordosis angle)이 $21^{\circ}C$이하이고, 머리의 전방무게부하(anterior weight bearing, AWB)가 15mm이상이며, 경추 신전 관절가동범위(extension ROM)가 $70^{\circ}C$ 이하인 대학생을 선별하여 자발적 동의를 구하였다, Mulligan 기법(1995) 중 SNAGS로 경추 신전과 굴곡 운동을 주당 3회, 4주간 통증이 있는 관절을 치료사가 지속적인 종속활주운동(sustained accessory glide)을 적용하는 동안 환자가 능동적으로 관절운동을 각 회마다 천천히 8회 정도 적용하였다. 측정 방법은 방사선 검사와 경부장애지수를 통해 실시하였다. 실험 결과 두부전방자세 대상자에게 경부관절가동술 적용 후 경부관절가동술군에서 경부의 AWB와 ARA, 굴곡신전 범위 변화, NDI에 대한 변화가 있음을 알 수 있었다. 대조군에서는 거의 변화가 없었다. 결론적으로 관절가동술 적용이 경부관절의 자세개선을 향상시키는데 영향을 미친 것으로 나타났고, 또한 두경부의 기능개선에서도 도움이 된 것으로 나타났다.

• PNF and Movement
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• 제4권1호
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• pp.63-69
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• 2006

Purpose : To identify the effects of Hold-Relax of proprioceptive neuromuscular facilitation (PNF) on the functional improvement of patients with neck myofascial pain syndrome. Methods : The present research investigated 30 patients with neck myofascial syndrome, dividing them into a group doing Hold-Relax of proprioceptive neuromuscular facilitation. This study examined degree of recovery from neck pain by comparing their neck myofascial pain syndrome before and after the treatment, and compared to find difference in the degree of recovery from myofascial pain syndrome. Results : The results are as follows. For the Hold-Relax of proprioceptive neuromuscular facilitation(PNF), the visual analogue scale(VAS) decreased significantly for six weeks treatment, and the range of motion(ROM) of cervical vertebrae increased significantly(p<.05). Conlusion : This study suggest that Hold-Relax of proprioceptive neuromuscular facilitation have an effect on the functional improvement of patients with neck myofascial pain syndrome.

• 대한치과교정학회지
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• 제29권1호
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• pp.37-49
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• 1999

악관절 기능 장애는 교정치료 전,중 또는 후에 빈번하게 부딪치는 어려운 문제이다. 특히 장안모 고경군의 형태학적 특징상 악관절 기능이상이 쉽게 발현될수 있는 가능성을 갖고 있다. 이에 17세 이상의 여성중 SN-MP가 $38^{\circ}$ 이상인 장안모 유형 환자를 대상으로 악관절 기능 장애군 51명, 비장애군 42명을 대상으로 교정모형과 두부방사선 사진을 대상으로 통계처리하여 다음과 같은 결과를 얻었다. 1. 악관절 기능 장애군과 비장애군에서 수평 피개량과 수직 피개량은 통계적으로 유의한 차이를 보이지 않았다. 2. 악관절 기능 장애군과 비장애군에서 하악 평면에 대한 하악 제1대구치의 기울기 및 수직적 위치는 통계적으로 유의한 차이를 보였다. 3. 악관절 기능 장애군과 비장애군에서 기능적 요소로 두경부 자세, 혀, 및 설골의 위치는 통계적으로 유의한 차이를 보이지 않았다.