• 한국전문물리치료학회지
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• 제29권4호
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• pp.255-261
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• 2022

Background: For the elderly, masticatory function is one of the most important oral functions and the masticatory ability is related to the wearing of dentures. Many older people wear dentures for their masticatory function, but a significant number of older people who use dentures have found that they feel uncomfortable when performing their daily activities, such as performing masticating functions or talking. Objects: The purpose of this study is to investigate how the forward head posture (FHP), respiratory function and thickness of masseter (MS), and sternocleidomastoid (SCM) are affected by the presence or absence of dentures in the elderly, and what kind of correlation there is between these variables. Methods: The study was conducted on 11 patients in the normal group and 13 in the denture group. The participant's cognitive ability was evaluated using Mini-Mental State Examination Korean (MMSE-K), and the FHP was evaluated by measuring the craniovertebral angle (CVA). The thickness of the MS and SCM muscles were measured using ultrasound, and respiration was measured with a spirometry. As for the statistical method, the correlation of each variable was investigated using Spearman's correlation coefficient. Results: In the normal group, there was a significant correlation between forced vital capacity (FVC) and forced expiratory volume in 1 second (FEV1) (p < 0.001), and in the denture group, FVC and FEV1 (p < 0.001), maximal inspiratory pressure (MIP) and maximal expiratory pressure (MEP) (p < 0.001), CVA and Lt. MS (p = 0.012). Conclusion: CVA and Lt. MS of the denture group have a high negative correlation, it is related that the thickness of MS may be thick when the elderly wearing dentures are FHP.

• 대한통합의학회지
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• 제10권4호
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• pp.23-34
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• 2022

Purpose : This study examined the effects of pain, neck dysfunction, psychosocial level, headache impact test (HIT), postural alignment, and trapezius muscle tone of the complex exercise program using dynamic taping in patients with tension headache and chronic neck pain with forward head posture. Methods : The design of this is a randomized controlled trial (RCT). Thirty-four patients with chronic neck pain were screened using a randomized assignment program and assigned to experimental group (n=17) and control group (n=17). Both groups underwent a complex exercise program. In addition, the experimental group dynamic taping was applied to the upper trapezius muscle. All interventions were applied three times per week for four weeks. The visual analogue scale (VAS), the neck disability index (NDI), short form-12 health survey questionnaire (SF-12), Headache impact test-6 (HIT-6), Craniovertebral angle (CVA), Cranial rotation angle (CRA), upper trapezius muscle tone were compared to evaluate the effect on intervention. Results : Both groups showed significant differences before and after the intervention in VAS, NDI, SF-12, HIT-6, and CVA, CRA (p<.05). In addition, significant differences in NDI and upper trapezius muscle tone were observed between the experimental group and control group (p<.05). Conclusion : A complex exercise program using dynamic taping for patients with tension headache and chronic neck pain with forward head posture are effective method with clinical significance in improving the function and reducing upper trapezius muscle tone.

• 한국운동역학회지
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• 제33권1호
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• pp.1-9
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• 2023

Objective: This study identifies the difference among the heights of a chair's backrest (High, Mid, No), the biomechanical changes chair users undergo over time, and the variables that can measure musculoskeletal disorders, eventually providing information on the appropriate type of backrest. Method: Eleven healthy subjects in their 20s and 30s who had no experience with musculoskeletal disorders or surgical operations within the last 6 months participated in this study. Computer typing tasks were randomly designated and performed according to the type of chair backrest, and evaluation was performed for Flexion-Relaxation Ratio (FRR) analysis after the computer typing tasks. This study used eight infrared cameras (sampling rate: 100 Hz) and nine-channel electromyography (sampling rate: 1,000 Hz). ANOVA with repeated measures was conducted to verify the results, with the statistical significance level being α = .05. Results: Although there was no significant difference in craniovertebral angle (CVA), this study showed time and interaction effects depending on the height of the backrest (p<.05). When working without the backrest, the head-spine angle was lower compared to the chairs with backrest, based on the computer work. As for the head angle, the higher the back of the chair was, the less the head flexion and the body angle became, whereas the body flexion became less when there was a backrest. In addition, the body flexion increased over time in all types of backrests (p<.05). The muscle activity of the upper body tended to be high in the high backrest chair. On the other hand, a lower muscle activity was found with a low backrest. Conclusion: These results show that a chair is more ergonomic when the body angle is correctly set without bending and when it is supported by a low backrest. Accordingly, this study determines that the backrest affects shoulder and neck musculoskeletal disorders during typing and that medium-height backrest chairs can help prevent musculoskeletal disorders, contrary to the expectation that high-backrest chairs are preferable.

• 대한정형도수물리치료학회지
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• 제29권2호
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• pp.59-67
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• 2023

Background: The purpose of this study is to analyze the effect of shoulder and neck stabilization exercise using a gym ball for healthy women in their 20s with round shoulder and forward head posture, it is intended to try and find improvement for posture. Methods: The subjects of the study were 25 women who understood the purpose of the research and voluntarily agreed to participate in the experiment. They carried out the shoulder and neck stabilization exercise program using a gym ball, which was conducted for 35 minutes, 3 times a week for 4 weeks. The position of the round shoulder and shoulder bones was measured using an tape measurement and were recorded in both at pre, 2 weeks, and post intervention. The craniovertebral angle (CVA) and craniorotational angle (CRA) was measured using an image J. Results: The round shoulder posture left was statistically significantly different within group (p<.05); however, the round shoulder posture right wasn't statistically significantly different (p>.05). As a result of this contrast, test were significant different in both at pre, 2 weeks and post. The scapular position on the left and right were statistically significantly different within the group (p<.05). As a result of the contrast, test were significant different in both at pre, 2 weeks and post (p<.05). The CVA and CRA on the left and right were statistically significantly different within the group (p<.05). As a result of the contrast, test were significant different in both at pre, 2 weeks and post (p<.05). Conclusion: The gym ball exercises improved the posture of women in their 20s. Therefore, gym ball exercises can help improve the quality of life of those with shoulder and neck pain.

• 한국전문물리치료학회지
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• 제30권3호
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• pp.184-193
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• 2023

Background: Studies investigating the immediate effects of a single intervention to correct forward head posture are rare. Objects: This study aimed to compare the changes in treatment effects in patients with forward head posture and neck pain after manual and self-exercise therapy over a 1-hour period. Methods: Twenty-eight participants were randomly divided into manual and self-exercise therapy groups. Following the initial evaluation, manual or self-exercise therapy was applied to each group for 30 minutes each in the prone, supine, and sitting positions. The variables measured were the craniovertebral angle (CVA), stress level, pain level, and sternocleidomastoid (SCM) stiffness. After the intervention, re-evaluation was conducted immediately, 30 minutes later, and 1 hour later. Two-way analysis of variance (ANOVA) was used to compare the maintenance of treatment effects between the two groups. Results: Based on the two-way mixed ANOVA variance, there was no interaction between the groups and time for all variables, and no main effects were found between the groups. However, a significant effect of time was observed (p < 0.05). Post hoc tests using Bonferroni's correction revealed that in both groups, the CVA, pain, and stress showed significant improvements immediately after the intervention compared with before the intervention, and these treatment effects were maintained for up to 1 hour after the treatment (p < 0.0083) in the manual therapy group. However, the stress level was maintained until 30 minutes later (p < 0.0083) in the self-exercise group. There was no significant decrease in right SCM stiffness before and after the intervention; however, left SCM stiffness significantly decreased after the self-exercise intervention (p < 0.0083). Conclusion: Both manual and self-exercise therapy for 30 minutes were effective in reducing forward head posture related to the CVA, pain, and stress levels. These effects persisted for at least 30 minutes.

• 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.

• 한국전문물리치료학회지
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• 제23권2호
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• pp.57-66
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• 2016

Background: For the treatment of forward head posture (FHP) and forward shoulder posture, methods for strengthening scapular retractors and deep cervical flexors and stretching pectoralis and upper cervical extensors are generally used. No study has yet assessed whether suboccipital release (SR) followed by cranio-cervical flexion exercise (CCFE) (SR-CCFE) will result in a positive change in the shoulders and neck, showing a "downstream" effect. Objects: The purpose of this study was to investigate the immediate effects of SR-CCFE on craniovertebral angle (CVA), shoulder abduction range of motion (ROM), shoulder pain, and muscle activities of upper trapezius (UT), lower trapezius (LT), and serratus anterior (SA) and LT/UT and SA/UT muscle activity ratios during maximal shoulder abduction in subjects with FHP. Methods: In total, 19 subjects (7 males, 12 females) with FHP were recruited. The subject performed the fifth phase of CCFE immediately after receiving SR. CVA, shoulder abduction ROM, shoulder pain, muscle activities of UT, LT, and SA, and LT/UT and SA/UT muscle activity ratios during maximal shoulder abduction were measured immediately after SR-CCFE. A paired t-test and Wilcoxon signed-rank test were used to determine the significance of differences in scores between pre- and post-intervention in the same group. Results: The CVA (p<.001) and shoulder abduction ROM (p<.001) were increased significantly post-versus pre-intervention. Shoulder pain was decreased significantly (p<.001), and LT (p<.05) and SA (p<.05) muscle activities were increased significantly post- versus pre-intervention. The LT/UT muscle activity ratio was increased significantly post- versus pre-intervention (p<.05). However, there was no significant change in UT muscle activity and SA/UT muscle activity ratio between pre- and post-intervention (p>.05). Conclusion: SR-CCFE was an effective intervention to improve FHP and induce downstream effect from the neck to the trunk and shoulders in subjects with FHP.

• 한국전문물리치료학회지
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• 제27권1호
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• pp.1-10
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• 2020

Background: Thoracic spine self-mobilization exercise is commonly used to manage patients with neck pain. However, no previous studies have investigated the effects of thoracic spine self-mobilization exercise alone in patients with chronic neck pain. Objects: The purpose of this study was to investigate the effects of thoracic self-mobilization using a tool on cervical range of motion (ROM), disability level, upper body posture, pain and fear-avoidance beliefs questionnaire (FABQ) in patients with chronic neck pain. Methods: The subjects were 49 patients (21 males, 28 females) with chronic neck pain. The subjects were randomly divided into an experimental group (EG, n = 23) and control group (CG, n = 26). For the EG, thoracic self-mobilization was applied. We placed a tool (made with 2 tennis balls) under 3 different vertebral levels (T1-4, T5-8, T9-12) of the thoracic spine and the subjects performed crunches, which included thoracic flexion and extension in supine position. Five times × 3 sets for each levels, twice a week, for 4 weeks. Cervical pain, disability, upper body posture, FABQ results, and ROM were evaluated at baseline, after 4 weeks of intervention, and at 8 weeks of follow-up. Assessments included the quadruple visual analogue scale (QVAS); Northwick Park neck pain questionnaire (NPQ); craniovertebral angles (CVA), forward shoulder angle (FSA) and kyphosis angle (KA) measurements for upper body posture; FABQ and cervical ROM testing. Results: The EG showed a statistically significant improvement after intervention in the QVAS (-51.16%); NPQ (-53.46%); flexion (20.95%), extension (25.32%), left rotation (14.04%), and right rotation (25.32%) in the ROM of the cervical joint; KA (-7.14%); CVA (9.82%); and FSA (-4.12%). Conclusion: These results suggest that, for patients with chronic neck pain, thoracic self-mobilization exercise using a tool (tennis balls) is effective to improve neck pain, disability level, the ROM, and upper body posture.

• 한국산학기술학회논문지
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• 제18권4호
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• pp.624-631
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• 2017

본 연구의 목적은 머리 전방 자세 성인에 대하여 8주간 슬링에서의 푸쉬업 플러스 운동이 근활성도와 폐기능에 어떠한 영향을 미치는지 알아보고자 하였다. 총 16명의 머리 전방 자세 성인이 모집 되었고 대조군과 실험군으로 각 8명씩 배정 되었다. 슬링에서의 니푸쉬업 플러스와 안정한 면에서 니푸쉬업 플러스 운동을 2015년 7월 6일부터 8월 28일까지 8주간 나누어 시행하였고 주 3회 실시하였다. 머리 척추각을 측정시 두군에서 (p<0.001)의 증가를 보였고 머리 회전각 측정시 대조군에서 (p<0.05), 실험군에서 (p<0.001)의 감소를 보였다. 두 군에서 근활성도는 위 등세모근(p<0.001)의 감소와 앞톱니근, 아래 등세모근의(p<0.001)의 증가를 나타내었고 폐기능 측정시 대조군에서(p<0.01), 실험군에서(p<0.001)의 증가를 보였다. 결론적으로 푸쉬업 플러스 운동은 머리 전방 자세를 개선시키고 호흡근들의 활성화를 높일뿐더러 폐기능 강화에 효과적이며 슬링에서의 푸쉬업 플러스 운동이 머리 전방 자세의 개선에는 더욱 효과적이지만 폐기능에는 유의한 차이가 없었다. 따라서 슬링에서의 푸쉬업 플러스 운동은 머리 전방자세 성인의 자세 개선과 폐기능에 효과적인 운동으로 추천 된다.

• 한국전문물리치료학회지
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• 제28권1호
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• pp.18-26
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• 2021

Previous studies have reported that deep neck flexor (DNF) exercise can improve neck problems, including neck pain, forward head posture, and headache, by targeting the deep and superficial muscles of the neck. Despite the prevailing opinion across studies, the benefits of DNF can vary according to the type of neck problems and the outcome measures adopted, ranging from positive outcomes to non-significant benefits. A meta-analysis was conducted in this study to assess conclusive evidence of the impact of DNF exercise on individuals with neck problems. We used PUBMED, MEDLINE, NDSL, EMBASE, and Web of Science to search for primary studies and the key terms used in these searches were "forward head posture (FHP)," "biofeedback," "pressure biofeedback unit," "stabilizer," "headache," and "neck pain." Twenty-four eligible studies were included in this meta-analysis and were coded according to the type of neck problems and outcome measures described, such as pain, endurance, involvement of neck muscle, craniovertebral angle (CVA), neck disability index (NDI), cervical range of motion (CROM), radiographs of the neck, posture, strength, endurance, and headache disability index. The overall effect size of the DNF exercise was 0.489. The effect sizes of the neck problems were 0.556 (neck pain), -1.278 (FHP), 0.176 (headache), and 1.850 (mix). The effect sizes of outcome measures were 1.045 (pain), 0.966 (endurance), 0.894 (deep neck flexor), 0.608 (superficial neck flexor), 0.487 (CVA), 0.409 (NDI), and 0.252 (CROM). According to the results of this study, DNF exercise can effectively reduce neck pain. Thus, DNF exercise is highly recommend as an effective exercise method for individuals suffering from neck pain.