• 한국콘텐츠학회논문지
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• 제11권12호
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• pp.326-334
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• 2011

본 연구의 목적은 깊은 목굽힘근과 깊은 목폄근의 두께를 목근육 지구력 검사 동안 측정하여 목통증 경험 유무에 따라 깊은 목근육들의 크기에 차이가 있는 지 관찰하였다. 컴퓨터 사용이 많은 대학생 65명이 참여하였으며, 목통증이나 두통으로 인하여 일상생활을 수행하는데 제약이 없고 현재 척추증상이 없는 자를 대상으로 하였다. 근육의 두께는 근지구력검사를 수행하는 중 근이완기, 수축기와 제한시점에서 각각 측정하였다. 목통증과 기능제한에 대한 정보는 설문지를 통하여 수집하였다. 목통증 경험이 없는 대상자들 (그룹1)의 근지구력 시간이 목통증 경험이 있는 대상자들(그룹2)보다 통계적으로 유의하게 길었다 (p<0.01). 그룹1 대상자의 왼쪽 긴목근이 그룹2 대상자보다 근이완기에서 두껍게 관찰되었으며(p=0.02), 오른쪽 긴머리근은 목통증 경험이 없는 대상자들이 근수축에서 제한시점까지의 변화가 목통증 경험이 있는 대상자보다 크게 관찰되었다(p=<0.01). 목통증과 연관하여 특정 근육의 기능파악이 중요하며, 임상 대상자들의 목수축 패턴과 근기능에 대한 연구가 더 필요하다.

• 한국전문물리치료학회지
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• 제29권3호
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• pp.180-186
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• 2022

Background: The craniocervical flexion test (CCFT) was developed for the activation and endurance of deep cervical flexors. However, the muscle thickness and muscle thickness changing ratio of the sternocleidomastoid (SCM) and deep cervical flexor (DCF) muscles in subjects with and without forward head posture (FHP) have not been reported. Objects: To determine the difference in thickness of the SCM and DCF muscles and the difference in the muscle thickness changing ratio between SCM, DCF, and DCF/SCM 20 mmHg and DCF/SCM 30 mmHg between subjects with and without FHP. Methods: Thirty subjects with and without FHP were enrolled. The muscle thickness of the SCM and DCF was measured when maintained at a baseline pressure of 20 mmHg and a maximum pressure of 30 mmHg using a pressure biofeedback unit during the CCFT. Ultrasonography was used to capture images of SCM and DCF muscle thickness during the CCFT, which was calculated using the picture archiving and communication system (PACS). Results: We observed a significant difference within the pressure main effect between SCM and DCF at a baseline pressure of 20 mmHg and a maximum pressure of 30 mmHg (p < 0.05). However, there was no significant difference in the muscle thickness and muscle thickness changing ratio for SCM and DCF during CCFT between subjects with and without FHP. Conclusion: There was no significant difference in the muscle thickness recruitment pattern during CCFT in posture changes between subjects with and without FHP.

• 한국전문물리치료학회지
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• 제23권3호
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• pp.11-20
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• 2016

Background: A forward head posture (FHP) is one of the most common types of poor head posture in patients with neck disorder. A prolonged FHP might increase pressure on the posterior cranio-cervical structure and exhibit reduced performance on a cranio-cervical flexion test (CCFT). CCFT is included to activate deep cervical flexor muscles and inhibit excessive activation of superficial cervical flexor muscles. Therefore, the selective activation of deep cervical flexors is needed for effective exercise for FHP. Objects: The purpose of this study was to compare muscle thickness between longus colli (Lco) and sternocleidomastoid (SCM) using ultrasonography in subjects with FHP depending on head support. Methods: This was a cross-sectional, case-control research design study. The ultrasonographic images of Lco and SCM were taken in 17 subjects with FHP during the 5 phases of the CCFT with and without a head support. Towel was used for supporting head to make the neutral head position in supine. Changes in muscle thickness during the test were calculated to infer muscle activation. Data were analyzed using repeated measures of two-way analysis of variance with the significance level of .05. Results: When subjects performed the CCFT with head support, there was a significant difference in muscle thickness of Lco and SCM (p<.05). According to a post hoc paired t-test, change of thickness of Lco was greater at all phases, and change of thickness of SCM muscle was less at phase 4 and 5 in condition with head support (p<.01) compared to condition without head support (p<.01). Conclusion: The result of this study suggest that applying head support for neutral head position during CCFT could be a useful method for activating Lco muscle without excessive activation of SCM muscle.

• 문화기술의 융합
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• 제5권4호
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• pp.227-235
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• 2019

본 연구의 목적은 거북목을 가진 사람에게 메켄지 폄운동과 어깨안정화운동이 앞쪽머리자세에 미치는 영향에 대해 알아보는 것이다. 연구대상자는 30명의 거북목을 가진 평범하고 건강한 사람들로 이루어져 있다. 대상자는 어깨안정화운동과 메켄지 폄운동으로 나누어(인원=30, 남자 15명, 여자 15명) 무작위로 나누어 6주 동안 실시되었다. 본 연구는 마름근, 아래등세모근의 운동프로그램과 깊은목굽힘근, 위등세모근, 어깨올림근의 신장프로그램을 통한 목뼈의 머리척추각(Cervical Vertebra Angle) 값과 각 근육별 근전도의 차이를 알아보았다. 앞쪽머리자세와 경우에는 목과 등근육의 활성도가 감소하고 피로도는 증가함을 보였다. 이러한 결과는 목과 머리의 불안정한 상태를 안정시키기 위해서는 위등세모근, 깊은목굽힘근, 어깨올림근의 신장과 마름근, 아래등세모근의 운동을 통해 거북목의 개선에 긍정적인 변화를 줄 것으로 보인다. 이러한 근육들의 불균형한 수축과 과도한 긴장으로 근육의 경직과 피로가 누적되며 이러한 상태가 계속 유지되게 되면 만성화상태가 되어 근육의 불균형으로 인해 통증을 유발할 수 있으며, 피로의 누적으로 인하여 자극에 대한 반응과 근력을 약화시켜서 목 디스크가 발생할 확률이 높아질 것으로 사료된다.

• 한국산학기술학회논문지
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• 제21권1호
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• pp.284-290
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• 2020

본 연구는 SNAGs(Sustained natural apophyseal glides)기법과 시각을 융합한 바이오피드백 훈련이 목 기능 장애 환자에게 고유수용성 감각과 목의 기능장애에 미치는 영향을 알아보고자 하였다. 목 기능장애 환자 31명을 대상으로 무작위로 SNAGs기법과 바이오피드백 훈련으로 할당하였으며, 관절위치 감각과 목 기능장애 평가를 중재 전-후 실시하였다. 16명의 SNAGs 중재그룹은 멀리건 벨트를 이용하여 굽힘, 폄, 회전을 실시하였고, 15명의 바이오피드백군은 시각적 피드백을 통한 깊은목 굽힘근 훈련을 실시하였다. 두 집단은 동일한 시간, 동일한 조건에서 20분 동안 주당 2회를 4주간 실시하였다. 바이오피드백 훈련 집단이 SNAGs 집단보다 고유수용성 감각에서 좌, 우 회전 모두 유의한 향상을 보였으며(p< 0.05), 목 기능장애는 SNAGs기법을 이용한 집단이 바이오피드백 훈련 집단보다 유의한 효과를 보였다(p<0.05). 따라서 SNAGs기법은 목의 기능제한 해결에 효과적이며, 바이오피드백 훈련은 고유수용성 감각 향상에 긍정적인 중재 방법이 될 것이다. 향후 목 통증 환자에 대한 연구를 진행시, 질환의 특성에 따라 중재방법을 선택 할 수 있을 것이다.

• 한국산학기술학회논문지
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• 제22권2호
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• pp.659-666
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• 2021

이 연구는 정상 성인에서 머리-목 굽힘 운동 시 시선의 각도와 압력이 깊은목굽힘근의 두께변화에 미치는 영향을 알아보고자 하였다. 본 연구에는 27명이 참여하였다. 머리-목굽힘 운동하는 동안 4가지(0°, 20°, 40°, 60°)의 시선과 5가지(20mmHg, 22mmHg, 24mmHg, 26mmHg, 28mmHg)의 압력에서 목긴근과 목빗근의 근 두께는 초음파 영상을 이용해 측정하였다. 시선 각도 및 압력변화에 따른 목긴근과 목빗근의 두께 변화를 비교 분석하기 위하여 반복측정분산분석을 수행하였다. 본 연구결과, 목긴근은 20과 22mmHg에서 0°와 20°, 0°와 40°, 0°와 60°은 유의한 차이를 보였으며, 20°에서 가장 근활성도가 높았다(p<.05). 목빗근은 28mmHg에서 0°와 20°, 20°와 40°, 40°와 60°은 유의한 차이를 보였으며, 20°에서 가장 낮은 근활성도를 보였다(p<.05). 본 연구에서 머리-목 굽힘 운동 시에는 시선의 방향을 20°로 설정하는 것이 목긴근의 활성화를 높이고, 목빗근의 근활성도를 낮추어 운동의 효과를 얻을 수 있다는 것을 찾았다. 본 연구의 결과를 바탕으로 임상환경에서 머리-목 굽힘 운동시에 시선 방향을 설정하여 운동의 효과를 증대시키길 바란다.

• Archives of Reconstructive Microsurgery
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• 제15권2호
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• pp.92-100
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• 2006

Radial forearm free flap (RFFF) has been established itself as a versatile and widely used method for reconstruction of the head and neck, although it is still criticized for high mortality of donor site. Delayed wound healing, cosmetic deformity, vascular compromise and potentially reduced wrist function have many plastic surgeons hesitate to adapt it as a first choice in micro-reconstruction. To overcome these drawbacks, some techniques for donor-site repair such as V-Y advancement with full thickness skin graft (FTSG), application of artificial dermis ($Terudermis^{(R)}$) or acellular dermal matrix ($AlloDerm^{(R)}$), and double-opposing rhomboid transposition flap have been reported. Authors performed 4 cases of RFFF in old-aged patients of the head and neck cancer from April 2005 to February 2006. We compared the outcomes of donor site of RFFF which were resurfaced with split thickness skin graft (STSG) only and STSG overlying an $AlloDerm^{(R)}$. Patients were all males ranging from 59 to 74 years old (mean, 67.5). Three of them had tongue cancers, and the other showed hypopharyngeal cancer. All cases were pathologically confirmed as squamous cell carcinomas. We included the deep fascia into the flap, so called subfascially elevated RFFF in three cases, and in the other one, we dissected the RFFF suprafascially leaving the fascia intact. The donor site of the suprafascially elevated RFFF was resurfaced with STSG only. Among three of subfascially elevated RFFFs, donor-sites were covered with thin STSG only in one case, and STSG overlying $AlloDerm^{(R)}$ in two cases. All RFFFs were survived completely without any complication. The donor site of the suprafascially elevated RFFF was taken well with STSG only. But, the partial graft loss exposing brachioradialis and flexor carpi radialis muscle was unavoidable in all the subfascially elevated RFFFs irregardless of $AlloDerm^{(R)}$ application. Considering that many patients of the head and neck cancer are in old ages, we believe the RFFF is still a useful and versatile choice for resurfacing the head and neck region after cancer ablation. Its reliability and functional characteristics could override its criticism for donor site in old-aged cancer patients.

• 한국전문물리치료학회지
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• 제27권4호
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• pp.272-277
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• 2020

Background: Forward head posture (FHP) is common postural malalignment. FHP is described relatively extension to upper cervical and lower cervical is relatively flexion. Although several researchers mentioned the lower cervical flexion posture in FHP, most of the studies related to FHP is focused on the deep cervical flexor function. Objects: The purposes of present study is to compare the cervical strength (upper cervical extension [UCE], lower cervical extension [LCE], upper cervical flexion [UCF], lower cervical flexion [LCF]) between individuals with and without FHP. Methods: Fifty-one participants are recruited. Participants who have the craniovertebral angle (CVA) less than 48 degree were classified to the FHP group (n = 24) and the others were included in without FHP group (n = 27). The cervical strength (UCE, LCE, UCF, LCF) were measured using Smart KEMA strength sensor and the strength data was normalized by body weight. All strength measurement conducted at head and neck neutral position in sitting. Independent t-test was used to compare the cervical strength between individuals with and without FHP. Results: The mean value of CVA was greater in without FHP group than with FHP group (p < 0.000). The strength value of UCF (p < 0.002) and LCE (p < 0.001) was significant less in FHP group than without FHP group. But no significant differences were seen in the LCF and UCE strength between two groups. Conclusion: UCF and LCE weakness in FHP group should be considered to evaluate and manage the individuals with FHP.

• 한국전문물리치료학회지
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• 제20권4호
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• pp.32-39
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• 2013

Abdominal curl-up exercise may excessively increased superficial neck flexor such as sternocleidomastoid (SCM) muscle. Also, the muscle activity of the abdominal muscles haven't investigated during abdominal curl-up with craniocervical flexion (CCF). Therefore, the purpose of our study was to determine the effect of CCF on the muscle activity of the abdominal and SCM muscles during abdominal curl-up. Twelve healthy subjects (six men and six women) with no history of abdominal or lower back pain within 6 weeks were recruited. Surface electromyographic signals were collected on SCM, rectus abdominis (RA), internal oblique (IO), and external oblique (EO) muscles bilaterally during performing the traditional abdominal curl-up and the abdominal curl-up with CCF. Paired t-tests were used to compare the differences in the muscle activity of the bilateral SCM, RA, EO, and IO muscles between the traditional abdominal curl-up and the abdominal curl-up with CCF (p<.05). There was significantly lower electromyogram (EMG) activity of the both SCMs during the abdominal curl-up with CCF (Right SCM, $39.50{\pm}15.29%MVIC$; Left SCM, $38.24{\pm}17.31%MVIC$) than with the traditional abdominal curl-up (Right SCM, $54.85{\pm}20.05%MVIC$; Left SCM, $53.18{\pm}26.72%MVIC$) (p<.05). The activity of abdominal muscles were not significantly different between the traditional abdominal curl-up and the abdominal curl-up with CCF. The abdominal curl-up with CCF requires significantly less muscle activity of SCM. Consequently, the abdominal curl-up with CCF is recommended to prevent excessive activation of superficial cervical flexors during abdominal curl-up exercise.

• 한국전문물리치료학회지
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• 제16권3호
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• pp.9-15
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• 2009

The purpose of this study was to examine contraction of abdominal muscles on surface electromyographic (EMG) activity of superficial cervical flexors, rib cage elevation and angle of craniocervical flexion during deep cervical flexion exercise in supine position. Fifteen healthy subjects were participated for this study. All subjects performed deer cervical flexion exercise with two methods. The positions of two methods were no volitional contraction of abdominal muscles in hook-lying position with 45 degree hip flexion (method 1) and 90 degrees hip and knee flexion with feet off floor for inducing abdominal muscle contraction (method 2). Surface EMG activities were recorded from five muscles (sternocleidmastoid, anterior scaleneus, recuts abdominis, external oblique, internal oblique). And distance of rib cage elevation and angle of craniocervical flexion were measured using a three dimensional motion analysis system. The EMG activity of each muscle was normalized to the value of reference voluntary contraction (%RVC). The EMG activities, distance of rib cage elevation. and angle of craniocervical were compared using a paired t-test between two methods. The results showed that the EMG activities of sternocleidmastoid and anterior scaleneus during deep cervical flexion exercise in method 2 were significantly decreased compared to method 1 (p<.05). Distance of rib cage elevation and angle of craniocervical flexion were significantly decreased in method 2 (p<.05). The findings of this study indicated that deep cervical flexion exercise with contraction of abdominal muscles could be an effective method to prevent substitute motion for rib cage elevation and contraction of superficial neck flexor muscles.