• Journal of the Korean Society of Physical Medicine
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• v.8 no.4
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• pp.655-666
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• 2013

PURPOSE: The main objective of this study is observing the effects of the functional postural trunk exercise (FPTE) on deep cranio-cervical flexor (CCF) muscle endurance applied on neck pain patients suffering from the acute whiplash-association disorder (WAD). METHODS: The study was tested with 47 patients with neck pain. All patients were equally treated with the ordinary therapy, only experimental group (n=23) was treated with FPTE: assumption of an upright lumbo-pelvic and spinal postural position, adding a neck lengthening manoeuvre in addition. Patients attended physical therapy for 3 times a week, for 4 weeks. Visual analogue scale (VAS) for pain, neck disability index (NDI), range of motion (ROM), were recorded both before and after the intervention. Also muscle activity in the CCF test was employed to analyze the changes between before and after. RESULT: After 4 weeks of training intervention, a remarkable increase in muscle endurance, rotation, extension ROM (p<.05) and decrease in pain and NDI (p<.05) in both groups. Further, the differences between groups were muscle endurance (F=60.350, p<.01), pain, and the left rotation ROM (p<.05). CONCLUSION: From the results, the experimental group had significant the increase in muscle endurance, and the significant decrease in pain. Whilst further research in this category is necessary, these observations suggest that applying exercise in early diagnosis can be of help to treat the neck pain patients suffering from the WAD.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.20 no.1
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• pp.1-7
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• 2014

Background: As the increase of forward head position, we studied the change of thickness of deep cervical flexor (DCF) compared of with sternocleidomastoid (SCM). we measured and analysed the change of thickness of the neck flexor for forward head position and cranio-cervical flexion exercise (CCFE). Methods: Using a cross-sectional design, we conducted the study selecting 35 healthy adults (12 males, 23 females). We measured the craniovertebral angle (CVA), instructed them to perform the CCFE, and measured the DCF and SCM using ultrasonography during the contraction and relaxation period. Results: Intra-reliability of SCM is .96, longus capitis is .92 and longus coli is .97. we compared according to the change of forward head position, Correlation of DCF is .841, and DCF/SCM is .754 by significant positive correlation. At the comparison of CCFE and Resting muscle thickness, SCM and DCF is .00, DCF/SCM is .68. Conclusion: There is a strong positive correlation between the change amount of DCF and DCF/SCM as the increase of CVA.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.29 no.3
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• pp.43-53
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• 2023

Background: Patients with neck pain develop instability due to muscle imbalance, decreased proprioception, and balance disorders. Studies have examined various exercise methods as treatment methods, but few studies have compared the effects of cervical stabilization exercise and dynamic balance exercise. The purpose of this study was to investigate the effects of dynamic balance exercise on pain, functional level, and psychosocial level in patients with non-specific chronic neck pain. Methods: Thirty-four non-specific chronic neck pain patients were randomly assigned to the experimental group (EG, n=17) and control group (CG, n=17); the cervical stabilization exercise and dynamic balance exercise program were applied to the EG; and only the cervical stabilization exercise program was applied to the CG. The intervention was conducted twice a week, for six weeks. Assessment items evaluated pain, dysfunction (Korean version neck disability index), range of motion, craniocervical flexion test, cervical deep flexor endurance test, and psychosocial level. Data analysis was performed using intention-to-treat analysis as assigned. To analyze differences in the items assessed in the two groups, we used a repeated measures analysis of variance with an interaction between group (EG, CG) and time point (baseline, 6 weeks, 12 weeks). Results: The endurance of the cervical flexor muscles between the group and the measurement point after intervention (p<.05). Both groups showed significantly improved endurance between time points after the intervention (p<.05), with the EG showing a greater change than the CG. None of the other measurement items differed in the pattern of change between measurement points. Conclusion: In conclusion, the EG applying a cervical stabilization exercise and a dynamic balance exercise experienced a significant difference in muscle endurance improvement compared to the CG. We propose an exercise intervention program that includes stabilization exercises and dynamic balance exercises for patients with chronic cervical pain who lack muscle endurance.

• The Journal of Korean Physical Therapy
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• v.28 no.3
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• pp.183-188
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• 2016

Purpose: The aim of the study was to investigate neck posture, range of motion, muscle endurance and self-report of pain and disability in smartphone users. Methods: Seventy-eight university student volunteers, aged between 18 and 30 years (mean age 23.2), were assessed for: a head-neck posture by measuring cranial vertical angle, neck range of motions using cervical range of motion device, and a deep neck flexor endurance using a stabilizer. Finally, subjects were asked about their neck pain and completed disability questionnaires, ie, Short Form McGill Pain Questionnaire, Neck Disability Index, and World Health Organization Disability Assessment Schedule 2.0. Results: Thirty-eight subjects experienced recurrent neck pain with/without upper limb pain (neck pain group) and 40 reported no current neck pain with/without upper limb pain (no neck pain group). Differences were found between groups on pain and disability questionnaires. Subjects with neck pain had significantly higher disability scores than those of no neck pain group. However, there were no differences observed between groups in a head-neck posture, neck range of motions, and deep neck muscle endurance time. The smartphone usage time was negatively correlated with neck pain intensity and disability score whereas it had positive relationship with flexibility and posture. Conclusion: Group differences were observed as lower capacity not only for neck specific daily activities but for general functioning in daily routine when the neck pain and no neck pain groups were compared. Therefore, functioning in daily activities should be investigated as prevention for further developing neck pain in smartphone users.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.27 no.2
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• pp.1-8
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• 2021

Background: Chronic neck pain (CNP) is associated with weakness in the deep neck flexor muscles, a shortening of the neck extensors, and a reduction in endurance. In addition, muscle imbalance can lead to neck pain and musculoskeletal dysfunction. This study compared neck extensor muscle fatigue, muscle strength, and muscle endurance time between patients with CNP and healthy adults during isometric neck extension. Methods: Thirty participants (15 patients with CNP and 15 healthy adults) were recruited in this research. The outcome measures included splenius capitis (SC) muscle fatigue, isometric neck extensor strength, and muscle endurance. The independent T-test was used to compare the continuous dependent variables between the CNP group and the healthy group. Results: The independent T-test indicated that muscle fatigue in the left SC differed significantly between the CNP group and the healthy group. A significant difference was also noted in the isometric neck extensor and neck extensor strength between the groups. Conclusion: Our results provided promising clinical evidence that patients with CLP have reduced neck extensor strength and endurance and increased SC muscle fatigue, which results in neck pain.

• Physical Therapy Rehabilitation Science
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• v.9 no.4
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• pp.302-308
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• 2020

Objective: The endurance and strength of deep neck flexor (DNF) muscles have a major role on the function and stability of the cervical spine. In recent years, there has been a lack of research that have investigated the muscle tone of the superficial neck muscles. The purpose of this study was to examine the relationship of between contraction ratio of the DNF and sternocleidomastoid (SCM) muscles, DNF endurance, and muscle tension of the neck muscles. Design: Cross-sectional study. Methods: Forty-seven subjects (male=20, female=27) participated in this study. The muscle tone of the upper trapezius (UT), SCM, and suboccipital (SO) muscle was measured using a contact soft tissue tone-measuring instrument. For the contraction ratio of the SCM and longus colli muscle, the thickness of the relaxation and maximum contraction state of the SCM and longus colli muscles were assessed using a diagnostic ultrasound measuring instrument and a pressure biofeedback unit. The deep neck flexor endurance test (DNFET) was performed in a cranio-cervical flexion posture. The correlations between the measured variables were investigated. Results: The relationship between the DNFET and SO tone showed a significant negative correlation (p<0.05). The relationship between the DNFET and contraction ratio showed a significant positive correlation (p<0.01). There was no significant correlation between the DNFET and SCM and UT tone. Conclusions: This study confirmed that there is a relationship between DNF endurance, DNF activation, and SO tone. The information on the results of this study may be used as a reference that can be actively applied in the clinical environment.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.25 no.1
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• pp.71-76
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• 2019

Background: An 8-year-old girl had severe neck pain and stiffness after trauma. CT scan showed atlantoaxial rotatory subluxation (AARS). She had conservative treatment because she did not have neurological symptoms and spinal basilar artery dysfunction. Conservative therapy was halter traction twice for 4 weeks. However, pain and stiffness persisted. She had been recommended to have surgery from her physician, but she received manual therapy for non-surgical procedures. Methods: The joint mobilization, muscle energy technique, motor control exercise, and deep neck flexor (DNF) endurance exercise were applied as manual therapy and 10 session for 2weeks. Results: Clinical outcomes were measured at initial baseline, after 2 weeks, and after 6weeks. Active range of motion was completely restored after 6weeks and numeric pain rating scale was completely reduced after 2 weeks. The strength of neck flexor muscle recovered to normal after 2 weeks, and the DNF endurance was improved to 25 seconds after 2 weeks and to 42 seconds after 6weeks. Motor control capacity recovered to 30 ㎜Hg after 2 weeks. Conclusions: This case report describes the immediate and short-term clinical outcomes for a patient presenting with symptoms of neck pain following AARS. Clinical rationale and patient preference aided the decision to incorporate manual therapy as a treatment for this patient. Manual therapy has shown a successful recovery in AARS patients, more research is needed to validate the inference of this case report.

• Journal of Korean Medicine Rehabilitation
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• v.25 no.4
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• pp.139-146
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• 2015

We researched two patients complaining about chronic neck pain with kyphotic cervical curvature. We assumed that the patients' symptom was caused by weakened deep neck flexor and activated superficial muscles around neck. So, acupuncture therapy, SCENAR therapy and self exercise with wooden neck pillow were used to treat the patients. We measured their pain by numerical rating scale (NRS) and neck disability index (NDI) before and after treatment. And cervical curvature was evaluated by Cobb method (C1-C7) and Ishihara Index. As a result, NRS and NDI significantly reduced and cervical curvature was also improved. Therefore, we conclude that acupuncture therapy with SCENAR therapy and self exercise using wooden neck pillow is an effective treatment to reduce chronic neck pain with kyphotic cervical curvature. But there is a limit on this study due to insufficient number of cases and absence of control group. Further studies will be needed.

• Journal of the Ergonomics Society of Korea
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• v.27 no.4
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• pp.59-64
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• 2008

The aims of this study were to compare and analyze two types of deep cervical flexion exercises, craniocervical flexion and cervical flexion, and to ascertain their relative effects on neck and shoulder pain and functional improvement. The participants of the study were individuals who work in sedentary jobs in an office environment. 54 appropriate subjects were chosen and randomly divided into two groups: one group underwent a craniocervical flexion exercise program and the other a cervical flexion exercise program. The six week exercise program consisted of home exercises performed by each subject five times a week and education once a week. Neck-shoulder pain, muscle strengthening, cervical alignment were measured prior to commencement of the exercise programs and again after six weeks. At completion of the six week, both exercise programs decreased neck pain (p<.05). Forward head postures were reduced, and the craniocervical flexion exercise program was more effective in reducing forward head posture (p<.05). The maximum muscle strength and 50% of maximum muscle strength maintaining time of the deep cervical flexor muscles were significantly increased. There were no significant changes of the cervical lordotic curve. The results of this study showed deep cervical flexion exercise was effective in the treatment of neck and shoulder pain, however craniocervical flexion exercise was more effective than cervical flexion exercise.

• Journal of Korean Physical Therapy Science
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• v.6 no.4
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• pp.145-151
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• 1999

Pain is the most common symptom that brings a patient to the hospital. Repetitious stress and sprain injury result in various pains, and so we tried to improve cervical movement and release from pain by using taping technique of actual agonists and postural muscles in addition to psychological relaxation. The 4 patient with neck problems were applied Arikawa taping approaches. The flexor or extensor patterns were determined by Arikawa method at first. if the symptoms and patterns were similar, the taping was attached same point. After taping on major muscles of causing neck pain levator scapula, scalenus medius, sternocleidomastoid, splenius capitis, semispinalis capitis. - we found neck pain released and cervical ROM increased. In conclusion, we determined cervical movement related to rotation of splenius capitis, extention of semispinalis capitis, levator scapula, flexion and rotation of scalenus medius.