• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.12 no.1
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• pp.57-67
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• 2006

Musculoskeletal neck dysfunction syndromes are common in outpatient musculoskeletal pain practice. The underlying musculoskeletal and neurologic causes of pain are variable. In the management of these patients, it is important to accurately identify and treat these pain generators to optimize patient outcome. It is the purpose of this review to discuss three main categories of functional anatomy, the role of superficial/deep muscular system and the scientific evidence for optimal physical therapy intervention for cervical dysfunction. Specifically there is evidence of lowered microcirculation in the upper trapezius muscle, morphological signs of disturbed mitochondrial function which appears to be limited to type I fibers and an increased cross-sectional area of type I muscle fibers despite a lower capillary to fiber area ratio. In acute neck pain syndrome, changes in muscle activity of painful muscles may result from segmental and supraspinal inhibitory effects. Muscle activation is closely related to the control of joint movements and postures and it is difficult to separate the influence of the two components. Both the altered muscle recruitment patterns and altered kinematics appear to be a poor adaptation for pain of the head - neck region, as they are likely to result in increased compressive loading in the cervical spine, affecting muscles, articular structures such as zygapophyseal joints, connective tissues and neural tissues which are all peripheral generators of referred pain. The rectus capitus posterior minor muscle shows that it is one of the most important muscles of the suboccipital region. In this article, i reviewed the anatomy, neurophysiology, function and dysfunction as well as the treatment of cervical dysfunction.

• The Journal of Korean Physical Therapy
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• v.23 no.1
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• pp.1-5
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• 2011

Purpose: The purpose of this study was to investigate changes in muscle activation associated with foot position during a sit-to-stand exercise among normally healthy elderly subjects. Methods: Eight subjects (male=3; female=5; mean age=$70.13{\pm}{\pm}2.53$years) were recruited.The activation of six muscles (neck extensor; lumbar extensor; hamstring; rectus femoris; gastrocnemius; tibialis anterior) was measured by surface EMG (TeleMyo 2400T G2, Noraxon Inc., USA) during a sit-to-stand protocol under three different foot positions (ankle dorsiflexion of 0, 15, or 30 degrees). Results: Muscle activation of the neck extensor and hamstring was decreased according to the change in foot position (p<0.05), but activation of the rectus femoris was increased (p<0.05). Muscle activation of the neck extensor was significantly different between 0 and 15 degrees (p<0.05). Muscle activation of the hamstring was significantly different between 0 and 15 degrees and between 0 and 30 degrees (p<0.05). Muscle activation of the rectus femoris was significantly different between 0 and 30 degrees and between 15 and 30 degrees (p<0.05). However, activation of lumbar extensor, gastrocnemius and tibialis anterior muscles did not significantly differ between foot positions. Conclusion: These findings suggest that muscle activation during a sit-to-stand movement differs depending on foot position. We believe that these differences should be considered when educating the elderly regarding proper body movements.

• Journal of the Korean Society of Physical Medicine
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• v.7 no.3
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• pp.339-348
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• 2012

Purpose : The purpose of this study is to compare muscle activations of neck, trunk and leg in cerebral palsy of spastic diplegia with genu recurvatum and knee flexion contracture, when using anterior and posterior walkers. Methods : We selected 21 cerebral palsy and received the written consent to participate in this study. The inclusion criteria for participation required patients to have spastic diplegic CP; to be between 3~6 years of age, to have a GMFCS III grade, to have no botulinum toxin injection and orthopedics surgery within before six months starting the study. Measurements of muscle activities (sternocleidomastoid, splenius capitis, rectus abdominis, erector spinea, gluteus maximus, rectus femoris, medial hamstring and calf muscles) were evaluated anterior and posterior walker ambulations. Statistical evaluation of these data were accomplished by utilizing the paired t-test and independent t-test by SPSS 20.0 program. Significance level was set at p<.05. Results : The following results were obtained. There was significant difference on muscle activation of neck, trunk and legs(soleus except) in anterior and posterior walkers. There was no significant difference in muscle activation of neck but significant difference in muscle activation of trunk, legs between genu recurvatum and knee flexion contracture(rectus abdominis, medial hamstring when using anterior walker, rectus abdominis, erector spinea, gluteus maximus, medial hamstring when using posterior walker). Conclusion : The conclusion of this study is the different knee joint forms would have different effect on muscle activation of trunk and legs while cerebral palsy of spastic diplegic ambulated with anterior walker and posterior walker.

• The Journal of Korean Physical Therapy
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• v.29 no.1
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• pp.7-15
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• 2017

Purpose: This randomized controlled trial was conducted to compare the effectiveness of global postural reeducation to segmental stretching in subjects with neck and shoulder pain. Methods: Sixteen subjects with neck and shoulder pain were randomized into two intervention groups, a global posture reeducation group (n=8) that performed muscle chain stretching, and a segmental stretching group (n=8) that performed conventional static muscle stretching. The intervention program consisted of two 40 minutes individual sessions per week for four weeks. Subjects were evaluated pre-intervention, two-week after intervention and at a four-week follow-up appointment for pain intensity, disability and health-related quality of life. Two-way repeated analysis of variance was used for between-time and between-group comparisons. The significance level was 0.05. Results: Significant pain relief and decreasing discomfort of the neck and shoulder were observed after intervention in both groups, and there was an interaction between time lapse and groups (pain, F=10.31, neck disability, F=25.45, shoulder disability, F=12.82, p<0.05). Quality of life also improved after intervention in both groups. Moreover, the physical components score improved, and a significant interaction was observed between time and groups (F=4.85, p<0.05). However, no significant improvement in mental component score of quality of life and no significant interaction between time and groups were observed (p>0.05). Conclusion: These findings suggest that a GPR intervention in subjects with neck and shoulder pain induces greater improvement of pain and disability and quality of life than segmental stretching.

• Journal of the Korean Society of Physical Medicine
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• v.11 no.1
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• pp.71-82
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• 2016

PURPOSE: The purpose of this case report was to determine the effect of therapeutic exercise on posture, pain, and muscle activity in two patients with forward head posture (FHP). METHODS: A-31-year-old male (patient A) and a 19-year-old women (patient B) presented with FHP, neck pain, and headache. The therapeutic exercise program consisted of cervical mobilization, deep cervical flexors strengthening, and cervical extensors stretching, for 40 min/d, 2 d/week, for 8 weeks. Neck pain (VAS), neck disability (NDI), cervical range of motion (CROM), lateral view of cervical spine X-ray (indicating the FHP), and asymmetrical neck and shoulder muscular activity ratio were measured before, after 4 weeks, and after 8 weeks of corrective exercise. RESULTS: VAS and NDI decreased in patients A and B after exercise compared to before the program. CROM increased in patients A and B at flexion, extension, side bending, and rotation after exercise compared to before the program. FHP decreased in patients A and B at distance after exercise compared to before the program. In addition, asymmetrical neck and shoulder muscles activity ratio improved in patients A and B after exercise compared to before the program. CONCLUSION: We demonstrated in a case report that therapeutic exercise increases ROM, decreases pain and disability of neck, FHP, and asymmetry muscle activity ratio in patients with FHP. These finding have clinical implications for therapeutic exercise in patients with FHP.

• Physical Therapy Korea
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• v.27 no.1
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• pp.45-52
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• 2020

Background: A backpack is available equipment for moving some objects. Most studies have found that the appropriate weight limit of backpack for students is between 10% to 15% of their body weight (BW). However, Some students should carry a backpack heavier than 15% of BW. Therefore, It is associated with abnormal shoulder and neck posture on students. Objects: This study tested the effects that various amounts of weight carried by university students in their backpacks had on their cervical posture and electromyography of neck muscle. Methods: The subjects consisted of 12 students (6 male, 6 female) in university. There were three loading conditions tested: no backpack, a backpack that weighed 10% and 15% of the student's BW. The dependent variables were the craniovertebral angle (tragus to C7) and the neck muscle activities (sternocleidomastoid, upper trapezius). All 12 subjects were asked to walk while wearing a backpack for 5 minutes and were then instructed to rest for 2 minutes. Results: When assessing the craniovertebral angle, the results of this study were significantly decreased in the order of 0%, 10%, and 15%. And then, there were significantly increased electromyography of neck muscles that comparison of the weight of 10% and 15% on 0%. It was found that as the weight of the backpack increased, the craniovertebral angle decreased (p < 0.05) and the muscle activities increased (upper trapezius p = 0.012, sternocleidomastoid p = 0.013). Conclusion: Our study recommended that some students shouldn't carry on over the 15% backpack of own weight, and also they should distribute backpack load to equal on body for optimal posture.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.32 no.2
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• pp.94-97
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• 2021

Muscle tension dysphonia (MTD) is a voice disorder characterized by excessive tension of the laryngeal muscles during phonation. Voice therapy is the gold standard of treatment for MTD. However, patients with MTD do not always respond to voice therapy. Multidisciplinary approaches have been attempted to treat intractable MTD such as lidocaine instillation, lidocaine injection to recurrent laryngeal nerve, botox injection and excision of false ventricle using CO₂ laser. Recently, injection laryngoplasty is suggested that assists in more efficient phonation and voice therapy to MTD patients. A patient with intractable MTD underwent lidocaine injection and injection laryngoplasty showed improved voice quality and remained stable until postoperative 3 months without any complications.

• Imaging Science in Dentistry
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• v.53 no.3
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• pp.257-263
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• 2023

Fibrodysplasia ossificans progressiva is a rare hereditary disorder characterized by progressive heterotopic ossification in muscle and connective tissue, with few reported cases affecting the head and neck region. Although plain radiographic findings and computed tomography features have been well documented, limited reports exist on magnetic resonance findings. This report presents 2 cases of fibrodysplasia ossificans progressiva, one with limited mouth opening due to heterotopic ossification of the lateral pterygoid muscle and the other with restricted neck movement due to heterotopic ossification of the platysma muscle. Clinical findings of restricted mouth opening or limited neck movement, along with radiological findings of associated heterotopic ossification, should prompt consideration of fibrodysplasia ossificans progressiva in the differential diagnosis. Dentists should be particularly vigilant with patients diagnosed with fibrodysplasia ossificans progressiva to avoid exposure to diagnostic biopsy and invasive dental procedures.

• Physical Therapy Rehabilitation Science
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• v.6 no.4
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• pp.196-201
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• 2017

Objective: Musculoskeletal neck pain have many symptoms which include decreased range of motion (ROM) and muscle strength, and increased pain. However, the management methods are controversial. The purpose of this study was to examine the effects of three interventions on ROM, strength, and pressure pain threshold (PPT) with musculoskeletal neck pain. Design: Pretest-posttest design. Methods: Thirty subjects participated in this experiment. They were randomly assigned to thefollowing groups: passive stretching (PS) group (n=10), massage (MASS) group (n=10), and muscle energy technique (MET) group (n=10). The treatment were applied bilaterally on the upper trapezius. The PS was applied 3 times for 30 seconds each time. The MASS was applied using two different techniques for 2 minutes per technique. For MET, the subjects performed 2 sets of 3 repetitions of isometric resistance exercise that was maintained for 10 seconds, followed by 10 seconds of rest. ROM, strength, and PPT parameters were measured after intervention. Results: In the MASS group, there was a significant improvement in all outcomes except for muscle strength (p<0.05). In the MET group, ROM and strength significantly improved compared to the pre-treatment results (p<0.05). As result of measuring the amount of change in each group, there was a significant difference in ROM (flexion) in the PS group compared with the MASS and MET group, a significant difference in strength in the MET group compared with the PS and MASS groups, and a significant difference in PPT in the MASS groups compared with the PS and MET groups (p<0.05). Conclusions: This study showed that PS, MASS, and MET are effective methods for improving ROM, strength, and PPT for musculoskeletal neck pain. Therefore, various therapeutic interventions for improving ROM, strength, and pain are suggested.

• PNF and Movement
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• v.15 no.2
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• pp.159-166
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• 2017

Purpose: This study attempts to determine the effects of applying three kinds of breathing exercises for four weeks on the neck muscle activation of subjects with a forward head posture. Methods: A total of 30 adults aged in their twenties (15 men and 15 women) with a forward head posture who voluntarily agreed to participate after listening to the purpose and procedure of this research were chosen as the subjects of this study. The subjects were randomly divided into either the diaphragmatic breathing exercise (DBE) group, the abdominal drawing-in maneuver (ADIM) group, or the abdominal expansion method (AEM) group according to the breathing intervention scheme. Each group included ten subjects. The muscle activity of the sternocleidomastoid, scalenus anterior, and splenius capitis was measured in all the groups prior to the intervention, two weeks after the intervention, and four weeks after the intervention. All the interventions were implemented for 30 minutes a day, three times a week, for a total of four weeks. Results: No significant between-group difference was observed in terms of the change in neck muscle activity according to the four-week intervention scheme. Further, there was no interaction between the intervention period and the intervention scheme in relation to the change in neck muscle activity. Conclusion: The results of this study suggest that abdominal expansion exercise is as effective as other breathing exercise methods for subjects with a forward head posture. We therefore expect that abdominal expansion exercise can be used as a scheme for the prevention of symptoms as well as therapy for patients with a forward head posture.