Yang, Hee Jun;Lee, Dong Hun;Kim, Yang Woo;Lee, Sang Gu;Cheon, Young Woo
Archives of Plastic Surgery
/
제43권6호
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pp.529-535
/
2016
Background The trapezius muscle flap is not usually the first reconstructive option for skin and soft tissue defects in the posterior neck and scalp due to surgeons' unfamiliarity with the surgical anatomy and developments in free tissue transfer techniques. The goals of this study were to describe the clinical use of trapezius flaps in posterior neck and scalp reconstruction, and to investigate the vascular anatomy of trapezius flaps in Asians in order to obtain information facilitating the safe design and elevation of flaps in which most of the muscle is preserved. Methods A retrospective chart review was performed of 10 patients who underwent trapezius muscle flap for posterior neck and scalp defects. We also performed an anatomical study of 16 flaps harvested from 8 preserved Asian adult cadavers and evaluated the main landmarks relevant for trapezius muscle flap. Results In the anatomical study, the mean vertical height from the inferior angle of the scapula to the point at which the superficial cervical artery penetrated the trapezius was $4.31{\pm}2.14cm$. The mean vertical height of the trapezius muscle flap pivot point was $9.53{\pm}2.08cm$ from the external occipital protuberance. Among the 10 flaps, partial necrosis on the overlaid skin graft occurred in 1 patient and postoperative seroma occurred in another patient. Conclusions Vascular variations in the trapezius muscle flap are uncommon in Asians, but when present, such variations appear to have little impact on harvesting the flap or on its circulation. The trapezius muscle flap is a viable alternative for posterior neck and scalp reconstruction.
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.
Objectives The purpose of this study was to investigate the correlation between walking ability of lumbar spinal stenosis patients and the cross-sectional area (CSA) of lumbar paraspinal muscles. Methods This study was carried out on 62 lumbar spinal stenosis patients who had limited walking abilities because of neurogenic claudication (NC). All patients received more than 2 weeks of complex treatment at Mokhuri Neck&Back Hospital. CSA of lumbar paraspinal muscles was measured from axial T2-weighted MRI and divided by CSA of adjacent vertebral body to avoid influence of body statues (RCSA-Relative CSA). Pain Free Walking Distance and Numerical Rating Scale (NRS) was measured before and after treatment. Results The Pain Free Walking Distance had significantly increased in patients who had bigger RCSA of psoas muscle (r=0.313, p<0.05). Conclusions The psoas muscle can be a predictive factor for restoring walking ability of lumbar spinal stenosis patients who have limitations walking.
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.
An experimental study was conducted to investigate the effects of turtle neck syndrome, so called, on muscular fatigue and muscle activity. Six subjects (males) participated and performed the prolonged casual computer work in the study. EMG signals from six muscles of the dominant neck-back region were acquired and recorded for 10 seconds at the beginning and the end of three hours computer work. EMG was recorded from six muscles by using a computerized data recording and analysis system. Power spectrum function of EMG was calculated off-line by means of a signal processing software package. Power spectrum functions were smoothed with a moving average filter of 21 points and normalized with respect to the maximal value achieved during the trials. Muscle activity and median frequencies of Sternocleidomastoid(SCM) in turtle neck posture was approximately 51%, which were less than those in normal neck posture. SCM also showed the biggest decrease in median frequency. Results will provide the insight into the neck-back injury mechanism of turtle neck patients. Furthermore, they will be helpful in developing rehabilitation programs for restoring patients' neck-back functions.
Objective: The purpose of this study was to investigate the effect of a lower trapezius strengthening exercise program on an unstable support surface on pain, neck dysfunction, psychosocial factors, and postural alignment in neck pain patients with forward head posture. Design: A randomized controlled trial Methods: A total of 36 neck pain patients participated in this study. Screening tests were performed and assigned to experimental group (n=18) and control group (n=18) using randomization program. Both groups performed the lower trapezius strengthening exercise program. In addition, in the experimental group, an exercise program for lower trapezius muscle strengthening was performed on an unstable support surface. All interventions were performed 3 times a week, for a total of 5 weeks. quadruple visual analogue scale (QVAS), neck disability index (NDI), short form (SF)-12, and postural alignment were measured before and after the intervention to compare their effectiveness. Results: Both groups showed significant differences in QVAS, NDI, SF-12, and postural alignment before and after intervention (p<0.05). In addition, the experimental group showed significant differences in NDI and postural alignment compared to the control group (p<0.05). Conclusions: The lower trapezius strengthening exercise program on unstable support surfaces is an effective intervention method with clinical significance in improving neck disability and postural alignment in patients with neck pain with forward head posture.
Objectives : This study was designed to compare the effect of Muscle Relaxation Pharmacopuncture(JS5-MR) and Chuna Manual Therapy on the patients with neck pain caused by traffic accidents. Methods : We investigated 39 cases of patients with neck pain cased by traffic accidents, who had been treated from April 2014 to December 2014. We divided patients into two groups : Group A was treated with Muscle Relaxation Pharmacopuncture and Group B was treated with Chuna Manual Therapy. We measured the effectiveness of treatment using Visual Analog Scale(VAS) and Neck Disability Index(NDI) score. Results : In result each group had significant decrease in VAS and NDI after treatment. Group A showed significant decrease as compared to Group B in NDI change. But there was no significant difference in the VAS change between two groups. Conclusions : According to the result of this study, it was suggested that Chuna Manual Therapy and Muscle Relaxation Pharmacopuncture are effective in reducing neck pain casued by traffic accidents. Muscle Relaxation Pharmacopuncture was more effective in reducing NDI. Further well designed prospective study is needed.
PURPOSE: Forward head posture and turtle neck are common musculoskeletal disorders of the cervical vertebrae. The purpose of this study was to investigate the effects of combined exercise training and chiropractic on the grip strength and cervical muscle strength of subjects with forward head posture and turtle neck. METHODS: The subjects were divided into two groups: forward head posture (n=9) and turtle neck (n=9). Both groups performed combined exercise training and chiropractic. The subjects were instructed about the exercise training once a week. This training was performed for 30 minutes every day for 8 weeks, and the chiropractic was performed for 15 minutes once a week. The cervical muscle strength and grip strength were measured. Two-way repeated measured ANOVA was performed for statistical analysis. RESULTS: In changes to the left grip strength, the main effect over time was significant, but the interaction effect and the main effect in the groups were not significant. In changes to the right grip strength, no difference was found to be statistically significant. In changes to the cervical muscle strength, no difference was found to be statistically significant. CONCLUSION: The increases of grips strengths and cervical muscle strength in forward head posture group were greater than turtle neck group but there were not found to be statistically significant.
Purpose : The purpose of this study was to investigate the effects of curl-up and proprioceptive neuromuscular facilitation (PNF) neck flexion exercises on stroke patients' trunk muscle activity, ability to control the trunk, and balance by comparing two exercise methods. Methods : The study involved patients who had been diagnosed with stroke based on the results of computerized tomography or magnetic resonance imaging at O Hospital in Daegu, South Korea, between January and July 2020. In total, 30 subjects were selected and by flipping a coin, randomly assigned to an experimental group (n=15) that performed PNF neck flexion exercises and a control group (n=15) that performed curl-up exercises. Both groups received traditional rehabilitation therapy for 30 minutes a day five times a week for a six-week period. In addition, the experimental group performed PNF neck flexion exercises and the control group curl-up exercises for 15 minutes a day five times a week over the same period. The subjects' muscle activity in the rectus abdominis (RA), external oblique (EO), and internal oblique (IO) were measured before and after the experiment. The subjects' trunk impairment scale (TIS) and Berg balance scale (BBS) scores were also assessed. Paired t test was performed to measure the amount of statistical change before and after intervention in both groups. An independent sample T test was performed to measure the amount of statistical change between the two groups. Results : Both groups experienced statistically significant increases in their RA, IO and EO muscle activity, total TIS scores, and total BBS scores after the intervention. No statistically significant differences in the changes before and after the intervention were found for any of the resulting values between the two groups. Conclusion : A comprehensive review of the study's results suggested that neck flexion exercises using the PNF irradiation concept and curl-up exercise are effective in increasing stroke patients' abdominal muscle activity and improving trunk control ability and balance in chronic stroke patients.
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.
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