• PNF and Movement
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• v.19 no.1
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• pp.137-146
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• 2021

Purpose: The study aimed to determine the effect of proprioceptive neuromuscular facilitation (PNF) lower trapezius muscle strengthening exercise on pain, cervical range of motion (ROM), and neck disability index (NDI) in patients with chronic neck pain. Methods: Following baseline measurements, the subjects (n = 30) with chronic neck pain were randomized into two groups: the PNF group (n = 15) that received PNF strength training of the lower trapezius muscles or a control group (n = 15) that received gentle palpation of the skin. Each group participated in the intervention for 30 min, three times per week for six weeks. The visual analogue scale for pain, ROM, and NDI of both groups were recorded at both pre- and post-intervention. Paired t-tests were used to determine significant changes in the post-intervention compared with pre-intervention, and independent t-tests were used to analyze differences in the dependent variables between the two groups. Results: After the six-week intervention, both groups experienced significantly decreased pain and NDI (p < 0.05) and significantly increased cervical flexion, extension, lateral flexion, and rotation ROM (p < 0.05). The PNF group that received PNF strength exercise of the lower trapezius muscles showed greater improvements in pain and NDI and cervical rotation of ROM than those of the control group (p < 0.05). Conclusion: These results suggest that the PNF lower trapezius strengthening exercise reduces neck pain and disability level and enhances cervical ROM in patients with chronic neck pain.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.11 no.2
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• pp.1-12
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• 2005

The purpose of this study is compare the effects of two therapeutic processes-i) conservative Myofacial Release Technique along and ii) Transcutaneous Electrical Nerve stimuliation alone - on the increase in the range of motion(ROM) and on the decrease in patient's pain with chronic Neck pain. The subjects of the study were student with choronic neck pain in Daegu health university. Half of them (10) took conservative Myofacial Release Technique along and the others (10) took Transcutaneous Electrical Nerve stimuliation alone. I used 3D Motion analysis. The range of motion (ROM) in six areas-flexion, extension, left lateral flexion, right lateral flexion, left rotation, right rotation-to check the effectiveness of the two combinations of methods, measured pain with visual analogue scale (VAS) to see the effect on pain reduce. Assement was conducted to the groups before the treatment began and affer the four weeks treatment ended. This study shows that both groups demonstrated significant improvement in ROM increase and pain reduction. Flexion ROM increases were significant in MFR and TENS after treatment 2 weeks and 4 weeks. Extension ROM increases were significant in MFR and TENS after treatment 2 weeks. Right rotation ROM was no significant differences were found in MFR and TENS after treatment all weeks. Right lateral flexion ROM increases were significant in MFR and TENS after treatment 3 weeks. Left lateral flexion ROM increases were significant in MFR and TENS after treatment 1 weeks. But the others no significant differences were in MFR group and TENS group during 4 weeks.

• Physical Therapy Korea
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• v.28 no.2
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• pp.138-145
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• 2021

Background: Forward head posture (FHP) causes various posture imbalances associated with the head and neck. Myofascial release is an effective treatment method used for relaxing muscles and reducing muscle hyperactivity, but no studies have been conducted on suboccipital and neck muscles related to FHP. Objects: The purpose of this study was to investigate the immediate effect of roller massages on the cranio-cervical flexion (CCF) range of motion (ROM) and CCF strength applied to suboccipital and neck muscles in subject with forward head posture. Methods: Twenty-four FHP subjects (male: 13, female: 11) were recruited for this study. All subjects were recruited with a craniovertebral angle (CVA) of 53 degrees or less and a head tilt angle (HTA) of 20.66 degrees or higher. CCF strength was measured using Pressure biofeedback unit (PBU) in the supine posture and CCF ROM was measured using smartphone-based inclinometer. Roller massage (RM) was applied to suboccipital and neck muscles for 2 minutes and CCF ROM and strength were remeasured. Results: These results of this study showed that CCF ROM was a significant difference in CCF ROM before and after RM (p < 0.05). CCF strength also showed a significant difference before and after RM (p < 0.05). Conclusion: RM method might be recommended to increase the immediate ROM and strength of CCF in subjects with forward head posture.

• The Journal of Korean Physical Therapy
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• v.15 no.3
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• pp.65-90
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• 2003

To identify the effects of joint mobilization on the functional improvement of patients with neck pain, the present research investigated 60 neck pain patients, dividing them into a group doing joint mobilization, a group doing Mckenzie exercise and a group using modalities. This study examined patients degree of recovery from neck pain by comparing their neck pain before and after the treatment, and compared three groups to find difference in the degree of recovery from neck pain. The results of this study are as follows : 1. For the joint mobilization group, the visual analogue scale (VAS) decreased significantly for three weeks treatment, and the range of motion (ROM) of cervical vertebrae increased significantly(p<.05). 2. For the Mckenzie exercise group, the visual analogue scale decreased significantly for three weeks treatment, and the range of motion cervical vertebrae increased significantly(p<.05). 3. For the modality using group, the visual analogue scale decreased significantly for three weeks treatment, and the range of motion of cervical vertebrae increased significantly(p<.05). 4. In the comparison of VAS and ROM of the three groups before and after the treatment, significant differences were found among the three groups in VAS after three weeks' treatment, and in ROM before the treatment(p<.05). 5. In all the three groups, VAS decreased and the ROM of cervical vertebrae increased after the treatment, and in particular, the decrease of VAS and the increase of the ROM of cervical vertebrae were remarkable in the joint mobilization group.

• 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.

• Journal of the Korean Society of Physical Medicine
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• v.16 no.3
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• pp.81-87
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• 2021

PURPOSE: This study compared the cross-sectional areas (CSA) of the cervical muscles of straight neck patients and normal participants during a craniocervical flexion exercise (CCFE) using computerized tomography (CT) to investigate the effects of CCFE on the cervical curve. METHODS: Eighteen subjects were recruited for this study. Nine subjects were allocated to the straight neck group (subjects with pain and a cervical lordosis angle of less than 20°); the remainder formed the control group (subjects with a cervical lordosis angle greater than 20°). The CSA of the subjects' neck flexors (longus colli, longus capitis, and sternocleidomastoid) were measured by CT during rest and CCFE in the supine position, and the range of motion (ROM) of neck flexion was measured using a C-ROM instrument in a sitting. RESULTS: The straight neck group had a significantly smaller CSA of the longus colli, longus capitis, and sternocleidomastoid than the control group (p < .05). Both the straight neck and control groups showed statistically significant increases in the CSA of the neck flexors during CCFE compared to that at rest (p < .05). In addition, the straight neck group showed a significantly smaller ROM of neck flexion than the control group (p < .05). CONCLUSION: The results of this study provide more concrete evidence for therapists by demonstrating that CCFE improves the neck function by strengthening the neck flexors and increasing the neck stability for straight neck patients. Therefore, it is necessary to perform CCFE and neck extension exercises to rehabilitate straight neck patients.

• Physical Therapy Korea
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• v.22 no.1
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• pp.58-68
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• 2015

This study aimed to determine the effect of lower trapezius muscle strengthening exercises on pain, neck disability index (NDI), cervical range of motion (ROM), and lower trapezius muscle strength in patients with unilateral neck pain. Following baseline measurements, the subjects (N=40) with unilateral neck pain were randomized into one of two 5 weeks exercise intervention groups: a experimental group (EG, $n_1=20$) that received strength training of the lower trapezius muscles or a control group (CG, $n_2=20$) that received routine physical therapy program. Each group participated in the intervention for 30 minutes, 3 times a week, for 5 weeks. All participants performed 2 repetitions of each intervention per day. The numeric pain rating scale for pain, NDI, ROM, and lower trapezius strength were recorded both pre- and post-intervention for both groups. Paired t-tests were used to determine significant changes post-intervention compared with pre-intervention and independent t-tests were used to analyze differences in the dependent variables between the 2 groups. After the 5-weeks intervention, both groups experienced significantly decreased pain and disability level (p<.05) and significantly increased cervical flexion, extension, lateral flexion, and rotation ROM (p<.05). The EG that received strength training of the lower trapezius muscles showed greater improvements in pain and functional disability level, cervical rotation, and lower trapezius strength than the CG (p<.05). These results suggest that a lower trapezius strengthening exercises reduce neck pain and neck disability level and enhance cervical ROM and lower trapezius strength level in patients with unilateral neck pain.

• The Journal of Korean Physical Therapy
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• v.22 no.3
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• pp.1-8
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• 2010

Purpose: The main causes of chronic neck pain (CNP) are wrong postures and degenerative changes. This study investigated the effects of specific exercise on elderly women with CNP. Methods: 29 elderly women who complain of CNP were classified into experimental group (14) and control group (15). The experimental group was treated with specific exercise and minimal conventional therapy, whereas the control group was treated only with conventional therapy. Then the effects on the visual analogue scale (VAS), neck disability index (NDI), self-rating anxiety scale (SAS), Korean form of geriatric depression scale (KGDS), and range of motion (ROM) were compared between the two groups. Results: The experimental group showed significantly improved results in VAS, NDI, SAS, KGDS, and ROM after intervention (p<0.05), as did the control group (p<0.05). The comparison of changes in the experimental group before and after intervention showed superior results in the SAS, NDI, and ROM (flexion, rotation, lat. flexion) results when compared with the control group (p<0.05). Conclusion: Specific exercise is effective in the improvement of SAS, NDI, and ROM for elderly women with CNP.

• Physical Therapy Korea
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• v.27 no.1
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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.

• PNF and Movement
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• v.16 no.1
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• pp.115-123
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• 2018

Purpose: The aim of this study was to investigate the effect of mandible position on proprioception and range of motion (ROM) during neck stabilization exercise using a sling in healthy adults. Methods: The subjects were randomly assigned to either a sling exercise and mandible open group (n=10) or a sling exercise and mandible closed group (n=12). The sling exercise-mandible open group and sling exercise-mandible closed group took part in an exercise program for 30min, three times per week for 4 weeks. After each training session, head repositioning accuracy (HRA) and the ROM of the cervical spine were measured. Wilcoxon's test was conducted to verify changes within each group, and the Mann-Whitney U test was performed to examine between-group differences. Results: The HRA of the cervical spine was significantly increased during left rotation and extension in the sling exercise-mandible open group. In addition, there were significant differences in both rotations and extension in the two groups. The ROM of the cervical spine increased significantly during both rotations in the sling exercise-mandible closed group. In addition, there was a significant difference in right rotation and extension in both groups. Conclusion: Cervical stabilization exercise using a sling, with the mandible closed increased proprioception and the ROM of the cervical spine.