• Physical Therapy Korea
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• v.28 no.1
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• pp.18-26
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• 2021

Previous studies have reported that deep neck flexor (DNF) exercise can improve neck problems, including neck pain, forward head posture, and headache, by targeting the deep and superficial muscles of the neck. Despite the prevailing opinion across studies, the benefits of DNF can vary according to the type of neck problems and the outcome measures adopted, ranging from positive outcomes to non-significant benefits. A meta-analysis was conducted in this study to assess conclusive evidence of the impact of DNF exercise on individuals with neck problems. We used PUBMED, MEDLINE, NDSL, EMBASE, and Web of Science to search for primary studies and the key terms used in these searches were "forward head posture (FHP)," "biofeedback," "pressure biofeedback unit," "stabilizer," "headache," and "neck pain." Twenty-four eligible studies were included in this meta-analysis and were coded according to the type of neck problems and outcome measures described, such as pain, endurance, involvement of neck muscle, craniovertebral angle (CVA), neck disability index (NDI), cervical range of motion (CROM), radiographs of the neck, posture, strength, endurance, and headache disability index. The overall effect size of the DNF exercise was 0.489. The effect sizes of the neck problems were 0.556 (neck pain), -1.278 (FHP), 0.176 (headache), and 1.850 (mix). The effect sizes of outcome measures were 1.045 (pain), 0.966 (endurance), 0.894 (deep neck flexor), 0.608 (superficial neck flexor), 0.487 (CVA), 0.409 (NDI), and 0.252 (CROM). According to the results of this study, DNF exercise can effectively reduce neck pain. Thus, DNF exercise is highly recommend as an effective exercise method for individuals suffering from neck pain.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.21 no.1
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• pp.284-290
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• 2020

This study was undertaken to determine the effects of SNAGs (sustained natural apophyseal glides) and visual convergence biofeedback on the proprioception and neck disability of patients with chronic neck dysfunction. A total of 31 patients with neck dysfunction were assigned to either SNAGs (n = 16) or biofeedback (n = 15). The groups were assessed for proprioception and neck disability, before and after the intervention. The SNAGs were performed using belt with flexion, extension and right-left rotation, whereas biofeedback training included visual feedback training with deep neck flexor. Intervention was implemented for 20 minutes, twice a week for 4 weeks. Biofeedback training a showed significant effect on the joint position sense (left and right rotation) as compared to the SNAGs group (p< 0.05), whereas neck disability index was significantly effective for SNAGs (p< 0.05). Ed. Notes: The previous statement lacked clarity. I have suggested the edit as per my understanding. Please review and revise appropriately, if required. Therefore, the SNAGs technique is effective for neck function, and biofeedback training is a positive intervention method for enhancing the proprioceptive sensation. In future studies on patients with neck pain, it may be possible to select an intervention method based on the characteristics of the disease.

• Journal of The Korean Society of Integrative Medicine
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• v.7 no.3
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• pp.159-169
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• 2019

Purpose: The purpose of this study was to provide an effective method of exercise therapy for patients with cervicogenic headache. Methods: The subjects were divided into the following three groups according to the intervention received: cervix-stabilizing exercise (n=12, group 1), transcranial direct current stimulation (n=12, group 2), and cervix-stabilizing exercise combined with transcranial direct current stimulation (n=12, group 3). The intragroup and intergroup differences in muscle characteristics and neck disability index were compared and analyzed. Results: The comparison and analysis of the changes in muscle tone and post hoc analysis revealed statistically significant intragroup decreases in the upper trapezius and suboccipitals in groups I and III, and statistically significant intergroup differences in the upper trapezius, with greater changes in group III than in group II, and in the suboccipitals, with greater changes in groupIII than in groups Iand II. The comparison and analysis of the change in muscle stiffness and post hoc analysis revealed a statistically significanti ntra group decrease in the upper trapezius in group Iand suboccipitals in group III, and a statistically significant intergroup difference in both muscles, with greater change in group III than in group II. The comparison and analysis of change in neck disability index and post hoc analysis revealed a statistically significant intragroup decrease in all the three groups and a statistically significant intergroup difference, with greater change in group III than in groups I and II. Conclusion: The neck-stabilizing exercise and transcranial direct current stimulation were shown to be effective in decreasing the tone of the cervical muscles by stabilizing the cervical bone and improving muscle durability, and in improving the movement and limitation of joint range of motion by decreasing muscle tone and stiffness.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.18 no.2
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• pp.87-93
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• 2012

Background: Headaches arising from cervical musculoskeletal disorders are common. Conservative therapies are recommended as the choice of first treatment. Evidence to the effects of manual therapy is inconclusive and available only during the short term. There is no evidence to exercise, and no study has investigated the effect of combined therapies for cervicogenic headache. Methods: In this study, 30 participants who met the diagnostic criteria for cervicogenic headache were randomized into two groups: experimental group and control group. The experimental group was performed myofascial release (MFR), Mulligan technique and self stretching exercises. The control group was performed electrical therapy and self stretching exercises. Assessments were performed to 30 participants before and after 4 weeks therapy. The components of assessments were headache intensity(HI), headcahe duration (HD), neck pain (NP) and neck disability index (NDI). Results: After 4 weeks therapy, HI, HD, neck pain and NDI were significantly reduced in both groups (p<.01). The HI, HD, neck pain and NDI were significantly reduced in experimental group more than in the control group (p<.01). Conclusions: Manual therapy could reduce the symptoms of cervicogenic headache.

• Journal of Korean Physical Therapy Science
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• v.24 no.2
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• pp.61-70
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• 2017

Purpose : The purpose of this study was to examine the effect of therapeutic massage and Mckenzie exercise on pain and range of motion in chronic neck pain patient: a case study. Method : A Twenty-year old female subject with chronic neck pain was selected, she received therapeutic massage and Mckenzie exercise for 30 minutes a day, three days a week for five weeks. Pain was measured visual analog scale(VAS), neck disability index(NDI) and the Copenhagen neck functional disability scale (CNFDS). Range of motion was measured using a goniometer(shoulder joint) and the CROM Deluxe(cervical range of motion instrument). Result : VAS, NDI and CNFDS were decreased 3 score, 4 score and 6 score(respectively) than before the training. The range of motion was increased in shoulder joint and neck movement than before the training. Conclusion : The massage and Mckenzie exercise increased range of motion in shoulder joint and neck movement, and decreased neck pain in chronic neck pain patient. Additional research on therapeutic massage and Mckenzie exercise for improving pain and range of motion is need.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.21 no.12
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• pp.43-51
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• 2020

This study examined how the eight-week spinal stabilization exercise program affects the cervical disability index, postural balance ability, and body shape change. The exercise program performed 60 minutes of spinal stabilization exercise three times a week for eight weeks. Sixteen patients with chronic neck pain, who complained of neck pain for six months, were classified into exercise group (n=8 patients) and control group (n=8 patients). The results before and after the eight-week exercise program were observed. Significant differences were observed in the time, group, and interaction of the neck disability index (p<.05). The balance ability showed significant interaction effects between the groups and periods (p<.05). Significant differences were noted in the timing and interaction in the pelvic inclination angle in posture change (p<.05), and there were significant differences in the group, timing, group, and interaction in the cervical and shoulder position angles (p<.05). The above results showed that the spinal stabilization exercise significantly improved the cervical disability index, balance ability change, and body shape change in patients with chronic neck pain. Future studies will analyze the specific changes in spinal structure through radiographic imaging to increase the validity of spinal stabilization exercise.

• Journal of Acupuncture Research
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• v.25 no.5
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• pp.69-76
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• 2008

Objectives : The objective of this study was to observe the correlation between Cervical hypolordosis and Neck pain. Methods : Cervical lordosis(Cobb method[C1-C7], Cobb method[C2-C7], Ishihara index) was measured using the sagittal radiograph of the cervical spine and Neck pain(VAS scale, Neck Disability Index) was evaluated. Based on Cobb method[C1-C7], 48 subjects(Cobb method[C1-C7]${\leq}45^{\circ}$) were divided into Hypolordosis group and Normal group. Window version SPSS 12K was used for statistical analysis about correlation between Cervical lordosis and Neck pain, also about difference of the Neck pain between Normal and Hypolordosis group. Results : It was as follows, 1. Cobb method[C1-C7] and Neck pain(VAS scale, NDI) showed a significant correlation coefficient (p<0.05). Ishihara Index and NDI also showed a significant correlation coefficient of -0.297(p=0.040). 2. The VAS scale in the hypolordosis group was $5.62{\pm}2.34$ and that of the normal group was $3.41{\pm}2.01$(p=0.001). The NDI in the hypolordosis group was $2.30{\pm}0.66$ and that of the normal group was $1.81{\pm}0.51$(p=0.007). There was no significant difference in Age, Sex between both group. Conclusions : There was a significant correlation between Cervical hypolordosis and Neck pain. Hypolordosis group complained a severe neck pain.

• Journal of Korean Medicine Rehabilitation
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• v.27 no.1
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• pp.37-51
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• 2017

Objectives This study was designed to identify the effect of acupuncture combined with wooden neck pillow self-exercise program (WSP). Methods 25 eligible subjects with chronic neck pain were recruited from September 2015 to August 2016. Subjects were treated by acupuncture twice a week for 4 weeks, also were educated WSP and exercised every day for 4 weeks. They were assessed using PI-NRS, NDI and the maximum muscle strength of deep cervical flexor muscles (DCF) before and after treatment. Also the Cobb's angle (C1-C7), Ishihara index, Park method were assessed for evaluating the radiographical changes. Variables were compared using paired t-test. And correlates analysis was used for analyzing relationship between differentials in the maximum muscle strength of DCF and differentials in cervical spine curvature measurement methods. Results Among the 25 subjects, 4 subjects were lost to follow-up or excluded in accordance with the criteria. Significant differences on NRS, NDI and the maximum muscle strength of DCF were seen after treatment (p<0.001). In radiological finding, cervical spine curvature measurement methods were significantly increased (p<0.001, p<0.05, p<0.05). Differentials in the maximum muscle strength of DCF significantly correlates to differentials in Ishihara index (R=0.479, p<0.05). Conclusions Acupuncture combined with WSP may decrease neck pain intensity and associated disability, and also increase the muscle strength of DCF and cervical lordosis, in patients with chronic neck pain. Especially, Improving the muscle strength of DCF has a relationship with improving Ishihara index. However, due to the design of this study, this treatment can not be compared with other treatments. Future randomized project should be needed.

• Journal of Haehwa Medicine
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• v.20 no.1
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• pp.127-135
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• 2011

Objectives : The purpose of this study was to investigate the effect of treatment with Sacro-Occipital Technique block on musculoskeletal pain caused by traffic accident by analysis of the Visual Analogue Scale(VAS), Neck Disability Index(NDI), Pain Disability Index(PDI), Oswestry Low back Pain Disability Index(ODI) and Short Form - McGill Pain Qusetionnaire (SF-MPQ). Methods : This study carried out on 18 patients who have received hospital treatment in Daejeon Univ. Dun-San Oriental Hospital. Control group got acupunture-therapy, herbal medication, physical therapy and Experimental group got all the therapies and treatment with Sacro-Occipital Technique block. We measured VAS, NDI, PDI, ODI and SF-MPQ on 1st day and 7 days later. Results : After being treated by our methods, Both group were improved in VAS, NDI, PDI, ODI, and SF-MPQ. Especially, Experimental group was significantly meaningful improved in VAS, PDI, and ODI. Control group was significantly meaningful improved in VAS and SF-MPQ. But, differences between control and experimental group were nonsignificant. Conclusions : The results suggest that treatment with Sacro-Occipital Technique block is not significantly meaningful but gives a positive impact on musculoskeletal pain caused by traffic accident. But further long term study in a large scale is needed.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.27 no.3
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• pp.57-67
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• 2021

Background: This study examined the effects of the muscle energy technique and cervical traction after applying conservative physical therapy in patients with cervical radiculopathy. Methods: Patients were randomly divided into two groups muscle energy technique (8 subjects) and cervical traction (8 subjects). Each group performed their exercise 70 minutes per day, three times week for four weeks. Pain intensity was measured with a visual analogue scale (VAS). Function was measured with the neck disability index (NDI). Cervical range of motion (ROM) was measured with a cervical range of motion (CROM) goniometer. Results: After four weeks of therapy, VAS (p<.05) and NDI (p<.05) significantly decreased, and ROM significantly increased in both groups (p<.05). There were also significant differences between the two groups for these three measures (p<.05). Conclusion: The muscle energy technique and cervical traction are more effective than cervical traction alone in reducing VAS and NDI and increasing ROM in patients with cervical radiculopathy.