• Journal of Korean Physical Therapy Science
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• v.29 no.2
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• pp.38-47
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• 2022

Background: The purpose of this study was to investigate the effect of the combined application of manipulation and stabilization exercises on pain and spinal curvature in patients with chronic back pain. Design: Randomized controlled trial Methods: The research subjects included 24 women in their 40s and 50s who have chronic back pain. The sample was evenly divided into an experimental group, which received the combined application of manipulation and stabilization exercises, and a control group, which received stabilization exercises only. The 30-minute intervention was applied five times a week for eight weeks. A bivariate repeated measures analysis of variances was conducted to identify the differences between the two groups before the experiment, after the fourth week, and at the end of the eight-week experiment. The level of statistical significance was set at.05. This analysis examined the within-group changes and the between-group changes using a paired t-test and an independent t-test, respectively. Results: Changes in pain differed significantly depending on the time of the measurement, the interaction between the time of the measurement and each group, and between the two groups (p<.05). Changes in the curvature of the bones of the neck, the bones of the back, and the lumbar vertebrae differed significantly depending on the time of the measurement and the interaction between the time of the measurement and each group (p<.05). Conclusion: The combined application of manipulation and stabilization exercises demonstrated a positive effect on changes in pain and spinal curvature, and the method is expected to be a useful intervention for reducing pain and improving spinal curvature in patients with back pain.

• Journal of Korean Neurosurgical Society
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• v.53 no.1
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• pp.49-51
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• 2013

A case of traumatic spondyloptosis of the cervical spine at the C6-C7 level is reported. The patient was treated succesfully with a anterior-posterior combined approach and decompression. The patient had good neurological outcome after surgery. A-51-year-old female patient was transported to our hospital's emergency department after a vehicle accident. The patient was quadriparetic (Asia D, MRC power 4/5) with severe neck pain. Plain radiographs, computerize tomography and spinal magnetic resonance imaging (MRI) showed C6-7 spondyloptosis and C5, C6 posterior element fractures. Gardner-Wells skeleton traction was applied. Spinal alignment was reachived by traction and dislocation was decreased to a grade 1 spondylolisthesis. Then the patient was firstly operated by anterior approach. Anterior stabilization and fusion was firstly achieved. Seven days after first operation the patient was operated by a posterior approach. The posterior stabilization and fusion was achieved. Postoperative lateral X-rays and three-dimensional computed tomography showed the physiological realignment and the correct screw placements. The patient's quadriparesis was improved significantly. Subaxial cervical spondyloptosis is a relatively rare clinical entity. In this report we present a summary of the clinical presentation, the surgical technique and outcome of this rarely seen spinal disorder.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.21 no.1
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• pp.49-56
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• 2015

Background: Although many of those who drive for a living are exposed to repetitive and awkward posture and whole body vibration which cause them cumulative trauma disorder, therapeutic studies related to the problems from the transport unit are still somewhat inadequate. The purpose of this case report is to identify the effect of combined exercise program on patients suffering chronic neck pain caused by long hour of intra-city bus driving. Method: A total of 4 subjects are selected as patients, all of whom have more than 10 years of experience in intra-city bus transportation services. These people have suffered from neck pain for years. We ran the combined exercise program 3 times a week for 4 weeks and respectively evaluated the results after the 2nd and 4th week. We implemented conventional physiotherapy for 40 minutes, another 40 minutes of combined exercise program, and then educated the patients to enable themselves to do active stretching program as a home program. The combined exercise program contained 3 different stages. 1st stage: active stretching program, 2nd stage combined stabilization exercise and strengthening exercise, 3rd stage: proprioceptive exercise Result: After 4 weeks of intervention, there was enhance in the range of motion. $12^{\circ}$ increase in flexion, $10^{\circ}$ in extension, $6^{\circ}$ in lateral flexion respectively, and $10^{\circ}$ in rotation on average. VAS(visual analgue scale) decreased by 33% on average, NDI(neck diability index) by 28% and fatigability by 23%. Conclusion: There were improved results in the range of motion, NDI, VAS, and in fatigability after applying combined exercise program to intra-city bus drivers exposed to whole body vibration and cumulative trauma disorder.

• 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.

• Journal of the Korean Society of Physical Medicine
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• v.9 no.1
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• pp.125-132
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• 2014

PURPOSE: This study aims to determine the optimal knee joint angle and hip joint angle for minimizing the cervical muscle tension and maximizing the muscle activity of the trunk during the bridging exercise for trunk stabilization. METHODS: The bridging exercise in this study included seven forms of exercise: having a knee joint flexion angle of $120^{\circ}$, $90^{\circ}$, $60^{\circ}$, $45^{\circ}$ and hip joint abduction angle of $15^{\circ}$, $10^{\circ}$, $5^{\circ}$. The posture of the bridging exercise was as follows. To prevent the increase of hyper lumbar lordosis during the bridging exercise, the exercise was practiced after maintaining the lumbar neutral position through the pelvic posterior tilting exercise. RESULTS: The abduction angles did not result in statistically significant effects on the cervical erector, external oblique, rectus abdominis and erector spinae muscles. However, in relation to the knee joint angles, during the bridging exercise, statistically significant results were exhibited. CONCLUSION: The knee joint angle affected the muscle activity of the neck muscle. The greater the knee joint angle, the lower the load placed on the neck muscle. In contrast, the load increased as the knee joint angle decreased. In addition, the muscle activity of the neck muscle and trunk muscle increased as the knee joint angle decreased.

• Journal of Korean Neurosurgical Society
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• v.52 no.1
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• pp.21-26
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• 2012

Objective : To evaluate a new posterior atlantoaxial fixation technique using a nitinol shape memory loop as a simple method that avoids the risk of vertebral artery or nerve injury. Methods : We retrospectively evaluated 14 patients with atlantoaxial instability who had undergone posterior C1-2 fusion using a nitinol shape memory loop. The success of fusion was determined clinically and radiologically. We reviewed patients' neurologic outcomes, neck disability index (NDI), solid bone fusion on cervical spine films, changes in posterior atlantodental interval (PADI), and surgical complications. Results : Solid bone fusion was documented radiologically in all cases, and PADI increased after surgery (p<0.05). All patients remained neurologically intact and showed improvement in NDI score (p<0.05). There were no surgical complications such as neural tissue or vertebral artery injury or instrument failure in the follow-up period. Conclusion : Posterior C1-2 fixation with a nitinol shape memory loop is a simple, less technically demanding method compared to the conventional technique and may avoid the instrument-related complications of posterior C1-2 screw and rod fixation. We introduce this technique as one of the treatment options for atlantoaxial instability.

• 대한상한금궤의학회지
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• v.10 no.1
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• pp.125-132
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• 2018

Objective : The purpose of this study is to review a case of hypertension. The patient was 41 years, a male. We stabilized blood pressure after administration of Daehuanghuanglianxiexin-tang. In this paper, we review the interpretation of Shanghanlun by analyzing the patient's progress, diagnosis, treatment. Methods : Blood pressure changes have been monitored during the period. Additionally, We have observed the patients' compliance and accompanied symptom by the timeline analysis. Results : According to Shanghanlun disease pattern identification diagnostic system, Wediagnosed a Greater yang disease. The patient was treated with Daehuanghuanglianxiexin-tang for 2 months. Daehuanghuanglianxiexin-tang was able to control blood pressure to under 120mmhg / 80mmhg. During the treatment period, the accompanied symptom Stiffness and pain in posterior neck has improved, patient's compliance was good, and symptoms improved without significant complication Conclusions : Taking of the Daehuanghuanglianxiexin-tang makes patient's blood pressure controlled to safe and stable range and eases the discomfort of posterior neck pain.

• Journal of the Korean Society of Physical Medicine
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• v.11 no.3
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• pp.65-72
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• 2016

PURPOSE: The purpose of this study is to determine the differences between the muscle activity of cranio-cervical flexion and extension muscles according to the types of tools used through a short-term intervention of cranio-cervical static stabilization exercises using small tools. METHODS: A total of fifteen male and female adults in their 20s who showed forward head posture in the overall body posture measurement system participated in this study. Each subject performed cranio-cervical static stabilization exercises about flexion and extension while using a sling, a foam roller, a TOGU ball, and without tools separately, and the muscle activity of the sternocleidomastoid muscle, scalenus anterior and splenius capitis was measured. Each value was measured for 10 seconds a total of three times. The maximum voluntary isometric contraction value was computed using the average during the middle four seconds. RESULTS: Cranio-cervical flexion exercises using various tool types, the average activity of the sternocleidomastoid and scalenus anterior muscles was significantly higher when applying the TOGU ball (p<.05). According to the results of implementing cranio-cervical flexion exercise using various tools, the maximum muscle activity of the sternocleidomastoid muscle was significantly higher for the TOGU ball (p<.05). CONCLUSION: Based on these results, the provision of an unstable surface using small tools rather than a stable surface is recommended as an exercise scheme for proprioceptive stimulation in a forward head posture. Particularly, we recommend using the TOGU ball for the provision of an unstable surface to increase the muscle activity of the sternocleidomastoid muscle and scalenus anterior.

• Physical Therapy Korea
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• v.26 no.4
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• pp.1-9
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• 2019

Background: Cervical dysfunction is a common pathomechanical marker in individuals with forward head posture (FHP). To overcome the limitations of the isometric chin-tuck (ICT) exercise, dynamic neuromuscular stabilization (DNS), which emphasizes an entire spinal chain exercise, has recently shown promising clinical results. Objects: Purpose of this study was to compare the immediate effects between ICT and DNS techniques. Methods: 43 young subjects (mean age, $24.0{\pm}5.0$ years) were recruited. Group of subjects with FHP were measured under baseline, ICT, and DNS conditions. Outcome measures included sitting height, longus colli (LC) and sternocleidomastoid (SCM) muscle thickness and LC/SCM thickness ratio. One-way repeated measures ANOVA was used to compare the continuous dependent variables among FHP, ICT, and DNS conditions at p<.016. Results: Both ICT and DNS exercise conditions yielded significantly increased LC muscle thickness, LC/SCM thickness ratio and sitting height than did FHP condition (p<.0001, respectively). Sitting height was significantly greater in DNS exercise than in the ICT exercise (p<.0001). Conclusion: The present results demonstrated that sitting height was greater in the DNS exercise than in the ICT exercise, as well as both corrective postural training exercises were effective on LC/SCM muscle balance ratio when compared with the baseline FHP condition. Therefore, it is considered that DNS exercise can be the recommended exercise for people with FHP.

• Journal of The Korean Society of Integrative Medicine
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• v.10 no.3
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• pp.13-25
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• 2022

Purpose : The purpose of this study was to investigate the effects of combined cervical stabilization exercise (CSE) and stretching exercise (SE) on office workers with forward head posture (FHP). Methods : A total of 32 office workers with forward head posture were randomly assigned to experimental (n=16) and control (n=16) groups. The experimental group underwent combined CSE and SE, and the control group underwent cervical self-myofascial release and SE. Both groups performed exercises for 40 min per day, thrice per week for a total of 6 weeks. Craniovertebral angle (CVA), respiration, disability, and joint range of motion (ROM) before and 6 weeks after intervention were measured and compared. Results : There was no significant between-group difference in the general characteristics (p>.05). The intra-group comparison showed significant differences in the visual analog scale (VAS) and neck disability index (NDI) of both groups post-intervention (p<.05). CVA and forced expiratory volume in 1 seconds (FEV₁) were significantly improved post-intervention in the experimental group only (p<.05). In the experimental group, all ROM variables were significantly improved post-intervention. In contrast, in the control group, all ROM variables improved significantly post-intervention, except for extension (p<.05). The inter-group comparison showed significant differences in NDI, left lateral flexion, right lateral flexion, and left rotation between the two groups (p<.05). Conclusion : The combination of CSE and SE, which stabilizes the cervical spine, had positive effects on cranial rotation angle, respiration, disability, and joint ROM in office workers with forward head posture. Therefore, the combination of the two exercises may be an effective option to reduce symptoms and prevent postural problems in office workers with FHP.