• Physical Therapy Rehabilitation Science
• /
• v.9 no.3
• /
• pp.191-196
• /
• 2020

Objective: Congenital muscular torticollis (CMT) is a disease with abnormal head and neck posture in infants. It affects the child's movement and development and can lead to complications. Therefore, this study aims to find out what factors influence the rehabilitation treatment duration of infants with CMT. Design: Cross-sectional study. Methods: The subjects were 63 infants under 90 days of age who were diagnosed with CMT. Age, thickness of the sternocleidomastoid muscle (SCM) on the affected and non-affected side, head tilt angle, and head rotation angle of the affected head in infants were collected. The ratio of muscle thickness was calculated from the thickness of the affected SCM and the thickness of the non-affected SCM (A/N ratio). All subjects underwent conservative physical therapy twice a week for 30 minutes, and the end of the treatment was when the angle of head tilt was normal or less than 5 degrees, and the treatment duration was calculated. Results: Age, thickness of affected SCM, and head tilt were significantly correlated with treatment duration (p<0.05). The thickness of the non-affected SCM, A/N ratio, and head rotation angle did not show any correlation with treatment duration. The factors affecting the treatment duration were head tilt and age, showing 21% explanatory power of adjusted R². Conclusions: The main factors affecting the treatment duration of infants with CMT are head tilt and age. Therefore, more attention should be directed to the infant's head tilt and age for effective physical therapy of infants with CMT.

• Journal of Korean Physical Therapy Science
• /
• v.31 no.1
• /
• pp.88-97
• /
• 2024

Background: This study was to investigate effects of Correlation Analysis between Cervical-Vertebra Angle and Neck Range of Motion, Muscle Strength, Sternocleidomastoid Thickness of Patients with Forward Head Posture Design: Correlation Analysis. Methods: The subjects of this study were a total of 54 people in the forward head position and their ages were between 30 and 50 years old. The subjects cranio-vertebral angles, neck extension, neck flexion, neck rotation angles, neck flexor strength, neck extensor strength, sternocleidomastoid thickness were evaluated through measuring instruments. The thickness of the sternocleidomastoid muscle was measured using an imaging ultrasound diagnostic device (ultra sound, Versana Premier, GE Medical systems, China). CVA was measured by measuring the side photo of the subject was taken with a camera and evaluated.. neck joint range of motion was measured through digital inclinometer for extension, flexion, and neck rotation. neck muscle strength was measured by measuring the using a digital sthenometer. Data analysis in this study was statistically processed using SPSS version 26.0 (IBM SPSS Inc., USA). Correlation analysis was used and the statistical significance level was set at 0.05. Results: The results neck extension(r= 0.70^**), neck flexion(r= 0.67^**), neck rotation(r= 0.56^**), neck extensor muscle strengt(r= 0.85^**), neck flexor muscle strength(r= 0.66^**), sternocleidomastoid thicknes(r= -0.81^**) It indicates that there is a correlation. Conclusion:These results improve the Cervical-vertebra angle of patients with forward head posture should include a program to improve the thickness of the SCM. In the future, study can be used as an evidentiary material for treatment interventions to improve the Cervical-vertebra angle of patients with forward head posture.

• Journal of the Korean Society of Physical Medicine
• /
• v.6 no.4
• /
• pp.497-504
• /
• 2011

Purpose : Chronic cervical pain is a common source of disability in society. There has been no research regarding the amount of pressure for the deep cervical flexors during cranio-cervical flexion exercise (CCFE). The purpose of this study is to determine optimal pressure levels to facilitate deep cervical muscles (longus colli & longus capitis) during cranio-cervical flexion exercise, using ultrasound measurement of the muscles. Methods : Using a cross-sectional design, the study was performed in an experimental group of 19 subjects (7 men, 12 women) with no cervical pain. Participants were instructed to perform the CCFE, and during the five incremental stages of the test, changes in thickness, as compared to resting baseline values, were measured using ultrasonography for sternocleidomastoid muscle (SCM) and deep cervical muscles (DCF). Results : Both DCF and SCM muscles demonstrated an increase in recruitment with each progressive phase of the test. In comparing the different pressure increments, the most significant changes found in DCF thickness were between phase 2 and phase 3 (p<.05). However no differences were found between pressure increments for SCM thickness (p>.05). Conclusion : The results suggest 26 mm Hg as the optimal pressure level during cranio-cervical flexion exercise for facilitation of deep cervical flexor.

• Physical Therapy Rehabilitation Science
• /
• v.9 no.4
• /
• pp.302-308
• /
• 2020

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.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
• /
• v.20 no.1
• /
• pp.1-7
• /
• 2014

Background: As the increase of forward head position, we studied the change of thickness of deep cervical flexor (DCF) compared of with sternocleidomastoid (SCM). we measured and analysed the change of thickness of the neck flexor for forward head position and cranio-cervical flexion exercise (CCFE). Methods: Using a cross-sectional design, we conducted the study selecting 35 healthy adults (12 males, 23 females). We measured the craniovertebral angle (CVA), instructed them to perform the CCFE, and measured the DCF and SCM using ultrasonography during the contraction and relaxation period. Results: Intra-reliability of SCM is .96, longus capitis is .92 and longus coli is .97. we compared according to the change of forward head position, Correlation of DCF is .841, and DCF/SCM is .754 by significant positive correlation. At the comparison of CCFE and Resting muscle thickness, SCM and DCF is .00, DCF/SCM is .68. Conclusion: There is a strong positive correlation between the change amount of DCF and DCF/SCM as the increase of CVA.

• Korean Journal of Radiology
• /
• v.21 no.12
• /
• pp.1374-1382
• /
• 2020

Objective: To determine whether ultrasonography at initial presentation can help assess the clinical severity of congenital muscular torticollis (CMT) in infants without a sternocleidomastoid muscle (SCM) mass. Materials and Methods: This retrospective study included 71 infants aged less than 12 months (4.1 ± 2.3 months) with non-mass CMT. The clinical severity was divided into three grades (groups 1-3) based on the degree of lateral head bending or cervical rotation. The difference (SCM-D) and ratio (SCM-R) between the maximal thickness of the affected and non-affected SCMs were obtained using transverse and longitudinal ultrasonography. The sonographic echotexture and echogenicity of the involved SCM were reviewed. Results: A significant difference was observed in the SCM-D (0.42 ± 0.30 mm in group 1; 0.74 ± 0.50 mm in group 2; 1.14 ± 0.85 mm in group 3; p = 0.002) and SCM-R (1.069 ± 0.067 in group 1; 1.129 ± 0.087 in group 2; 1.204 ± 0.150 in group 3; p = 0.001) among the groups when measured along the longitudinal but not along the transverse ultrasonography plane. The areas under the curves of the SCM-R and SCM-D measured by longitudinal ultrasonography were 0.731 (p < 0.001) and 0.731 (p < 0.001) for group 1 versus groups 2-3. The proportions of heterogeneous echotexture or hyperechogenicity in the involved SCM did not differ significantly among the three clinical groups (all p > 0.05). Conclusion: Ultrasonography can aid in assessing the clinical severity of CMT in infants without an SCM mass at the time of initial diagnosis. The SCM-R and SCM-D helped grade the clinical severity when obtained by longitudinal scan.

• Anatomy and Cell Biology
• /
• v.51 no.4
• /
• pp.305-308
• /
• 2018

Anatomical variations of the sternocleidomastoid muscle (SCM) have been observed to occupy multiple origins and insertion points and have supernumerary heads, sometimes varying in thickness. During routine dissection, a SCM was observed to have six distinct insertions that interface with the course of the superior nuchal line, ending at the midline, bilaterally. This variation was also seen to receive innervation from the accessory nerve as well as the great auricular nerve. To our knowledge, this variant of supernumerary insertions and nerve innervations has not yet been reported. These variants may pose as problematic during surgical approaches to the upper neck and occiput, and should thus be appreciated by the clinician. Herein we discuss the case report, possible embryological origins, and the clinical significance of the observed variant SCM.

• Journal of the Korea Academia-Industrial cooperation Society
• /
• v.22 no.2
• /
• pp.659-666
• /
• 2021

This study aimed to investigate the effect of changes in pressure levels and gaze directions on deep neck flexor muscle thickness. Twenty-seven subjects participated in this study. Ultrasound imaging of the longus colli (LC) and sternocleidomastoid (SCM) were measured in four gaze directions (0°, 20°, 40°, 60°) and five pressure levels (20 mmHg, 22 mmHg, 24 mmHg, 26 mmHg, 28 mmHg) during cranial-cervical flexor (CCF) exercises. Repeated ANOVA was performed for analysis of muscle thickness difference according to gaze direction and pressure levels in LC and SCM. Results: LC showed a significant difference between 0° and 20°, 0° and 40°, and 0° and 60° at pressures of 20 mmHg and 22 mmHg (p<.05). SCM displayed a significant difference between 0° and 20°, 20° and 40°, and 40° and 60° at 28 mmHg (p<.05). In this study, it was found that setting the gaze direction to 20° for the CCF exercise can increase the activation of LC and lower the activity of SCM to obtain the effect of exercise. Based on the results of this study, it is hoped that the beneficial effects of the CCF exercise can be increased by setting an optimal gaze direction in a clinical environment.

• Physical Therapy Korea
• /
• v.29 no.4
• /
• pp.255-261
• /
• 2022

Background: For the elderly, masticatory function is one of the most important oral functions and the masticatory ability is related to the wearing of dentures. Many older people wear dentures for their masticatory function, but a significant number of older people who use dentures have found that they feel uncomfortable when performing their daily activities, such as performing masticating functions or talking. Objects: The purpose of this study is to investigate how the forward head posture (FHP), respiratory function and thickness of masseter (MS), and sternocleidomastoid (SCM) are affected by the presence or absence of dentures in the elderly, and what kind of correlation there is between these variables. Methods: The study was conducted on 11 patients in the normal group and 13 in the denture group. The participant's cognitive ability was evaluated using Mini-Mental State Examination Korean (MMSE-K), and the FHP was evaluated by measuring the craniovertebral angle (CVA). The thickness of the MS and SCM muscles were measured using ultrasound, and respiration was measured with a spirometry. As for the statistical method, the correlation of each variable was investigated using Spearman's correlation coefficient. Results: In the normal group, there was a significant correlation between forced vital capacity (FVC) and forced expiratory volume in 1 second (FEV1) (p < 0.001), and in the denture group, FVC and FEV1 (p < 0.001), maximal inspiratory pressure (MIP) and maximal expiratory pressure (MEP) (p < 0.001), CVA and Lt. MS (p = 0.012). Conclusion: CVA and Lt. MS of the denture group have a high negative correlation, it is related that the thickness of MS may be thick when the elderly wearing dentures are FHP.