• Physical Therapy Korea
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• v.20 no.4
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• pp.32-39
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• 2013

Abdominal curl-up exercise may excessively increased superficial neck flexor such as sternocleidomastoid (SCM) muscle. Also, the muscle activity of the abdominal muscles haven't investigated during abdominal curl-up with craniocervical flexion (CCF). Therefore, the purpose of our study was to determine the effect of CCF on the muscle activity of the abdominal and SCM muscles during abdominal curl-up. Twelve healthy subjects (six men and six women) with no history of abdominal or lower back pain within 6 weeks were recruited. Surface electromyographic signals were collected on SCM, rectus abdominis (RA), internal oblique (IO), and external oblique (EO) muscles bilaterally during performing the traditional abdominal curl-up and the abdominal curl-up with CCF. Paired t-tests were used to compare the differences in the muscle activity of the bilateral SCM, RA, EO, and IO muscles between the traditional abdominal curl-up and the abdominal curl-up with CCF (p<.05). There was significantly lower electromyogram (EMG) activity of the both SCMs during the abdominal curl-up with CCF (Right SCM, $39.50{\pm}15.29%MVIC$; Left SCM, $38.24{\pm}17.31%MVIC$) than with the traditional abdominal curl-up (Right SCM, $54.85{\pm}20.05%MVIC$; Left SCM, $53.18{\pm}26.72%MVIC$) (p<.05). The activity of abdominal muscles were not significantly different between the traditional abdominal curl-up and the abdominal curl-up with CCF. The abdominal curl-up with CCF requires significantly less muscle activity of SCM. Consequently, the abdominal curl-up with CCF is recommended to prevent excessive activation of superficial cervical flexors during abdominal curl-up exercise.

• Safety and Health at Work
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• v.9 no.3
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• pp.319-325
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• 2018

Background: Prolonged neck flexion during smartphone use is known as a factor of neck pain and alteration of neck muscle activity. Studies on the effects of shoulder taping on neck discomfort and neck muscle responses while texting on a smartphone are still lacking. The aim of this study was to examine the effects of shoulder taping on neck discomfort using a numerical rating scale, and neck muscle activity and fatigue using a surface electromyography during a texting task on a touchscreen smartphone. Methods: Twenty-five healthy adolescents used the dominant hand to perform a 30-minute texting task using a touchscreen smartphone at two separate times under one of the following two conditions: taping across the upper trapezius muscle and no taping. Neck discomfort, normalized root mean square, and normalized median frequency slopes for upper trapezius, cervical erector spinae, and sternocleidomastoid muscles were recorded. Results: The results revealed that shoulder taping provided significantly lower neck discomfort than no taping (p < 0.001). However, shoulder taping did not significantly alter normalized root mean square and normalized median frequency slope values of all muscles when compared with no taping controls. Conclusion: Shoulder taping reduces neck discomfort but does not affect neck muscle activity and fatigue while texting on a touchscreen smartphone.

• Archives of Plastic Surgery
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• v.37 no.4
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• pp.477-480
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• 2010

Purpose: Ganglioneuromas are well-differentiated tumors derived from neuroectodermal neural crest cells. Although these tumors can occur anywhere along the sympathetic chain from the base of the skull to the pelvic cavity, they usually develop in the posterior mediastinum and retroperitoneum these tumors are rarely found in the cervical region. Method: We report the case of a 16-year-old male patient with neurofibromatosis type 1 who was admitted because of a palpable mass centrally located on the left side of the neck. A preoperative contrast-enhanced neck computed tomography image showed a low-density homogeneous mass on the parapharyngeal space along with marked displacement of the trachea and carotid vessels. Round and soft masses were also detected on both axillae. Results: The patient subsequently underwent complete excision of the neck mass via the transcervical approach. The mass was smooth and well encapsulated between the sternocleidomastoid muscle and the trachea. Further, the mass appeared to arise from the cervical sympathetic chain, which was preserved during surgery. Both the axillary masses were also excised. The histopathological findings were ganglioneuroma for the neck mass and neurofibroma for both the axillary masses. Conclusion: Cervical ganglioneuromas are rare tumors that present as enlarging parapharyngeal cervical masses in the oropharynx or neck. To our knowledge, a case of cervical ganglioneuroma associated with neurofibromatosis type 1 has never been reported. In patients with neurofibromatosis, multiple tumors may develop, and therefore periodic clinical and radiological follow-up is recommended. Further, repeated imaging analysis should be performed if the presence of another tumor is suspected.

• The Journal of Korean Physical Therapy
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• v.28 no.1
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• pp.46-51
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• 2016

Purpose: This study intended to classify voluntary respiratory exercise and exercise using breathing training equipment to suggest proper respiratory exercise to relieve symptoms of patients with severe chronic obstructive pulmonary disease. Methods: Sixteen subjects were randomly selected for experimental group I, which performed feedback breathing exercise and 15 subjects were randomly selected for experimental group II, which performed a complex breathing exercise. The mediation program was performed 30 minutes a session, once a day, three times a week, for five weeks. This study analyzed before and after results within groups and between groups through measurement of respiratory muscle activity and health-related quality of life. Results: Activity of sternocleidomastoid muscle and scalene muscle increased meaningfully within experimental group I and activity of diaphragm increased significantly within experimental group II (p<0.05) and there was a meaningful difference in health-related quality of life within experimental group II (p<0.05). Significant differences in change of activity of respiratory muscle and health-related quality of life were observed between groups (p<0.05). Conclusion: This study showed conflicting results between activity of agonist and synergist in patients with severe chronic obstructive pulmonary disease according to types of respiratory exercise and that complex respiratory exercise is more effective in health-related quality of life. Therefore, it found that the more severity increase, the more self-respiratory technique is an effective program. Diversified approach methods will be needed to improve respiratory function and quality of life for patients, and continuous clinical studies will be needed in the future.

• Journal of the Korean Society of Physical Medicine
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• v.7 no.3
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• pp.339-348
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• 2012

Purpose : The purpose of this study is to compare muscle activations of neck, trunk and leg in cerebral palsy of spastic diplegia with genu recurvatum and knee flexion contracture, when using anterior and posterior walkers. Methods : We selected 21 cerebral palsy and received the written consent to participate in this study. The inclusion criteria for participation required patients to have spastic diplegic CP; to be between 3~6 years of age, to have a GMFCS III grade, to have no botulinum toxin injection and orthopedics surgery within before six months starting the study. Measurements of muscle activities (sternocleidomastoid, splenius capitis, rectus abdominis, erector spinea, gluteus maximus, rectus femoris, medial hamstring and calf muscles) were evaluated anterior and posterior walker ambulations. Statistical evaluation of these data were accomplished by utilizing the paired t-test and independent t-test by SPSS 20.0 program. Significance level was set at p<.05. Results : The following results were obtained. There was significant difference on muscle activation of neck, trunk and legs(soleus except) in anterior and posterior walkers. There was no significant difference in muscle activation of neck but significant difference in muscle activation of trunk, legs between genu recurvatum and knee flexion contracture(rectus abdominis, medial hamstring when using anterior walker, rectus abdominis, erector spinea, gluteus maximus, medial hamstring when using posterior walker). Conclusion : The conclusion of this study is the different knee joint forms would have different effect on muscle activation of trunk and legs while cerebral palsy of spastic diplegic ambulated with anterior walker and posterior walker.

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

• Journal of the Korean Society of Physical Medicine
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• v.14 no.3
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• pp.13-20
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• 2019

PURPOSE: Sitting with crossed legs may have an effect on maintaining a healthy body posture and proper functioning of the respiratory system. Thus, this study's objective was to identify whether or not sitting with crossed legs affects the vertebral angle, chest wall mobility, the pulmonary function, and the activity of the respiratory muscles. METHODS: Thirty healthy subjects were recruited for this study (16 males and 14 females). The vertebral angle, chest wall mobility, pulmonary function, and the activity of the respiratory muscle were measured while the subjects sat in the correct posture and these factors were again measured with the subjects seated with their legs crossed. Three-dimensional motion analysis was used to determine the trunk and lumbar vertebral angles. Surface electromyography was employed to measure the sternocleidomastoid, the rectus abdominis, and the external and internal oblique abdominis muscles. A tapeline was utilized to evaluate the subjects' chest wall mobility. Spirometry was assessed to determine the forced vital capacity and forced expiratory volume in one second. Paired t-tests were then performed (p<.05). RESULTS: There were significant differences in the trunk and lumbar flexion angles, the chest wall mobility, the activity of the right external oblique muscle, and the left internal oblique abdominis muscle. However, the difference in pulmonary function did not reach statistical significance. CONCLUSION: A crossed leg posture caused slight thoracic extension and lumbar flexion, which may lead to a decrease of the chest wall mobility and also to an imbalance of the abdominal muscles. Therefore, sitting with a crossed leg posture should be avoided. Yet a crossed leg posture did not have any clinical effect on the pulmonary function of healthy people. It may be necessary to study the effects of sitting with crossed legs over an extended period of time for patients suffering with impaired respiratory function.

• Archives of Plastic Surgery
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• v.46 no.5
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• pp.414-420
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• 2019

Background Congenital muscular torticollis (CMT) is characterized by persistent head tilt toward the affected side. No consensus exists regarding the cause of this disorder. In this study, we analyzed various clinical factors in patients with CMT who were treated with surgical release. This analysis enabled us to identify potential causative factors of CMT and to establish a basis for surgical interventions. Methods In total, 584 patients who underwent surgical intervention for CMT from October 2007 to December 2016 were included in this study. Their demographic characteristics, birthrelated factors, and clinical features were analyzed. Results Data from 525 patients were analyzed in this study after exclusion of those with insufficient information. Before birth, 31 patients (5.9%) were diagnosed with oligohydramnios, and 87 (16.6%) had a breech presentation. Seven (1.3%) cases of clavicle fracture and two (0.4%) cases of cephalohematoma were noted at birth. Before surgery, 397 patients (75.6%) underwent physiotherapy and 128 patients (24.4%) did not. The duration of physiotherapy ranged from 1 to 50 months (average, 6 months). Conclusions Our study shows that 16.6% of the CMT patients presented in the breech position, which is a much higher rate than that observed in the general population (3%-4%). We hypothesize that being in the breech position as a fetus appears to exert a significant influence on shortening and fibrosis of the sternocleidomastoid muscle.

• Journal of the Korean Society of Physical Medicine
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• v.14 no.2
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• pp.53-61
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• 2019

PURPOSE: Forward head posture (FHP) is a head-on-trunk malalignment that results in musculoskeletal dysfunction and neck pain. To improve forward head posture, both the craniocervical flexion exercise (CCFE) and the visual guide (VG) technique have been used. This study compared the immediate effects of CCFE and VG combined with CCFE on craniovertebral angle (CVA), as well as on the activity of the sternocleidomastoid (SCM) and anterior scalene (AS) muscles during CCFE in subjects with FHP. METHODS: In total, 16 subjects (nine males, seven females) with FHP were recruited using the G-power software. Each subject conducted CCFE and CCFE combined with VG in random order. The CVA was recorded using a digital camera and the ImageJ image analysis software. The EMG data of SCM and AS were measured by surface electromyography. A paired T-test was used to assess differences between the effects of the CCFE and VG combined with CCFE interventions in the same group. RESULTS: The CVA was significantly greater for CCFE combined with the VG than for CCFE alone (p<.05). The activity of the SCM and AS muscles was also significantly greater when the VG was combined with CCFE than during CCFE alone across all craniocervical flexion exercise phases (p<.05). CONCLUSION: Use of the VG technique combined with CCFE improved FHP in subjects with FHP compared to CCFE alone.

• PNF and Movement
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• v.17 no.1
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• pp.137-144
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• 2019

Purpose: This study examined the effects of the abdominal drawing-in maneuver (ADIM) on muscle activity in the trunk and legs while subjects walk on a ramp. Methods: The subjects were healthy adult males (n=15) and females (n=8) in their twenties. The subjects were asked to maintain the ADIM contraction for 15 minutes using a pressure biofeedback unit. Their muscle activity was then measured while ascending or descending the ramp with or without the ADIM contraction maintained. Activity in the sternocleidomastoid, splenius capitis, rectus abdominis, external oblique abdominal, transversus abdominis, erector spinae, vastus medialis, and vastus lateralis muscles was measured using surface electromyography (TM DTS, Noraxon, USA). A paired t-test was conducted using SPSS 18.0 (IBM) for statistical data processing. Results: Maintaining the ADIM contraction during ascension led to a significant increase (p<0.05) in muscle activity for the rectus abdominis, transversus abdominis, vastus medialis, and vastus lateralis, but a significant decrease (p<0.05) in muscle activity for the erector spinae, when compared to the same activity without the ADIM maintained. Furthermore, maintaining the ADIM contraction during descent led to a significant increase (p<0.05) in muscle activity for the rectus abdominis, external abdominal oblique, transversus abdominis, vastus medialis, and vastus lateralis, but a significant decrease (p<0.05) in muscle activity for the erector spinae, when compared to the same activity without the ADIM maintained. Conclusion: As a result of this study, it maintains the ADIM and reduces lumbar muscle activity at the waist and increases muscle activity in the legs when walking on a ramp. Therefore, maintaining the ADIM contraction during ramp walking is recommended as training to improve the function of patients' muscular skeleton.