• PNF and Movement
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• v.18 no.3
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• pp.333-341
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• 2020

Purpose: The purpose of this study was to investigate the effect of open and closed kinetic chain exercises with a sling on neck flexor thickness during chin-in movement in office workers with forward head posture. Methods: Thirty-one selected subjects randomly performed chin-in movement in open kinetic chain and closed kinetic chain exercises using a sling. All subjects were measured for their neck flexor thickness using ultrasound measurement equipment during the performance of chin-in movement in open and closed kinetic chain exercised. A paired t-test was used to compare the thickness of the total neck flexor, superficial, and deep neck flexor, respectively, between open and closed kinetic chain exercises with chin-in movement. Results: The thickness of the superficial neck flexor diminished in size more greatly during the chin-in movement with the closed kinetic chain than the open kinetic chain, but this was not a statistically significant difference (p > 0.05). On the other hand, the thickness of the total neck flexor and deep neck flexor had more greatly increased during the chin-in movement with the closed kinetic chain than the open kinetic chain, and this was a statistically significant differences (p < 0.05). Conclusion: This study suggested that chin-in movement with a closed kinetic chain is more effective in activating the deep neck flexor than the open kinetic chain. Thus, we believe that the closed kinetic chain exercise using a sling is an effective intervention to correct the postural alignment of individuals with forward head posture.

• The Journal of Korean Physical Therapy
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• v.29 no.5
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• pp.265-270
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• 2017

Purpose: This study examined the effects of neck stabilization exercises with vibratory stimulation on the neck disability index and thickness of the deep neck flexor. Methods: Thirty subjects (control group=15, experimental group=15) with mild neck pain were enrolled in the study. The control group underwent craniocervical flexion exercise (control group, CG) and the experimental group was given craniocervical flexion exercise with vibratory stimulus (experimental group, EG) (3 sets, 3 times per week for 6 weeks). To examine the effects of exercise, the subjects were evaluated using the neck disability index (NDI), the thickness of the deep neck flexor muscle, and muscle strength. An independent and paired t-test were used to compare the effects of the exercise between the groups. Results: The NDI score of the two groups increased significantly after 6 weeks of treatment (p<0.001) and there was a significant difference between the EG group at 3 weeks (p<0.05) and 6 weeks (p<0.01). The thickness of the deep neck flexor in the CG group increased significantly after 6 weeks of treatment in all pressure stages (p<0.001). The EG group showed a significant increase after 3 and 6 weeks of treatment in all pressure stage (p<0.001), and 22 mmHg, a significant difference between 3 and 6 weeks (p<0.05) and among 24, 28, and 30 mmHg at 6 weeks (p<0.05). The maximum muscle strength of the deep neck flexion muscles increased significantly in the two groups after 6 weeks of treatment (p<0.001) and there was significant difference between the EG group at 6 weeks (p<0.01). Conclusion: Craniocervical flexion exercise with vibratory stimulus decreases the NDI, and increases the thickness of the deep neck flexor and maximum muscle strength of the deep neck flexion muscles in patients with mild neck pain.

• The Journal of Korean Physical Therapy
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• v.28 no.6
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• pp.349-354
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• 2016

Purpose: The purpose of the study was to investigate the thickness of deep neck flexors (DNF) and sternocleidomastoid muscle (SCM) bilaterally during deep neck flexor endurance test using ultrasonography images. Methods: Healthy volunteers (n=22), 20-25 (mean 22.2) years old, were recruited for the study. Participants were asked to perform the craniocervical flexion test (CCFT) in a seated position to measure deep neck flexor endurance. The thickness of DNF and SCM was assessed bilaterally and was measured using ultrasonography images at resting, contracted, pre-terminal and terminal phases of the neck muscle endurance test. Muscle contraction pattern was also observed along with the changes in muscle thickness from the resting phase to the terminal phase. Repeated-measure ANOVA was employed to compare muscle thickness bilaterally at each phase. Results: The thickness of right and left muscles was found to be significantly different in DNF both at resting and contracted phases (p=0.02, p<0.01, respectively), whereas no significant difference was observed in SCM at resting or contracted phases (p=0.59, p=0.18, respectively). Thickness changes from resting to contracted phase were not significantly different both in DNF and SCM (p=0.18, p=0.22, respectively). Muscle contraction patterns in right and left muscles were shown to be similar. Conclusion: The current study, performed on (with) healthy subjects, significantly detected different right and left muscle thickness in DNF, but the muscle contraction patterns were similar in DNF and SCM bilaterally. Further study is required to investigate DNF and SCM muscle size and function in people with neck pain.

• The Journal of Korean Physical Therapy
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• v.31 no.1
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• pp.1-6
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• 2019

Purpose: This paper proposes proper and effective neck exercises by comparing the deep and superficial cervical flexor muscle activities and thickness according to the pressure level during cranio-cervical flexion exercises between a normal posture group and forward head posture group. Methods: A total of 20 subjects (8 males and 12 females) without neck pain and disabilities were selected. The subjects' craniovertebral angles were measured; they were divided into a normal posture and a forward head posture group. During cranio-cervical flexion exercises, the thickness of the deep cervical flexor neck muscle and the activity of the surface neck muscles were measured using ultrasound and EMG. Results: The results showed that the thickening of the deep cervical flexor was increased significantly to 28 and 30 mmHg in the forward head posture group. The sternocleidomastoid muscle activity increased significantly to 24, 26, 28, and 30 mmHg in the forward head posture group. The anterior scalene muscle activity increased significantly to 26, 28, and 30mmHg in the forward head posture group. A significant difference of 26, 28, and 30 mmHg in the sternocleidomastoid and anterior scalene muscles was observed between two groups. Conclusion: To prevent a forward head posture and maintain proper cervical curve alignment, the use of the superficial cervical flexor muscles must be minimized. In addition, to perform a cranio-cervical flexion exercises to effectively activate the deep cervical flexor muscles, 28 and 30 mmHg for normal posture adults and 28 mmHg for adults with forward head postures are recommended.

• Physical Therapy Korea
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• v.22 no.4
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• pp.44-50
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• 2015

This study compared the effects of the initial head position (i.e., a HHP versus a relaxed head position) of subjects with and without a FHP on the thickness of the deep and superficial neck flexor muscles during CCF. The study recruited 6 subjects with a FHP and 10 subjects without a FHP. The subjects performed CCF in two different head positions: a HHP, with the head aligned so that the forehead and chin formed a horizontal line, and a relaxed head position (RHP), with the head aligned in a self-selected comfortable position. During the CCF exercise, the thickness of the longus colli (LCo) and the thickness of the sternocleidomastoid (SCM) were recorded using ultrasonography. The thickness of each muscle was measured by Image J software. The statistical analysis was performed with a two-way mixed-model analysis of variance. The thickness of the SCM differed significantly (p<.05) between the subjects with and without FHP. According to a post $h^{\circ}C$ independent t-test, the change in thickness of the SCM increased significantly during CCF in the subjects with FHP while adopting a HHP compared to that in the subjects without FHP. The change in thickness of the SCM was not significantly different between the two positions in subjects without FHP, and there was no significant change in thickness of the LCo muscle during the CCF exercise according to the initial position in both subjects with and without FHP. The results suggest that CCF should be performed in RHP to minimize contraction of the SCM in subjects with a FHP.

• Journal of the Korean Society of Physical Medicine
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• v.8 no.2
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• pp.253-261
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• 2013

PURPOSE: The Purpose of this study was to investigate the changes in the thickness of Sternocleidomastoid muscle(SCM) and deep cervical flexor muscle(DCF) through CranioCervical Flexion Exercise(CCFEx) Using Sling. METHODS: Subjects were randomly allocated two group: control group (n=21) without neck pain, experimental group (n=17) with pain. Muscle thickness was measured using CranioCervical Flexion Test(CCFT) and ultrasonography before or after intervention. RESULTS: In experimental group, compared with muscle thickness of exercise before, SCM thickness rate of change was slightly decreased according to pressure increased after exercise(p<.05). CONCLUSION: The results of this study showed that CCFEx using sling is effective for SCM and DCF of choric neck pain patients.

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

• Physical Therapy Korea
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• v.22 no.1
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• pp.19-29
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• 2015

Impaired respiratory function is common in patients with stroke. The purpose of this study were to investigate the effectiveness of exercises and to assess forced vital capacity and peak cough flow after completion of neck stabilizing and respiratory reeducation exercises (combining diaphragmatic breathing and pursed-lip breathing exercises). The 45 participants were randomly assigned to an experimental group 1 ($n_1=15$), experimental group 2 ($n_2=15$), and a control group ($n_3=15$). All subjects performed conservative physical therapy for 30 minutes. Experimental group 1 undertook the neck stabilizing exercise and the respiratory reeducation exercise. Experimental group 2 undertook the respiratory reeducation exercise. Additional exercise did not exceed 30 minutes, five times a week for six weeks. The subjects were assessed for deep neck flexor thickness and breathing function (forced vital capacity, forced expiratory volume at one second, forced expiratory volume at one second/forced vital capacity, peak expiratory flow, and manual assisted peak cough flow) at pre-post value. The results of this study were as follows. Experimental group 1 showed a significant increase only in deep neck flexor thickness change rate (p<.05). All groups showed significant increases in forced vital capacity, forced expiratory volume at one second, and peak expiratory flow in pre-post measurement (p<.05). Experimental groups 1 and 2 showed an increase in manual assisted peak cough flow in pre-post measurement (p<.05). There was no significant difference between experimental group 1 and experimental group 2, but experimental group 1 improved more than experimental group 2 in respiratory function as a whole. In conclusion, these findings suggest that the neck stabilizing exercise in combination with the respiratory reeducation exercise can improve forced vital capacity and peak cough flow in patients with stroke.

• Journal of the Korean Society of Physical Medicine
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• v.11 no.4
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• pp.139-146
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• 2016

PURPOSE: The purpose of this study was to determine the effect of craniocervical flexion exercise with masticatory muscle contraction in patients with neck pain. Patients with neck pain also experience muscle weakness and limitation of activities of daily living. Craniocervical flexion exercise with masticatory muscle contraction may increase the thickness of the deep cervical flexor muscles, thereby reducing pain and limitations on activities of daily living. METHODS: Twenty-six volunteers participated in this study. The subjects were randomly divided into an experimental group (n=13) and a control group (n=13). Both groups performed craniocervical flexion exercise using a pressure biofeedback unit; the experimental group performed craniocervical flexion exercise with masticatory muscle contraction for 20 minutes, 3 times a week for 4 weeks. Assessment tools included ultrasonography for measurement of muscle thickness and the Neck Disability Index for the level of pain and function. RESULTS: The rate of change in muscle thickness in both groups significantly increased (p<.05), with a significantly greater increase in the experimental group than in the control group (p<.05). The Neck Disability Index score significantly improved (p<.05) in both groups, with significantly greater improvement in the experimental group compared with the control group (p<.05). CONCLUSION: These results suggest that craniocervical flexion exercise with masticatory muscle contraction can be effective in increasing muscle thickness and improving the Neck Disability Index score in patients with neck pain.

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