• Journal of the Korean Society of Physical Medicine
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• v.15 no.3
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• pp.51-59
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• 2020

PURPOSE: The purpose of this study was to provide clinical basic data to reduce pain and improve function by comparing neck muscle activity and neck alignment using self-stretching and passive stretching exercises for chronic neck pain caused by forward head posture. METHODS: The subjects were divided into 15 subjects assigned to perform self-stretching exercise and 15 subjects assigned to perform passive stretching exercise. The intervention was conducted for a total of 4 weeks. The muscle activity in the neck was measured by surface electromyography (EMG) before intervention, and craniovertebral and cranial rotation angles were measured by X-ray. The 4-week intervention was conducted and the above items re-measured in the same manner and analyzed. RESULTS: Muscle activity within both groups after intervention using self-stretching or passive stretching exercise was significantly different (p < .05)(p < .01). Neck alignment of both groups was significantly different (p < .001)(p < .01). Further, muscle activities of the upper trapezius and splenius capitis muscles showed significant differences (p<.05). Lastly, neck alignment showed statistically significant difference (p < .05). CONCLUSION: Self-stretching exercise activated motor nerves as a posture correction exercise, thereby improving inhibition of muscle activity, muscle contraction delay, and pathological conditions of the muscle. For future research, interventions of self-stretching exercise will be needed for patients with chronic back pain accompanied by forward head posture, and various clinical studies on postural improvement of forward head posture by maintaining a normal muscle tone state are needed.

• Physical Therapy Rehabilitation Science
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• v.9 no.2
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• pp.98-104
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• 2020

Objective: The shoulders are a particularly an important body part for elite boxers. The purpose of this study was to investigate the characteristics of the upper trapezius (UT), infraspinatus (IS) muscle tone, pain, and isokinetic muscle function of shoulder movements such as external rotation, internal rotation, protraction, and retraction according to the scapular position of elite boxers of the Korean national team. Design: Cross-sectional study. Methods: Using the double square method, the scapular position was measured and divided into the forward scapular position group (n=8) with a measurement distance of 135 mm or more, and the normal scapular position group (n=10) with a measurement distance of less than 135 mm. Through the numeric rating scale of the subject, the pain value displayed during movement was measured. The muscle tone of the subjects' UT and IS were measured. The isokinetic muscle function of ER, IR, protraction, and retraction were measured using isokinetic exercise equipment. Results: The results of this study showed statistically significant differences when comparing muscle tone of the UT and IS, shoulder pain, isokinetic function of ER and IR, protraction, and retraction according to scapular position (p<0.05). Conclusions: The findings of this study were that shoulder muscle tone, pain, and isokinetic muscle function were affected according to the scapular position of elite boxers. In the future, this information may be a useful indicator when studying the effects of medium and long-term intervention in elite boxers who possess these characteristics.

• Journal of The Korean Society of Integrative Medicine
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• v.9 no.1
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• pp.123-131
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• 2021

Purpose : The time spent using smart devices is constantly increasing, particularly in recent times. Using smart devices for a long time with an incorrect posture may lead to cerebral palsy (CP), instability, and abnormal muscle tone. Therefore, we aimed to investigate the relationships among cervical instability, deep neck flexor (DNF) activity, range of motion (ROM), and muscle tonus. Methods : Fifty subjects with CP participated in this study, and they were physiotherapists at W Hospital in Daejeon. Those who voluntarily participated in the research were selected as candidates who fulfilled the selection criteria. According to an instability test, 25 subjects were assigned to the instability and control groups. All subjects first underwent the instability test to be allocated to the appropriate group. Those in the instability group tested positive on the instability test. The Neck Disability Index (NDI), ROM, muscle tone, and DNF activity were measured to evaluate their relationships. The DNF strength and endurance were measured using a cranio-cervical flexion test. The upper trapezius (UT), sternocleidomastoid (SCM), and suboccipital (SO) muscle tones were measured using a contact soft tissue tone measuring instrument. The statistical significance level was set to .05. Results : There were significant differences in the flexion, extension, and rotation of the cervical ROM (CROM) between the two groups (p<.05). The SCM, UT, and SO muscle tones were significantly different between the two groups (p<.05). The DNF strength and endurance showed a significant difference between the two groups (p<.05). Conclusion : We found that there were significant increases in the CROM and muscle tone and decrease in the DNF strength and endurance in the instability group. This indicated that cervical instability is affected by the DNF strength and endurance. We may recommend DNF exercises in cases of cervical instability in clinical environments.

• Journal of the Ergonomics Society of Korea
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• v.33 no.2
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• pp.143-153
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• 2014

Objective: The aim of this study is to investigate the effects of trunk-forearm supported sitting on trunk flexion angle, trunk extensor fatigue and seat contact pressure. Background: The relationship between sitting posture and musculoskeletal disorders of the trunk extensor fatigue and seat contact pressure has been documented. The trunk-forearm support type ergonomic chair was devised from the fact that trunk-forearm support has been reported to reduce trunk extensor activity and discomfort. Method: Using three different sitting postures, upright ($P_1$), trunk-forearm supported ($P_2$) and normal sitting ($P_3$), six healthy subjects participated in the study. Motion capture system was used to collect head and trunk flexion angle, and surface electromyography (sEMG) was used to collect myoelectric signal of upper trapezius, lower trapezius, erector spinae, multifidus, and pressure mat system was used to measure seat contact pressure. Results: When trunk and forearm were supported by the ergonomic chair, higher head flexion angle showed upright > trunk-forearm supported > normal in order, and muscle fatigue showed less than upright and normal sitting. Mean seat contact pressure decreased 19% than upright sitting. But muscle fatigue was not affected by each condition. Conclusion: Trunk-forearm supported sitting of the ergonomic chair showed positive effect in respect of trunk and head flexion angle, trunk extensor fatigue, seat contact pressure. To acquire comprehensive understanding of the effectiveness of the ergonomic chair, further studies such as anatomical effects from measurement of external applied loading effect to the body from interface pressure analysis are required. Application: The results of the publishing trend analysis might help physiological effects of trunk-forearm support type chair.

• Clinical Pain
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• v.18 no.1
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• pp.52-57
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• 2019

Spinal accessory neuropathy (SAN) is commonly caused by an iatrogenic procedure, and that caused by tumors is very rare. We present a case of a 49-year-old man suffering from weakness in the right trapezius and sternocleidomastoid muscle. An electrophysiology study confirmed proximal SAN. Fluorodeoxyglucose (FDG)-positron emission tomography (PET)/computed tomography (CT) revealed a diffuse large B-cell lymphoma compressing the right spinal accessory nerve. Ultrasonography showed definite atrophy on the trapezius and sternocleidomastoid muscles. In addition, post-chemotherapy FDG-PET/CT showed increased FDG uptake in the right upper trapezius, suggestive of denervation. This is the first report of SAN caused by direct compression by a diffuse large B-cell lymphoma, comprehensively assessed by an electrophysiology study, ultrasonography, and FDG-PET/CT.

• Fashion & Textile Research Journal
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• v.19 no.4
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• pp.504-514
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• 2017

Discomfort as well as muscular pain and musculoskeletal diseases occur in cases of stressed posture due to prolonged pressure. Therefore, the American Academy of Orthopaedic Surgeons (AAOS) and Pediatric Orthopaedic Society of North America (POSNA) recommend that bags that weigh no more than 15 - 20% of the wearer's weight. However, despite the prolonged pressure from using baby carriers, there are no recommendations and limited studies on how to protect wearers. Therefore, this study investigates subjective fatigue according to the usage of waist support and hip seat. Based on this, muscle fatigue and secondary subjective fatigue according to three types of currently commercial baby carriers (X-type, H-type, and H-hip type) were measured. Subjective comfortability was evaluated on a 5 point Likert-scale and subjective fatigue was evaluated on Borg's CR-10 scale. Objective muscle fatigue was also compared by measuring and analyzing electromyogram (EMG). The results of primary subjective fatigue showed statistically significant changes in the shoulders, waist, calves, and soles of the feet according to the usage of hip seats and waist support. Electromyogram measurements also showed less muscle fatigue at the upper trapezius muscle and thoracic erector spine muscle for the H-hip seat baby carrier, which has both waist support and hip seat, compared to an X-type baby carrier, which has neither. However, results of subjective fatigue showed opposite results at the waist despite having same results at the shoulders and beneath the shoulders. This show discrepancies between objective muscle fatigue and subjective fatigue; therefore, that both aspects must be taken into consideration when developing ergonomic baby carriers.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.12 no.1
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• pp.57-67
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• 2006

Musculoskeletal neck dysfunction syndromes are common in outpatient musculoskeletal pain practice. The underlying musculoskeletal and neurologic causes of pain are variable. In the management of these patients, it is important to accurately identify and treat these pain generators to optimize patient outcome. It is the purpose of this review to discuss three main categories of functional anatomy, the role of superficial/deep muscular system and the scientific evidence for optimal physical therapy intervention for cervical dysfunction. Specifically there is evidence of lowered microcirculation in the upper trapezius muscle, morphological signs of disturbed mitochondrial function which appears to be limited to type I fibers and an increased cross-sectional area of type I muscle fibers despite a lower capillary to fiber area ratio. In acute neck pain syndrome, changes in muscle activity of painful muscles may result from segmental and supraspinal inhibitory effects. Muscle activation is closely related to the control of joint movements and postures and it is difficult to separate the influence of the two components. Both the altered muscle recruitment patterns and altered kinematics appear to be a poor adaptation for pain of the head - neck region, as they are likely to result in increased compressive loading in the cervical spine, affecting muscles, articular structures such as zygapophyseal joints, connective tissues and neural tissues which are all peripheral generators of referred pain. The rectus capitus posterior minor muscle shows that it is one of the most important muscles of the suboccipital region. In this article, i reviewed the anatomy, neurophysiology, function and dysfunction as well as the treatment of cervical dysfunction.

• 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.

• The Journal of Korean Physical Therapy
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• v.22 no.3
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• pp.17-21
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• 2010

Purpose: This study was designed to investigate possibilities for quantitative analysis using the electromyography and sonography. For better understanding, we evaluated the correlation between the pressure pain threshold and sonography, spontaneous electrical activity in trigger points located in the upper trapezius muscle. Methods: Thirty three active subjects volunteered to participate in this study (n=33). They had a palpable taut band, exquisite spot tenderness of a nodule in a taut band, spontaneous pain, referred pain, jump sign, local twitch response, and a painful limit to full stretch range of motion. We measured Pressure pain threshold, density, white area index, root mean square, and reaction. Pearson’s correlation coefficient was calculated to estimate the relationship between the pressure pain threshold and other variables including density, white area index, root mean square, and reaction time. Results: There were significant correlations between pressure pain threshold and density (r=-0.75, p<0.01), and between pressure pain threshold and white area index (r=-0.74, p<0.01). A significant correlations between pressure pain threshold and root mean square (r=-0.59, p<0.01). The significant correlation was found between pressure pain threshold and reaction time (r=-0.64, p<0.01). Conclusion: These should indicate whether quantitative analysis can be done using the characteristics of electromyography and sonography.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.13 no.3
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• pp.1229-1237
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• 2012

This study aimed to investigate the effect of hand grip force on the activity of shoulder muscles in 2 arm postures. The muscle activity of the upper trapezius, lower trapezius, infraspinatus, anterior deltoid, and posterior deltoid muscles in 22 healthy subjects (11 men and 11 women) were measured using surface electrodes during 4 hand gripping tasks (0%, 30%, 50%, and 70% of maximum voluntary contraction) in 2 shoulder positions (neutral position and $90^{\circ}$ elevation position). Among changing grip force significantly differenced infraspinatus, anterior deltoid, and posterior deltoid muscles' activity in the shoulder neutral position(p<0.05). In the shoulder $90^{\circ}$ elevation position, anterior deltoid, posterior deltoid muscles' activity was significantly differenced(p<0.05). Hand gripping was found to alter muscle activation. The hand grip task activated the infraspinatus muscle in the neutral position and inhibited the deltoid muscle in the $90^{\circ}$ elevation position. This finding may prove useful for the development preventative measures and rehabilitation strategies for shoulder injuries.