• PNF and Movement
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• v.16 no.2
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• pp.217-227
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• 2018

Purpose: The purpose of this study is to examine the effects of proprioceptive neuromuscular facilitation (PNF) exercises on the neck disability index and deep neck flexor endurance of acute whiplash injury patients and to provide basic data for PNF exercises for musculoskeletal system disorder patients. Methods: Twenty acute whiplash injury patients were randomly assigned to an experimental group (n=10) and were treated with PNF exercises whereas a control group (n=10) underwent general exercises. Each session lasted 15 minutes and was performed five times a week for two weeks. The degree of pain was assessed using a visual analogue scale (VAS) and the degree of neck disability was measured by the neck disability index (NDI). Craniocervical flexor endurance (CCFE) tests were conducted to measure deep neck flexor endurance. Results: In terms of the intragroup changes in VAS, NDI, and CCFE, there were significant decreases in both the experimental and the control groups. After intervention, there were significant differences between the experimental group and the control group in terms of intergroup changes in VAS, NDI and CCFE. Conclusion: Although the exercises that are generally applied to acute whiplash injury patients are effective on the whole, PNF exercises are considered to be beneficial, given the improvements in the neck disability index and deep neck flexor endurance.

• The Journal of Churna Manual Medicine for Spine and Nerves
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• v.16 no.2
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• pp.97-105
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• 2021

Objectives This study is aimed to evaluate cost-effectiveness of treatment of Korean Medicine for whiplash associated disorders (WAD) and to suggest the direction of future research. Methods We searched papers in Pubmed database to use some keywords indicating whiplash injury syndrome, treatment of Korean Medicine and cost-effectiveness. After searching, appropriate papers were selected depending on the exclusion criteria. The selected papers were analyzed in the sections of author, publication year, intervention and control groups, outcome measurement, the list including in the cost, cost-effectiveness, cost-utility and study design. Results Four studies about effect of Korean medicine and 3 studies about economic evaluation were finally included. Acupuncture was effective for balance disorder and neck pain. Economic evaluation studies used analytical decision model or cost-consequence analysis. Cost-effectiveness analysis using visual analog scale and cost-utility analysis using quality adjusted life years were performed. Initiating timing of proper management affected the consequence of treatments. Direct and indirect medical costs including supportive devices, and non-medical costs such as litigation were considered. Conclusions We conclude that studies haven't been conducted so far to evaluate the cost-effectiveness of Korean Medicine in whiplash injury syndrome. Thus, future studies are needed in this section.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.16 no.1
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• pp.26-36
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• 2010

Purpose: The study compared the muscle activity and ratio of upper trapezius (UT) to lower trapezius (LT) activity between acute and chronic whiplash-associated disorder (WAD) patients. Methods: Twelve healthy (male: 7), 14 acute WAD (male: 7), and 11 chronic WAD (male: 3) volunteers participated in this study. Electromyography using a surface EMG recorded the activity of the upper trapezius and lower trapezius of both shoulders (dominant and non-dominant) during $120^{\circ}$ elevation when standing and shoulder depression when sitting. The testing order was selected randomly. Subjects were asked to maintain each experimental position for 5 seconds at end range. EMG activity was normalized using the maximal voluntary isometric contraction (MVIC) elicited using a manual muscle-testing technique. One-way repeated measures analysis of variance (ANOVA) was used to compare the average root mean square (RMS) value of EMG activity for each condition. Results: The EMG activity of the dominant UT for chronic WAD subjects was significantly higher than for acute WAD subjects during $120^{\circ}$ elevation (p<.05). The EMG activity of the dominant LT for acute WAD subjects was significantly lower than for the control group (p<.05) during $120^{\circ}$ elevation. The EMG activity of the dominant LT for WAD patients was significantly lower than for the control group during shoulder depression (p<.05), and the chronic WAD patients scored significantly the lowest (p<.01). The dominant UT/LT for chronic WAD patients was significantly higher than the ratio for acute WAD subjects during shoulder depression (p<.05); this result was higher than for the control group (p<.01). The non-dominant UT/LT (ratio) for chronic WAD patients was significantly higher than the ratio for acute WAD subjects during shoulder depression (p<.05). Conclusion: The UT for chronic WAD subjects was hyperactive when compared to the acute WAD subjects, and the was hypoactive for both acute and chronic patients, therefore intra-trapezius imbalance was more prevalent during shoulder depression.

• Physical Therapy Rehabilitation Science
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• v.12 no.3
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• pp.310-319
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• 2023

Objective: The purpose of this study was to investigate the effects of a combination of progressive scapular stabilization exercises, neck and thoracic spine mobilization, and thermoelectric physical therapy on pain, range of motion, muscle strength, and function in patients with acute whiplash injury. Design: A randomized controlled trial design. Methods: A total of 24 subjects were included in this study. They were randomly assigned to an experimental group (n=12) that performed scapular stabilization exercises, neck and thoracic spine mobilization, and physiotherapy, and a control group (n=12) that only performed neck and thoracic spine mobilization and physiotherapy. The pre-test was conducted before the intervention and consisted of a total of 12 treatment sessions of 60 minutes each, three times a week. A posttest was conducted 4 weeks later. Pain, range of motion, muscle strength, and function were assessed before and after intervention. Results: The results of the study showed that there was a significant difference in pain reduction and range of motion and muscle strength improvement in the experimental group, and a significant difference was also found between the experimental group and the control group in terms of functional evaluation. Conclusions: The combination of exercise therapy and joint mobilization technique and physical therapy resulted in greater improvements in pain, range of motion, strength, and function assessment, contributing to improved overall function.

• The Journal of Korean Obstetrics and Gynecology
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• v.32 no.4
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• pp.39-54
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• 2019

Objectives: The purpose of this study is to analyze both treatment and adverse events of Korean medicine treatment for whiplash associated disorder patients during pregnancy. Methods: We investigated the medical records of 44 pregnant patients who had got into car accidents from April 1, 2018 to May 31, 2019. Results: 100 percent of the inpatients and 88 precent of the outpatients were treated by acupuncture. 79 percent of the inpatients and 72 precent of the outpatients were treated by chuna, and 86 percent of the inpatients and 64 precent of the outpatients were treated by pharmacopuncture. Out of 32 patients with low back pain, 94 percent were treated by acupuncture, 47 percent by phramacopuncture and 38 precent by chuna. 90 percent of 31 patients with cervical pain were treated by acupuncture, 71 percent were treated by pharmacopuncture and 77 percent were treated by chuna. There were adverse events like cough, rhinorrhea, dilatation of cervix and worsen low back pain during or after the treatment. Conclusions: Korean medicine treatment including chuna and pharmacopuncture can be applied to pregnant women injured by traffic accident.

• Journal of the Korean Society of Physical Medicine
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• v.8 no.4
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• pp.655-666
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• 2013

PURPOSE: The main objective of this study is observing the effects of the functional postural trunk exercise (FPTE) on deep cranio-cervical flexor (CCF) muscle endurance applied on neck pain patients suffering from the acute whiplash-association disorder (WAD). METHODS: The study was tested with 47 patients with neck pain. All patients were equally treated with the ordinary therapy, only experimental group (n=23) was treated with FPTE: assumption of an upright lumbo-pelvic and spinal postural position, adding a neck lengthening manoeuvre in addition. Patients attended physical therapy for 3 times a week, for 4 weeks. Visual analogue scale (VAS) for pain, neck disability index (NDI), range of motion (ROM), were recorded both before and after the intervention. Also muscle activity in the CCF test was employed to analyze the changes between before and after. RESULT: After 4 weeks of training intervention, a remarkable increase in muscle endurance, rotation, extension ROM (p<.05) and decrease in pain and NDI (p<.05) in both groups. Further, the differences between groups were muscle endurance (F=60.350, p<.01), pain, and the left rotation ROM (p<.05). CONCLUSION: From the results, the experimental group had significant the increase in muscle endurance, and the significant decrease in pain. Whilst further research in this category is necessary, these observations suggest that applying exercise in early diagnosis can be of help to treat the neck pain patients suffering from the WAD.

• The Korean Journal of Pain
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• v.37 no.2
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• pp.107-118
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• 2024

Nociplastic pain by the "International Association for the Study of Pain" is defined as pain that arises from altered nociception despite no clear evidence of nociceptive or neuropathic pain. Augmented central nervous system pain and sensory processing with altered pain modulation are suggested to be the mechanism of nociplastic pain. Clinical criteria for possible nociplastic pain affecting somatic structures include chronic regional pain and evoked pain hypersensitivity including allodynia with after-sensation. In addition to possible nociplastic pain, clinical criteria for probable nociplastic pain are pain hypersensitivity in the region of pain to non-noxious stimuli and presence of comorbidity such as generalized symptoms with sleep disturbance, fatigue, or cognitive problems with hypersensitivity of special senses. Criteria for definitive nociplastic pain is not determined yet. Eight specific disorders related to central sensitization are suggested to be restless leg syndrome, chronic fatigue syndrome, fibromyalgia, temporomandibular disorder, migraine or tension headache, irritable bowel syndrome, multiple chemical sensitivities, and whiplash injury; non-specific emotional disorders related to central sensitization include anxiety or panic attack and depression. These central sensitization pain syndromes are overlapped to previous functional pain syndromes which are unlike organic pain syndromes and have emotional components. Therefore, nociplastic pain can be understood as chronic altered nociception related to central sensitization including both sensory components with nociceptive and/or neuropathic pain and emotional components. Nociplastic pain may be developed to explain unexplained chronic pain beyond tissue damage or pathology regardless of its origin from nociceptive, neuropathic, emotional, or mixed pain components.

• Journal of Pharmacopuncture
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• v.17 no.4
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• pp.7-14
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• 2014

Objectives: The purpose of this study is to analyze trends in domestic studies on pharmacopuncture therapy for treating cervical disease. Methods: This study was carried out on original copies and abstracts of theses listed in databases or published until July 2014. The search was made on the Oriental medicine Advanced Searching Integrated System (OASIS) the National Digital Science Library (NDSL), and the Korean traditional knowledge portal. Search words were 'pain on cervical spine', 'cervical pain', 'ruptured cervical disk', 'cervical disc disorder', 'stiffness of the neck', 'cervical disk', 'whiplash injury', 'cervicalgia', 'posterior cervical pain', 'neck disability', 'Herniated Nucleus Pulposus (HNP)', and 'Herniated Intervertebral Disc (HIVD)'. Results: Twenty-five clinical theses related to pharmacopuncture were selected and were analyzed by year according to the type of pharmacopuncture used, the academic journal in which the publication appeared, and the effect of pharmacopuncture therapy. Conclusion: The significant conclusions are as follows: (1) Pharmacopunctures used for cervical pain were Bee venom pharmacopuncture, Carthami-flos pharmacopuncture, Scolopendra pharmacopuncture, Ouhyul pharmacopuncturen, Hwangryun pharmacopuncture, Corpus pharmacopuncture, Soyeom pharmacopuncture, Hwangryunhaedoktang pharmacopuncture, Shinbaro phamacopuncture. (2) Randomized controlled trials showed that pharmacopuncture therapy combined with other methods was more effective. (3) In the past, studies oriented toward Bee venom pharmacopuncture were actively pursued, but the number of studies on various other types of pharmacopuncture gradually began to increase. (4) For treating a patient with cervical pain, the type of pharmacopuncture to be used should be selected based on the cause of the disease and the patient's condition.

• Korean Journal of Acupuncture
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• v.36 no.1
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• pp.81-91
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• 2019

Objectives : Symptoms caused by traffic accidents can be divided into localized pain and systemic symptoms. Edema and pain can be increased due to obesity. During hospitalization of obese patients after traffic accident injury, obesity and systemic symptoms such as edema, dizziness, abdominal fullness and heavy body feeling might increase more by decreased physical activity due to pain. Methods : This report details on two cases of obese female inpatients with systemic symptoms after a car accident who were treated with wild ginseng complex (WGC) pharmacopuncture combined with Korean Medicine (KM) automobile insurance treatment. The Numeric Rating Scale (NRS), Neck Disablility Index (NDI) and the Oswestry Disablility Index (ODI) were evaluated before and after treatment for comparison. Body composition was also measured. Results : Localized pain improved with a decrease in patients' NRS, NDI and ODI scores. Systemic symptoms increased during hospitalization were also improved with changes of body composition. Conclusions : Combining WGC pharmacopuncture with KM automobile insurance treatment may be synergistically effective for the treatment of obese patients with systemic symptoms such as edema, heavy body feeling and abdominal fullness.