• 제목/요약/키워드: cva

검색결과 302건 처리시간 0.023초

뇌졸중 환자의 운동기능에 원격재활이 미치는 효과: 체계적 문헌고찰 (Effects of Telerehabilitation on Motor Function of Stroke Patients: A Systematic Review)

  • 신윤찬;박지혁
    • 재활치료과학
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    • 제7권4호
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    • pp.7-18
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    • 2018
  • 목적: 뇌졸중 환자에게 원격재활을 적용하고 운동기능의 변화를 알아본 연구들을 체계적으로 고찰하여 원격재활에서 사용한 원격감독 방법과 원격으로 제공된 중재의 효과를 알아보아 국내에서의 적용을 위한 기초자료를 제공하려 한다. 연구방법: 2000년부터 2018년 4월까지의 국외 문헌들을 PubMed, Embase 그리고 Cochrane을 통해 수집하였고 RISS를 통해 국내 문헌을 검색, 수집하였다. 국외 논문 검색어로는 Telerehabilitation, Telemedicine, Stroke을 사용하였고 국내 문헌은 원격재활, 뇌졸중, stroke, CVA, 뇌혈관질환 검색어를 사용하였다. 총 406개의 국외 문헌과 15개의 국내 문헌이 검색되었으며 결과적으로 총 7개의 문헌이 분석대상 문헌으로 선정되었다. 결과: 7편의 문헌 모두 원격재활을 적용받는 그룹에게 중재를 원격에서만 제공하였으며 전, 후 비교를 통해 운동기능에서 유의미한 효과를 확인하였다. 또한 원격재활 중재의 유의미한 효과를 전, 후 비교(n=7) 및 그룹간의 비교(n=4)를 통해 분석하여 운동기능에서의 긍정적인 효과를 확인하였다. 사용된 원격감독은 목적에 따라 중재로써의 감독(n=4)과 확인을 위한 감독(n=3)으로 분류할 수 있었다. 결론: 본 연구를 통해 전통적인 재활 서비스를 제공받는 것에 제한이 있는 뇌졸중 환자들에게 원격재활의 적용이 잠재적인 대체 방법이 될 수 있음을 제한적으로 확인하였다. 원격재활의 실질적인 국내적용을 위해서는 국내 실정에 맞는 비용효과에 대한 연구가 필요하며, 원격재활을 통해 제공되는 가장 효율적인 중재별 원격감독 방법을 확인해 볼 수 있는 연구가 이루어져야 할 것이다.

KOMPSAT 광학영상을 이용한 광범위지역의 도시개발 변화탐지 (Change Detection of Urban Development over Large Area using KOMPSAT Optical Imagery)

  • 한유경;김태헌;한수희;송정헌
    • 대한원격탐사학회지
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    • 제33권6_3호
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    • pp.1223-1232
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    • 2017
  • 본 연구는 KOMPSAT 광학영상을 이용하여 광범위지역에 대한 도시개발 변화를 탐지하는 방법론을 제시한다. 다른 시기에 취득된 KOMPSAT 영상 간의 방사적인 불일치를 최소화하기 위해서, 본 연구에서는 광범위지역에 대한 변화탐지에 적합한 영역별 간이 방사보정을 전처리과정으로 적용하였다. 도시개발에 대한 변화탐지 결과정확도를 향상시키기 위해서, 환경부에서 제공하는 중분류 토지피복도를 이용하여 수계, 산림과 같은 비관심지역을 제거하였다. 대표적인 변화탐지 기법인 분광변화벡터분석(Change Vector Analysis, CVA) 기법을 적용하여 도시개발에 의해 발생한 변화를 탐지하였다. 제안 기법에 대한 적용을 위해 세종시를 연구지역으로 선정하였으며, 2007년 5월과 2016년 5월에 KOMPSAT-2호로 취득한 영상과 2014년 3월에 KOMPSAT-3호로 취득한 영상을 조합하여 총 세 실험지역을 구축하였다. 2007년 5월 KOMPSAT-2호 영상과 2014년 3월 KOMPSAT-3호 영상으로 구성된 실험지역에 대한 변화탐지 정확도 평가를 수행한 결과, 약 91.00%의 변화탐지 전체정확도를 보였다. 본 연구를 통해 넓은 지역에 대량으로 발생한 도시개발 변화를 효과적으로 탐지할 수 있음을 확인하였다.

유헬스케어(U-health Care)에서 양도락의 활용 방안 (The Application of Ryodoraku in the U-health Care System)

  • 송호섭
    • Journal of Acupuncture Research
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    • 제27권6호
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    • pp.115-122
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    • 2010
  • Objectives : The purpose of this study was to propose the utilization plan of Ryodoraku in the U-health care systems. Methods : Computerized literature searches were performed for Ryodoraku related articles using the following databases: KISS, RISS, DBPIA, NDSL from 1990 to Oct 2010. Search terms were '양도락' or 'Ryodoraku' or 'U-health'. Due to Ryodoraku coming from Japan, additional literature review(articles published by 2008) on Japanese journal of Ryodoraku medicine was done for compensation. Results : 1. Introduction of U-health : As rapid progress of population aging and strong interest in health, the demand for the traditional Korean medical service is increasing. Until now healthcare service has provided post treatment by face-to-face manner. But according to related researches, proactive treatment is resulted to be more effective for preventing diseases. Particularly, the existing healthcare services have limitations in preventing and managing chronic geriatric degenrative diseases such as metabolic syndrome, CVA, coronary heart diseases, parkinson's diseases, degenerative joint disease, spondylosis, etc., because the cause of the above is complex and even related to life habit. As the advent of ubiquitous technology, patients with the chronic geriatric degenrative diseases can improve life habit such as poor eating habits and physical inactivity without the constraints of time and space through u-healthcare service. Therefor, lots of researches for u-healthcare service focus on providing the personalized healthcare service for preventing and managing that. To cope with this situations, The concept of u-healthcare service should be adopted in the traditional korean medicine and diagnostic devices suitable for it should be also devised and developed based on traditonal korean medine. 2. Review of existing Ryodoraku related articles for applying to U-health : articles investigating feasibility applying Ryodoraku to meridian diagnosis and raising problems of it, articles providing recent research trends of Ryodoraku, Ryodoraku related articles considering usefulness for U-health, and articles confirming the repeatability and reproducity of Ryodoraku were included. Based on the review of the above Ryodoraku related articles, several application of Ryodoraku in the U-health care system. Conclusions : To make preparations for the increasing need of traditional Korean medicine due to rising morbidity rate of chronic geriatric degenerative diseases, it is necessary to appropriately apply Ryodoraku to the U-health care system. The application of Ryodoraku is as follows. 1. To use Ryodoraku additionally to the established diagnostic device of metabolic syndrome, CVA, coronary heart diseases, parkinson's diseases, degenerative joint disease, spondylosis. 2. To apply Ryodoraku to the symptoms or diseases having a tendency to be diagnosed by correlation between the affected meridian and the lesion such as headache, nuchal pain, shoulder pain, low back pain, sciatica, HNP, etc. 3. To secure the repeatability and reproducity of Ryodoraku. 4. To devise and develop Ryodoraku appliance in order to overcome the known drawbacks and to improve error of measurement.

수원시 주민의 대체의학 수용실태 조사 (Attitudes toward Complementary and Alternative Medicine in Suwon City)

  • 전기홍;송현종;박인휘;유승철;송미숙
    • Journal of Preventive Medicine and Public Health
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    • 제32권2호
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    • pp.162-169
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    • 1999
  • Objectives: The aim of this study was to investigate the attitudes toward complementary and alternative medicine among 1,490 residents(339 households) in Suwon city. Methods: All respondents were asked about types, frequency, effects, side-effects, views, and cost of complementary or alternative medicine through a questionnaire from July 24th to 27th. Six therapies were investigated: diet; acupuncture/ massage/ chiropractic etc., mind control such as Ki/ Yoga/ spiritual therapy/ relaxation therapy etc.; nutritional supplements, cultural remedies; and Herb medications Results: The results of this survey were as follows: 35.6% of respondents had experiences with at least one or more types of complementary and alternative medicine. The average number of different types of therapies used was 3.4. More experience with various types of therapies were found among those respondents of higher education, older age group, higher income, married group, religious group than among the opposite groups of respondents. Herb medications were used most frequently(39.8%), followed by minor grains(37.9%), Ginseng(23.8%), Boshintang(21.5%), acupuncture(20.3%), Gaesojou(15.3%) Gingko nut(12.0%), mushroom(11.5%), Cupping therapy(10.2%), and black goat(0.0%). Acupuncture and Herb medications were used for treatment of hypertension the most frequently; minor grains or silkworm for treatment of diabetic mellitus; vegetables for treatment of obesity; acupuncture, Cupping Therapy, Herb medications for treatment of rheumatism; and acupuncture, Herb medications, or exercises for treatment of Cerebro Vascular Accident(CVA). The average costs of treatment were 108,000 Won for hypertension, 87,200 Won for diabetic mellitus, 16,800 Won for obesity, 68,800 Won for rheumatism, and 87,500 Won for CVA. Among 10.9% of respondents, there were 13 cases of side-effects with acupuncture, Herb medications, and Gaesojou. Among the cases of side-effects, majority was due to Herb medications. Respondents reported that Cupping Therapy was the most effective, followed by acupuncture, Ginseng, Gingko nut, Boshintang, black goat, minor grains, Gaesojou, Herb medications, vegetables, and mushroom. In response to the views of complementary and alternative medicine which they had used, they recommended minor grains first, followed by Ginseng, acupuncture, Gingko nut, Cupping Therapy, vegetables, Boshintang, black goat, mushroom and Herb medications. In contrast, they did not recommend Herb medications, acupuncture, nor Gaesojou. Conclusions: These findings indicate that many people use various complementary and alternative medicine without any guidelines for treatment of serious chronic diseases not even to invigorate themselves. It is, therefore, suggested that medical doctors or scientists verify the true effects or side-effects from the most common complementary or alternative therapies through experiments. Also medical doctors should provide a comfortable atmosphere for discussion among doctors and patients who would like to try these therapies.

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융합평가 지수에 따른 고해상도 위성영상 기반 변화탐지 정확도의 비교평가 (Comparison of Change Detection Accuracy based on VHR images Corresponding to the Fusion Estimation Indexes)

  • ;최석근;최재완;양성철;변영기;박경식
    • 대한공간정보학회지
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    • 제21권2호
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    • pp.63-69
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    • 2013
  • 변화탐지 기법은 위성영상의 활용 및 국토 모니터링에 있어서 필수적인 알고리즘이다. 그러나, 변화탐지 기법을 고해상도 위성영상에 적용할 경우, 다시기 영상 간의 기하학적 차이 등에 의하여 변화탐지 정확도가 저하될 수 있다. 본 연구에서는 효과적인 위성영상의 변화탐지를 위하여 기존의 융합 영상 평가지수를 활용하고자 한다. 또한, 기존의 다시기 위성영상을 활용한 일반적인 변화탐지 기법과 교차융합영상을 이용한 변화탐지 결과를 비교하여, 다시기 고해상도 위성영상에 적합한 변화탐지 기법을 제안하고자 한다. 이를 위해, 융합영상 평가 지수인 ERGAS, UIQI, SAM를 무감독 변화탐지 기법에 적용하고 기존의 CVA를 이용한 변화탐지 기법의 결과와 비교하였다. 또한, 영상융합 기법에 따른 고해상도 위성영상 변화탐지 정확도를 평가하여 고해상도 위성영상의 무감독 변화탐지에서 발생할 수 있는 기하학적 오차를 최소화할 수 있는 방법을 분석하였다. 실험결과, 교차융합영상과 ERGAS 지수를 활용한 변화탐지 기법이 기존 기법과 비교하여 상대적으로 높은 변화지역 탐지 가능성을 가지는 것을 확인할 수 있었다.

전방머리자세에 변화에 따른 턱관절 기능 및 정량적 체성감각의 상관분석 (The Function and Quantitative Somatosensory Correlation Analysis of Temporomendibular Joint according to Forward Head Posture)

  • 이은상
    • 한국산학기술학회논문지
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    • 제20권12호
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    • pp.645-651
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    • 2019
  • 본 연구는 전방머리자세와 턱관절 장애 및 정량적 턱관절의 체성감각의 상관관계를 알아보고자 연구를 진행하였다. 본 연구는 대상자 선정요구를 충족한 62명의 대상자(22.15±2.56세)을 대상으로 전방머리자세에 대한 중재 후 전방머리 자세 변화에 따른 턱관절 기능 및 체성감각의 상관관계를 분석하였다. 전방머리자세에 대한 중재는 바이오피드백 훈련을 실시하였으며, 주 3회 총 4주간 총 12회 진행되었다. 전방머리자세를 평가하기 위하여 머리-척추각을 검사하였으며, 턱관절 기능은 입 벌림과 좌, 우측 치우침을 검사 하였고, 체성감각의 변화를 확인하기 위하여 진동역치감각을 측정하였다. 연구결과 머리 척추각의 변화에 따른 턱관절 기능(p<0.001) 및 체성감각(p<0.001)의 변화는 모두 유의한 상관관계를 보였다. 연구 결과 전방머리자세와 턱관절 기능 및 체성감각에 유의한 상관관계를 보였으며, 본 연구를 기반으로 턱관절 장애로 고통 받고 있는 환자들에게 턱관절 치료에 새로운 패러다임을 제공 할 수 있을 것이며, 향후 턱관절의 치료에 대한 기초 자료로 제공 될 수 있을 것이다.

EAV의 측정치(測定値)와 병증유형(病症類型)의 상관성(相關性)에 관(關)한 연구(硏究) (A syudy on the correlativity of EAV (Electroacupuncure acc.Voll)'s measurement and symptoms of a disease)

  • 한주석;송일병
    • 대한한방내과학회지
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    • 제15권2호
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    • pp.383-417
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    • 1994
  • By making use of the EAV(Electroacupuncture acc. Voll) combined meridian theory of oriental medicine with electronics which was contrived to recognize the physiological and pathological changes of human body, the following conclusions were made in comparison with EAV measurements and types of symptoms(anxiety & headache, fatigue, palpitation, dizzness, abdominal distension. nausea, gastric disturbance. constipation & diarrhea, fatty liver, cva), QSCC, and blood type test. 367 patients including 124 with nervous gastrointestinal problems were selected for this research. 1. From the point of variance of the tested patients 124 nervous gastrointestinal patients, Liver meridian and Spleen meridian showed hyperenergia and Large intestine meridian, Circulation meridian, Triple warmer meridian showed hypoergia 2. In each symptom as the nervous gastrointestinal symptom Liver meridian showed hyperenergia, Large intestine meridian, Circulation meridian and Triple warmer meridian showed hypoergia . 3. In an objective comparison with other symptoms, firstly among the headache & anxiety group left Gall Bladder, Triple warmer and Stomach meridian showed remarkable hypoergia, secondly among fatigue group showed hypoergia in Triple warmer meidian and hyperenergia of Stomach meridian. and thirdly among palpitation group showed hypoergia of Kidney meridian, and lastly among dizzness group showed hypoergia of Gall Bladder, Stomach, Circulation and Small intestine meridian. 4. All of gastric disturbance, nausea, abdominal distention, constipation and diarrhea group showed hyperenergia in Stomach meridian and Spleen meridian. gastric disturbance group showed remarkably hypoergia in Circulation. Small intestine, Lung and Large intestine meridian. Nausea group showed hypoergia in Gall bladder and Urinary bladder meridian. Abdominal distenton group showed hypoergia of Large intestine. Constipation and diarrhea group showed hypoergia of Kidney and left Circulation meridian. 5. Fatty liver group showed hyperenergia of Liver meridian of 83.3%, Gall Bladder, Stomach and Spleen meridian. Urinary bladder and Kidney meridian showed hypoergia 6. CVA group showed hyperenergia in Liver and Circulation meridian. 7. Blood type in typical classification had no significant bearings on each other. 8. QSCC for the attempt of objective materials of constitutional diagnosis had no correlativity in comparison with EAV measurements. In conclusion EAV is thought be used as a diagnostic method in oriental medicine and further research is needed regarding it can be used as a useful method for verifying the characteristics and early finding of symptoms.

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일부 농촌 지역 노인 만성질환자 가족의 부담감에 관한 연구 (A Study of the Family Caregiver's Burden for the Elderly with Chronic disease in a Rural Area)

  • 장인순
    • 가정간호학회지
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    • 제2권
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    • pp.19-34
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    • 1995
  • The purpose of this study was to analysis level on family caregiver's burden for the elderly with chronic disease in a rural area and to choose priority care group, thereby facilitating the development of interventions to reduce the caregiver's burden. For this purpose, data were collected by questionaire from June 10 to October 8, 1994. The instruments for data collection were Caregiver Burden Inventory by Novak(1989) and Zarit et al(1982), severity of dementia by Hughes Scales(1982), ADL by Lawton(1971), patients' family caregiving activity by pre-survey and reference review(Lee, 1993 ; Jang, 1990 ; Yoo, 1982). The subjects were 213 family caregiver of elderly with chronic disease in a rural area. The data was analysed by the use of t-test, ANOVA, correlation and multiple regression. The results were as follows ; 1. Total burden was evaluated below average, the mean of family burden was 46.98. By the diagnostic classification, Hypertension was 27.37, DM 32.46, CVA 62.96, Dementia 61.24. 2. Significant variables which were correlated to the family caregiver's burden were the patient's disease diagnosis (F=33.82, p<0.001), severity of dementia(F=30.52, p<0.001), the status of disease management(F=11.53, p<0.001), ADL(F=10.54, p<0.001), PADL(F=7.50, p<0.001), income(F=7.17, p<0.001), caregiver's health status(F=24.53, p<0.001), a view of patient's prognosis (F=22.17, p<0.001), relationship with the patient(F=33.82, p<0.001), the number of hours per day spent on caregiving(F=77.52, p<0.001), level of intimacy of caregiver and patients(F=8.75, p<0.001), level of helping(F=4.90, p<0.01), the frequency of caregiving activity(F=3.80, p<0.01), the number of admission(F=5.54, p<0.01), the length of caregiving(F=4.43, p<0.01), other chronic patient in family(t=2.81, p<0.01), caregiver's job(F=3.11, p<0.01), the duration of illness(F=2.98, p<0.05), caregiver's religion(F=2.93, p<0.05), medical security(F=3.89, p<0.05), caregiving's helper(t=2.42, p<0.05). 3. PADL was the most important predictor to family caregiver burden(R2=0.6611). In addition to this, IADL, caregiver's health status, the length of caregiving. level of intimacy of caregiver and patients, patient's age, the patient's disease diagnosis and patient's job accounted for 76% of family caregiver burden. 4. The criteria of priority care group were as follows ; the mean of family caregiver burden was above 58, above of moderate ADL, the number of hours per day spent on caregiving above of 8 hours, above of moderate dementia. By the diagnostic classification, number of priority care group, Hypertension was 4 (8.0%), DM 4(8.0%), CVA 34(64.1%), Dementia 45(75.0%).

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뇌졸중 후 중추성 통증 환자에 대한 봉독약침요법약침 치료 효과에 대한 임상적 연구 (Clinical Study on the Effect of Bee Venom Acupuncture Therapy on the Post-stroke Pain)

  • 정경숙;김수현;박선경;임호제;윤형선;안호진
    • Journal of Acupuncture Research
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    • 제22권3호
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    • pp.69-75
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    • 2005
  • 2004년 5월부터 2004년 9월까지 동서한방병원에 입원한 환자로 뇌 전산단층조영술이나 자기공명영상에 의해 뇌졸중으로 진단받은 환자들 중 중추성 통증을 가진 20명중 기존의 침구 및 한약 치료, 물리치료를 통해 통증에 있어서 만족할 만 한 개선이 없던 환자들을 대상으로 중풍칠처화(中風七處火) 및 아시혈(阿是穴)을 중심으로 3주에 걸쳐 봉독약침을 시술하고 환자의 주관적 통증을VAS로 객관화하여 비교한 결과 아래와 같은 결론을 얻었다. 1. 대상 환자는 남자 11명(55%), 여자9명(45%)이 고 평균연령은 57.95세였으며, 뇌경색은 12명 (60%), 뇌출혈은 8명(40%)이었다. 2. 발병 후 치료 시작 시점까지 경과 된 기간은 3 개월 이상이 12병(60%)으로 가장 많았고, 15 일 이상 3개월 미만이 7명(35%), 1개월 미만이 7명(5%)명 순으로 나타났다. 3. 통증 부위는 편측 상지가 10명(50%)으로 가장 많았으며, 편측 상하지 7명(35%), 편측 하지 2명(10%), 체간 1명(5%)의 순으로 나타났다. 4. 통증 양상은 복합적으로 나타났고 이를 중복해서 측정한 결과 쑤시는 증상이 14명(70%)으 로 가장 많았으며, 저린감 6명, 욱신거림 5명, 냉감 혹은 열감4명, 이질통 3명의 순으로 나타났다. 5. VAS통증 점수는 치료 전 $7.25{\pm}1.888$에서 1주 치료 후 $6.45{pm}1.932$(P<0.01)에서 2주후에는 $5.45{\pm}1.791$로(P<0.01), 3주 치료 후 에는 $4.45{\pm}1.761$(P<0.01)로 유의성 있게 감소하였다.

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소도구를 이용한 등뼈 자가 관절 가동성 운동이 만성 목통증 환자의 통증, 관절가동범위, 기능장애에 미치는 영향 (The Effects of Thoracic Spine Self-mobilization Exercise Using a Tool on Pain, Range of Motion, and Dysfunction of Chronic Neck Pain Patients)

  • 김수진;김선엽;이민지
    • 한국전문물리치료학회지
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    • 제27권1호
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    • pp.1-10
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    • 2020
  • Background: Thoracic spine self-mobilization exercise is commonly used to manage patients with neck pain. However, no previous studies have investigated the effects of thoracic spine self-mobilization exercise alone in patients with chronic neck pain. Objects: The purpose of this study was to investigate the effects of thoracic self-mobilization using a tool on cervical range of motion (ROM), disability level, upper body posture, pain and fear-avoidance beliefs questionnaire (FABQ) in patients with chronic neck pain. Methods: The subjects were 49 patients (21 males, 28 females) with chronic neck pain. The subjects were randomly divided into an experimental group (EG, n = 23) and control group (CG, n = 26). For the EG, thoracic self-mobilization was applied. We placed a tool (made with 2 tennis balls) under 3 different vertebral levels (T1-4, T5-8, T9-12) of the thoracic spine and the subjects performed crunches, which included thoracic flexion and extension in supine position. Five times × 3 sets for each levels, twice a week, for 4 weeks. Cervical pain, disability, upper body posture, FABQ results, and ROM were evaluated at baseline, after 4 weeks of intervention, and at 8 weeks of follow-up. Assessments included the quadruple visual analogue scale (QVAS); Northwick Park neck pain questionnaire (NPQ); craniovertebral angles (CVA), forward shoulder angle (FSA) and kyphosis angle (KA) measurements for upper body posture; FABQ and cervical ROM testing. Results: The EG showed a statistically significant improvement after intervention in the QVAS (-51.16%); NPQ (-53.46%); flexion (20.95%), extension (25.32%), left rotation (14.04%), and right rotation (25.32%) in the ROM of the cervical joint; KA (-7.14%); CVA (9.82%); and FSA (-4.12%). Conclusion: These results suggest that, for patients with chronic neck pain, thoracic self-mobilization exercise using a tool (tennis balls) is effective to improve neck pain, disability level, the ROM, and upper body posture.