• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.8 no.2
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• pp.57-71
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• 2002

Cervical pain is a rapid increase that is owing to a flexion-extension whiplash injury, unappropriated posture, chronical repetition injury from abdominal position of head and neck, excessive repeating work, chronical deficiency of excercise. Because of that is bring about muscle unbalance, tightness of cervical extensor muscle, weakness of cervical deep flexor muscles, instability of cervical region and reduction of proprioceptive sensor. Recent the role of muscle is more emphasized for preservation of sine stabilization. And cognition of integrated muscular system, importance for the operation and relation is increased to maintain stability of the motor system and pertinent function. Therefore we are going to introduce the sling exercise and stabilization exercise method for advanced efficient of cervical and upper limb and for the muscle strengthening to importance cervical stabilization through neurological program as control the reaction of cervical stabilization. Sling exercise therapy(SET) concept consists of a system of diagnosis and treatment. The system of diagnosis involves testing the muscle's tolerance through progressive loading in open and close kinetic chains. The SET system contains elements such as relaxation, increasing the range of movement, traction, training the stabilizing musculature, sensory-motor exercises, training in open and close kinetic chains, dynamic training of the mobilizing musculature, cardiovascular exercise, group exercise, personal exercise at home Sensory-motor training is an essential element of the SET concept. The emphasis is on closed kinetic chain exercise on an unstable surface, there by achieving optimum stimulation of the sensory-motor apparatus.

• PNF and Movement
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• v.16 no.3
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• pp.333-343
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• 2018

Purpose: The purpose of this study was to investigate the effects of a neck exercise using a proprioceptive neuromuscular facilitation (PNF) neck flexion and extension pattern on body balance in a progressive range of positions (supine, prone on elbow, and sitting), on numbness in the upper extremities, and on neck flexion motions in cervical myelopathy patients. Methods: One participant who was diagnosed with cervical myelopathy participated in this study. A reversal design (A-B-A') was used. The A and A' were the baseline period (no intervention), and B was the intervention period. The intervention used a neck extension pattern with a hold-relax technique and a neck flexion pattern with a combination of isotonic techniques in the supine position. Then, neck flexion and extension patterns were applied together with a reversal technique for stabilization, followed by a neck extension pattern with a combination of isotonic techniques in the prone position on the elbows. Finally, a neck flexion and extension pattern was used with a stabilizing reversal technique, and a neck extension pattern was applied with a combination of isotonic techniques in the sitting position for 60 minutes per day, 3 times per week for 8 weeks. To measure balance, numbness, and neck motion during neck flexion, the one-leg stand test and the visual analogue scale were used. Results: The right and left one-leg stand tests showed increased balance ability in the intervention phase. Upper extremity numbness was decreased in the intervention phase, and neck flexion motion was increased in the intervention phase. These increases were maintained after the intervention (Baseline II). Conclusion: These results suggest that a neck exercise using a PNF neck pattern with additional techniques in a progressive range of positions has a positive effect on cervical myelopathy patients for balance, numbness, and neck motion.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.21 no.1
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• pp.49-56
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• 2015

Background: Although many of those who drive for a living are exposed to repetitive and awkward posture and whole body vibration which cause them cumulative trauma disorder, therapeutic studies related to the problems from the transport unit are still somewhat inadequate. The purpose of this case report is to identify the effect of combined exercise program on patients suffering chronic neck pain caused by long hour of intra-city bus driving. Method: A total of 4 subjects are selected as patients, all of whom have more than 10 years of experience in intra-city bus transportation services. These people have suffered from neck pain for years. We ran the combined exercise program 3 times a week for 4 weeks and respectively evaluated the results after the 2nd and 4th week. We implemented conventional physiotherapy for 40 minutes, another 40 minutes of combined exercise program, and then educated the patients to enable themselves to do active stretching program as a home program. The combined exercise program contained 3 different stages. 1st stage: active stretching program, 2nd stage combined stabilization exercise and strengthening exercise, 3rd stage: proprioceptive exercise Result: After 4 weeks of intervention, there was enhance in the range of motion. $12^{\circ}$ increase in flexion, $10^{\circ}$ in extension, $6^{\circ}$ in lateral flexion respectively, and $10^{\circ}$ in rotation on average. VAS(visual analgue scale) decreased by 33% on average, NDI(neck diability index) by 28% and fatigability by 23%. Conclusion: There were improved results in the range of motion, NDI, VAS, and in fatigability after applying combined exercise program to intra-city bus drivers exposed to whole body vibration and cumulative trauma disorder.

• Journal of the Korean Society of Physical Medicine
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• v.17 no.2
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• pp.29-40
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• 2022

PURPOSE: This study examined the effects of an exercise program for the thoracic spine and scapula rather than the neck, which is the primary site of pain. METHODS: Thirty-two elementary school teachers with a forward head posture (FHP) were assigned randomly to either the experimental group (n = 16) or the control group (n = 16). The experimental group performed scapular stabilization exercise (SSE) and thoracic extension exercise (TEE), and the control group performed cervical self-myofascial release exercise and stretching exercise. The pulmonary functions, pain, craniovertebral angle (CVA), and cervical range of motion (CROM) were measured before the intervention and six weeks after. RESULTS: The within-group comparisons showed that the VAS and CROM (except for extension) in both groups were significantly different before and after the intervention (p < .05). The changes in the maximum inspiratory pressure (MIP), maximum expiratory pressure (MEP), forced vital capacity (FVC), forced expiratory volume at 1 sec (FEV1), and CVA were significant only in the experimental group (p < .05). The between-group comparisons showed a significant difference in the FVC, FEV1, VAS, CVA, and left lateral flexion (p < .05). CONCLUSION: The combination of SSE and TEE in the experimental group was more effective in improving the FHP and breathing ability. Moreover, the experimental group and control combination appeared to be effective in reducing pain and improving the CROM. The combination of SSE and TEE, which are exercises that do not target the cervical spine directly, was effective in improving the posture, respiration, neck pain, and CROM in elementary school teachers with FHP.

• Journal of the Korean Society of Physical Medicine
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• v.17 no.4
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• pp.1-13
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• 2022

PURPOSE: This study examined the effects of the craniovertebral angle, proprioception (joint error test), and the upper trapezius on the muscle tone when comparing cervical stabilization and scapula stabilization exercises and when two exercises were performed together. METHODS: The participants in this study agreed in advance, and this study was carried out by recruiting 27 university students in their twenties with mild frontal posture. The subjects were assigned randomly to three groups that performed cervical stabilization exercises, scapular stabilization exercises, and both cervical and scapular stabilization exercises. One-way repeated ANOVA was used to analyze the evaluation values of the 1^st, 3^rd, and 6^th weeks of exercise intervention within the group, and one-way ANOVA was used to compare the difference in the effects of exercise intervention among the three groups. RESULTS: Proprioception was significantly different in the cervical stabilization exercises (CSE) group and the cervical stabilization exercises + Scapular stabilization exercises (CSE+SSE) groups at three weeks, and there was a significant difference between the scapular stabilization exercises (SSE) group and the CSE+SSE group (p < .05). At six weeks, there was a significant difference between the CSE group and the CSE+SSE group, and there was a significant difference between the SSE group and the CSE+SSE group (p < .05). There was a significant difference between three and six weeks in the CSE group (p < .05). In the SSE group, there was a significant difference between pre and six weeks, and between three and six weeks (p < .05). In the CSE+SSE group, there was a significant difference between pre and three weeks, and between pre and six weeks (p < .05). On the other hand, there were no significant differences between CVA and muscular tone in all three groups (P > .05). CONCLUSION: In all groups, the proprioception (joint error test) showed significant improvement, and the CSE+SSE group showed greater improvement than the other groups. As a result, the appropriate combination of neck stabilization exercise and scapular stabilization exercise effectively improved proprioception in the presence of forward head posture (FHP).

• Journal of the Korean Society of Physical Medicine
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• v.9 no.1
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• pp.125-132
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• 2014

PURPOSE: This study aims to determine the optimal knee joint angle and hip joint angle for minimizing the cervical muscle tension and maximizing the muscle activity of the trunk during the bridging exercise for trunk stabilization. METHODS: The bridging exercise in this study included seven forms of exercise: having a knee joint flexion angle of $120^{\circ}$, $90^{\circ}$, $60^{\circ}$, $45^{\circ}$ and hip joint abduction angle of $15^{\circ}$, $10^{\circ}$, $5^{\circ}$. The posture of the bridging exercise was as follows. To prevent the increase of hyper lumbar lordosis during the bridging exercise, the exercise was practiced after maintaining the lumbar neutral position through the pelvic posterior tilting exercise. RESULTS: The abduction angles did not result in statistically significant effects on the cervical erector, external oblique, rectus abdominis and erector spinae muscles. However, in relation to the knee joint angles, during the bridging exercise, statistically significant results were exhibited. CONCLUSION: The knee joint angle affected the muscle activity of the neck muscle. The greater the knee joint angle, the lower the load placed on the neck muscle. In contrast, the load increased as the knee joint angle decreased. In addition, the muscle activity of the neck muscle and trunk muscle increased as the knee joint angle decreased.

• Physical Therapy Korea
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• v.26 no.4
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• pp.1-9
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• 2019

Background: Cervical dysfunction is a common pathomechanical marker in individuals with forward head posture (FHP). To overcome the limitations of the isometric chin-tuck (ICT) exercise, dynamic neuromuscular stabilization (DNS), which emphasizes an entire spinal chain exercise, has recently shown promising clinical results. Objects: Purpose of this study was to compare the immediate effects between ICT and DNS techniques. Methods: 43 young subjects (mean age, $24.0{\pm}5.0$ years) were recruited. Group of subjects with FHP were measured under baseline, ICT, and DNS conditions. Outcome measures included sitting height, longus colli (LC) and sternocleidomastoid (SCM) muscle thickness and LC/SCM thickness ratio. One-way repeated measures ANOVA was used to compare the continuous dependent variables among FHP, ICT, and DNS conditions at p<.016. Results: Both ICT and DNS exercise conditions yielded significantly increased LC muscle thickness, LC/SCM thickness ratio and sitting height than did FHP condition (p<.0001, respectively). Sitting height was significantly greater in DNS exercise than in the ICT exercise (p<.0001). Conclusion: The present results demonstrated that sitting height was greater in the DNS exercise than in the ICT exercise, as well as both corrective postural training exercises were effective on LC/SCM muscle balance ratio when compared with the baseline FHP condition. Therefore, it is considered that DNS exercise can be the recommended exercise for people with FHP.

• Journal of The Korean Society of Integrative Medicine
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• v.7 no.3
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• pp.159-169
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• 2019

Purpose: The purpose of this study was to provide an effective method of exercise therapy for patients with cervicogenic headache. Methods: The subjects were divided into the following three groups according to the intervention received: cervix-stabilizing exercise (n=12, group 1), transcranial direct current stimulation (n=12, group 2), and cervix-stabilizing exercise combined with transcranial direct current stimulation (n=12, group 3). The intragroup and intergroup differences in muscle characteristics and neck disability index were compared and analyzed. Results: The comparison and analysis of the changes in muscle tone and post hoc analysis revealed statistically significant intragroup decreases in the upper trapezius and suboccipitals in groups I and III, and statistically significant intergroup differences in the upper trapezius, with greater changes in group III than in group II, and in the suboccipitals, with greater changes in groupIII than in groups Iand II. The comparison and analysis of the change in muscle stiffness and post hoc analysis revealed a statistically significanti ntra group decrease in the upper trapezius in group Iand suboccipitals in group III, and a statistically significant intergroup difference in both muscles, with greater change in group III than in group II. The comparison and analysis of change in neck disability index and post hoc analysis revealed a statistically significant intragroup decrease in all the three groups and a statistically significant intergroup difference, with greater change in group III than in groups I and II. Conclusion: The neck-stabilizing exercise and transcranial direct current stimulation were shown to be effective in decreasing the tone of the cervical muscles by stabilizing the cervical bone and improving muscle durability, and in improving the movement and limitation of joint range of motion by decreasing muscle tone and stiffness.

• Journal of International Academy of Physical Therapy Research
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• v.10 no.3
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• pp.1862-1867
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• 2019

Background: The importance of postural stabilization and cervical mobilization in subjects with pain from the anterior head posture is drawing more attention. However, studies on head and neck stabilizing intervention after mobilization are lacking. Objective: To examine the effects of Kinesiotaping and posture setting exercise on forward head posture (FHP). Design: Crossover Study Design Methods: The subjects were 17 male and female college students in their 20s with FHP. They were randomized into the Kinesiology taping group (KTG) with 9 subjects and posture stabilizing exercise group (PSEG) with 8 subjects. The intervention was conducted for 4 weeks, and changes in pain, craniovertebral angle (CVA), and proprioception were observed before and after intervention. Results: Pain was significantly reduced in the KTG and PSEG both before and after intervention. CVA and proprioception were significantly increased only in the PSEG. The differences in CVA and proprioception between the two groups were significant. Conclusions: These findings suggest that the application of posture setting exercise could decrease pain, proprioceptive error and increase CVA on FHP.

• Journal of The Korean Society of Integrative Medicine
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• v.10 no.3
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• pp.13-25
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• 2022

Purpose : The purpose of this study was to investigate the effects of combined cervical stabilization exercise (CSE) and stretching exercise (SE) on office workers with forward head posture (FHP). Methods : A total of 32 office workers with forward head posture were randomly assigned to experimental (n=16) and control (n=16) groups. The experimental group underwent combined CSE and SE, and the control group underwent cervical self-myofascial release and SE. Both groups performed exercises for 40 min per day, thrice per week for a total of 6 weeks. Craniovertebral angle (CVA), respiration, disability, and joint range of motion (ROM) before and 6 weeks after intervention were measured and compared. Results : There was no significant between-group difference in the general characteristics (p>.05). The intra-group comparison showed significant differences in the visual analog scale (VAS) and neck disability index (NDI) of both groups post-intervention (p<.05). CVA and forced expiratory volume in 1 seconds (FEV₁) were significantly improved post-intervention in the experimental group only (p<.05). In the experimental group, all ROM variables were significantly improved post-intervention. In contrast, in the control group, all ROM variables improved significantly post-intervention, except for extension (p<.05). The inter-group comparison showed significant differences in NDI, left lateral flexion, right lateral flexion, and left rotation between the two groups (p<.05). Conclusion : The combination of CSE and SE, which stabilizes the cervical spine, had positive effects on cranial rotation angle, respiration, disability, and joint ROM in office workers with forward head posture. Therefore, the combination of the two exercises may be an effective option to reduce symptoms and prevent postural problems in office workers with FHP.