• Journal of Trauma and Injury
• /
• 제33권4호
• /
• pp.260-263
• /
• 2020

Necrotizing fasciitis is an infection of the subcutaneous tissue that results in destruction of the fascia and is disproportionately common in patients with chronic liver disease or diabetes. Necrotizing fasciitis of the head and neck is rare, but has a high fatality rate. A 50-year-old man with a past medical history of diabetes reported a chief complaint of a wound in the posterior neck due to trauma. The wound had grown and was accompanied by pus and redness, and the patient had a fever. When the patient was referred to department of plastic & reconstructive surgery, the sternocleidomastoid muscle, semispinalis capitis muscle, splenius capitis muscle, and trapezius muscles were exposed, and the size of the defect was about 25×20 cm. Dead tissue resection was performed before negative-pressure wound therapy, followed by a split-thickness skin graft (STSG). After a 2-week course of aseptic dressing post-STSG, the patient recovered completely. No postoperative complications were observed for 1 year. Necrotizing fasciitis is a life-threatening, rapidly spreading infection, requiring early diagnosis and active surgical treatment. In addition, broad-spectrum antibiotics are required due to the variety of types of causative bacteria. Broad necrotizing fasciitis of the posterior neck is rare, but can quickly progress into a life-threatening stage.

• 대한물리의학회지
• /
• 제10권2호
• /
• pp.17-27
• /
• 2015

PURPOSE: The purpose of this study was to compare the effects of three interventions (intervention by passive range of motion exercise plus manual cervical traction, Mulligan's joint mobilization, and strengthening exercises) after Kaltenborn's joint mobilization on the cervical spine alignment, and muscle activity in patients with a forward head posture. METHODS: The subjects were 39 students from H University in Chungnam and C University in Jeonbuk. The subjects in each group attended training sessions three times a week for four weeks. We used one-way ANOVA and Scheffe's post hoc test to compare values between groups, and used paired t-test to compare the values of the dependent variables within groups. RESULTS: The results showed that the active intervention group experienced a significant increase compared to the passive intervention group in terms of the craniovertebral angle, cervical lordosis angle, and had significant decreases compared to the passive intervention group in terms of the upper trapezius muscle activity. The active intervention group also had significant increases in craniovertebral angle and decreased anterior scalene muscle activity than the active-assistive intervention group. The active-assistive intervention group had significant decreases compared to the active intervention group in terms of the serratus anterior, levator scapulae, and splenius capitis muscle activity. CONCLUSION: It appears that the subjects with a forward head posture had significant improvements in the cervical lordosis angle, cranial rotation angle, craniovertebral angle, and muscle activity after intervention by Mulligan's joint mobilization (active-assistive intervention component) and strengthening exercises (active intervention component) after applying Kaltenborn's joint mobilization.

• 대한물리의학회지
• /
• 제18권4호
• /
• pp.145-154
• /
• 2023

PURPOSE: This study was conducted to investigate the effect of the sling exercise wearing a neck orthosis on the craniovertebral angle, muscle tension, and headaches in adults with a forward head posture and tension headache. METHODS: In this single-blinded, randomized, controlled, comparative study, a total of 22 adults with forward head postures and tension headaches were randomly assigned to the experimental group (sling exercise wearing a neck orthosis, n = 11) or the control group (sling exercise without a neck orthosis, n = 11). All participants undertook the sling exercise program (3×/week for 4 weeks). The craniovertebral angle, muscle tension, and headache were measured before and after the 4-week training. RESULTS: Significant improvements were observed in the craniovertebral angle, muscle tension, and headache in the experimental group (p < .05). This group also showed a larger decrease in the muscle tension and headache (upper trapezius, -4.97 Hz vs -1.70 Hz, p < .05; splenius capitis, -5.44 Hz vs -2.54 Hz, p < .05; headache, -19.73 score vs -14.64 score, p < .05, respectively). CONCLUSION: The sling exercise wearing a neck orthosis could be an effective way to relieve the symptoms caused by a forward head posture. It could also be a more effective way of decreasing muscle tension and headaches than the sling exercise without wearing a neck orthosis.

• PNF and Movement
• /
• 제15권2호
• /
• pp.159-166
• /
• 2017

Purpose: This study attempts to determine the effects of applying three kinds of breathing exercises for four weeks on the neck muscle activation of subjects with a forward head posture. Methods: A total of 30 adults aged in their twenties (15 men and 15 women) with a forward head posture who voluntarily agreed to participate after listening to the purpose and procedure of this research were chosen as the subjects of this study. The subjects were randomly divided into either the diaphragmatic breathing exercise (DBE) group, the abdominal drawing-in maneuver (ADIM) group, or the abdominal expansion method (AEM) group according to the breathing intervention scheme. Each group included ten subjects. The muscle activity of the sternocleidomastoid, scalenus anterior, and splenius capitis was measured in all the groups prior to the intervention, two weeks after the intervention, and four weeks after the intervention. All the interventions were implemented for 30 minutes a day, three times a week, for a total of four weeks. Results: No significant between-group difference was observed in terms of the change in neck muscle activity according to the four-week intervention scheme. Further, there was no interaction between the intervention period and the intervention scheme in relation to the change in neck muscle activity. Conclusion: The results of this study suggest that abdominal expansion exercise is as effective as other breathing exercise methods for subjects with a forward head posture. We therefore expect that abdominal expansion exercise can be used as a scheme for the prevention of symptoms as well as therapy for patients with a forward head posture.

• Journal of Acupuncture Research
• /
• 제36권1호
• /
• pp.55-58
• /
• 2019

The aim of this study was to investigate the efficacy of treatment with thread-embedding therapy for 24 patients with hemifacial spasm (HFS). The muscle spasm of these patients was treated with thread-embedding therapy. Patients with nuchal pain were treated with tendino-musculature acupuncture in the sternocleidomastoid, splenius, and trapezius muscles. We evaluated the treatment effect using the Scott's scale, where 20, 3, 1, and 0 patients presented Scott's grade 0, grade 1, grade 2, and grade 3, respectively. The grade of the spasm intensity decreased noticeably after treatment. The results revealed that the Scott's grade changed to 0 in 83.3% of HFS patients, and 91.7% patients felt satisfied with thread-embedding therapy. These findings suggested that thread-embedding therapy was effective and can be used widely for HFS.

• 대한물리의학회지
• /
• 제10권2호
• /
• pp.89-94
• /
• 2015

PURPOSE: The aim of this study was to determine the effect of device considering Mckenzie type for the subjects with forward head posture (FHP). METHODS: The subjects were 35 patients with FHP (mean age was $23.7{\pm}2.8$ years; mean height; $172.1{\pm}11.7$, mean weight; $65.8{\pm}13.9$, mean NDI(Neck Disability Index; $3.7{\pm}3.2$, mean FHP; $6.7{\pm}2.2$). We measured the posture with the Body style S-8.0(LU Commerce, South Korea) to evaluate the FHP. We collected the surface EMG(Myosystem 1400, Noraxon, USA) data to quantify changes in normalized activation levels of muscles in SternoCleidoMastoid muscle(SCM), Scalenus Anterior(SA), Trapezius upper fiber(TU) and Splenius Cervicis(SC), during the subjects were instructed to glide their head into a "chin-in" position for a retraction without and with device. RESULTS: The condition with device significantly decreased the %RVC of SA($90.84{\pm}40.54$), SCM($74.98{\pm}43.65$) and TU($67.60{\pm}47.83$) compared to the condition without device(SA;$100.39{\pm}56.32$, SCM;$119.03{\pm}109.26$, Trapezius;$80.55{\pm}39.27$). But the %RVC of capitis($65.87{\pm}47.83$) with device was increased($70.82{\pm}52.78$). There was significant difference in the %RVC between SCM and Trapezius muscle in two conditions. CONCLUSION: New device for FHP reduces the EMG activities of the TU, SCM and SA muscle. We have to develop the function of feedback to facilitate the motion in the future.

• Journal of Oral Medicine and Pain
• /
• 제33권4호
• /
• pp.339-352
• /
• 2008

목적: 측두하악장애 환자들에서 압통 검사를 통하여 경부근육 통증의 정도와 위치를 파악하고, 측두하악장애와 경부근육 통증과의 관련성을 규명하고자 하였다. 방법: 측두하악장애 환자(n=129, 여자 65.9% 평균=28.8세)에 대해서 두통, 목의 통증, 정서적 스트레스, 수면 장애, 이상 기능 습관 및 통증 강도에 대한 설문을 실시하였다. 저작계에 대하여 하악 운동범위, 악관절음, 악관절 촉진, 저작근 촉진 검사를 시행하였다. 빗목근 상부(sternocleidomastoid upper), 빗목근 중간(sternocleidomastoid middle), 등세모근 상부(upper trapezius), 머리널판근(splenius capitis), 머리반가시근(semispinalis capitis), 중간 목갈비근(scalene medius), 어깨올림근(levator scapulae)의 7부위의 경부 근육에 대하여 촉진에 의한 압통 검사를 하였다. 압통의 정도를 무통(0), 경도(1), 중등도(2), 심도(3)로 구분하여 판정하였다. 압통점수로부터 여러 통증점수 합계를 계산한 후 이후의 통계분석에 사용하였다. 결과: 80명(62.0%)의 환자가 설문에서 목의 통증을 경험한다고 답하였다. 측두하악장애 통증 점수와 경부 근육통 점수 간에는 유의한 상관관계가 있었다(r=0.538, P < 0.001). 경부 근육 중에서 중등도 이상의 압통이 40% 이상 발생하는 근육은 빗목근과 등세모근 상부였고 저작근 중에서는 깨물근(masseter) 중간에서 36%의 중등도 통증이 나타났다. 129명에 대한 경부근육통점수합과 측두하악장애통증점수합 사이에는 상당한 관련성이 있었으며($\rho$=0.502, P < 0.001), 측두하악장애통증점수합은 경부근육통점수합이 증가함에 따라 함께 증가하는 경향을 보였다(Y = 0.395 ${\cdot}$ X, $R^2$ = 0.659, P < 0.001). 저작근장애 환자에서 빗목근등세모근상부통증점수합과 관자근교근통증점수합은 중등도의 관련성($\rho$ = 0.375, P < 0.001)을 보였으며, 두 변수는 비례 관계에 있었다(Y = 0.359 ${\cdot}$ X, $R^2$ = 0.538, P < 0.001). 편측통증점수의 편상관관계분석에서 우측경부근육통증점수합과 좌측경부근육통증점수합은 가장 높은 상관성(r=0.802, P < 0.001)을 보였다. 우측측두하악장애통증점수합과 좌측측두하악장애통증점수합은 중등도의 상관성(r=0.481, P < 0.001)이 있었다. 편측성 측두하악장애 통증이 있는 20명의 환자에 대한 편상관관계분석에서 우측과 좌측의 편측경부근육통점수간의 상관성이 가장 높았고(r = 0.597, P = 0.009), 측두하악장애측통증점수합과 동측경부근육통증점수합 사이의 상관성(r = 0.564, P = 0.015)이 그 다음이었다. 결론: 측두하악장애 통증은 촉진에 의한 압통반응의 측면에서 경부근육 통증과 관련성을 보인다. 경부근육 중에서 빗목근과 등세모근상부가 중등도 이상의 통증을 흔하게 나타내며 저작근통증과 밀접한 관련이 있다. 경부근육에서는 통증의 대칭적인 이환 특성이 두드러지지만, 측두하악장애가 경부근육통의 수준에 영향을 주어 대칭적인 특성을 변화시킬 수 있다. 두부와 경부에 복잡한 통증 질환의 증상과 징후를 보이는 환자에서 경부 근육 통증의 진단과 치료에 관심을 가져야 한다.

• 대한약침학회지
• /
• 제7권2호
• /
• pp.57-64
• /
• 2004

This study was carried to identify the component of Small Intestine Meridian Muscle in human, dividing the regional muscle group into outer, middle, and inner layer. the inner part of body surface were opened widely to demonstrate muscles, nerve, blood vessels and the others, displaying the inner structure of Small Intestine Meridian Muscle. We obtained the results as follows; 1. Small Intestine Meridian Muscle is composed of the muscle, nerve and blood vessels. 2. In human anatomy, it is present the difference between a term of nerve or blood vessels which control the muscle of Meridian Muscle and those which pass near by Meridian Muscle. 3. The inner composition of meridian muscle in human arm is as follows ; 1) Muscle ; Abd. digiti minimi muscle(SI-2, 3, 4), pisometacarpal lig.(SI-4), ext. retinaculum. ext. carpi ulnaris m. tendon.(SI-5, 6), ulnar collateral lig.(SI-5), ext. digiti minimi m. tendon(SI-6), ext. carpi ulnaris(SI-7), triceps brachii(SI-9), teres major(SI-9), deltoid(SI-10), infraspinatus(SI-10, 11), trapezius(Sl-12, 13, 14, 15), supraspinatus(SI-12, 13), lesser rhomboid(SI-14), erector spinae(SI-14, 15), levator scapular(SI-15), sternocleidomastoid(SI-16, 17), splenius capitis(SI-16), semispinalis capitis(SI-16), digasuicus(SI-17), zygomaticus major(Il-18), masseter(SI-18), auriculoris anterior(SI-19) 2) Nerve ; Dorsal branch of ulnar nerve(SI-1, 2, 3, 4, 5, 6), br. of mod. antebrachial cutaneous n.(SI-6, 7), br. of post. antebrachial cutaneous n.(SI-6,7), br. of radial n.(SI-7), ulnar n.(SI-8), br. of axillary n.(SI-9), radial n.(SI-9), subscapular n. br.(SI-9), cutaneous n. br. from C7, 8(SI-10, 14), suprascapular n.(SI-10, 11, 12, 13), intercostal n. br. from T2(SI-11), lat. supraclavicular n. br.(SI-12), intercostal n. br. from C8, T1(SI-12), accessory n. br.(SI-12, 13, 14, 15, 16, 17), intercostal n. br. from T1,2(SI-13), dorsal scapular n.(SI-14, 15), cutaneous n. br. from C6, C7(SI-15), transverse cervical n.(SI-16), lesser occipital n. & great auricular n. from cervical plexus(SI-16), cervical n. from C2,3(SI-16), fascial n. br.(SI-17), great auricular n. br.(SI-17), cervical n. br. from C2(SI-17), vagus n.(SI-17),hypoglossal n.(SI-17), glossopharyngeal n.(SI-17), sympathetic trunk(SI-17), zygomatic br. of fascial n.(SI-18), maxillary n. br.(SI-18), auriculotemporal n.(SI-19), temporal br. of fascial n.(SI-19) 3) Blood vessels ; Dorsal digital vein.(SI-1), dorsal br. of proper palmar digital artery(SI-1), br. of dorsal metacarpal a. & v.(SI-2, 3, 4), dorsal carpal br. of ulnar a.(SI-4, 5), post. interosseous a. br.(SI-6,7), post. ulnar recurrent a.(SI-8), circuirflex scapular a.(SI-9, 11) , post. circumflex humeral a. br.(SI-10), suprascapular a.(SI-10, 11, 12, 13), first intercostal a. br.(SI-12, 14), transverse cervical a. br.(SI-12,13,14,15), second intercostal a. br.(SI-13), dorsal scapular a. br.(SI-13, 14, 15), ext. jugular v.(SI-16, 17), occipital a. br.(SI-16), Ext. jugular v. br.(SI-17), post. auricular a.(SI-17), int. jugular v.(SI-17), int. carotid a.(SI-17), transverse fascial a. & v.(SI-18),maxillary a. br.(SI-18), superficial temporal a. & v.(SI-19).

• 대한물리의학회지
• /
• 제11권2호
• /
• pp.41-52
• /
• 2016

PURPOSE: This study was conducted to compare the levels of usage of the superficial neck muscles during head rotation in forward head posture and in multimodal postures for improvement of cervical rotation movement impairment. METHODS: To acquire electromyography (EMG) signals from the sternocleidomastoid (SCM-M), upper trapezius (UPT-M), and the splenius capitis (SPC-M) muscles, 11 subjects practiced right rotation of the head in forward head postures (FHP), upright sitting postures (USP), upright sitting postures with supported arms (SUP), standing postures with the arms leaning against the wall (WSP), and four feet postures (FFP), respectively. RESULTS: The left SCM-M was used significantly more in the FFP compared to the FHP, but not in other postures (p<0.01). The left UPT-M was used significantly more in all postures other than the FHP. The right SPC-M was used significantly more in the FFP (p<0.001) and significantly less (p<0.05) in the SUP compared to the FHP. CONCLUSION: During the rotation of the head, although the usage of the SPC-M significantly decreased in SUP compared to FHP but the usage of the SCM-M and UPT-M did not decrease significantly in other postures compared to FHP. Further research is necessary to prove the hypothesis that special postures may reduce the activity of the superficial neck muscles during head rotation.

• 한국임상수의학회지
• /
• 제27권4호
• /
• pp.450-452
• /
• 2010

4년령의 수컷 요크셔테리어가 두부의 둔상에 의한 구토와 무의식을 주증으로 내원하였다. 육안검사에서 안면 부종, 피하 출혈, 과유연을 확인하였다. 방사선 검사에서 후두골편이 뒤쪽으로 변위되어 있음이 확인되었다. 3차원으로 재구성한 컴퓨터단층촬영 영상에서 골편의 배쪽 부분이 불완전하게 부착되어 있음을 보여주었고, 골편의 불안정성 때문에 골편적출술을 실시하기로 결정하였다. 골편의 제거 후, 결손부는 널판근을 이용한 근육판으로 보강하였다. 환자 상태는 약간의 실조성 보행을 제외하고, 점차 개선되었다. 술 후 20개월째 추적조사에서 운동실조는 더 이상 관찰되지 않았다. 심한 두 개 내 출혈과 두개골 골절에도 불구하고, 수술적인 중재를 시작하기까지 환자의 신경학적인 상태는 심하게 악화되지는 않았다. 이는 바깥쪽으로 변위된 골편이 신경학적 악화를 야기할 수 있는 두개내압의 증가를 방지하는데 주요한 역할을 했기 때문이라고 사료된다.