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Effect of Cervical Corrective Exercises on Pain, Neck Posture, and Intersegmental Motion of Cervical Spine in a Patient With Cervical Radiculopathy: A Case Report

  • Yun, Sung-joon (Dept. of Rehabilitation Medicine, Wonju Severance Christian Hospital) ;
  • Kim, Moon-hwan (Dept. of Rehabilitation Medicine, Wonju Severance Christian Hospital) ;
  • Weon, Jong-hyuck (Dept. of Physical Therapy, College of Tourism & Health Science, Joongbu University) ;
  • Kwon, Oh-yun (Dept. of Physical Therapy, College of Health Science, Yonsei University)
  • 투고 : 2015.10.07
  • 심사 : 2015.11.07
  • 발행 : 2015.11.19

초록

This case report describes the effectiveness of cervical corrective exercises in a patient with cervical radiculopathy (CR) who experienced radicular pain, upper limb paresis, and limited functional activity. A 39-year-old male with cervical radiculopathy performed the cervical corrective exercises for reducing pain. Pain intensity, cervical posture, and active range of motion of cervical intersegmental spine motion were measured baseline, after 4 weeks, and after 8 weeks with self-reported questionnaire and radiographs. After 8 weeks of intervention, the patient demonstrated alleviated radicular symptoms, improved neck posture and active range of flexion and extension of the cervical intersegmental spine. Especially in the angle between the cervical vertebra 6 and 7, the angle was changed from $-4.69^{\circ}$ to $3.30^{\circ}$ during resting position after intervention. The present case indicates that the cervical corrective exercises might be a possible treatment to effectively reduce radicular symptoms, improve neck posture, and active cervical intersegmental motion for patient with CR.

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참고문헌

  1. Barrey C, Champain S, Campana S, et al. Sagittal alignment and kinematics at instrumented and adjacent levels after total disc replacement in the cervical spine. Eur Spine J. 2012;21(8):1648-1659. https://doi.org/10.1007/s00586-012-2180-8
  2. Bogduk N. The anatomy and pathophysiology of neck pain. Phys Med Rehabil Clin N Am. 2011;22(3):367-382. https://doi.org/10.1016/j.pmr.2011.03.008
  3. Boyling JD, Jull GA. Grieve's Modern Manual Therapy: The vertebral column. 3rd ed. Edinburgh, Churchill Livingstone, 2005:451-470.
  4. Butler DS, Jones MA. Mobilisation of the Nervous System. 1st ed. Melbourne, Churchill Livingstone, 1991:148-154, 157-159.
  5. Cassidy JD, Lopes AA, Yong-Hing K. The immediate effect of manipulation versus mobilization on pain and range of motion in the cervical spine: A randomized controlled trial. J Manipulative Physiol Ther. 1992;15(9):570-575.
  6. Cleland JA, Childs JD, Whitman JM. Psychometric properties of the neck disability index and numeric pain rating scale in patients with mechanical neck pain. Arch Phys Med Rehabil. 2008;89(1):69-74. https://doi.org/10.1016/j.apmr.2007.08.126
  7. Dvorak J, Hayek J, Zehnder R. CT-functional diagnostics of the rotatory instability of the upper cervical spine. Part 2. An evaluation on healthy adults and patients with suspected instability. Spine (Phila Pa 1976). 1987;12(8):726-731. https://doi.org/10.1097/00007632-198710000-00002
  8. Dvorak J, Panjabi MM, Novotny JE, et al. In vivo flexion/extension of the normal cervical spine. J Orthop Res. 1991;9(6):828-834. https://doi.org/10.1002/jor.1100090608
  9. Falla D, Lindstrøm R, Rechter L, et al. Effectiveness of an 8-week exercise programme on pain and specificity of neck muscle activity in patients with chronic neck pain: A randomized controlled study. Eur J Pain. 2013;17(10):1517-1528. https://doi.org/10.1002/j.1532-2149.2013.00321.x
  10. Falla D, O'Leary S, Fagan A, et al. Recruitment of the deep cervical flexor muscles during a postural- correction exercise performed in sitting. Man Ther. 2007;12(2):139-143. https://doi.org/10.1016/j.math.2006.06.003
  11. Falla DL, Jull GA, Hodges PW. Patients with neck pain demonstrate reduced electromyographic activity of the deep cervical flexor muscles during performance of the craniocervical flexion test. Spine (Phila Pa 1976). 2004;29(19):2108-2114. https://doi.org/10.1097/01.brs.0000141170.89317.0e
  12. Good M, Stiller C, Zauszniewski JA, et al. Sensation and distress of pain scales: Reliability, validity, and sensitivity. J Nurs Meas. 2001;9(3):219-238.
  13. Harms-Ringdahl K, Ekholm J, Schuldt K, et al. Load moments and myoelectric activity when the cervical spine is held in full flexion and extension. Ergonomics. 1986;29(12):1539-1552. https://doi.org/10.1080/00140138608967267
  14. Jull G, Falla D, Treleaven J, et al. Retraining cervical joint position sense: The effect of two exercise regimes. J Orthop Res. 2007;25(3):404-412. https://doi.org/10.1002/jor.20220
  15. Kolehmainen I, Harms-Ringdahl K, Lanshammart H. Cervical spine positions and load moments during bicycling with different handlebar positions. Clin Biomech (Bristol Avon). 1989;4(2):105-110. https://doi.org/10.1016/0268-0033(89)90047-8
  16. Martinez-Segura R, Fernandez-de-las-Penas C, Ruiz-Saez M, et al. Immediate effects on neck pain and active range of motion after a single cervical high-velocity low-amplitude manipulation in subjects presenting with mechanical neck pain: A randomized controlled trial. J Manipulative Physiol Ther. 2006;29(7):511-517. https://doi.org/10.1016/j.jmpt.2006.06.022
  17. Mayoux-Benhamou MA, Revel M, Vallee C, et al. Longus colli has a postural function on cervical curvature. Surg Radiol Anat. 1994;16(4):367-371. https://doi.org/10.1007/BF01627655
  18. Norkin CC, White DJ. Measurement of Joint Motion: A guide to goniometry. 2nd ed. Philadelphia, PA, F.A. Davis Co., 1995:54-62, 196-197.
  19. Rahdakrishnan K, Litchy WJ, O'Fallon WM, et al. Epidemiology of cervical radiculopathy. A population- based study from rochester, minnesota, 1976 through 1990. Brain. 1994;117(Pt 2):325-335. https://doi.org/10.1093/brain/117.2.325
  20. Sahrmann S. Movement System Impairment Syndromes of the Extremities, Cervical and Thoracic Spines. St Louis, Mosby, 2010:51-86.
  21. Treleaven J, Jull G, LowChoy N. The relationship of cervical joint position error to balance and eye movement disturbances in persistent whiplash. Man Ther. 2006;11(2):99-106. https://doi.org/10.1016/j.math.2005.04.003
  22. Vernon H, Mior S. The neck disability index: A study of reliability and validity. J Manipulative Physiol Ther. 1991;14(7):409-415.
  23. Wainner RS, Gill H. Diagnosis and nonoperative management of cervical radiculopathy. J Orthop Sports Phys Ther. 2000;30(12):728-744. https://doi.org/10.2519/jospt.2000.30.12.728
  24. World Medical Association General Assembly. World medical association declaration of helsinki: Ethical principles for medical research involving human subjects. J Int Bioethique. 2004;15(1):124-129. https://doi.org/10.3917/jib.151.0124