한국전문물리치료학회지 (Physical Therapy Korea)

  • 제23권3호
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  • Pages.11-20
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  • 2016
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  • 1225-8962(pISSN)
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  • 2287-982X(eISSN)
한국전문물리치료학회 (Korean Research Society of Physical Therapy)
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앞쪽머리자세를 가진 대상자의 머리-목 굽힘 검사 시 머리받침 유무에 따른 긴목근과 목빗근의 근두께 변화량 비교

Effect of the Head Support on a Change in Muscle Thickness for Longus Colli and Sternocleidomastoid During Cranio-Cervical Flexion Test in Subjects With Forward Head Posture

  • 박준상 (서울 척병원 재활센터) ;
  • 송시정 (서울 척병원 재활센터) ;
  • 정희석 (서울 척병원 재활센터) ;
  • 권오윤 (연세대학교 보건과학대학 물리치료학과)
  • Park, Jun-sang (Dept. of Rehabilitation, Seoul Chuk Hospital) ;
  • Song, Si-jeong (Dept. of Rehabilitation, Seoul Chuk Hospital) ;
  • Jung, Hee-seok (Dept. of Rehabilitation, Seoul Chuk Hospital) ;
  • Kwon, Oh-yun (Dept. of Physical Therapy, College of Health Science, Yonsei University)
  • 투고 : 2016.07.07
  • 심사 : 2016.08.08
  • 발행 : 2016.09.17
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초록

Background: A forward head posture (FHP) is one of the most common types of poor head posture in patients with neck disorder. A prolonged FHP might increase pressure on the posterior cranio-cervical structure and exhibit reduced performance on a cranio-cervical flexion test (CCFT). CCFT is included to activate deep cervical flexor muscles and inhibit excessive activation of superficial cervical flexor muscles. Therefore, the selective activation of deep cervical flexors is needed for effective exercise for FHP. Objects: The purpose of this study was to compare muscle thickness between longus colli (Lco) and sternocleidomastoid (SCM) using ultrasonography in subjects with FHP depending on head support. Methods: This was a cross-sectional, case-control research design study. The ultrasonographic images of Lco and SCM were taken in 17 subjects with FHP during the 5 phases of the CCFT with and without a head support. Towel was used for supporting head to make the neutral head position in supine. Changes in muscle thickness during the test were calculated to infer muscle activation. Data were analyzed using repeated measures of two-way analysis of variance with the significance level of .05. Results: When subjects performed the CCFT with head support, there was a significant difference in muscle thickness of Lco and SCM (p<.05). According to a post hoc paired t-test, change of thickness of Lco was greater at all phases, and change of thickness of SCM muscle was less at phase 4 and 5 in condition with head support (p<.01) compared to condition without head support (p<.01). Conclusion: The result of this study suggest that applying head support for neutral head position during CCFT could be a useful method for activating Lco muscle without excessive activation of SCM muscle.

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참고문헌

  1. Braun BL, Amundson LR. Quantitative assessment of head and shoulder posture. Arch Phys Med Rehabil. 1989;70(4):322-329.
  2. Brown SH, McGill SM. A comparison of ultrasound and electromyography measures of force and activation to examine the mechanics of abdominal wall contraction. Clin Biomech (Bristol, Avon). 2010;25(2):115-123. http://dx.doi.org/10.1016/j.clinbiomech.2009.10.001
  3. Cagnie B, Derese E, Vandamme L, et al. Validity and reliability of ultrasonography for the longus colli in asymptomatic subjects. Man Ther. 2009;14(4): 421-426. http://dx.doi.org/10.1016/j.math.2008.07.007
  4. Cassidy JD, Carroll L, Cote P. The Saskatchewan health and back pain survey. The prevalence of low back pain and related disability in Saskatchewan adults. Spine (Phila Pa 1976). 1998;23(17):1860-1866. https://doi.org/10.1097/00007632-199809010-00012
  5. Cheung Lau HM, Wing Chiu TT, Lam TH. Clinical measurement of craniovertebral angle by electronic head posture instrument: A test of reliability and validity. Man Ther. 2009;14(4):363-368. http://dx.doi.org/10.1016/j.math.2008.05.004
  6. Chiu TT, Ku WY, Lee MH, et al. A study on the prevalence of and risk factors for neck pain among university academic staff in Hong Kong. J Occup Rehabil. 2002;12(2):77-91. https://doi.org/10.1023/A:1015008513575
  7. Chiu TT, Law EY, Chiu TH. Performance of the craniocervical flexion test in subjects with and without chronic neck pain. J Orthop Sports Phys Ther. 2005;35(9):567-571. https://doi.org/10.2519/jospt.2005.35.9.567
  8. Falla D, Farina D. Neural and muscular factors associated with motor impairment in neck pain. Curr Rheumatol Rep. 2007;9(6):497-502. https://doi.org/10.1007/s11926-007-0080-4
  9. Falla D, Jull G, Dall'Alba P, et al. An electromyographic analysis of the deep cervical flexor muscles in performance of craniocervical flexion. Phys Ther. 2003;83(10):899-906.
  10. Falla D, Jull G, Hodges PW. Feedforward activity of the cervical flexor muscles during voluntary arm movements is delayed in chronic neck pain. Exp Brain Res. 2004;157(1):43-48. https://doi.org/10.1007/s00221-003-1814-9
  11. Fernandez-de-las-Penas C, Perez-de-Heredia M, Molero-Sanchez A, et al. Performance of the craniocervical flexion test, forward head posture, and headache clinical parameters in patients with chronic tension-type headache: A pilot study. J Orthop Sports Phys Ther. 2007;37(2):33-39. https://doi.org/10.2519/jospt.2007.2401
  12. Grace EG, Sarlani E, Reid B. The use of an oral exercise device in the treatment of muscular TMD. Cranio. 2002;20(3):204-208. https://doi.org/10.1080/08869634.2002.11746212
  13. Griegel-Morris P, Larson K, Mueller-Klaus K, et al. Incidence of common postural abnormalities in the cervical, shoulder, and thoracic regions and their association with pain in two age groups of healthy subjects. Phys Ther. 1992;72(6):425-431. https://doi.org/10.1093/ptj/72.6.425
  14. Hanten WP, Lucio RM, Russell JL, et al., Assessment of total head excursion and resting head posture. Arch Phys Med Rehabil. 1991;72(11): 877-880. https://doi.org/10.1016/0003-9993(91)90003-2
  15. Harms-Ringdahl K, Ekholm J. Intensity and character of pain and muscular activity levels elicited by maintained extreme flexion position of the lower-cervical-upper-thoracic spine. Scand J Rehabil Med. 1986;18(3):117-126.
  16. Hides J, Wilson S, Stanton W, et al. An MRI investigation into the function of the transversus abdominis muscle during "drawing-in" of the abdominal wall. Spine (Phila Pa 1976). 2006;31(6): E175-E178. https://doi.org/10.1097/01.brs.0000202740.86338.df
  17. Ishida H, Suehiro T, Kurozumi C, et al. Correlation between neck slope angle and deep cervical flexor muscle thickness in healthy participants. J Bodyw Mov Ther. 2015;19(4):717-721. http://dx.doi.org/10.1016/j.jbmt.2015.04.001
  18. Jesus FM, Ferreira PH, Ferreira ML. Ultrasonographic measurement of neck muscle recruitment: A preliminary investigation. J Man Manip Ther. 2008;16(2):89-92. https://doi.org/10.1179/106698108790818486
  19. Jesus-Moraleida FR, Ferreira PH, Pereira LS, et al. Ultrasonographic analysis of the neck flexor muscles in patients with chronic neck pain and changes after cervical spine mobilization. J Manipulative Physiol Ther. 2011;34(8):514-524. http://dx.doi.org/10.1016/j.jmpt.2011.08.006
  20. Jull G, Amiri M, Bullock-Saxton J, et al. Cervical musculoskeletal impairment in frequent intermittent headache. Part 1: Subjects with single headaches. Cephalalgia. 2007;27(7):793-802. https://doi.org/10.1111/j.1468-2982.2007.01345.x
  21. Jull GA, Falla D, Vicenzino B, et al. The effect of therapeutic exercise on activation of the deep cervical flexor muscles in people with chronic neck pain. Man Ther. 2009;14(6):696-701. http://dx.doi.org/10.1016/j.math.2009.05.004
  22. Jull G, Kristjansson E, Dall' Alba P. Impairment in the cervical flexors: A comparison of whiplash and insidious onset neck pain patients. Man Ther. 2004;9(2):89-94. https://doi.org/10.1016/S1356-689X(03)00086-9
  23. Jull GA, O'Leary SP, Falla DL. Clinical assessment of the deep cervical flexor muscles: The craniocervical flexion test. J Manipulative Physiol Ther. 2008;31(7):525-533. http://dx.doi.org/10.1016/j.jmpt.2008.08.003
  24. Kang JH, Park RY, Lee SJ, et al. The effect of the forward head posture on postural balance in long time computer based worker. Ann Rehabil Med. 2012;36(1):98-104. http://dx.doi.org/10.5535/arm.2012.36.1.98
  25. Koppenhaver SL, Hebert JJ, Fritz JM, et al. Reliability of rehabilitative ultrasound imaging of the transversus abdominis and lumbar multifidus muscles. Arch Phys Med Rehabil. 2009;90(1): 87-94. http://dx.doi.org/10.1016/j.apmr.2008.06.022
  26. Liebenson C. Rehabilitation of Spine: A practitioner's manual. 2nd ed. Philadelphia. Lippincott Williams & Wilkins, 2007:248-252.
  27. Lluch E, Schomacher J, Gizzi L, et al. Immediate effects of active cranio-cervical flexion exercise versus passive mobilisation of the upper cervical spine on pain and performance on the cranio-cervical flexion test. Man Ther. 2014;19(1): 25-31. http://dx.doi.org/10.1016/j.math.2013.05.011
  28. McMeeken JM, Beith ID, Newham DJ, et al. The relationship between EMG and change in thickness of transversus abdominis. Clin Biomech (Bristol, Avon). 2004;19(4):337-342. https://doi.org/10.1016/j.clinbiomech.2004.01.007
  29. Minakuchi H, Kuboki T, Matsuka Y, et al. Randomized controlled evaluation of non-surgical treatments for temporomandibular joint anterior disk displacement without reduction. J Dent Res. 2001;80(3):924-928. https://doi.org/10.1177/00220345010800031501
  30. Neumann DA. Kinesiology of the Musculoskeletal System: Foundations for rehabilitation. 2nd ed. St Louis, Mosby, 2010:398-404.
  31. O'Leary S, Jull G, Kim M, et al. Cranio-cervical flexor muscle impairment at maximal, moderate, and low loads is a feature of neck pain. Man Ther. 2007;12(1);34-39. https://doi.org/10.1016/j.math.2006.02.010
  32. O'Leary S, Jull G, Kim M, et al. Training mode-dependent changes in motor performance in neck pain. Arch Phys Med Rehabil. 2012;93(7):1225-1233. http://dx.doi.org/10.1016/j.apmr.2012.02.018
  33. Quek J, Pua YH, Clark RA, et al. Effects of thoracic kyphosis and forward head posture on cervical range of motion in older adults. Man Ther. 2013; 18(1):65-71. http://dx.doi.org/10.1016/j.math.2012.07.005
  34. Sahrmann S. Movement System Impairment Syndromes of the Extremities, Cervical and Thoracic Spines. St Louis, Mosby, 2010:51-86.
  35. Sauter SL, Schleifer LM, Knutson SJ. Work posture, workstation design, and musculoskeletal discomfort in a VDT data entry task. Hum Factors. 1991;33(2):151-167. https://doi.org/10.1177/001872089103300203
  36. Sterling M, Jull G, Wright A. Cervical mobilisation: Concurrent effects on pain, sympathetic nervous system activity and motor activity. Man Ther. 2001;6(2):72-81. https://doi.org/10.1054/math.2000.0378
  37. Szeto GP, Straker L, Raine S. A field comparison of neck and shoulder postures in symptomatic and asymptomatic office workers. Appl Ergon. 2002; 33(1):75-84. https://doi.org/10.1016/S0003-6870(01)00043-6
  38. Vasavada AN, Li S, Delp SL. Influence of muscle morphometry and moment arms on the moment-generating capacity of human neck muscles. Spine (Phila Pa 1976). 1998;23(4):412-422. https://doi.org/10.1097/00007632-199802150-00002
  39. Watson DH, Trott PH. Cervical headache: An investigation of natural head posture and upper cervical flexor muscle performance. Cephalalgia. 1993;13(4):272-284. https://doi.org/10.1046/j.1468-2982.1993.1304272.x
  40. Yip CH, Chiu TT, Poon AT. The relationship between head posture and severity and disability of patients with neck pain. Man Ther. 2008;13(2): 148-154. https://doi.org/10.1016/j.math.2006.11.002

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