This study was performed to investigate the factors affecting muscle activity and cephalometric variables according to change of head postures. For this study, 150 patients with temporomandibular disorders and 80 dental students without any signs and symptoms of temporomandibular disorders were selected as the patients group and as the normal group, respectively. Head position to body-midline in frontal plane and upper quarter posture to body plumb line in sagittal plane were observed clinically and electromyographic(EMG) activity of anterior temporalis, masseter, sternocleidomastoideus, and trapezius on clenching were recorded with $BioEMG^{(R)}$ in four head postures, which were natural head posture(NHP), forward head posture(FHP), $20^{\circ}$ upward head posture(UHP), and $20^{\circ}$ downward head posture(DHP). Cephaloradiographs were also taken in the same head postures as in EMG taking, but that was taken only in NHP for the patient group. Cephalometric variables measured were SN angle, CVT angle, atlas inclination angle, occlusal plane angle, Me-C2 angle, pharyngeal width, occiput~axis distance, area of pharyngeal space, and cervical curvature. The data were analyzed by SAS statistical program. The results of this study were as follows : 1. Between the patient and the normal group, there were significant difference in distance from plumb line to acromion, eye-tragus angle, electromyographic activity of the four muscles, and cephalometric variables of linear measurement. 2. There was no consistent pattern of correlation between upper quarter posture, EMG activity and cephalometric variables in any case without relation to cervical curvature and head position in frontal plane. 3. Sternocleidomastoid muscle only showed variation of electromyographic activty with changes of head postures, but all the muscles did show correlation with head postures. 4. All the cephalometric variables measured in this study showed difference of mean value by head posture, and CVT angle, pharyngeal width, occiput-atlas distance, and area of pharyngeal space showed correlation between these variables with change from NHP to FHP, and from NHP to UHP.
Journal of the Korean Society of Physical Medicine
/
v.1
no.1
/
pp.93-108
/
2006
Purpose : To evaluate effects of McKenzie exercise on the functional recovery and forward head posture of chronic neck pain patients. Methods : The subjects were consisted of fifteen patients who had abnormal neck posture, mild neck pain (28 males, 17 females; mean aged 21.9) from 19 to 33 years of age(mean age 21.9). All subjects were received McKenzie exercise for 35 minutes with clinical massage per day three times a week during 4 weeks period. Neck disability index was used to measure functional disability level. Visual analogue scale(VAS) was used to measure subjective pain level. craniovetebral angle(CVA), cranial rotation angle(CRA) was used to measure forward head posture with digital camera. All measurements of each patients were measured at pre-treatment and after 2 week, after 4 week, post-treatment on 2 week. Result : The VAS of McKenzie exercise was significantly reduced between pre-treatment and post-treatment (p<.05) and effects of pain reduce was continued follow 2 weeks. The Neck Disability Index of McKenzie exercise was significantly reduced between pre-treatment and post-treatment (p<.05) and effects of pain reduce was continued follow 2 weeks. The CVA of McKenzie exercise was significantly reduced between pre-treatment and post-treatment (p<.05) and effects of pain reduce was continued follow 2 weeks. The CRA of McKenzie exercise was not significantly reduced between pre-treatment and post-treatment (p<.05). Conclusion : McKenzie exercise improved pain and function of Chronic neck pain patients.
This study was performed to investigate the relationship between Forward Head Posture(FHP) and Craniomandlbular Disorders(CMDs). Many studies reported that there was some relationship between them, however, there is still controversy. So It Is necessary to observe and compare many more patients with CMDs wirh normal controls. For the study 85 patients with CMDs and 37 dental students were selected as experimentals and controls, respectively. And the experimentals were classified Into two groups, that is, TMJ internal derangement group and muscle disorders group according to clinical diagnosis. For measuring the FHP, CROM(Cervical-Range-of-Notion)was used. This goniometer is composed of three part. First, gravity goniometer for flexion and extension. Second, magnetic compass and yoke for rotational movement. And last, forward head arm and vertebra locator for forward head posture. Next T-Scan, electronic occlusal analyzer, was used for recording of occlusal contact state. Other items such as maximum opening, lateral excursion, Helkimo's anamnestic index, and muscle palpation point from Friction's craniomandibular index were checked clinically by one examiner. The result of this study were as follows : 1. In male, control group showed much more measurement in resting forward head posture than did experimental group. But there were not significant differences between groups in female subject. From this results, the author contended that CROM is new measuring system and differ from other goniometers in some aspect, so that results should be re-evaluated 2. Mean value of maximum mouth opening in nearly all groups were greater than 40mm. and mouth opening had a significant correlation with occlusal force and with anamnestic index both sex. 3. Mean value of palpation point had not any correlationship with forward head posture in both sex, but there was significant difference between upper and lower group by rounded shouldes. 4. In summary, there was no significant relationship between forward head posture and sign and symptom of Craniomandibular Disorders.
This paper was designed to investigate the causes of child hearing loss which is essential to language development especialy in young childhood. Accurate history taking, precise otolaryngological examination and impedence audiometry were performed on 185 hard of hearing children under age 5 during last 8 months and investigated its causes. The results were as follows: 1. Infections diseases were the most common causes of sensorineural hearing loss (44/123cases, 30.1%), and mother's condition during pregnancy the second, and birth injury or head trauma the third. 2. Acute or chronic ear ear diseases were the most common causes of counductive hearing loss (32/62, 51.6%), frequent URI the second (19/62, .30.6%), and adenoid vegetation the third (7/62, 11.3%). 3. The majority of causes of child hearing loss under age 5 was exogenous (179/185 cases, 96.8%), and the minority was endogenous (6/185 cases, 3.2%).
Journal of the Korean Society of Physical Medicine
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v.10
no.2
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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.
Objectives The purpose of this study was to improve the comfort of daily life such as reduction of headache and increase of movement of neck by using muscle relaxation approach and joint movement approach for office worker with tension type headache of foward head posture sitting over 5 hours. Methods For this, 9 male and 15 female participated in the foward head posture with tension type headache. Each group consisted of 3 male and 5 female. Groups are divided into groups, such as muscle relaxation therapy, joint movement therapy, muscle relaxation and joint movement therapy. After intervention for each group for a month, we measured neck movement and head disability index and neck disability index 2 week. SPSS 23.0 (IBM Corp., Armonk, NY, USA) was used for data analysis. The one-way repeated analysis of variance (ANOVA), one-way ANOVA, compared t-test was used for statistical analysis. Results Three intervention groups have brought improvements in neck movement and daily life comfort. There is significant difference in the improvement of neck extension and change in neck disability index between 2 and 4 weeks in the joint movement approach compared to muscle relaxation approach, muscle relaxation and joint movement approach. Conclusions Office workers are exposed to tension type headache. However, muscle relaxation approach and joint movement approach can improve neck movement and daily life comfort.
Early diagnosis for upper facial trauma is difficult by using the standard Water's view (S-Water's) in general radiograph due to overlapping of anatomical structures, the uncertainty of patient positioning, and specific patients with obese, pediatric, old, or high-risk. The purpose of this study was to analyze appropriate exposure angles through a comparison of two different protocols (S-Water's vs. reverse Water's view (R-Water's)) by using a head phantom. A head phantom and general radiograph with 75 kVp, 400 mA, 45 ms 18 mAs, and SID 100 cm. Images of R-Water's were obtained by different angles in the range of $0^{\circ}$ to $50^{\circ}$, which adjusted an angle at 1 degree interval in supine position. Survey elements were developed and three observers were evaluated with four elements including the maxillary sinus, zygomatic arch, petrous ridge, and image distortion. Statistical significant analysis were used the Krippendorff's alpha and Fleiss' kappa. The intra-class correlation (ICC) coefficient for three observers were high with maxillary, 0.957 (0.903, 0.995); zygomatic arch, 0.939 (0.866, 0.987); petrous ridge, 0.972 (0.897, 1.000); and image distortion, 0.949 (0.830, 1.000). The high-quality image (HI) and perfect agreement (PA) for acquired exposure angles were high in range of the maxillary sinus ($36^{\circ}-44^{\circ}C$), zygomatic arch ($33^{\circ}-40^{\circ}$), petrous ridge ($32^{\circ}-50^{\circ}$), and image distortion ($44^{\circ}-50^{\circ}$). Consequently, an appropriate exposure angles for the R-Water's view in the supine position for patients with facial trauma are in the from $36^{\circ}$ to $40^{\circ}$ in this phantom study. The results of this study will be helpful for the rapid diagnosis of facial fractures by simple radiography.
Total body irradiation is operated to irradicate malignant cells of bone marrow of patients to be treated with bone marrow transplantation. Field size of a linear accelerator or cobalt teletherapy unit with normal geometry for routine technique is too small to cover whole body of a patient. So, any special method to cover patient whole body must be developed. Because such environments as room conditions and machine design are not universal, some characteristic method of TBI for each hospital could be developed. At Seoul National University Hospital, at present, only a cobalt unit is available for TBI because source head of the unit could be tilted. When the head is tilted outward by 90$^{\circ}$, beam direction is horizontal and perpendicular to opposite wall. Then, the distance from cobalt source to the wall was 319 cm. Provided that the distance from the wall to midsagittal plane of a patient is 40cm, nominal field size at the plane(SCD 279cm) is 122cm$\times$122cm but field size by measurement of exposure profile was 130cm$\times$129cm and vertical profile was not symmetric. That field size is large enough to cover total body of a patient when he rests on a couch in a squatting posture. Assuming that average lateral width of patients is 30cm, percent depth dose for SSD 264cm and nominal field size 115.5cm$\times$115.5cm was measured with a plane-parallel chamber in a polystyrene phantom and was linear over depth range 10~20cm. An anthropomorphic phantom of size 25cm wide and 30cm deep. Depth of dose maximum, surface dose and depth of 50% dose were 0.3cm, 82% and 16.9cm, respectively. A dose profile on beam axis for two opposing beams was uniform within 10% for mid-depth dose. Tissue phantom ratio with reference depth 15cm for maximum field size at SCD 279cm was measured in a small polystyrene phantom and was linear over depth range 10~20cm. An anthropomorphic phantom with TLD chips inserted in holes on the largest coronal plane was bilaterally irradiated by 15 minute in each direction by cobalt beam aixs in line with the cross line of the coronal plane and contact surface of sections No. 27 and 28. When doses were normalized with dose at mid-depth on beam axis, doses in head/neck, abdomen and lower lung region were close to reference dose within $\pm$ 10% but doses in upper lung, shoulder and pelvis region were lower than 10% from reference dose. Particulaly, doses in shoulder region were lower than 30%. On this result, the conclusion such that under a geometric condition for TBI with cobalt beam as SNUH radiotherapy departement, compensators for head/neck and lung shielding are not required but boost irradiation to shoulder is required could be induced.
Recently the development of portable digital wireless imaging system, which acquires digital radiation images by using wireless LAN telecommunications function in an easy and fast way, provides lots of convenience for people. Considering the characteristics of portable imaging tests on emergency and critical patients, this study aims to suggest guidelines for Digital wireless detector by evaluating the effect of de-centering of focus-grid and displacement of subject in detector on the quality of image. The equipments used for this study were Elmo-T6 Digital Mobile X-ray system (SIMAZU Corp.), el' Tor ($14{\times}17$ "Wireless detector), Grid (10:1) and Chest & head phantom. After acquiring post-processing image according to dose increase and de-centering image of grid-focus and head phantom displacement image, this study compared, analyzed and evaluated these images by using a digital image analysis program by Image J. In the change of images based on dose increase, images were rough in the dose of 0.5 mAs, while there was no difference among images in the proper dose of 1~2 mAs and, especially from 2.5 mAs, average value of pixels radically decreased, affecting contrast. Over 3 mAs, contrast dropped due to saturation phenomenon of lungs. As the result of analysis using Image J program, with the increase of displacement between focus-grid and head phantom, the frequency of low pixel value also increase, causing the outline of surface image to disappear, which in turn affects contrast. For better quality imaging, a radiographer must be aware before the time of test that the image quality can be changed based on the critical patient's posture, movement, respiration, displacement of X-ray tube and distance of imaging.
This study was performed to investigate the effects of repetitive mandibular opening movement and change of head posture on the vibration of temporomandibular(TM) joint. For this study, 23 patients with internal derangement of TM joint were selected. All they had clinically noticeable TM joint sound. Observation of the joint vibration were performed in four head postures, namely, natural head posture (NHP), forward head posture(FHP), upward head posture(UHP), and downward head posture(DHP). For recording of joint sound vibration, Sonopak of Biopak system(Bioresearch Inc., Milwaukee, USA) was used, The author could take results related to integral higher than 300Hz, integral lower than 300Hz, ratio of integral higher than 300Hz to integral lower than 300Hz, total integral which was sum of higher and lower integral, peak amplitude, and peak frequency in each opening movement, which was carried out three times in each head posture. Integral means amount of vibration. The data obtained were analysed by SPSS windows program and the results of this study were as follows : 1. In NHP, total integral in right TM joint was 5O.3Hz in the first opening, 67.9Hz in the second opening, and 74.0Hz in the third opening movement, bur there was no significant increase of total integral with repetitive opening movement. This finding was similar in left TM joint. Integral lower than 300Hz were higher than integral higher than 300Hz in almost every opening movement. 2. There was no significant difference of total integral between right and left side of TM joint, but there was a tendency of higher total integral in right TM joint than that in left TM joint except for results in DHP. 3. Peak amplitude in NHP ranged from 2.0 to 4.7, and peak frequency in NHP were 101.4-170.0Hz. And there was no consistent findings related to increase or decrease of these value according to repetitive opening in each head posture. 4. Change of head posture did not result any difference in integral, peak amplitude, and peak frequency. In conclusion, change of head posture and repetitive mandibular opening movement did not make any significant effect on the vibration of temporo-mandibular joint, especially, on total integral, peak amplitude, and peak frequency.
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