• Journal of the Korean Society of Physical Medicine
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• v.10 no.4
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• pp.69-80
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• 2015

PURPOSE: The purpose of the present study was to apply joint mobilization in a sitting position and in a prone position to patients with acute mechanical neck pain and compare the immediate treatment effects in these two positions. METHODS: After the baseline was assessed, 46 patients were randomly assigned to two groups: experimental group I ($n_1=23$) for joint mobilization in the sitting position and experimental group II ($n_2=23$) for joint mobilization in the prone position at the symptomatic cervical level. The patients in both groups received treatment by unilateral posterior-anterior gliding for 30 seconds per trial, 10 trials per session, for a total of 5 minutes, and two trials of 10 active extending motions with distraction per trial. RESULTS: In the Wilcoxon signed-rank test, all the pain and physical function variables were significantly improved after intervention in both groups (p<.05). In the Mann-Whitney U test, which compared the differences before and after the intervention between the two groups, experimental group I showed significant improvement over experimental group II in resting pain (p<.01), satisfaction with the treatment (p=.01), left rotation (p<.01) and CCFE (p<.01). In the analysis of covariance results, experimental group I showed significant improvement over experimental group II in the most painful motion pain (p<.01) and the most painful quadrant motion pain (p<.01). CONCLUSION: These outcomes suggest that joint mobilization should be applied in sitting positions for patients with acute mechanical neck pain that feel pain during sustained positions, extension or rotation.

• Physical Therapy Korea
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• v.22 no.3
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• pp.50-60
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• 2015

The purpose of this study was to apply the joint mobilization technique to the level of segments with pain and to the level of segments with hypomobility respectively and compare the immediate effects of the joint mobilization technique on the pain, the active cervical range of motion (ROM), and treatment satisfaction of patients with acute mechanical neck pain. After the baseline assessment, forty-two patients were randomized into two groups: a painful group ($n_1=21$) that received joint mobilization at the most painful cervical spine level and a hypomobile group ($n_2=21$) that received joint mobilization at the most hypomobile cervical level. The patients received an intervention that applied unilateral posterior-anterior gliding for 5 minutes and two repetitions of 10 times of active extension motion with distraction. In the Wilcoxon signed-rank test, the painful group and the hypomobile group were improved significantly in all pain variables (p<.001), while the painful group was improved significantly in the active cervical flexion (p<.001), extension (p<.001), left side-bending (p<.01), right side-bending (p=.001), left rotation (p<.001), and right rotation (p<.001). The hypomobile group was significantly improved in active cervical flexion (p=.001), extension (p<.001), left side-bending (p<.05), right side-bending (p=.001), left rotation (p=.001), and right rotation (p<.01) after intervention. In the Mann-Whitney U test, there was no significant difference in any of the dependent variables after the intervention between the two groups, but the painful group was slightly superior to the hypomobile group in all variables except for the right lateral flexion ROM and treatment satisfaction. These outcomes suggest that the cervical joint mobilization may be applied to either the level of painful segments or the hypomobile segments for the treatment of patients with acute mechanical neck pain.

• Korean Journal of Oriental Medicine
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• v.2 no.1
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• pp.514-550
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• 1996

There are many theory in acupuncture mechanism, so we must know the detail contents. and then we can use the acupuncture as we know. the follow article will be helpful in this part. 1. Spinal cord are role in intermediate part in somatosensorypathway also in acupuncture stumulating tract 2. Acute pain pathway started in laminae I, V of gray colmn, next are the spinothalamic tract(trigeminal spinothalamic tract in above neck part) and then go to the specific thalamic nucleus. but chronic pain in laminae II, III, VI, VII, next are spinoreticular tract(trigeminal spinoreticular tract in the neck part) and finally to the nonspecific thalamic nucleus. 3. Thalamus is very important area in somatosensory stimuation including acupuncture stumulating sensory also as a pain control center. but except this, there are Hypothalamus, Limbic system Cerebral cortex and Cerebellum as intermediator. as we Know hypothalamus is related to the emotional analgesic system with a limbic system. 4. A ${\delta$ fiber has relationship in Acute, sharp and initial pain, contrary this C fiber is related with Chronic, dull and last pain. 5. In Acupuncture mechanism of pain analgesia, there are two theory, one is gate control theory as large fiber another is stimuation produced analgesia as small diameter fier. 6. In DNIC, the stimulation sources are mechanical, thermal, heating, pain and acupuncture stimulation etc. we call these as a Heterotopic Noxious Stimulation. 7. In DNIC, SRD(Subnucleus reticularis dorsalis)is core nucleus in pain imtermediated analgesic mechanism. 8. Takeshige insisted nonacupuncture point dependent analgesic mechanism and acupuncture point dependent analgesic mechanism. and protested that Stimulation acupuncture piing evoke blocking nomacupuncture point analgesic pathway.