• Journal of the Korean Society of Physical Medicine
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• v.9 no.1
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• pp.125-132
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• 2014

PURPOSE: This study aims to determine the optimal knee joint angle and hip joint angle for minimizing the cervical muscle tension and maximizing the muscle activity of the trunk during the bridging exercise for trunk stabilization. METHODS: The bridging exercise in this study included seven forms of exercise: having a knee joint flexion angle of $120^{\circ}$, $90^{\circ}$, $60^{\circ}$, $45^{\circ}$ and hip joint abduction angle of $15^{\circ}$, $10^{\circ}$, $5^{\circ}$. The posture of the bridging exercise was as follows. To prevent the increase of hyper lumbar lordosis during the bridging exercise, the exercise was practiced after maintaining the lumbar neutral position through the pelvic posterior tilting exercise. RESULTS: The abduction angles did not result in statistically significant effects on the cervical erector, external oblique, rectus abdominis and erector spinae muscles. However, in relation to the knee joint angles, during the bridging exercise, statistically significant results were exhibited. CONCLUSION: The knee joint angle affected the muscle activity of the neck muscle. The greater the knee joint angle, the lower the load placed on the neck muscle. In contrast, the load increased as the knee joint angle decreased. In addition, the muscle activity of the neck muscle and trunk muscle increased as the knee joint angle decreased.

• Journal of The Korean Society of Integrative Medicine
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• v.10 no.4
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• pp.241-250
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• 2022

Purpose : The purpose of this study was to investigate the effect of backward walking exercise on changes in the cervical angle and gait parameters in subjects with moderate forward head posture. Methods : Four subjects were selected for this study. In particular, subjects with an average of 43 subjects with moderate craniovertebral angles were selected as the criteria for subject selection. The exercise program consisted of a 5 minutes warm-up exercise, 20 minutes main exercise, and 5 minutes cool-down exercise. In the main exercise, the treadmill speed was 2.5 km/h for men, 2.0 km/h for women in the first week, from the 2nd week to the 4th week, it was increased by 0.5 km/h every week. Results : Craniovertebral angle increased by 2.06±2.46 ° before and after the backward walking exercise, and craniorotational angle decreased by -1.69±3.33 ° before and after exercise. As for the gait parameters, in the amount of change before and after the backward walking exercise, the left foot pressure was 4.58±5.70 % from front to back and the right foot pressure was 5.08±3.06 % from front to back. The left step length and right step length showed a change of -.33±4.43 cm and -2.08±7.26 cm, respectively. stride length showed a change of -2.59±11.18 cm. The left and right stance phase showed a change of -1.02±2.03 % and -1.23±1.54 %, respectively. The left and right swing phase showed changes of 1.02±2.03 % and 1.22±1.53 %, respectively. The left and right step times were -.01±.06 sec and -.02±.12 sec, respectively. The stride time showed a change of -.03±.18 sec. Conclusion : Changes in cervical angle and gait parameters were confirmed by performing backward walking exercise for subjects with moderate forward head posture for 4 weeks. Therefore, additional research should be conducted based on this case study.

• Journal of Korean Neurosurgical Society
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• v.56 no.2
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• pp.114-120
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• 2014

Objective : At present, gold-standard technique of cervical cord decompression is surgical decompression and fusion. But, many complications related cervical fusion have been reported. We adopted an extended anterior cervical foraminotomy (EACF) technique to decompress the anterolateral portion of cervical cord and report clinical results and effectiveness of this procedure. Methods : Fifty-three patients were operated consecutively using EACF from 2008 to 2013. All of them were operated by a single surgeon via the unilateral approach. Twenty-two patients who exhibited radicular and/or myelopathic symptoms were enrolled in this study. All of them showed cervical cord compression in their preoperative magnetic resonance scan images. Results : In surgical outcomes, 14 patients (64%) were classified as excellent and six (27%), as good. The mean difference of cervical cord anterior-posterior diameter after surgery was 0.92 mm (p<0.01) and transverse area was $9.77mm^2$ (p<0.01). The dynamic radiological study showed that the average post-operative translation (retrolisthesis) was 0.36 mm and the disc height loss at the operated level was 0.81 mm. The change in the Cobb angle decreased to 3.46, and showed slight kyphosis. The average vertebral body resection rate was 11.47%. No procedure-related complications occurred. Only one patient who had two-level decompression needed anterior fusion at one level as a secondary surgery due to postoperative instability. Conclusions : Cervical cord decompression was successfully performed using EACF technique. This procedure will be an alternative surgical option for treating cord compressing lesions. Long-term follow-up and a further study in larger series will be needed.

• Physical Therapy Korea
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• v.27 no.4
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• pp.272-277
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• 2020

Background: Forward head posture (FHP) is common postural malalignment. FHP is described relatively extension to upper cervical and lower cervical is relatively flexion. Although several researchers mentioned the lower cervical flexion posture in FHP, most of the studies related to FHP is focused on the deep cervical flexor function. Objects: The purposes of present study is to compare the cervical strength (upper cervical extension [UCE], lower cervical extension [LCE], upper cervical flexion [UCF], lower cervical flexion [LCF]) between individuals with and without FHP. Methods: Fifty-one participants are recruited. Participants who have the craniovertebral angle (CVA) less than 48 degree were classified to the FHP group (n = 24) and the others were included in without FHP group (n = 27). The cervical strength (UCE, LCE, UCF, LCF) were measured using Smart KEMA strength sensor and the strength data was normalized by body weight. All strength measurement conducted at head and neck neutral position in sitting. Independent t-test was used to compare the cervical strength between individuals with and without FHP. Results: The mean value of CVA was greater in without FHP group than with FHP group (p < 0.000). The strength value of UCF (p < 0.002) and LCE (p < 0.001) was significant less in FHP group than without FHP group. But no significant differences were seen in the LCF and UCE strength between two groups. Conclusion: UCF and LCE weakness in FHP group should be considered to evaluate and manage the individuals with FHP.

• The Journal of Korean Physical Therapy
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• v.14 no.1
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• pp.187-195
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• 2002

This study was performed to assess the efficacy of Activator for the patient with chronic neck pain. Mail, 26 years old, is treated with Activator, which was applied for 15 minutes every two days during the 4 weeks. The results of this study are as follows: 1. The treated case compared with the previous case showed that R.O.M particularly increased in flexion and extension. 2. The atlas/skull angle compared with the previous case showed that the angle increased from $0.8^{\circ}$ to $1.5^{\circ}$. In the atlas/skull, normal angle is $5.6^{\circ}$. 3. The angle of cervical curve lordosis compared with the previous case showed that the angle increased from $38.3^{\circ}$ to $48.1^{\circ}$. In the healthy spine, the angle is $42.0^{\circ}$. 4. The anterior curvature compared with the previous case showed that curve radii decreased from 7,220mm to 200mm. In the spine, normal curvature is 165mm. 5. Rush Jackson's angle compared with the previous case showed that the angle increased from $14.8^{\circ}$ to $29.1^{\circ}$. In the healthy spine, normal angle is $39.9^{\circ}$. We can not find significant level for Activator, but it is considered that activator method of chiropractic technique is effective.

• PNF and Movement
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• v.22 no.1
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• pp.1-11
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• 2024

Purpose: The prevalent use of mobile devices may contribute to musculoskeletal disorders, such as forward head posture (FHP), among users. The measurement of the craniovertebral angle (CVA) using photographic images is frequently employed in assessing FHP. Although manual CVA measurement using photographic images is reliable in clinical settings, computer programs or mobile applications to support tele-physical therapy are not yet fully developed. Therefore, in the current study, we propose an automatic method for extracting CVA from photographic images of FHP subjects to facilitate tele-physical therapy. Methods: To develop the automatic CVA measuring computer program, photographic images were obtained from 10 FHP participants. The location information obtained from the markers attached to the tragus and the spinous process of the seventh cervical vertebra were used as coordinates. Using these coordinates, straight line 1 was generated by connecting the seventh spinous process of the cervical vertebra and the tragus, while straight line 2 was drawn parallel to the coordinate obtained from the seventh spinous process of the cervical vertebra. The arc tangent function was used to calculate the angle between the two straight lines. The automatic CVA measurement computer program utilizing photographic images was developed using MATLAB (ver. 2016b). Results: The results showed that the automatic CVA measurement computer program demonstrated stable repeatability and high accuracy. Conclusion: The proposed approach was able to automatically estimate the CVA using photographic images. The developed computer program can potentially be used for easier and more reliable clinical assessment of FHP.

• The Journal of Churna Manual Medicine for Spine and Nerves
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• v.8 no.2
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• pp.21-29
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• 2013

Objectives : The purpose of this study is to investigate the relation between cervical spine lateroflexion and upper limb numbness after whiplash injury by traffic accident. Methods : Outpatients who visited Jaseng korean medicine hospital after traffic accident took cervical MRI. Patients who had Normal disc and bulging disc were reviewed to measure the cervical lateroflexion by C2-C7 Cobb's angle & scalenus muscle's length through neutrality AP X-ray views. For statistics, we used SPSS version 18.0 for windows. Results : Groups classified into difference of scalenus muscle's length were showen statistical significance than into cobb's angle. Means of numbness group's length difference are $4.18{\pm}2.26mm$ and that of non-numbness group is $1.59{\pm}1.17mm$. Unilateral numbness group had greater angle and longer of length's difference than non-numbness group. Conclusions : The more severe the lateroflexion of the upper extremity numbness occurs well. Group classifed into difference of scalenus muscle's length has more tendency of occurrence of upper limb numbness than that into cobb's angle. And upper limb numbness occurs more frequently at the same direction of lateroflexion.

• Journal of the Ergonomics Society of Korea
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• v.30 no.2
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• pp.339-347
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• 2011

Objective: The purpose of this study was to evaluate of various material of pillows by using biomechanical variables such as the cervical stability, head pressure distribution, and muscle activity. Method: Eight subjects participated in the experiment. Three different materials such as polyester sponge, memory foam and the buckwheat shell used for Korean traditional pillow were tested. Electro-goniometer, six channels of electromyography(EMG), ten channels of the head pressure sensors were used to measure the biomechanical responses. Surface electrodes were attached to the right/left semispinals capitis(RSC, LSC), the right/left sternocleidomastoid(RSM, LSM), the right/left upper trapezius(RUT, LUT). The cervical stability was evaluated by the angle deviated from the standing neck position. The head pressure distribution was evaluated by the pressure per unit area recorded on the sensors and the intensity of peak pressure. Electromyography(EMG) data were analyzed by using root mean square(RMS) and mean power frequency(MPF). Results: The buckwheat shell material showed a higher stability in the cervical spine then the other pillows during spine position. In terms of head pressure distribution, the memory form indicated the lowest pressure at supine position, buckwheat shell material indicated the lowest pressure during lying down to side, and polyester cushion recorded the highest pressure at all postures. Conclusion: The buckwheat shell material has a biomechanical advantage to maintain a healthy neck angle and reduce the pressure on the head, which means the buckwheat shell is a potential material for ergonomic pillow design. The pillow with memory form showed second best biomechanical performance in this study. Application: The shape of the buckwheat shell pillow and the characteristics of materials can be used to design the pillow preventing neck pain and cervical disk problems.

• Journal of Korean Neurosurgical Society
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• v.48 no.4
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• pp.342-346
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• 2010

Objective : This study assessed the efficacy of anterior cervical discectomy and fusion (ACDF) with cage alone compared with ACDF with plate instrumentation for radiologic and clinical outcomes in two-level cervical degenerative disease. Methods : Patients with cervical degenerative disc disease from September 2004 to December 2009 were assessed retrospectively. A total of 42 patients received all ACDF at two-level cervical lesion. Twenty-two patients who underwent ACDF with cage alone were compared with 20 patients who underwent ACDF with plate fixation in consideration of radiologic and clinical outcomes. Clinical outcomes were assessed using Robinson's criteria and posterior neck pain, arm pain described by a 10 point-visual analog scale. Fusion rate, subsidence, kyphotic angle, instrument failure and the degenerative changes in adjacent segments were examined during each follow-up examination. Results : VAS was checked during each follow-up and Robinson's criteria were compared in both groups. Both groups showed no significant difference. Fusion rates were 90.9% (20/22) in ACDF with the cage alone group, 95% (19/20) in ACDF with the plate fixation group (p = 0.966). Subsidence rates of ACDF with cage alone were 31.81% (7/22) and ACDF with plate fixation were 30% (6/20) (p = 0.928). Local and regional kyphotic angle difference showed no significant difference. At the final follow-up, adjacent level disease developed in 4.54% (1/22) of ACDF with cage alone and 10% (2/20) of ACDF with plate fixation (p= 0.654). Conclusion : In two-level ACDF, ACDF with cage alone would be comparable with ACDF with plate fixation with regard to clinical outcome and radiologic result with no significant difference. We suggest that the routine use of plate and screw in 2-level surgery may not be beneficial.

• Journal of Korean Neurosurgical Society
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• v.59 no.4
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• pp.368-373
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• 2016

Objective : Delayed hinge fracture (HF) that develops after cervical open door laminoplasty can be a source of postoperative complications such as axial pain. However, risk factors related to this complication remain unclear. We performed a retrospective clinical series to determine risk factors for delayed HF following plate-only open-door cervical laminoplasty. Methods : Patients who underwent plate-only open-door laminoplasty and had available postoperative computed tomography (CT) scans (80 patients with 270 laminae) were enrolled. Hinge status, hinge gutter location, open location, hinge width, number of screws used, operation level, and open angle were observed in the CT to determine radiographic outcome. Demographic data were collected as well. Radiographic and clinical parameters were analyzed using univariate and multivariate logistic regression analysis to determine the risk factors for HF. Results : Univariate logistic regression analysis results indicated poor initial hinge status, medially placed hinge gutter, double screw fixation on the elevated lamina, upper surgical level, and wide open angle as predictors for HF (p<0.05). Initial hinge status seemed to be the most powerful risk factor for HF (p=0.000) and thus was collinear with other variables. Therefore, multivariate logistic regression analysis was performed excluding initial hinge status, and the results indicated that medially placed hinge gutter, double screw fixation on the elevated lamina, and upper surgical level were risk factors for HF after adjustment for other confounding factors. Conclusion : To prevent HF and to draw a successful postoperative outcome after cervical laminoplasty, surgical and clinical precautions should be considered.