• Physical Therapy Rehabilitation Science
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• v.12 no.2
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• pp.105-114
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• 2023

Objective: The study examined the validity and reliability of tele-assessment of cervical range of motion (ROM) through video conferencing. Design: A cross-sectional study Methods: The study included 22 healthy adults as subjects and 10 physical therapists as evaluators. The subjects underwent both face-to-face and tele-assessment of cervical ROM. The CROM (Cervical Range of Motion) device was used for reference measurements in the face-to-face assessment. The evaluators assessed the subjects' ROM through visual inspection (VI) and using a Universal Goniometer (UG) in the tele-assessment. Results: The results showed a significant correlation between the face-to-face and tele-assessment measurements for all ROM contents. The correlation coefficients ranged from r=0.54 to 0.71 (p<0.05), indicating concurrent validity. In terms of inter-rater reliability, the ICC values for both VI and UG assessments in the tele-assessment were high, with ICCs of 0.93 and 0.92, respectively. Additionally, the study investigated the usability of the tele-assessment method and environment. The satisfaction of the participants and evaluators was assessed using the Telehealth Usability Questionnaire (TUQ), which evaluates perceptions, usability, and satisfaction with telehealth services. Conclusions: In conclusion, tele-assessment of cervical range of motion using video conferencing was valid and reliable. Also, investigated participant and evaluator satisfaction and opinions, providing insights into the clinical value of tele-assessment. It is important to note that the study was conducted only healthy adults, and further research may be needed to validate the tele-assessment method in populations with cervical dysfunction or neck pain. These findings support the potential effectiveness of telerehabilitation services in assessing and managing musculoskeletal disorders.

• Journal of Acupuncture Research
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• v.30 no.4
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• pp.25-33
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• 2013

Objectives : To assess the test-retest reliability and the intratest repeatability in measuring the cervical range of motion of healthy subjects with wireless microelectromechanical system inertial measurement unit(MEMS-IMU) system and to discuss the feasibility of this system in the clinical setting to evaluate the cervical spine musculoskeletal. Methods : 12 healthy people who were evaluated as no- or mild-disability with neck disability index were participated. Their cervical motion were measured with IMU twice in consecutive two days for the test-retest reliability study. Intratest repeatability was calculated in the two tests separately. The calculated intraclass correlation coefficients(ICC) were discussed and compared with the those of the previous studies. Results : Cervical range of motion data were acquired and statistically processed: left rotation($61.64^{\circ}$), right rotation($65.12^{\circ}$), extension($61.98^{\circ}$), flexion($52.81^{\circ}$), left bending($39.31^{\circ}$), right bending($41.08^{\circ}$). ICCs were 0.77~0.98(intratest repeatability) and 0.74~0.93 (test-retest reliability) in the primary motion. In the coupling motion, intratest repeatability ICCs were 0.93~ 0.99(transverse primary plane), 0.88~0.97(saggital primay plane), and 0.77~0.93(coronal primary plane). Test-retest reliability of coupling motion were 0.90~0.97(transverse primary plane), 0.00~0.72(saggital primary plane), and 0.04~0.76(coronal primary plane). Conclusions : Several types of range-of-motion devices are now on use in many fields including medicine, but the practicality of the devices in clinical use is questionable for the convenient and economical aspects. In this study, we presented the reliability of cervical range of motion test with the developed wireless MEMS-IMU system and discussed its potential utility in clinical use.

• Physical Therapy Rehabilitation Science
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• v.4 no.1
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• pp.49-54
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• 2015

Objective: Cervical stabilization exercises are frequently to improve strength and endurance of cervical muscles. The purpose of this study was to identify changes in head repositioning accuracy (HRA) and neck proprioception through cervical stabilization exercises in healthy adults. Design: One group pretest-posttest design. Methods: Thirteen participants with no previous history of neck pain or injury to the cervical spine were recruited. HRA was measured by equipment including laser pointer, helmet, eye patch and marking pens. The distance between the spot where the beam had stopped and the center of the graph paper was measured three times with the averaged value used as the head repositioning accuracy. Neck proprioception was measured by a cervical range of motion device (CROM). Subjects wore the CROM tester and were to look straight ahead while bending his/her neck. Subjects were instructed to perform extension, lateral flexion and rotation, and the values were then measured and recorded. The measurements were performed pre-intervention, and after cervical stabilization exercise. Results: There was no significant difference on HRA after intervention. In addition, there was no significant difference on neck proprioception compared with pre-intervention. Conclusions: The present study did not identify any effect on HRA and neck proprioception of cervical stabilization exercise. Further investigations are required to elucidate this in old aged participants and patients with neck pain.

• Journal of the Korean Society of Physical Medicine
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• v.7 no.4
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• pp.509-514
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• 2012

PURPOSE: This study aims to compare the effects of upper backbone joint mobilization and self-stretching exercise in the patients with chronic neck pain. METHODS: Thirty seven patients with chronic neck pain were divides into self stretching group(SSG, n=18) and mobilization group(MG, n=19). To assess the degree of neck pain, the visual analog scale (VAS) was utilized, and to measure the joint range of motion at the flexion-extension, it was compared and analyzed by using the cervical range of motion (CROM) device. RESULTS: The joint range of motion and visual analog scale of SSG and MG showed significant effects on both groups. In the comparison of groups, there was no significant difference, but it indicated effects on improving the pain and the range of joint motion in MG. CONCLUSION: According to the analysis, not only self-stretching exercise intervening for direct treatment but also upper backbone joint mobilization intervening for indirect treatment are effective to improve the pain and the range of motion.

• Journal of The Korean Society of Integrative Medicine
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• v.9 no.1
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• pp.123-131
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• 2021

Purpose : The time spent using smart devices is constantly increasing, particularly in recent times. Using smart devices for a long time with an incorrect posture may lead to cerebral palsy (CP), instability, and abnormal muscle tone. Therefore, we aimed to investigate the relationships among cervical instability, deep neck flexor (DNF) activity, range of motion (ROM), and muscle tonus. Methods : Fifty subjects with CP participated in this study, and they were physiotherapists at W Hospital in Daejeon. Those who voluntarily participated in the research were selected as candidates who fulfilled the selection criteria. According to an instability test, 25 subjects were assigned to the instability and control groups. All subjects first underwent the instability test to be allocated to the appropriate group. Those in the instability group tested positive on the instability test. The Neck Disability Index (NDI), ROM, muscle tone, and DNF activity were measured to evaluate their relationships. The DNF strength and endurance were measured using a cranio-cervical flexion test. The upper trapezius (UT), sternocleidomastoid (SCM), and suboccipital (SO) muscle tones were measured using a contact soft tissue tone measuring instrument. The statistical significance level was set to .05. Results : There were significant differences in the flexion, extension, and rotation of the cervical ROM (CROM) between the two groups (p<.05). The SCM, UT, and SO muscle tones were significantly different between the two groups (p<.05). The DNF strength and endurance showed a significant difference between the two groups (p<.05). Conclusion : We found that there were significant increases in the CROM and muscle tone and decrease in the DNF strength and endurance in the instability group. This indicated that cervical instability is affected by the DNF strength and endurance. We may recommend DNF exercises in cases of cervical instability in clinical environments.

• The Journal of Korean Physical Therapy
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• v.21 no.4
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• pp.1-7
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• 2009

Purpose: Cervical pain is caused mainly by a static position, lasting work, bad habits and stress, and is accompanied by pain in the upper trapezius. Traditionally, heat and traction, exercise, mobilization, manipulation have been used to treat cervical pain. This study examined the effect of stretching and manipulation (high-velocity low-amplitude: HVLA) on the pain and ROM in women with chronic cervical and upper shoulder pain. Methods: Fifty-two women diagnosed with chronic cervical and upper shoulder pain were enrolled in this study. Among them, 26 patients (experiment group) were managed by passive stretching and manipulation, and another 26 patients (control group) were treated with physical therapy intervention (hat pack: HP, transcutaneous electrical nerve stimulation: TENS, ultra sound: US). Each group made use of a Visual Analogue Scale (VAS) and the highly reliable (flextion: 0.92, extention: 0.99) cervical range of motion (CROM) to compare the possible changes in pain and ROM in the two groups after treatment. Results: In the experimental group, the pain decreased and the ROM has increased in all directions. In the control group, the pain decreased but the ROM was not changed in all directions. Conclusion: According to the results, passive stretching and manipulation is effective for increasing the ROM and decreasing the level of pain. Moreover, physical therapy intervention (HP, TENS, US) is effective for immediately decreasing the pain but has little effect on the ROM.

• Journal of the Korean Society of Physical Medicine
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• v.11 no.1
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• pp.71-82
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• 2016

PURPOSE: The purpose of this case report was to determine the effect of therapeutic exercise on posture, pain, and muscle activity in two patients with forward head posture (FHP). METHODS: A-31-year-old male (patient A) and a 19-year-old women (patient B) presented with FHP, neck pain, and headache. The therapeutic exercise program consisted of cervical mobilization, deep cervical flexors strengthening, and cervical extensors stretching, for 40 min/d, 2 d/week, for 8 weeks. Neck pain (VAS), neck disability (NDI), cervical range of motion (CROM), lateral view of cervical spine X-ray (indicating the FHP), and asymmetrical neck and shoulder muscular activity ratio were measured before, after 4 weeks, and after 8 weeks of corrective exercise. RESULTS: VAS and NDI decreased in patients A and B after exercise compared to before the program. CROM increased in patients A and B at flexion, extension, side bending, and rotation after exercise compared to before the program. FHP decreased in patients A and B at distance after exercise compared to before the program. In addition, asymmetrical neck and shoulder muscles activity ratio improved in patients A and B after exercise compared to before the program. CONCLUSION: We demonstrated in a case report that therapeutic exercise increases ROM, decreases pain and disability of neck, FHP, and asymmetry muscle activity ratio in patients with FHP. These finding have clinical implications for therapeutic exercise in patients with FHP.

• Journal of the Korean Society of Physical Medicine
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• v.4 no.4
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• pp.257-267
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• 2009

Purpose：The purpose of this study is to examine the effectiveness of ultrasound and myofascial release in patients who have opening mouth limitation and temporomandibular disorder. Methods：Twenty students were randomly assigned to a myofascial release group(n=10) or an ultrasound group(n=7). Each group was treated for 15 minutes per a every treatment session for four weeks. Cervial range of motion(CROM) was used to measure cervical R.O.M., and a mm(millimeter) graduated ruler was used to measure opening mouth limitation. Results：Results of the follows : 1. The neck extension of range of motion of both groups was significantly increased in length of time (p<.05). 2. The neck flexion of range of motion of both groups was significantly increased (p<.05). 3. The quantity of opening mouth of temporomandibular joint of both groups was significantly increased (p<.05). Conclusion：These data suggest that myofascial release and ultrasound are beneficial to increasing a functional recovery of neck(flexion and extension) and opening mouth.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.28 no.1
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• pp.39-51
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• 2022

Background: The purpose of this study is to investigate the effect of neck and shoulder self-stretching exercise using audiovisual media on neck pain, postural alignment, and joint position error in women with chronic neck pain. Methods: The subjects included 20 women that gave consent to participate in the study voluntarily. They performed the self-stretching exercises using audiovisual media was carried out 20 minutes 5 times a week during 3 weeks. Neck disability index (NDI) and visual analogue scale (VAS) were used to measure the functional disability and pain, A pressure pain threshold was measured using an algometer, and a cervical range of motion (CROM) measurement tool was used to measure the range of motion and error of proprioceptive position sense of the cervical spine. To assess posture alignment, forward head angle (FHA), forward shoulder angle (FSA) were measured using image J software. Results: The neck pain intensity was statistically significantly within group (p<.05). Neck and shoulder functional disability were a statistically significant difference within group (p<.05). Splenius capitis and upper trapezius pressure pain threshold were statistically significant difference in within group (p<.05). The postural alignment was statistically significantly within group (p<.05). The cervical range of motion in neck extension, right and left lateral flexion were statistically significantly within group (p<.05). The joint position error in neck flexion, extension, right and left lateral flexion decreased statistically significantly within group (p<.05). Conclusion: Self-stretching exercise using audiovisual media increased the mobility of the neck, decreased neck pain and joint position error, and improved posture alignment. As a result, there was a positive effect by applying the self-stretching exercise using audiovisual media to people with neck pain. Based on this, it is thought that it can be used as the basis for research related to home training programs for healthy self-management.

• Journal of Oral Medicine and Pain
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• v.20 no.1
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• pp.171-183
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• 1995

This study was carried out to investigate the relationship between tensed mandibular positions, muscle tenderness and EMG activity, respectively, and between range of motion of the neck and sternocleidomastoid muscle tenderness. Under stressful conditions, most of people take several types of behavioral patterns. Two of them observed frequently are clenching of teeth and grasping of fist. Prolonged clenching or grasping should increase electromyographic activity of associated muscle, especially muscles of mastication and neck muscles and will cause hyperfunction, dysfunction and muscle pain. So it is necessary to relate EMG activity with muscle pain. The author performed routine clinical examination in 47 patients with Temporomandibular Disorders, especially for presence or absence of muscle tenderness. Mandibular rest position was used as a baseline reference position and two more position in which EMG activity was taken were rest postion with grasping of fist and teeth clenching position. BioEMG of Biopak system (Bioresearch Inc, USA) was used for measuring of integrated EMG in masseter, anterior temporalis, anterior belly of digastic muscle and sternocleidomastoid muscle. To measure of the range of neck motion. CROM(Cervical-Range-of Motion, USA) was used. The obtained results were as follows : 1. EMG activity of all muscles except in masseter was higher in grasping of fist than those in rest position and there were significant correlation in EMG activity between the two position except in anterior belly of digastric muscle. 2. When comparing EMG activity between tender and non-tender muscle, all examined muscles did not show any significant difference. From this data, we could conclude that EMG activity was generally not changed with tenderness, of couse, it might be dependent with degree of muscle tenderness. 3. Number of tender points in examined muscles was also not significantly different between in patients with masticatory muscle disorders and in patients with internal derangement. 4. Cervical posture and range of motion of the neck was not differed significantly between in patients with and in patients without tenderness of sternocleidomastoid muscle.