• The Korean Journal of Pain
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• v.37 no.2
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• pp.164-177
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• 2024

Background: Neck and jaw pain is common and is associated with jaw functional limitations, postural stability, muscular endurance, and proprioception. This study aimed to investigate the effect of jaw and neck pain on cranio-cervico-mandibular functions and postural stability in patients with temporomandibular joint disorders (TMJDs). Methods: Fifty-two patients with TMJDs were included and assessed using Fonseca's Questionnaire and the Helkimo Clinical Dysfunction Index. An isometric strength test was performed for the TMJ depressor and cervical muscles. The TMJ position sense (TMJPS) test and cervical joint position error test (CJPET) were employed for proprioception. Total sway degree was obtained for the assessment of postural stability. Deep neck flexor endurance (DNFE) was assessed using the craniocervical flexion test. The mandibular function impairment questionnaire (MFIQ) was employed to assess mandibular function, and the craniovertebral angle (CVA) was measured for forward head posture. Results: Jaw and neck pain negatively affected CVA (R² = 0.130), TMJPS (R² = 0.286), DNFE (R² = 0.355), TMJ depressor (R² = 0.145), cervical flexor (R² = 0.144), and extensor (R² = 0.148) muscle strength. Jaw and neck pain also positively affected CJPET for flexion (R² = 0.116) and extension (R² = 0.146), as well as total sway degree (R² = 0.128) and MFIQ (R² = 0.230). Conclusions: Patients with painful TMJDs, could have impaired muscle strength and proprioception of the TMJ and cervical region. The jaw and neck pain could also affect postural stability, and the endurance of deep neck flexors as well as mandibular functions in TMJDs.

• PNF and Movement
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• v.4 no.1
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• pp.63-69
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• 2006

Purpose : To identify the effects of Hold-Relax of proprioceptive neuromuscular facilitation (PNF) on the functional improvement of patients with neck myofascial pain syndrome. Methods : The present research investigated 30 patients with neck myofascial syndrome, dividing them into a group doing Hold-Relax of proprioceptive neuromuscular facilitation. This study examined degree of recovery from neck pain by comparing their neck myofascial pain syndrome before and after the treatment, and compared to find difference in the degree of recovery from myofascial pain syndrome. Results : The results are as follows. For the Hold-Relax of proprioceptive neuromuscular facilitation(PNF), the visual analogue scale(VAS) decreased significantly for six weeks treatment, and the range of motion(ROM) of cervical vertebrae increased significantly(p<.05). Conlusion : This study suggest that Hold-Relax of proprioceptive neuromuscular facilitation have an effect on the functional improvement of patients with neck myofascial pain syndrome.

• The Journal of Korean Physical Therapy
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• v.28 no.6
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• pp.349-354
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• 2016

Purpose: The purpose of the study was to investigate the thickness of deep neck flexors (DNF) and sternocleidomastoid muscle (SCM) bilaterally during deep neck flexor endurance test using ultrasonography images. Methods: Healthy volunteers (n=22), 20-25 (mean 22.2) years old, were recruited for the study. Participants were asked to perform the craniocervical flexion test (CCFT) in a seated position to measure deep neck flexor endurance. The thickness of DNF and SCM was assessed bilaterally and was measured using ultrasonography images at resting, contracted, pre-terminal and terminal phases of the neck muscle endurance test. Muscle contraction pattern was also observed along with the changes in muscle thickness from the resting phase to the terminal phase. Repeated-measure ANOVA was employed to compare muscle thickness bilaterally at each phase. Results: The thickness of right and left muscles was found to be significantly different in DNF both at resting and contracted phases (p=0.02, p<0.01, respectively), whereas no significant difference was observed in SCM at resting or contracted phases (p=0.59, p=0.18, respectively). Thickness changes from resting to contracted phase were not significantly different both in DNF and SCM (p=0.18, p=0.22, respectively). Muscle contraction patterns in right and left muscles were shown to be similar. Conclusion: The current study, performed on (with) healthy subjects, significantly detected different right and left muscle thickness in DNF, but the muscle contraction patterns were similar in DNF and SCM bilaterally. Further study is required to investigate DNF and SCM muscle size and function in people with neck pain.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.29 no.3
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• pp.43-53
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• 2023

Background: Patients with neck pain develop instability due to muscle imbalance, decreased proprioception, and balance disorders. Studies have examined various exercise methods as treatment methods, but few studies have compared the effects of cervical stabilization exercise and dynamic balance exercise. The purpose of this study was to investigate the effects of dynamic balance exercise on pain, functional level, and psychosocial level in patients with non-specific chronic neck pain. Methods: Thirty-four non-specific chronic neck pain patients were randomly assigned to the experimental group (EG, n=17) and control group (CG, n=17); the cervical stabilization exercise and dynamic balance exercise program were applied to the EG; and only the cervical stabilization exercise program was applied to the CG. The intervention was conducted twice a week, for six weeks. Assessment items evaluated pain, dysfunction (Korean version neck disability index), range of motion, craniocervical flexion test, cervical deep flexor endurance test, and psychosocial level. Data analysis was performed using intention-to-treat analysis as assigned. To analyze differences in the items assessed in the two groups, we used a repeated measures analysis of variance with an interaction between group (EG, CG) and time point (baseline, 6 weeks, 12 weeks). Results: The endurance of the cervical flexor muscles between the group and the measurement point after intervention (p<.05). Both groups showed significantly improved endurance between time points after the intervention (p<.05), with the EG showing a greater change than the CG. None of the other measurement items differed in the pattern of change between measurement points. Conclusion: In conclusion, the EG applying a cervical stabilization exercise and a dynamic balance exercise experienced a significant difference in muscle endurance improvement compared to the CG. We propose an exercise intervention program that includes stabilization exercises and dynamic balance exercises for patients with chronic cervical pain who lack muscle endurance.

• Journal of the Korean Society of Radiology
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• v.8 no.2
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• pp.89-96
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• 2014

This paper tries to examine whether the application of joint mobilization to subjects who have the forward head posture due to malalignment in the cervical joint has influence on posture changes and functions in the cervical joint. The subjects were 39 students from G University in Gyeongsangbuk-do. The cervical joint mobilization was applied to 20 subjects and not to 19. The students with a cervical lordosis angle of $21^{\circ}C$ or less, an anterior weight bearing (AWB) of 15mm or greater, and a cervical extension ROM of $70^{\circ}C$ or less in terms of radiography were selected as subjects under their voluntary agreement. The patients actively performed the joint mobilization slowly 8 times per session while therapists continuously applied sustained accessory glide to their painful joints 3 times per week for 4 weeks along with the cervical expansion and flexion in SNAGS among other Mulligan's (1995) techniques. The measurement was carried out in terms of radiographic inspection and neck disability indexes. As a result of the experiment, it turned out that the subjects with the forward head posture had changes in the cervical AWB and ARA, the ranges of expansion and flexion, and the NDI(Neck Disability Index) after the intervention for the experimental group by applying cervical joint mobilization. There were no changes observed in the control group. In conclusion, the application of joint mobilization turned out to have influence on the improvement of cervical joint postures, and craniocervical region functions.