• Physical Therapy Rehabilitation Science
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• 제9권4호
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• pp.302-308
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• 2020

Objective: The endurance and strength of deep neck flexor (DNF) muscles have a major role on the function and stability of the cervical spine. In recent years, there has been a lack of research that have investigated the muscle tone of the superficial neck muscles. The purpose of this study was to examine the relationship of between contraction ratio of the DNF and sternocleidomastoid (SCM) muscles, DNF endurance, and muscle tension of the neck muscles. Design: Cross-sectional study. Methods: Forty-seven subjects (male=20, female=27) participated in this study. The muscle tone of the upper trapezius (UT), SCM, and suboccipital (SO) muscle was measured using a contact soft tissue tone-measuring instrument. For the contraction ratio of the SCM and longus colli muscle, the thickness of the relaxation and maximum contraction state of the SCM and longus colli muscles were assessed using a diagnostic ultrasound measuring instrument and a pressure biofeedback unit. The deep neck flexor endurance test (DNFET) was performed in a cranio-cervical flexion posture. The correlations between the measured variables were investigated. Results: The relationship between the DNFET and SO tone showed a significant negative correlation (p<0.05). The relationship between the DNFET and contraction ratio showed a significant positive correlation (p<0.01). There was no significant correlation between the DNFET and SCM and UT tone. Conclusions: This study confirmed that there is a relationship between DNF endurance, DNF activation, and SO tone. The information on the results of this study may be used as a reference that can be actively applied in the clinical environment.

• Journal of The Korean Society of Integrative Medicine
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• 제12권3호
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• pp.143-153
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• 2024

Purpose : Forward head posture (FHP), characterized by the anterior positioning of the head relative to the spine, is a common postural deviation that can lead to neck pain, reduced mobility, and muscle imbalances. Recently, high-frequency deep heat therapy (HFDT) has been gaining attention for the intervention of FHP. This research aims to investigate the efficacy of HFDT in comparison to instrument assisted soft-tissue mobilization (IASTM) for treating FHP among 30 young adults. Methods : Participants were randomly assigned to either the HFDT or IASTM group. The study focused on examining changes in neck joint mobility, pain thresholds, rounded shoulder distance, lower trapezius muscle strength, and neck dysfunction. Measurements were taken before and after the interventions. Paired t-tests were used for within-group analyses, and independent t-tests were employed for between-group comparisons. The statistical significance level α was set to .05. Results : Statistically significant improvements were observed across all measured parameters in both groups (p<.05). The HFDT group showed significantly greater enhancements in neck joint mobility, pain thresholds, rounded shoulder distance, lower trapezius muscle strength, and neck dysfunction parameters. Specifically, HFDT was more effective than IASTM in improving neck joint mobility, right upper trapezius pain threshold, left rounded shoulder distance, and right lower trapezius strength. The only exceptions were neck flexion range of motion, left upper trapezius pain threshold, right rounded shoulder distance, and left lower trapezius strength, where no significant differences were found between the groups. Conclusion : The findings suggest that HFDT, by combining the benefits of high-frequency therapy and manual therapy, effectively alleviates upper trapezius muscle pain and tension, enhances neck mobility, and strengthens lower trapezius muscles. Thus, HFDT could be considered a valuable intervention for clinicians aiming to address FHP and associated musculoskeletal problems.

• The Journal of Korea Robotics Society
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• 제18권2호
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• pp.182-188
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• 2023

Due to the acceleration of an aging society, the need for lower limb exoskeletons to assist gait is increasing. And for use in daily life, it is essential to have technology that can accurately estimate gait phase even in the walking environment and walking speed of the wearer that changes frequently. In this paper, we implement an LSTM-based gait phase estimation learning model by collecting gait data according to changes in gait speed in outdoor level ground and stair environments. In addition, the results of the gait phase estimation error for each walking environment were compared after learning for both max hip extension (MHE) and max hip flexion (MHF), which are ground truth criteria in gait phase divided in previous studies. As a result, the average error rate of all walking environments using MHF reference data and MHE reference data was 2.97% and 4.36%, respectively, and the result of using MHF reference data was 1.39% lower than the result of using MHE reference data.

• The Journal of the Korea Contents Association
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• 제11권12호
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• pp.326-334
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• 2011

The aim of the study was to investigate the thickness of deep neck muscles during neck endurance tests using ultrasonography images to assess muscle sizes in persons with or without neck pain experience. Sixty-five university students volunteered for the study. The thicknesses of longus colli, longus capitis, semispinalis and cervical multifidus were assessed bilaterally using diagnostic ultrasound equipment during each endurance test. Participants were divided into two groups based on their Neck Pain(NP) experience; 45 subjects of those had no experience of NP (Group1) whereas 20 subjects of those reported NP experience sometime in their lives (Group2). Endurance time of both neck flexion and extension tests in Group1 showed significantly longer than Group's (p<0.01). The thicknesses of deep neck flexors and extensors were observed smallest at the terminal of endurance tests in general. Only left longus colli was found to be significantly smaller at rest in subjects of Group2 than Group 1's (P=0.02). The size difference between at contraction and the terminal of right longus capitis was observed bigger in subjects of group1 than subjects in group2. Future studies are needed to conduct with clinical subjects to assess contraction patterns of neck muscles.

• The Journal of Korean Physical Therapy
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• 제16권1호
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• pp.157-182
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• 2004

The purpose of this study was to evaluate effects of lumbar stabilizing exercise on the functional recovery and the range of motion of low back pain patients. The subjects were consisted of sixty patients who had non specific chronic low back pain(32 females. 28 males; mean aged 37.3) from 19 to 65 years of age(mean age : 37.3). All subjects randomly assigned to the lumbar stabilizing exercise group, the modalities treatment group, the manual treatment group. Lumbar stabilizing exercise group received manual treatment with lumbar stabilizing exercise for 30minutes, modalities treatment group received hot pack used thermal therapy for 20minutes and ICT used electrical therapy for 20minutes and US or MWD used deep thermal therapy for 15minutes, manual treatment group received modalities treatment with therapeutic massage for 10minutes and joint mobilization or manipulation for 10minutes per day and three times a week during 4 weeks period. The Multilevel Roland-Morris Disability Questionnaire(MR-MDQ) was used to measure functional disability level. Visual Analogue Scale(VAS) was used to measure subjective pain level. Remodified Schober test(RST) was used to measure forward flexion range of motion of lumbar segment. Finger-to-Floor test(F-T-FT) was used to measure forward flexion range of motion of full spine of low back pain patients. All measurements of each patients were measured at pre-treatment and 4 week post-treatment. The results of this study were summarized as follows : 1. The MR-MDQ of lumbar stabilizing exercise group, modalities treatment group, and manual treatment group was significantly reduced between pre-treatment and post-treatment(p<.05). 2. The VAS of lumbar stabilizing exercise group, modalities treatment group, and manual treatment group was significantly reduced between pre-treatment and post-treatment(p<.05). 3. The RST of lumbar stabilizing exercise group, modalities treatment group, and manual treatment group was significantly reduced between pre-treatment and post-treatment(p<.05). 4. The F-T-FT of lumbar stabilizing exercise group, modalities treatment group, and manual treatment group was significantly reduced between pre-treatment and post-treatment(p<.05). 5. The results of analyzed effects of MR-MDQ, RST, F-T-FT were significantly reduced (p<.05), but VAS wasn't significantly reduced(p>.05) between treatment type of lumbar stabilizing exercise group and modalities treatment group and manual treatment group according to pre-treatment and post-treatment. 6. The results of LSD post-hoc to find difference between treatment type of lumbar stabilizing exercise group and modalities treatment group and manual treatment group according to pre-treatment and post-treatment that MR-MDQ was significantly reduced stabilizing exercise group than modalities treatment group(p<.05), and VAS wasn't significantly reduced all treatment group(p>.05), and RST was significantly reduced stabilizing exercise group than modalities treatment group(p<.05), and F-T-FT was significantly reduced stabilizing exercise group than modalities treatment group and manual treatment group (p<.05).

• Journal of Korean Neurosurgical Society
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• 제61권2호
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• pp.277-281
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• 2018

Objective : Craniovertebral junctional anomalies constitute a technical challenge. Surgical opening of atlantoaxial joint region is a complex procedure especially in patients with nuchal deformity like basilar invagination. This region has actually very complicated anatomical and functional characteristics, including multiple joints providing extension, flexion, and wide rotation. In fact, it is also a bottleneck region where bones, neural structures, and blood vessels are located. Stabilization surgery regarding this region should consider the fact that the area exposes excessive and life-long stress due to complex movements and human posture. Therefore, all options should be considered for surgical stabilization, and they could be interchanged during the surgery, if required. Methods : A 53-year-old male patient applied to outpatients' clinic with complaints of head and neck pain persisting for a long time. Physical examination was normal except increased deep tendon reflexes. The patient was on long-term corticosteroid due to an allergic disease. Magnetic resonance imaging and computed tomography findings indicated basilar invagination and atlantoaxial dislocation.The patient underwent C0-C3-C4 (lateral mass) and additional C0-C2 (translaminar) stabilization surgery. Results : In routine practice, the sites where rods are bound to occipital plates were placed as paramedian. Instead, we inserted lateral mass screw to the sites where occipital screws were inserted on the occipital plate, thereby creating a site where extra rod could be bound.When C2 translaminar screw is inserted, screw caps remain on the median plane, which makes them difficult to bind to contralateral system. These bind directly to occipital plate without any connection from this region to the contralateral system.Advantages of this technique include easy insertion of C2 translaminar screws, presence of increased screw sizes, and exclusion of pullout forces onto the screw from neck movements. Another advantage of the technique is the median placement of the rod; i.e., thick part of the occipital bone is in alignment with axial loading. Conclusion : We believe that this technique, which could be easily performed as adjuvant to classical stabilization surgery with no need for special screw and rod, may improve distraction force in patients with low bone density.

• Archives of Plastic Surgery
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• 제45권6호
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• pp.557-563
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• 2018

Background Numerous Dupuytren's fasciectomy techniques have been described, each associated with unique surgical challenges, complications and recurrence rates. We describe a common ground surgical approach to Dupuytren's disease; 3-dimensional fasciectomy (3DF). 3DF aims to address the potential contributors to the high recurrence rate of Dupuytren's disease and unite current limited fasciectomy practice that varies considerably between surgeons. Methods We describe the 3DF principles; raising thin skin flaps (addressing dermal involvement), excising diseased palmar fascia with a 3-5 mm clearance margin (treating highly locally recurrent conditions) and excising the vertical septae of Legueu and Juvara (providing deep clearance, hence addressing all potentially involved pathological tissue). The surgical outcomes between traditional limited fasciectomy (LF) and 3DF are compared. Results From the 786 operations included (n=585), postoperative recurrence rates were significantly lower for the 3DF group (2/145, 1.4%) than the LF group (72/641, 11.2%) (P= 0.001), and the time to recurrence was significantly longer ($5.0{\pm}0years$ vs. $4.0{\pm}0.2years$; P<0.0001). With recurrence excluded, there were no differences between the postoperative complication rates for 3DF (5/145, 3.5%) and LF (41/641, 6.4%) (P=0.4). Conclusions Our results suggest that 3DF leads to lower recurrence rates and a longer disease-free period for patients, without increasing complications. 3DF provides a safe, efficacious, common ground surgical approach in the treatment of Dupuytren's flexion deformity.

• Journal of the Korean Society of Physical Medicine
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• 제11권1호
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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.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• 제8권2호
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• pp.57-71
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• 2002

Cervical pain is a rapid increase that is owing to a flexion-extension whiplash injury, unappropriated posture, chronical repetition injury from abdominal position of head and neck, excessive repeating work, chronical deficiency of excercise. Because of that is bring about muscle unbalance, tightness of cervical extensor muscle, weakness of cervical deep flexor muscles, instability of cervical region and reduction of proprioceptive sensor. Recent the role of muscle is more emphasized for preservation of sine stabilization. And cognition of integrated muscular system, importance for the operation and relation is increased to maintain stability of the motor system and pertinent function. Therefore we are going to introduce the sling exercise and stabilization exercise method for advanced efficient of cervical and upper limb and for the muscle strengthening to importance cervical stabilization through neurological program as control the reaction of cervical stabilization. Sling exercise therapy(SET) concept consists of a system of diagnosis and treatment. The system of diagnosis involves testing the muscle's tolerance through progressive loading in open and close kinetic chains. The SET system contains elements such as relaxation, increasing the range of movement, traction, training the stabilizing musculature, sensory-motor exercises, training in open and close kinetic chains, dynamic training of the mobilizing musculature, cardiovascular exercise, group exercise, personal exercise at home Sensory-motor training is an essential element of the SET concept. The emphasis is on closed kinetic chain exercise on an unstable surface, there by achieving optimum stimulation of the sensory-motor apparatus.

• Journal of Korean Physical Therapy Science
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• 제24권2호
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• pp.45-52
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• 2017

Purpose : Most of the moderns have been spent sedentary life style in front of desk or on the chairs, so that their hamstring muscles are shorted commonly and the shortness of hamstring muscles are caused to some problems in functional activities. The purpose of this study was to compare the effectiveness of thermotherapy with hot-pack and ultrasound on the tightness of hamstring muscles in individuals with hamstring tightness. Method : Twenty-eight persons with hamstring tightness participated in this study. They were randomly assigned to three exercise groups: stretching group(n=10), hot-pack group(n=9), and ultrasound group(n=9). Before experiment, this study measured the angle of hip flexion using a inclinometer in all participants. Stretching group conducted actively stretching on their shorted leg for 30 seconds, 3 times, and rest for 10 seconds between each exercises. Hot-pack group have applied hot-pack($70{\sim}75^{\circ}C$) on shorted hamstring muscles for 20 minutes before stretching exercise. Ultrasound group have applied therapeutic ultrasound(1 MHz and 1.5W/cm2) on shorted hamstring muscles for 10 minutes before stretching exercise. All data was analysed using one-way repeated ANOVA. Result : The results revealed that ultrasound therapy before stretching is more effective to the flexibility on hamstring muscles than hot-pack before stretching and stretching only. Conclusion : The results of this study show that thermotherapy with therapeutic ultrasound will be effective on the shortness of hamstring muscles before stretching exercise.