• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.21 no.2
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• pp.33-37
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• 2015

Background: The purpose of this study on the effects of deep cervical flexors strengthening exercise to forward head posture and pain of neck in patients with chronic neck pain. Method: We selected 30 subjects among neck pain patients and carried out measurements. The subjects' forward head posture was measured including head tilt angle (HTA), neck flexion angle (NFA) and forward shoulder angle (FSA), neck disability index (NDI), numeric rating scale (NRS). The subjects underwent deep cervical flexors muscle strengthening with pressure bio-feedback device for 4 weeks. Then, after intervention, the subjects' forward head posture was measured again. It was performed Wilcoxon signed-ranks test for confirming the effect of deep cervical flexor muscles strengthening exercise. Results: As a result of comparison of measurements before and after intervention, we found that there were statistically significant improvement in the subjects' NDI, NRS and forward head posture including head tilt angle, neck flexion angle and forward shoulder angle. Conclusion: We concluded that deep cervical flexors strengthening exercise has the effect of alleviation of neck pain patients and is effective for forward head posture.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.23 no.1
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• pp.53-58
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• 2017

Background: The purpose of this study was to effect of action observation with deep neck flexors strengthening exercise on pain and function in patients with chronic neck pain. Methods: Thirty patients with chronic neck pain were randomly action observation with deep neck flexors strengthening exercise group (AOT group; n=15) and deep neck flexors strengthening exercise group (FSE group; n=15). The intervention was applied for 50 minutes a day, 5 times a week for a total of 4 weeks. The intervention effect were evaluated before and after the intervention. visual analogue scale (VAS), pressure pain threshold (PPT), and Korea neck disability index (KNDI). Results: As a result of comparing within group, AOT group showed pre and post test, VAS (p<.01), PPT (p<.01), KNDI (p<.01) and FSE group VAS (p<.01), PPT (p<.05), KNDI (p<.01) significantly. In the comparison between the two groups, AOT group than FSE group in VAS, PPT and KNDI significantly (p<.05). Conclusion: Action observation with deep neck flexors strengthening exercise were founded to effective in reducing pain and improving function in patients with chronic neck pain. It is suggested as basic data of clinical intervention.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.19 no.2
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• pp.23-29
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• 2013

Background: People who have painful neck have reduced proprioception in the neck. Reduced proprioception in the neck is related to the muscle spindle activity in the deep neck flexors. The aim of this study was to know that proprioception in the neck was increased by strengthening exercise of the deep neck flexors. Methods: Thirty subjects with chronic neck pain were randomly assigned to the experimental group (n=15) and the control group (n=15). Deep neck flexor muscle exercise with stabilizer were conducted for the study group three times a week for six weeks. Relocation errors in 30 degree rotation to the left were measured three times before and after intervention each. Results: Neck disability index were decreased in the experimental group (p<.05) but not in the control group (p>.05). Relocation errors were decreased in the experimental group after intervention (p<.05), but not in the control group (p>.05). Conclusions: Proprioception in the neck can be increased by the strengthening exercise of deep neck flexors in the subject with chronic neck pain.

• 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.17 no.1
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• pp.41-48
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• 2022

PURPOSE: This study examined the relationship between the cervical lordosis angle (CLA) and the craniovertebral angle (CVA) and between CVA and a cross-sectional area (CSA) of the cervical muscles. METHODS: In 17 healthy college students, the CLA was measured using a posterior tangent technique. The CVA was analyzed using photographic images, and the CSA of the cervical muscles, including longus colli, longus capitis, and sternocleidomastoid, was evaluated using computerized tomography. The Pearson's correlation coefficient was used to determine the relationship between these variables and a neck disability index. RESULTS: The CVA correlated with the CLA and with a CSA of longus colli (r = .487, p = .047 and r = .592, p = .012, respectively). The CLA correlated with a CSA of longus colli (r = .578, p = .015). CONCLUSION: This study clarified the relationship between the postural, structural, and muscular changes in the cervical regions. A significant correlation was observed between the CVA and a CSA of the longus colli with the CLA and between the CVA and the CSA of the longus colli. Prescription strengthening exercises for the deep neck flexors for individuals with a forward head posture and reduced cervical lordosis are useful.

• Physical Therapy Korea
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• v.23 no.2
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• pp.57-66
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• 2016

Background: For the treatment of forward head posture (FHP) and forward shoulder posture, methods for strengthening scapular retractors and deep cervical flexors and stretching pectoralis and upper cervical extensors are generally used. No study has yet assessed whether suboccipital release (SR) followed by cranio-cervical flexion exercise (CCFE) (SR-CCFE) will result in a positive change in the shoulders and neck, showing a "downstream" effect. Objects: The purpose of this study was to investigate the immediate effects of SR-CCFE on craniovertebral angle (CVA), shoulder abduction range of motion (ROM), shoulder pain, and muscle activities of upper trapezius (UT), lower trapezius (LT), and serratus anterior (SA) and LT/UT and SA/UT muscle activity ratios during maximal shoulder abduction in subjects with FHP. Methods: In total, 19 subjects (7 males, 12 females) with FHP were recruited. The subject performed the fifth phase of CCFE immediately after receiving SR. CVA, shoulder abduction ROM, shoulder pain, muscle activities of UT, LT, and SA, and LT/UT and SA/UT muscle activity ratios during maximal shoulder abduction were measured immediately after SR-CCFE. A paired t-test and Wilcoxon signed-rank test were used to determine the significance of differences in scores between pre- and post-intervention in the same group. Results: The CVA (p<.001) and shoulder abduction ROM (p<.001) were increased significantly post-versus pre-intervention. Shoulder pain was decreased significantly (p<.001), and LT (p<.05) and SA (p<.05) muscle activities were increased significantly post- versus pre-intervention. The LT/UT muscle activity ratio was increased significantly post- versus pre-intervention (p<.05). However, there was no significant change in UT muscle activity and SA/UT muscle activity ratio between pre- and post-intervention (p>.05). Conclusion: SR-CCFE was an effective intervention to improve FHP and induce downstream effect from the neck to the trunk and shoulders in subjects with FHP.