• Journal of the Korea Academia-Industrial cooperation Society
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• v.11 no.11
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• pp.4331-4337
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• 2010

This study was to investigate the effectiveness of deep neck flexor exercise with using modalities in pain reduction and functional improvement to those who have chronic neck pain. The subjects were instructed the patients with chronic neck pain (37 people). Randomized study design of two groups was used: Only using modalities group and deep neck flexor exercise group with using modalities, and each group was taken by three times per week for 12 weeks. To evaluate the effects of therapies was to research the questionnaire about VAS(visual analog scale), NDI(neck disability index), and endurance of deep neck flexor before experiment, after 6 weeks and after 12 weeks. In visual analog scale(VAS) and neck disability index(NDI), there were significant decreased in using modalities group and deep neck flexor exercise group after 6 weeks more than before experiments but were only significant decrease in deep neck flexor exercise group after 12 weeks. The endurance of deep neck flexor was significantly increased in deep neck flexor exercise group after 6 weeks and 12 weeks more than before experiments. Thorough these results deep neck flexor exercise has the effectiveness to the therapies of chronic neck pain. Using the deep neck flexor exercise would be high effects on pain reduction and functional improvement and also considered in improving the living qualities of those who have chronic neck pain.

• The Journal of Korean Physical Therapy
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• v.29 no.5
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• pp.265-270
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• 2017

Purpose: This study examined the effects of neck stabilization exercises with vibratory stimulation on the neck disability index and thickness of the deep neck flexor. Methods: Thirty subjects (control group=15, experimental group=15) with mild neck pain were enrolled in the study. The control group underwent craniocervical flexion exercise (control group, CG) and the experimental group was given craniocervical flexion exercise with vibratory stimulus (experimental group, EG) (3 sets, 3 times per week for 6 weeks). To examine the effects of exercise, the subjects were evaluated using the neck disability index (NDI), the thickness of the deep neck flexor muscle, and muscle strength. An independent and paired t-test were used to compare the effects of the exercise between the groups. Results: The NDI score of the two groups increased significantly after 6 weeks of treatment (p<0.001) and there was a significant difference between the EG group at 3 weeks (p<0.05) and 6 weeks (p<0.01). The thickness of the deep neck flexor in the CG group increased significantly after 6 weeks of treatment in all pressure stages (p<0.001). The EG group showed a significant increase after 3 and 6 weeks of treatment in all pressure stage (p<0.001), and 22 mmHg, a significant difference between 3 and 6 weeks (p<0.05) and among 24, 28, and 30 mmHg at 6 weeks (p<0.05). The maximum muscle strength of the deep neck flexion muscles increased significantly in the two groups after 6 weeks of treatment (p<0.001) and there was significant difference between the EG group at 6 weeks (p<0.01). Conclusion: Craniocervical flexion exercise with vibratory stimulus decreases the NDI, and increases the thickness of the deep neck flexor and maximum muscle strength of the deep neck flexion muscles in patients with mild neck pain.

• 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.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.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.25 no.1
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• pp.9-19
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• 2019

Background: This study was planned to assess and compare the effectiveness of cervical region stabilization exercise and strengthening exercise on pain and range of motion in patient with chronic neck pain. Methods: Fifty-one patient with chronic neck pain were randomly allocated into strengthening and stabilization exercise (SSE) group (n=27) and Strengthening exercise (SE) group (n=24). The program was carried for 12 sessions, 3 days/week in 4weeks. Pain intensity with visual analog scale (VAS), cervical range of motion, deep cervical flexor strengthening were evaluated before and after the intervention. Results: After the program, pain intensity decreased in group SE and SSE were found (p<.05). Range of motion and deep cervical muscle strength increased in group SE and SSE were found(p<.05). The intergroup comparison showed that significant difference in range of motion and deep cervical muscle strength (p<.05). Conclusions: The study suggest that both SSE program and SE program might be a useful treatment for patients with chronic neck pain. However SSE program might be superior in improving cervical range of motion and deep cervical flexor strength compare to SE program.

• Physical Therapy Korea
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• v.28 no.1
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• pp.18-26
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• 2021

Previous studies have reported that deep neck flexor (DNF) exercise can improve neck problems, including neck pain, forward head posture, and headache, by targeting the deep and superficial muscles of the neck. Despite the prevailing opinion across studies, the benefits of DNF can vary according to the type of neck problems and the outcome measures adopted, ranging from positive outcomes to non-significant benefits. A meta-analysis was conducted in this study to assess conclusive evidence of the impact of DNF exercise on individuals with neck problems. We used PUBMED, MEDLINE, NDSL, EMBASE, and Web of Science to search for primary studies and the key terms used in these searches were "forward head posture (FHP)," "biofeedback," "pressure biofeedback unit," "stabilizer," "headache," and "neck pain." Twenty-four eligible studies were included in this meta-analysis and were coded according to the type of neck problems and outcome measures described, such as pain, endurance, involvement of neck muscle, craniovertebral angle (CVA), neck disability index (NDI), cervical range of motion (CROM), radiographs of the neck, posture, strength, endurance, and headache disability index. The overall effect size of the DNF exercise was 0.489. The effect sizes of the neck problems were 0.556 (neck pain), -1.278 (FHP), 0.176 (headache), and 1.850 (mix). The effect sizes of outcome measures were 1.045 (pain), 0.966 (endurance), 0.894 (deep neck flexor), 0.608 (superficial neck flexor), 0.487 (CVA), 0.409 (NDI), and 0.252 (CROM). According to the results of this study, DNF exercise can effectively reduce neck pain. Thus, DNF exercise is highly recommend as an effective exercise method for individuals suffering from neck pain.

• Physical Therapy Korea
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• v.22 no.1
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• pp.19-29
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• 2015

Impaired respiratory function is common in patients with stroke. The purpose of this study were to investigate the effectiveness of exercises and to assess forced vital capacity and peak cough flow after completion of neck stabilizing and respiratory reeducation exercises (combining diaphragmatic breathing and pursed-lip breathing exercises). The 45 participants were randomly assigned to an experimental group 1 ($n_1=15$), experimental group 2 ($n_2=15$), and a control group ($n_3=15$). All subjects performed conservative physical therapy for 30 minutes. Experimental group 1 undertook the neck stabilizing exercise and the respiratory reeducation exercise. Experimental group 2 undertook the respiratory reeducation exercise. Additional exercise did not exceed 30 minutes, five times a week for six weeks. The subjects were assessed for deep neck flexor thickness and breathing function (forced vital capacity, forced expiratory volume at one second, forced expiratory volume at one second/forced vital capacity, peak expiratory flow, and manual assisted peak cough flow) at pre-post value. The results of this study were as follows. Experimental group 1 showed a significant increase only in deep neck flexor thickness change rate (p<.05). All groups showed significant increases in forced vital capacity, forced expiratory volume at one second, and peak expiratory flow in pre-post measurement (p<.05). Experimental groups 1 and 2 showed an increase in manual assisted peak cough flow in pre-post measurement (p<.05). There was no significant difference between experimental group 1 and experimental group 2, but experimental group 1 improved more than experimental group 2 in respiratory function as a whole. In conclusion, these findings suggest that the neck stabilizing exercise in combination with the respiratory reeducation exercise can improve forced vital capacity and peak cough flow in patients with stroke.

• Journal of the Korean Society of Physical Medicine
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• v.8 no.2
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• pp.253-261
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• 2013

PURPOSE: The Purpose of this study was to investigate the changes in the thickness of Sternocleidomastoid muscle(SCM) and deep cervical flexor muscle(DCF) through CranioCervical Flexion Exercise(CCFEx) Using Sling. METHODS: Subjects were randomly allocated two group: control group (n=21) without neck pain, experimental group (n=17) with pain. Muscle thickness was measured using CranioCervical Flexion Test(CCFT) and ultrasonography before or after intervention. RESULTS: In experimental group, compared with muscle thickness of exercise before, SCM thickness rate of change was slightly decreased according to pressure increased after exercise(p<.05). CONCLUSION: The results of this study showed that CCFEx using sling is effective for SCM and DCF of choric neck pain patients.

• PNF and Movement
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• v.18 no.3
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• pp.333-341
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• 2020

Purpose: The purpose of this study was to investigate the effect of open and closed kinetic chain exercises with a sling on neck flexor thickness during chin-in movement in office workers with forward head posture. Methods: Thirty-one selected subjects randomly performed chin-in movement in open kinetic chain and closed kinetic chain exercises using a sling. All subjects were measured for their neck flexor thickness using ultrasound measurement equipment during the performance of chin-in movement in open and closed kinetic chain exercised. A paired t-test was used to compare the thickness of the total neck flexor, superficial, and deep neck flexor, respectively, between open and closed kinetic chain exercises with chin-in movement. Results: The thickness of the superficial neck flexor diminished in size more greatly during the chin-in movement with the closed kinetic chain than the open kinetic chain, but this was not a statistically significant difference (p > 0.05). On the other hand, the thickness of the total neck flexor and deep neck flexor had more greatly increased during the chin-in movement with the closed kinetic chain than the open kinetic chain, and this was a statistically significant differences (p < 0.05). Conclusion: This study suggested that chin-in movement with a closed kinetic chain is more effective in activating the deep neck flexor than the open kinetic chain. Thus, we believe that the closed kinetic chain exercise using a sling is an effective intervention to correct the postural alignment of individuals with forward head posture.

• The Korean Journal of Pain
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• v.36 no.2
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• pp.242-252
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• 2023

Background: Neck pain is a common problem in the general population and second only to low back pain in musculoskeletal problems. The aim of this study is to compare three different types of exercise training in patients with chronic neck pain. Methods: This study was conducted on 45 patients with neck pain. Patients were divided into 3 groups: Group 1 (conventional treatment), Group 2 (conventional treatment plus deep cervical flexor training), and Group 3 (conventional treatment plus stabilization of the neck and core region). The exercise programs were applied for four weeks, three days a week. The demographic data, pain intensity (verbal numeric pain scale), posture (Reedco's posture scale), cervical range of motion ([ROM] goniometer), and disability (Neck Disability Index [NDI]) were evaluated. Results: In all groups, a significant improvement was found in terms of pain, posture, ROM, and NDI values in all groups (P < 0.001). Between the groups, analyses showed that the pain and posture improved more in Group 3, while the ROM and NDI improved more in Group 2. Conclusions: In addition to conventional treatment, applying core stabilization exercises or deep cervical flexor muscle training to patients with neck pain may be more effective in reducing pain and disability and increasing ROM than conventional treatment alone.