• Physical Therapy Rehabilitation Science
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• v.11 no.1
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• pp.97-104
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• 2022

Objective: Flexed posture commonly increases with age in older adults and is characterized by kyphosis and forward head posture. Changes in the posture with age affect both balance and mobility. This study was conducted to examine the effects of a cervical stabilization exercise for community-dwelling older adults to improve balance. Design: Two groups pretest-posttest design. Methods: Fifty older adults were randomly assigned into the cervical stabilization exercise group (n=24) and control group (n=25). The cervical stabilization exercise group (n=24) participated in group exercise for 60 minutes twice a week over 4 weeks. Timed up and go test (TUG), four square step test (FSST), functional reach test (FRT), postural sway, cervical range of motion (CROM), proprioception, craniovertebral angle (CVA) were evaluated before and after the intervention. Results: TUG, FSST, FRT, CROM, Proprioception, CVA showed significantly greater improvement, compared with a control group (p<0.05). Conclusions: Findings of this study demonstrate that cervical stabilization exercise can help improve not only neck functional capacities but also balance. Therefore, it may be used as an effective balance exercise program for community-dwelling older adults.

• PNF and Movement
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• v.21 no.1
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• pp.95-105
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• 2023

Purpose: The study aims to determine the effect of a breathing exercise on shoulder pain, range of motion (ROM), and forward head posture in patients with rotator cuff repair. Methods: In total, 25 patients with rotator cuff repair were included in this study. The experimental group (n = 13) underwent a breathing exercise, while the control group (n = 12) received traditional physical therapy. The visual analogue scales (VASs) for pain, flexion and abduction ROM, and the craniovertebral angle (CVA) of both groups were recorded at both pre- and post-intervention. Paired t-tests were used to determine significant changes in the post-intervention compared with the pre-intervention period, and independent t-tests were used to analyze differences in dependent variables between the two groups. Results: After the two-week intervention, the experimental group experienced a significantly decreased VAS (p < 0.05) and significantly increased ROM and CVA (p < 0.05), while the control group experienced a significantly decreased VAS (p < 0.05). Further, the experimental group that underwent the breathing exercise showed greater improvements in flexion and abduction ROM and in the CVA than the control group (p < 0.05). Conclusion: The results suggested that a breathing exercise can reduce shoulder pain and enhance ROM and posture in patients with rotator cuff repair.

• Korean Journal of Applied Biomechanics
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• v.19 no.3
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• pp.499-508
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• 2009

The purpose of this study was to compare and analyze flick shooting motion in penalty corner between high school players and national players in field hockey. Five high school players and six national players participated in this study. The 3D kinematic data were collected for each subject performing the penalty corner stroke. The results of the study were as follows: 1) The national players had higher stick head and ball velocity than the high school players. 2) The forward length between ball and support foot during ball catching with stick head was longer in the national players than the high school players. 3) At the Z axis of the E5 event, the center of gravity of the national players was lower than that of the high school players. 4) At the Z axis of the E5 event, left hip angle of the national players was lower than that of the high school players. 5) The national players had longer drag length of ball than the high school players. 6) The national players had higher hand and lower arm angular momentum than the high school players.

• Clinics in Shoulder and Elbow
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• v.22 no.1
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• pp.29-36
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• 2019

Background: The execution of fibular allograft augmentation in unstable proximal humerus fractures (PHFs) was technically demanding. In this study, the authors evaluated the clinical and radiographic outcomes after tricortical iliac allograft (TIA) augmentation in PHFs. Methods: We retrospectively assessed 38 PHF patients treated with locking-plate fixation and TIA augmentation. Insertion of a TIA was indicated when an unstable PHF showed a large cavitary defect and poor medial column support after open reduction, regardless of the presence of medial cortical comminution in preoperative images. Radiographic imaging parameters (humeral head height, HHH; humeral neck-shaft angle, HNSA; head mediolateral offset, HMLO; and status of the union), Constant score, and range of motion were evaluated. Patients were grouped according to whether the medial column support after open reduction was poor or not (groups A and B, respectively); clinical outcomes were compared for all parameters. Results: All fractures healed radiologically (average duration to complete union, 5.8 months). At final evaluation, the average Constant score was 73 points and the mean active forward flexion was $148^{\circ}$. Based on the Paavolainen assessment method, 33 patients had good results and 5 patients showed fair results. The mean loss of reduction was 1.32 mm in HHH and 5.02% in HMLO. None of the parameters evaluated showed a statistically significant difference between the two groups (poor and not poor medial column support). Conclusions: In unstable PHFs, TIA augmentation can provide good clinical and radiological results when there are poor medial column support and a large cavitary defect after open reduction.

• Clinics in Shoulder and Elbow
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• v.21 no.4
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• pp.220-226
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• 2018

Background: This study introduces a surgical technique with good clinical outcome useful in the treatment of osteoporotic displaced 3- or 4-part proximal humeral fractures. Methods: From May 2014 to February 2016, 16 patients with displaced 3- or 4-part proximal humeral fractures were treated by application of a locking plate with an endosteal strut allograft via a deltoid splitting approach with a minimum follow-up of 12 months. The allograft was inserted through a fractured gap of the greater tuberosity to support the humeral head and then fixed by a locking plate with meticulous soft tissue dissection to protect the axillary nerve. Surgical outcomes were evaluated by the American Shoulder and Elbow Surgeons (ASES) and visual analogue scale (VAS) scores, radiological imaging, and clinical examination. Fixation failure on radiographs was defined as a >$5^{\circ}$ loss of neck shaft angle (NSA) compared to that on an immediate postoperative radiograph. Avascular necrosis (AVN) of the humeral head was also evaluated. Results: In all cases, complete union was achieved. The ASES and VAS scores were improved to $85.4{\pm}2.1$ and $3.2{\pm}1.3$, respectively. Twelve patients (75.0%) had greater than a $5^{\circ}$ change in NSA; the average NSA change was $3.8^{\circ}$. Five patients (31.3%) had unsatisfactory ranges of motion exhibiting a <$100^{\circ}$ active forward flexion. No axillary nerve injuries or AVN were observed at the last follow-up. One patient was converted to reverse total arthroplasty due to severe pain and functional deficit. Conclusions: Minimally invasive fixation via a locking compression plate and an endosteal fibula strut allograft in Neer classification 3-or 4-part fractures with severe osteoporosis in elderly patients can achieve good clinical results.

• Journal of the Korean Society of Physical Medicine
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• v.13 no.2
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• pp.61-68
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• 2018

PURPOSE: This study aimed to examine the effects of self-stretching (SS) and joint mobilization (JM) on pain, craniovertebral angle (CVA), autonomic system function in chronic cervical pain patient with forward head posture (FHP). METHODS: A total of 30 male college students were selected as study subjects, and were divided into Group I (general physical therapy; GPT, n=10), Group II (GPT+SS, n=10), Group III (GPT+JM, n=10). All groups were evaluated three times a week for 4 weeks. Pain was measured by visual analogue scale (VAS), CVA was measured using digital goniometer and autonomic system function (heart rate; HR, skin conductivity; SC, LF norm, HF norm, LF/HF ratio) was measured by Biofeedback ProComp Infiniti. After 4 weeks, paired t-test was used to compare the changes within the group and one way ANOVA was used to compare those between the groups. RESULTS: In Group I, VAS was significantly decreased. In Group II and III was a significantly change in all items. In comparison between Group I and II was a difference in all items except HR. In comparison between Group I and III was a difference in all items. In comparison between Group II and III was a difference in VAS, LF norm and LF/HF ratio. CONCLUSION: This study showed that SS and JM can effectively reduce pain and normalize the autonomic system function.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.29 no.1
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• pp.11-23
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• 2023

Purpose: This study aimed to determine the effects of cervico-thoracic (C-T) mobilization technique and therapeutic exercise on muscle activity, craniovertebral angle (CVA), and neck disability index (NDI) in patients with neck pain. Methods: : A total of 30 patients with neck pain were included and divided into C-T mobilization combined with Pilates group (Experimental group; EG) and thoracic mobilization and self-exercise (Control group; CG) group; each group consisted of 15 patients. The exercises were performed by patients in both groups three times a week, for four weeks. NDI was used to measure functional disability and sEMG was used to measure muscle activity. Results: The EG participants showed significant improvement in the CVA and NDI after the intervention than the CG (p<.05). While both groups presented after intervention decreased muscle activity(upper trapezius), there were no statistically significant differences between the groups (p>.05). Conclusion: The findings of this study suggest that thoracic mobilization technique combined with Pilates exercise may have beneficial effects on CVA and NDI in patients with neck pain and forward head posture.

• PNF and Movement
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• v.14 no.3
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• pp.185-193
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• 2016

Purpose: The purpose of this study was to investigate the effects of neck patterns in proprioceptive neuromuscular facilitation (PNF) for neck movement and the neck disability index (NDI) among adults with forward head posture. Methods: Thirty-nine subjects were randomly assigned into two groups. Subjects in the proprioceptive neuromuscular facilitation exercise group (PNFG, n = 20) received 20 minutes of PNF neck pattern (flexion-Rt. lateral flexion-Rt. rotation followed by extension-Lt. lateral flexion-Lt. rotation) 3 times weekly for 4 weeks. Outcomes were measured using absolute rotation angle (ARA), anterior weight bearing (AWB), range of flexion and extension motions (RFEM), and neck disability index (NDI) methods before and after the 4-week intervention period. Results: There were significant effects for the PNFG, pre- and post-intervention, in ARA, AWB, RFEM, and NDI. There were significant differences in ARA, AWB, RFEM, and NDI compared with CG. Conclusion: The results of this study suggest the PNF neck pattern could be beneficial for adults with forward head posture.Purpose: This study investigates how abdominal muscular exercise based on proprioceptive neuromuscular facilitation (PNF) can affect chronic low back pain patients in terms of their pulmonary function, pain, and functional disability indexes. Methods: Fourteen target subjects with chronic low back were randomly assigned to the control group (n = 7) that performed abdominal muscle exercises and the experimental group (n = 7) that performed PNF abdominal muscular exercises. The exercises were performed five times a week for six weeks. To check the change in pulmonary function, the forced expiratory volume at one second (FEV1) and visible analogue scale (VAS) were measured to check the pain level. The disability level caused by back pain was measured by the Oswestry Disability Index (ODI). A paired t-test was applied to compare the differences between the groups before and after the intervention, and an independent t-test was used to compare the differences between the groups. The level of statistical significance was set as ${\alpha}=0.05$. Results: Before and after the intervention, the experimental group showed a significant change in FEV1 (p < 0.01), and both the experimental and the control groups showed significant changes in VAS and ODI (p < 0.01). A comparison of the differences between the groups indicated that the experimental group showed more significant changes in FEV1 (p < 0.05). Conclusion: According to the study results, PNF abdominal muscular exercise effectively improved pulmonary function, pain, and functional disability indexes in subjects with chronic back pain. The proposed program can be applied to chronic back pain patients as a useful therapy.

• 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.

• The Journal of the Korea Contents Association
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• v.10 no.6
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• pp.323-328
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• 2010

If a patient wearing arm sliding due to shoulder dislocation or fracture is impossible with abduction, the velpeau view is performed instead of superior-inferior axial projection view. However, it aggravates the patient's pain because it is difficult for the patient with dislocation or fracture to pull back the shoulders. Therefore, I suggest a new method of the 'modified velpeau view' that allows patients to lower their heads at examination. In order to investigate the easiness of fixing posture at examination and clinical utility, I conducted a study comparing the bone structures at the velpeau view and those at the modified velpeau view depending on wall-bucky and the patients' leaning forward angle ($30^{\circ},\;45^{\circ},\;60^{\circ}\;and\;75^{\circ}$), with the subjects of 20 velpeau view-prescribed patients amongst who had come to my hospital suspected of dislocation of shoulder or fracture and 30 healthy people from October of 2009 to January of 2010. Department of radiologists and orthopedics specialists evaluated the pictures for scales 0 to 5(best grade) under the given criteria. As a result of comparison in bone structures depending on wall-bucky and the leaning-forward angle in the group of healthy people, the velpeau view and the modified velpeau showed a similar diagnostic utility at $45^{\circ}$ and $60^{\circ}$. The picture evaluation result for proving diagnostic value showed that the anterior and posterior of shoulder heads and the anterior and posterior of glenoid fossa could be observed in the velpeau view; on the other hand, besides these areas acromioclavicular joint and coracoid process could be viewed in the modified velpeau view. This result verified that the modified velpeau view could replace the velpeau view for its diagnostic value as an examination method. This result, moreover, suggests that the modified velpeau view needs to be studied and improved from a variety of perspectives not only for an alternative for patients having troubles with the velpeau view position but also for clinical application of new test method for diagnosis of shoulder disorders other than dislocation of shoulder or fracture.