• Journal of the Korean Society of Physical Medicine
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• v.11 no.2
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• pp.41-52
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• 2016

PURPOSE: This study was conducted to compare the levels of usage of the superficial neck muscles during head rotation in forward head posture and in multimodal postures for improvement of cervical rotation movement impairment. METHODS: To acquire electromyography (EMG) signals from the sternocleidomastoid (SCM-M), upper trapezius (UPT-M), and the splenius capitis (SPC-M) muscles, 11 subjects practiced right rotation of the head in forward head postures (FHP), upright sitting postures (USP), upright sitting postures with supported arms (SUP), standing postures with the arms leaning against the wall (WSP), and four feet postures (FFP), respectively. RESULTS: The left SCM-M was used significantly more in the FFP compared to the FHP, but not in other postures (p<0.01). The left UPT-M was used significantly more in all postures other than the FHP. The right SPC-M was used significantly more in the FFP (p<0.001) and significantly less (p<0.05) in the SUP compared to the FHP. CONCLUSION: During the rotation of the head, although the usage of the SPC-M significantly decreased in SUP compared to FHP but the usage of the SCM-M and UPT-M did not decrease significantly in other postures compared to FHP. Further research is necessary to prove the hypothesis that special postures may reduce the activity of the superficial neck muscles during head rotation.

• Journal of the Ergonomics Society of Korea
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• v.35 no.6
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• pp.503-517
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• 2016

Objective: The aim of this study was to evaluate the effectiveness of 3 dimensional contoured pillow through analyzing contact pressure and to suggest its design guidelines through analyzing the posture of head and neck area. Background: The quality of sleep is a very important factor closely related with human's health. To improve the quality of sleep, the verification of design factors affecting the posture of the head and neck is needed, and a pillow design that can induce proper posture is required. Method: This study measured the contact pressures of the two reference groups (bead and cotton pillows) as a method to evaluate the design effectiveness of the contoured pillow. This study proposed 3-dimensional design guidelines by drawing anthropometry (head length) affecting cervical curvature angle (CCA) through the measurement of the participants' cervical curvature angles. Results: In the design effectiveness evaluation, the contact pressure of cervical region was higher than that of a reference group (cotton pillow), and contract area increased, and contract pressure decreased in the shape distributing the occipital region's body pressure. This study proposed pillow's cervical supporting height by percentile of a head length [head length (%tile) (cervical supporting height) affecting the posture of the head and neck: 14.6cm (5%tile) (6.2cm), 15.5cm (25%tile) (6.7cm), 16.4cm (50%tile) (7.1cm), and 19.3cm (75%tile) (8.9cm)]. Conclusion: This study confirmed the contoured pillow's design effectiveness maintaining cervical angle comfortable to sleep with the shape supporting the cervical vertebrae and by reducing the contact load of the occipital region. Also, this study proposed pillow design guidelines based on the 3-dimensional contoured pillow design effectiveness, through which the study laid the foundation for pillow design in a systematic method. Application: The results of this study are expected to be utilized as the basis data by which the optimum pillow type and pillow design according to main percentile can be standardized.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.24 no.1
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• pp.15-21
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• 2018

Background: The purpose of this study was to determine the effects of cervical deep muscle flexion exercise (CCFE) on craniovertebral angle, pain, and neck disability for patients with chronic neck pain Methods: The subjects of this study were randomly divided into three groups of 30 patients with chronic neck pain: rectus abodominis functional massage (n=10), cervical deep muscle flexion exercises group (n=10), and the control group(n=10). To assess visual analog scale (VAS) was used to test the neck pain, To assess neck posture was used to craniovertebral angle, VAS was used to test the neck pain, neck disability index (NDI) was used to test the neck dysfunction. All measurements were performed before and after each intervention was applied 3 times a week for 4 weeks. Results: In the results of all measurements, 2 groups except for the control group showed a significant change in the recovery of posture, neck pain, neck disability index (p<.05). Conclusions: Our results of this study showed that applying cervical deep muscle flexion exercise and rectus abodominis functional massage to patients with chronic neck pain improved cervical posture, neck pain, neck disability.

• The Journal of Korean Physical Therapy
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• v.23 no.1
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• pp.29-35
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• 2011

Purpose: The purpose of this study was to identify the effect of neck exercises on neck-shoulder posture and pain of high school students with neck disorders. Methods: Twenty seven subjects were randomly assigned to one of 3 groups a craniocervical flexion training group (CCFT), a neck strengthening exercise group (ST), and a basic stretching exercise group (CG). CCFT and ST exercised five times a week for eight weeks under the researcher's guidance. The control group performed basic stretching exercises. Diagnostic radiologic equipment was used for the measurement of neck-shoulder posture. Neck disability index, and numeric rating scales were used. Results: The CCFT showed a significant pre-post treatment difference on measures of neck flexion angle and forward shoulder angle changes compared to the ST and CG groups (p<0.05). The CCFT group also showed a significantly greater improvement on the neck disability index and numeric rating scales changes than the ST and CG groups (p<0.01). Conclusion: Because CCFT decreases neck flexion angle, forward shoulder angle, neck disability index, and pain in the forward head posture, it is useful for treating patients with neck disorders.

• Journal of the Korean Society of Physical Medicine
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• v.8 no.3
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• pp.337-342
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• 2013

PURPOSE: The Unilateral neglect is characterized by difficulty shifting attention to the side of space opposite the brain lesion and frequently reducing use of contralesional extremities. This study was to identify whether the visual deprivation was responsible for head position on unilateral neglect patient after stroke. METHODS: A patient with left middle cerebral artery infarction participated in the study. We assessed neglect using line bisection and star cancellation test. Patient was instructed to maintain correct alignment of trunk and head in a sit position. We evaluated degree of head lateral tilting and rotation. Then, patient was blocked visual input. Also, we evaluated head position in the same way. RESULTS: He scored 3 points in the line bisection test and 9 points star cancellation test. In postural evaluation, he had deviated posture such as lateral head tilting and rotation. After visual cue deprivation, patient showed different head position which was decreased degree of head tilting and rotation. CONCLUSION: For vertical body orientation, it was used multiple sensory references including the vestibular, somatosensory, and visual system. This finding suggested that abnormal posture of neglect patient could be related to the visual input. It has important clinical implications in terms of understanding the neglect.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.25 no.2
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• pp.57-64
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• 2019

Background: This study was designed to identify the effect of the taping on the forward head posture during computer work. Methods: Twenty healthy adults were statistically assigned into 2 groups, the taping group (n=10) and the control group (n=10). In order to induce delayed onset muscle soreness (DOMS), twenty subjects performed isometric exercise of the neck on Bobath table for 20 minutes. During the experiment, subjects in taping group were attached Kinesio-tape on their upper trapezius. By using 2-D motion analysis, measurements were taken before taping, at 24 hour, 48 hour, and 72 hour after inducing DOMS. The effects of taping were evaluated by the angle of the head. Results: The results of this study were as follows; 1) There was no significant difference between the taping group and the control group (p>.05). 2) The control group had no significance, but the taping group shown a significance on the angle of head during computer work (p<.01). The interaction of group x period also shown a significance (p<.01). Conclusion: From these result, it was revealed that the taping therapy on upper trapezius could improve the angle of head during computer work.

• The Journal of the Institute of Internet, Broadcasting and Communication
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• v.14 no.5
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• pp.131-135
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• 2014

The purpose of this study was to show the detection of the head movement within relatively the posture function. An analysis of the posture function was inquired a displacement that the ranges of stance direction showed generally a variation across all condition through the head movement. CNS condition (C_RL-MIN-AVG) was verified slightly greater variation at $0.226{\pm}0.04$ units. Somatosensory condition (So_$RL-_{MIN-AVG}$) was verified slightly greater variation at $0.939{\pm}0.46$ units. Vestibular condition (Ve_$RL-_{MIN-AVG}$) was verified slightly greater variation at $4.009{\pm}1.05$ units. Vision condition (Vi_$RL-_{MIN-AVG}$) was verified greater variation at $8.336{\pm}4.05$ units. When the movement head of vision characteristic function was presented a diminutive variance. On the CNS characteristic condition of the movement head function was presented a diminutive variance.

• Journal of Oral Medicine and Pain
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• v.25 no.2
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• pp.173-189
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• 2000

The purpose of this study was to evaluate the effect of specific head positions on the mandibular rotational torque movements in maximum mouth opening, protrusion and lateral excursion. Thirty dental students without any sign or symptom of temporomandibular disorders(TMDs) were included as a control group and 90 patients with TMDs were selected and examined by routine diagnostic procedure for TMDs including radiographs and were classified into 3 subgroups : disc displacement with reduction, disc displacement without reduction, and degenerative joint disease. Mandibular rotational torque movements were observed in four head postures: upright head posture(NHP), upward head posture(UHP), downward head posture(DHP), and forward head posture(FHP). For UHP, the head was inclined 30 degrees upward: for DHP, the head was inclined 30 degrees downward: for FHP, the head was positioned 4cm forward. These positions were adjusted with the use of cervical range-of-motion instrumentation(CROM, Performance Attainment Inc., St. Paul, U.S.A.). Mandibular rotational torque movements were monitored with the Rotate program of BioPAK system (Bioresearch Inc., WI, U.S.A.). The rotational torque movements in frontal and horizontal plane during mandibular border movement were recorded with two parameters: frontal rotational torque angle and horizontal rotational torque angle. The data obtained was analyzed by the SAS/Stat program. The obtained results were as follows : 1. The control group showed significantly larger mandibular rotational angles in UHP than those in DHP and FHP during maximum mouth opening in both frontal and horizontal planes. Disc displacement with reduction group showed significantly larger mandibular rotational angles in DHP and FHP than those in NHP during lateral excursion to the affected and non-affected sides in both frontal and horizontal planes(p<0.05). 2. Disc displacement without reduction group showed significantly larger mandibular rotational angles in FHP than those in any other head postures during maximum mouth opening as well as lateral excursion to the affected and non-affected sides in both frontal and horizontal planes. Degenerative joint disease group showed significantly larger mandibular rotational angles in FHP than those in any other head postures during maximum mouth opening, protrusion and lateral excursion in both frontal and horizontal planes(p<0.05). 3. In NHP, mandibular rotational angle of the control group was significantly larger than that of any other patient subgroups. Mandibular rotational angle of disc displacement with reduction group was significantly larger than that of disc displacement without reduction group during maximum mouth opening in the frontal plane. Mandibular rotational angle of disc displacement without reduction group was significantly larger than that of disc displacement with reduction group or degenerative joint disease group during maximum mouth opening in the horizontal plane(p<0.05). 4. In NHP, mandibular rotational angles of disc displacement without reduction group were significantly larger than those of the control group or disc displacement with reduction group during lateral excursion to the affected side in both frontal and horizontal planes. Mandibular rotational angle of disc displacement without reduction group was significantly smaller than that of the control group during lateral excursion to the non-affected side in frontal plane. Mandibular rotational angle of disc displacement without reduction group was significantly larger than that of disc displacement with reduction group during lateral excursion to the non-affected side in the horizontal plane(p<0.05). 5. In NHP, mandibular rotational angle of the control group was significantly smaller than that of disc displacement with reduction group or disc displacement without reduction group during protrusion in the frontal plane. Mandibular rotational angle of disc displacement without reduction group was significantly larger than that of the disc displacement with reduction group or degenerative joint disease group during protrusion in the horizontal plane. Mandibular rotational angle of the control group was significantly smaller than that of disc displacement without reduction group or degenerative joint disease group during protrusion in the horizontal plane(p<0.05). 6. In NHP, disc displacement without reduction group and degenerative joint disease group showed significantly larger mandibular rotational angles during lateral excursion to the affected side than during lateral excursion to the non-affected side in both frontal and horizontal planes(p<0.05). The findings indicate that changes in head posture can influence mandibular rotational torque movements. The more advanced state is a progressive stage of TMDs, the more influenced by FHP are mandibular rotational torque movements of the patients with TMDs.

• The Journal of Korean Physical Therapy
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• v.26 no.5
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• pp.358-364
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• 2014

Purpose: Flexed posture commonly increases with age in older women and is characterized by an excessive curvature in the thoracic spine (kyphosis), forward head posture, and decline in height. This study was conducted in order to determine the relationship between flexed posture, physical performance, and psychosocial factors in community dwelling elderly women in Korea. Methods: Fifty-two subjects with thoracic kyphosis of $40^{\circ}C$ or greater participated in this study. Flexed posture was measured using kyphosis angle (KA), forward head posture (FHP), and round shoulder (RS), and physical performance was evaluated using the short physical performance battery (SPPB), grip strength, and static and dynamic balance. Psychosocial factors were measured using depression and the quality of life (QOL). All data were analyzed using SPSS 18.0 software for windows. Results: KA showed significant correlation with SPPB score (r=-0.447) and dynamic balance (r=0.426) (p<0.05) depression (r=0.405) and QOL (r=-0.464) but not with grip strength and static balance in elderly individuals. FHP and RS showed significant correlation with SPPB score (r=0.002, r=-0341) and dynamic balance (r=-0.278, r=0.346) (p<0.05) but not with psychosocial factors. Conclusion: These findings suggest that flexed posture provides meaningful information about physical performance and psychosocial factors in elderly women. Our data suggest that the flexed posture may need to be addressed as part of the health management process for elderly women.

• The Journal of Korean Physical Therapy
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• v.28 no.2
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• pp.149-154
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• 2016

Purpose: The aim of this study is to suggest an intervention method for clinical use in the future by analyzing the effect of breathing exercise on activity of sternocleidomastoid muscle and scalenus anterior muscle, which are respiratory synergist muscles, and pulmonary functions in patients with forward head posture. Methods: Prior to the experiment, 12 patients (experimental group) performed feedback exhalation exercise along with conventional deep neck exercise, and 11 subjects (control group) performed feedback deep neck exercise along with conventional deep neck exercise. The intervention programs were performed for 40 minutes once a day (three times a week for four weeks). Results: Before intervention, %RMS was measured for surface electromyography (sEMG), and FVC, FEV1, and FEV1/FVC were measured using a spirometer. After four weeks, these items were re-measured under the same condition and analyzed. In within-group comparison of the experimental group, activity of sternocleidomastoid muscle and scalenus anterior muscle showed a significant decrease (p<0.05)(p<0.001), and forced vital capacity (FVC) showed a significant increase (p<0.05). In within-group comparison of the control group, activity of sternocleidomastoid muscle and scalenus anterior muscle showed a significant decrease (p<0.05), and in between-group comparison, there were significant differences in activity of sternocleidomastoid muscle and FVC (p<0.05). Conclusion: Long-term forward head posture restrains exercise performance of the neck and leads to exercise avoidance of the neck during daily activities, thus restraint factors might be created even while breathing. To cut off this link, a constant effort is required and diversified research on the correlation between neck functions and breathing should be conducted.