• Journal of the Korean Society of Physical Medicine
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• v.17 no.1
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• pp.63-74
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• 2022

PURPOSE: This study aimed to compare the effects of manual therapy with stabilization exercises to manual therapy alone, on neck pain and body functions in patients with chronic mechanical neck pain. METHODS: Twenty patients with chronic mechanical neck pain were recruited and randomly allocated into two groups. A control group(n = 10) was given the manual therapy alone and an experimental group(n = 10) was given the manual therapy with stabilization exercises. The intervention was carried out 3 days per week for 4 weeks. The cervical resting pain, the most painful motion pain, craniocervical flexor endurance, forward head posture and neck disability index were used to assess participants at baseline and after 4 weeks. RESULTS: A comparison of the parameters before and after the intervention showed that both groups experienced significant improvements in the resting pain, the most painful motion pain, craniocervical flexor endurance, and forward head posture except for the forward head posture in the control group. A comparison of the parameters between the groups did not show a significant difference. CONCLUSION: The results of this study suggest that the combined intervention of manual therapy with stabilization exercise does not seem to be more effective than manual therapy alone for improving neck pain, craniocervical flexor endurance, forward head posture, and the neck disability index in patients with chronic mechanical neck pain.

• Physical Therapy Korea
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• v.26 no.3
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• pp.42-56
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• 2019

Background: Individuals with mechanical neck pain show biomechanical and neurophysiological changes, including cervical spine muscle weakness. As a result of deep muscle weakness, it causes stability disability and reduced upper thoracic spine mobility, which finally leads to functional movement restriction such as limited range of motion and dysfunction. Recent studies have shown that thoracic spine manipulation and mobilization could reduce symptoms of mechanical neck pain in patients. Objects: The purpose of this study was to investigate the effects of thoracic mobility exercise on cervicothoracic function, posture feature, and pain intensity in individuals with mechanical neck pain. Methods: The study subjects were 26 persons who were randomly assigned to the experimental (with thoracic mobility exercise) and control groups (without thoracic mobility exercise), with 13 subjects in each group. The cervicothoracic function (neck functional disability level and cervicothoracic range of motion), posture feature, and pain rating (using a quadrupled visual analogue scale [QVAS]) were measured before, after 3 weeks, and after 6 weeks. Results: Statistically significant group-by-time interactions were found with repeated analyses of variance for the Korean neck disability index (KNDI), all cervical range of motion (CROM), all thoracic range of motion (TROM), cranial rotation angle, sagittal shoulder posture (SSP), and QVAS (p<.05). All groups showed significant improvements from all times in all the evaluated methods. The KNDI, CROM, TROM of left rotation, and SSP in the experimental group showed significant improvements after 3 weeks, and the TROM of the right rotation and QVAS in the experimental group showed significant improvements after 6 weeks when compared with the control group. Conclusion: Thoracic mobility exercise during 6 weeks might be effective intervention to improve the functional level, posture feature, and QVAS pain rating for managing individuals with mechanical neck pain.

• The Journal of Korean Physical Therapy
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• v.32 no.2
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• pp.126-131
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• 2020

Purpose: The purpose of this study was to compare the change in pain, Neck Disability Index score, and the craniovertebral angle by performing scapular correction exercise or general neck exercise for five weeks in participants with mechanical neck pain. Methods: A total of 31 participants were randomly assigned between the scapular correction exercise and the general neck exercise groups, and all participants performed intervention for 40 minutes each, three times a week for five weeks The effects were evaluated by measuring the Visual Analog Scale score, the Neck Disability Index score, and the craniovertebral angle, before and after the intervention. Independent t-tests were used to compare differences between two groups, and to compare differences between pre- and post-intervention, paired t-tests were used. Results: As measured before and after the intervention, the scapular correction exercise group showed significant improvement in all variables (p<0.05), while the general neck exercise group improved only in the neck disability index score. The differences between the two groups revealed further improvement in the scapular correction exercise group compared to the general neck exercise group (p<0.05). Conclusion: We found that five weeks of the scapular correction exercise to modify the position and movements of the scapula is clinically an important treatment tool for recovery from chronic mechanical neck pain symptoms and restoration of proper neck function.

• Journal of the Korean Society of Physical Medicine
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• v.10 no.2
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• pp.35-45
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• 2015

PURPOSE: The aim of this study is to investigate how upper thoracic manipulation and cervical stability training affects cervical range of motion and neck disability index of patients with chronic mechanical neck pain. METHODS: 30 patients with chronic mechanical neck pain, and randomly divided into the upper thoracic manipulation and the cervical stability training group. Upper thoracic manipulation group was conducted to the upper thoracic manipulation, and cervical stability training was conducted to the cervical stability training. Intervention period was 6 weeks, and 3 sessions, each of which was run for 5~10 minutes. The subjects were measured neck range of motion before and after intervention by electro-goniometer. Neck disability index was used to measure neck disability index Korean version. RESULTS: Comparison within groups, there were significant difference in neck range of motion before and after intervention, and Neck disability index significantly reduced in the cervical stability training group. The comparison between groups, there were no significant difference in neck range of motion and neck disability index. CONCLUSION: Upper thoracic manipulation and cervical stability training to the patients with chronic neck pain was helpful to improve neck range of motion and cervical stability training was helpful to improve neck disability index.

• Journal of the Korean Society of Physical Medicine
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• v.10 no.4
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• pp.69-80
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• 2015

PURPOSE: The purpose of the present study was to apply joint mobilization in a sitting position and in a prone position to patients with acute mechanical neck pain and compare the immediate treatment effects in these two positions. METHODS: After the baseline was assessed, 46 patients were randomly assigned to two groups: experimental group I ($n_1=23$) for joint mobilization in the sitting position and experimental group II ($n_2=23$) for joint mobilization in the prone position at the symptomatic cervical level. The patients in both groups received treatment by unilateral posterior-anterior gliding for 30 seconds per trial, 10 trials per session, for a total of 5 minutes, and two trials of 10 active extending motions with distraction per trial. RESULTS: In the Wilcoxon signed-rank test, all the pain and physical function variables were significantly improved after intervention in both groups (p<.05). In the Mann-Whitney U test, which compared the differences before and after the intervention between the two groups, experimental group I showed significant improvement over experimental group II in resting pain (p<.01), satisfaction with the treatment (p=.01), left rotation (p<.01) and CCFE (p<.01). In the analysis of covariance results, experimental group I showed significant improvement over experimental group II in the most painful motion pain (p<.01) and the most painful quadrant motion pain (p<.01). CONCLUSION: These outcomes suggest that joint mobilization should be applied in sitting positions for patients with acute mechanical neck pain that feel pain during sustained positions, extension or rotation.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.16 no.2
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• pp.61-66
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• 2010

Purpose: The purpose of this study was to determine the effect of TENS by physiotherapist versus home based TENS intervention to reduce pain and improve disability in patients with mechanical neck disorder. Methods: The subjects of the study were 30 selected patients who had been diagnosed with subacute or chronic neck disorders without neurological damage, during the period of four weeks, three times a week, and thirty minutes for one session, 15 patients received TENS by physiotherapist. 15 patients received home based TENS intervention. The primary outcome was pain intensity measured in using the Visual Analog Scale(VAS). The second outcome was Neck Disability Index to patient's disability. Results: The change in the pain perception degree were statistically significant in both group(p<0.05). TENS by physiotherapist group showed significantly improvement in disability, but, Home based TENS intervention group is not. TENS by physiotherapist group showed significantly greater improvement in pain intensity and patient's disability than the home based TENS intervention group. Conclusion: This study shows that received TENS by physiotherapist was effective in reducing pain, improving disability for mechanical neck disorder patient, physiotherapist' knowledge need to improve patient's pain and disability.

• Journal of International Academy of Physical Therapy Research
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• v.10 no.2
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• pp.1803-1809
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• 2019

Background: Cervical mobilization has been applied mainly for the improvement of arm and neck movements and pain reduction, and little research has been done to improve the executive function. Since this kind of so-called mechanical neck pain is one of most common symptoms, there are controversial issues about this with spine alignment. Posteroanterior (PA) mobilization from the Maitland concept is a process of examination, assessment, and treatment of neuromusculoskeletal disorder by manipulative physical therapy. Objective: To examine the short-term benefits of mobilization for patients with non-specific neck pain. Design: Dual-group Pretest-Posttest Design from the Quasi-Experimental research Methods: Fourteen participants (male 8, female 6; 20's of their age) with non-specific neck pains which are distributed all the unilateral or bilateral body side were recruited. Participants were categorized to Neck Pain with Movement Coordination Impairments (NPMCI) and Neck Pain with Mobility Deficits (NPMD) groups according to the results of physical examination. Professional physical therapist who has over 15-years-of clinical experience applicated manipulative therapy for the neck pain, an occupational therapist only conducted evaluations; K-NDI (Korean version of the Neck Disability Index), VAS (Visual Analog Scale), BDS-K (Korean version of Behavioral Dyscontrol Scale) for decreasing possible adverse effects; there were no person who reported other symptoms followed 4 weeks from the trial. Results: In the NPMCI group, data analysis indicated statistical differences between the PA mobilization interventions in NDI and BDS-K; even though, pain was reduced in VAS, this is not a significantly differ. In the NPMD group, data analysis represented statistical differences between the PA mobilization interventions in NDI, VAS and BDS-K; the scores were represented to be increased or the pain got relief. Conclusions: PA mobilization techniques according to Maitland concept have beneficial effects in patients with neck pain and other clinical positive effects which included neck disability, pain itself and motor function of upper extremity.

• Physical Therapy Korea
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• v.22 no.3
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• pp.50-60
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• 2015

The purpose of this study was to apply the joint mobilization technique to the level of segments with pain and to the level of segments with hypomobility respectively and compare the immediate effects of the joint mobilization technique on the pain, the active cervical range of motion (ROM), and treatment satisfaction of patients with acute mechanical neck pain. After the baseline assessment, forty-two patients were randomized into two groups: a painful group ($n_1=21$) that received joint mobilization at the most painful cervical spine level and a hypomobile group ($n_2=21$) that received joint mobilization at the most hypomobile cervical level. The patients received an intervention that applied unilateral posterior-anterior gliding for 5 minutes and two repetitions of 10 times of active extension motion with distraction. In the Wilcoxon signed-rank test, the painful group and the hypomobile group were improved significantly in all pain variables (p<.001), while the painful group was improved significantly in the active cervical flexion (p<.001), extension (p<.001), left side-bending (p<.01), right side-bending (p=.001), left rotation (p<.001), and right rotation (p<.001). The hypomobile group was significantly improved in active cervical flexion (p=.001), extension (p<.001), left side-bending (p<.05), right side-bending (p=.001), left rotation (p=.001), and right rotation (p<.01) after intervention. In the Mann-Whitney U test, there was no significant difference in any of the dependent variables after the intervention between the two groups, but the painful group was slightly superior to the hypomobile group in all variables except for the right lateral flexion ROM and treatment satisfaction. These outcomes suggest that the cervical joint mobilization may be applied to either the level of painful segments or the hypomobile segments for the treatment of patients with acute mechanical neck pain.

• Physical Therapy Korea
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• v.19 no.3
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• pp.51-60
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• 2012

This study aimed to determine the usefulness of classifying patients with neck pain on the basis of the results of passive scapular elevation test. We classified 21 patients with neck pain into positive (n=12) and negative (n=9) groups on the basis of passive scapular elevation test; the 2 groups then equally performed scapular stabilization exercise program for 30 min, 3 times a week, for 4 weeks. Visual analogue scale (VAS), neck disability index (NDI), and range of motion (ROM) were recorded both before and after the intervention for both groups. Paired t-test was used to determine that there were significant changes between before and after the intervention, and independent t-test was used for analyzing changes between two groups of dependent variables. After 4 weeks of training, we observed significant decrease in pain and disability (p<.05) and a significant increase in rotation, flexion, extension, and side-bending ROM (p<.05) in both groups. Further, between pre- and post-intervention evaluations, we observed a significant decrease in pain and disability and a significant increase in rotation and flexion ROM in the positive group than in the negative group (p<.05). These results indicate that passive scapular elevation test may be used to identify mechanical disorders of the cervicoscapular muscle in patients with neck pain. Therefore, we recommend the use of passive scapular elevation test to determine appropriate treatment intervention when treating patients with neck pain.

• Journal of Acupuncture Research
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• v.25 no.4
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• pp.191-196
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• 2008

Objective : The purpose of this study is to report the effect of T-shaped acupotomy for patients with Neck pain. Methods : We treated 16 patients who have Neck pain with T-shaped acupotomy. Results : It was effective to 14 patients among the 16 patients. Conclusions : This study demonstrate that T-shaped acupotomy useful effect on Neck pain. As though we had not wide expience in this treatment, more research is needed.