• Physical Therapy Korea
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• v.23 no.2
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• pp.20-34
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• 2016

Background: It is necessary to find and develop the effective way of intervention for patients with neck pain, since the neck pain is becoming increasingly common throughout the world. To identify the altered motor control in patient with neck pain would be informative to find and develop the effective way of intervention. Objects: The aim of this study was to review literature regarding the altered motor control in patients with neck pain, measured by using surface electromyography (sEMG), ultrasonography, and functional magnetic resonance imaging (fMRI), and to suggest prospective research work on neck pain. Methods: Case-control (neck pain/healthy) studies published between 2004 and 2015 that investigated neck muscle activation, thickness, cross-sectional area, and fat infiltrate were searched in Scopus, PubMed, and ScienceDirect. Twenty-eight articles were included in this study. Results: sEMG, ultrasonography, and fMRI were used complementarily to investigate the altered superficial and deep neck muscle activation, thickness, cross-sectional area, and fat infiltrate in patients with neck pain. They showed the following altered motor control when compared retrospectively with healthy subjects or during specific functional tasks: (1) increased superficial muscle activation, (2) lesser deep muscle thickness, (3) smaller cross-sectional area of the deep muscle, and (4) greater fat infiltrate in deep muscles. In particular, among the women, the office workers showed higher muscle activation of superficial neck muscles during functional tasks, although they did not have neck pain, than those who were not office workers. Conclusion: Studies revealed that patients with neck pain showed an altered motor control when compared with healthy subjects by using various assessment modalities. Understanding this phenomenon would help researchers design an effective intervention for alleviating neck pain or to evaluate the effectiveness of the intervention. In addition, we recommend that female office workers take measures to care for their necks before developing 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.

• PNF and Movement
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• v.15 no.3
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• pp.291-302
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• 2017

Purpose: The purpose of this study was to describe the effects of neck and trunk stabilization exercise on the onset time of trunk muscle contraction in the elderly. Methods: Elderly subjects were divided into 2 groups: a neck and trunk stabilization exercise group (NTSG) and a control group (CG). The NTSG performed both neck and trunk stabilization exercises and the CG performed gait training on a treadmill, at 30 min per session, 3 times per week, over 8 weeks. Surface electromyography was employed to measure the onset times of trunk muscle contractions in the right anterior deltoid, rectus abdominis, external oblique abdominis, internal oblique abdominis, and erector spinae muscles. Results: The NTSG subjects showed earlier and statistically significant onset of contraction in trunk muscles as compared to the CG. Conclusion: The combination of neck and trunk stabilization exercises may more effectively improve the onset of muscle contractions in the elderly than other types of exercise. The present study's findings may be used as basic data for the development of exercise programs suitable to the elderly, specifically for the design of home exercise programs.

• Safety and Health at Work
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• v.9 no.3
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• pp.319-325
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• 2018

Background: Prolonged neck flexion during smartphone use is known as a factor of neck pain and alteration of neck muscle activity. Studies on the effects of shoulder taping on neck discomfort and neck muscle responses while texting on a smartphone are still lacking. The aim of this study was to examine the effects of shoulder taping on neck discomfort using a numerical rating scale, and neck muscle activity and fatigue using a surface electromyography during a texting task on a touchscreen smartphone. Methods: Twenty-five healthy adolescents used the dominant hand to perform a 30-minute texting task using a touchscreen smartphone at two separate times under one of the following two conditions: taping across the upper trapezius muscle and no taping. Neck discomfort, normalized root mean square, and normalized median frequency slopes for upper trapezius, cervical erector spinae, and sternocleidomastoid muscles were recorded. Results: The results revealed that shoulder taping provided significantly lower neck discomfort than no taping (p < 0.001). However, shoulder taping did not significantly alter normalized root mean square and normalized median frequency slope values of all muscles when compared with no taping controls. Conclusion: Shoulder taping reduces neck discomfort but does not affect neck muscle activity and fatigue while texting on a touchscreen smartphone.

• Journal of Mechanical Science and Technology
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• v.17 no.8
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• pp.1140-1147
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• 2003

We have examined the effect on neck-muscle activation of altering whole body posture. A Rhesus monkey (Macaca mulatta) was trained to produce sinusoidal (0.25 Hz) head tracking movements in the sagittal plane when seated with trunk and head vertical or while standing in the quadrupedal position. Video-fluoroscopic images of cervical vertebral motion, and electromyographic (EMG) responses were recorded simultaneously. Results demonstrated that vertebral motion varied with body posture, occurring synchronously between all joints in the upright position and primarily at skull-$C_1$ when in the quadrupedal position. Muscle EMG activation was significantly greater (P<0.001) in the quadrupedal position than when upright for all muscles except semispinalis cervicis. Peak activation of all the muscles occurred prior to peak head extension in the quadrupedal position, suggesting synchronous activity between muscles. Data suggest that, when upright, muscles were activated in functional groupings defined by their anatomical arrangement. In the quadrupedal position, gravity acting on the horizontally oriented head produced greater activation and a collective response of the muscles.

• Journal of International Academy of Physical Therapy Research
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• v.11 no.1
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• pp.1960-1968
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• 2020

Background: The alignment of the neck and shoulder is important in people with forward head posture. However, previous studies have mainly conducted fragmentary studies on the neck and shoulders, and studies on the combined movement of the neck and shoulders are incomplete. Objective: To investigate the effects of 6 week dynamic exercise program using Thera-band on craniovertebral angle (CVA) in adults with forward head posture. Design: Quasi-experimental study. Methods: The study was conducted on 24 adults with forward head posture and experimented with neck and shoulder exercises and divided them into groups of neck exercises, shoulder exercises, and neck and shoulder exercises to measure CVA values before and after the experiment. The neck exercise program included flexion and extension muscles of the neck and shoulder exercises included dynamic exercise of the upper extremities such as the trapezius muscles and serratus anterior muscle. The CVA results were measured using PA200. Results: Following the interventions, neck exercise group showed significant improvement in CVA (P<.05), but shoulder exercise group and combined exercise group did not show any significant results (P>.05). However, both groups showed some positive results. Significant differences were seen in the comparisons between the three groups (P<.05), and the results of the post-hoc test showed significant differences in neck exercise group and shoulder exercise, neck exercise and combine exercise group. Conclusion: This study suggested that the Thera-band neck exercise is beneficial for foward head posture patients and is expected to be used in clinical trials.

• Journal of Oral Medicine and Pain
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• v.17 no.2
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• pp.19-25
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• 1992

The pressure pain thresholds of head and neck muscles of patients suffering from tensiontype headache220, all female, ages ranged from 13 to 50 years (28.4$\pm$9.6) and 39 healthy controls, all female, ages ranged from 14 to 46 years (24.4$\pm$9.2) were recorded by the electronic algometer (Electyronic Algometer Type I, Somedic, Stockholm, Sweden). And the obtained results were as follows : 1. The pressure pain thresholds of patient group were lower than those of controls in superior sternocleidomastoid muscle, middle sternocleidomastoid muscle, and trapezius insertion muscle (P<0.001) 2. The pressure pain thresholds of patient group were not different from those of controls in anterior temporal, middle temporal, posterior temporal, deep masseter, anterior masseter, inferior masseter, medial pterygoid, posterior digastric, splenius capitus and upper trapezius muscle (P>0.05). 3. Seventy-one percent of tension-type headache patients had more than one muscle, of whicb pressure pain threshold was lowered significantly (less than mean of control - 1.5SD). 4. The pressure pain thresholds of head and neck muscles should be considered as a criterion for the diagnosis of tension-type headache.

• Journal of Mechanical Science and Technology
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• v.14 no.3
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• pp.338-349
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• 2000

Neck muscle forces and spinal loads at the C4/5 level were estimated that result from isometric voluntary ramp efforts gradually developing to maximums in flexion, extension, left lateral bending and right lateral bending. Electromyographic (EMG) activities, a three-dimensional anatomic data of the neck and a hybrid model, EMG-assisted optimization (EMGAO) model, were used. The model computed the cervical loads at 25%,50%,75%, and 100% of peak moments. The highest model-predicted C4/5 joint compressive forces occurred during flexion; $361\;({\pm}164)\;N,\;811\;({\pm}288)\;N,\;1207\;({\pm}491)\;N\;and\;1674\;({\pm}319)\;N$ in 25%, 50%, 75% and 100% of peak moment respectively. Variations in load distribution among the agonistic muscles and co-contractions of antagonistic muscles were estimated during ramp efforts. Results suggest that higher C4/5 joint loads than previously reported are possible during isometric, voluntary muscle contractions. These higher physiological loads at C4/5 level must be considered possible during orthopedic reconstruction at this level.

• The Journal of the Korea Contents Association
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• v.20 no.7
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• pp.47-55
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• 2020

Along with the increased use of smart devices, the incidence of turtle neck syndrome among modern people has increased. Turtle neck syndrome is a posture in which the head is forward compared to the torso due to longer front muscles in the neck and shorter upper muscles, and it is more effective to fix the usual posture habits than surgery or medication. Thus, in this paper, a system is proposed to detect and warn posture that can cause turtle neck syndrome in real time. Image data of correct posture and turtle neck posture are collected to create a CNN-based learning model. Using only the webcam(Built-in camera), the sitting position that enters the camera is verified in real time through the learning model, and if it is a turtle neck position, it generates a warning sound and induces the correct posture. The system can induce people to correct their usual posture habits to treat turtle neck syndrome and prevent more serious diseases such as neck discs.

• Journal of the Korean Society of Physical Medicine
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• v.14 no.2
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• pp.137-144
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• 2019

PURPOSE: The continued use of smartphones has resulted in an abnormal body posture and neck alignment changes. Maintaining this posture for a long time weakens the flexor muscles in the neck and shortens the extensor muscles in the neck. This study examined the correlation between the suboccipital muscle tension and deep neck flexor muscle physical endurance according to the craniovertebral angles. METHODS: The craniovertebral angle, tension of the suboccipital muscle and endurance of the deep neck flexor muscle were measured in 58 healthy 20-year-old male and female college students. The tension of suboccipital muscle and endurance of the deep neck flexor muscle were then divided according to the body mass index (BMI). Their correlation with the craniovertebral angle was then examined. Each parameter was measured three times to determine the interrater reliability. RESULTS: The craniovertebral angle and suboccipital muscle tension showed differed significantly. On the other hand, the craniovertebral angle and deep neck flexor muscle physical endurance showed no significant differences. CONCLUSION: The results show that the craniovertebral angle and deep neck flexor muscle physical endurance were not correlated, but a smaller craniovertebral angle resulted in a higher suboccipital muscle tension.