• Journal of the Korean Society of Physical Medicine
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• v.14 no.1
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• pp.121-129
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• 2019

PURPOSE: This study was conducted to measure the effects of cervical stabilization exercises on neck pain, forward head posture, and the acoustic characteristics frequency and amplitude modulation of patients with chronic neck pain caused by forward head posture using pressure biofeedback. METHODS: 20 patients with chronic neck pain and voice disorders presenting at the S Exercise Center in Daegu, Korea, were included in the study. A cervical stabilization exercise program of 50 minutes per session was performed three times a week for eight weeks. Pressure biofeedback was utilized to determine the impact of the exercises on neck pain, forward head posture, and the acoustic characteristics of the patients. The measurements were taken prior to and after the intervention to determine any changes. RESULTS: A significant improvement in neck pain, craniovertebral angle and the acoustic characteristics frequency and amplitude modulation of the patients was demonstrated after the intervention (p<.05). CONCLUSION: Cervical stabilization exercises were demonstrated to have a significantly positive effect on neck pain, forward head posture, and vocalization stability in patients with chronic neck pain in the current study based on measurements taken using a pressure biofeedback system. This indicates that an improvement in forward head posture positively impacts postural stability and vocalization. Future studies investigating a greater range of interventions designed to improve neck pain and acoustical effects in patients with chronic neck pain and forward head posture patients are warranted.

• The Journal of Korean Physical Therapy
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• v.30 no.2
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• pp.47-53
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• 2018

Purpose: To find the effect of visual feedback of head angle with using a mobile posture-aware system on craniocervical angle and neck and shoulder muscles fatigue for preventing or decreasing the forward head posture. Methods: Twenty-four healthy young adults in Chungbuk to participate in this study. The subjects started to watch a movie clip for 10 minutes with visual feedback in $0^{\circ}$, $30^{\circ}$, and $60^{\circ}$ of head angles. During the task, surface electromyography (EMG) was used to collect data from the upper trapezius (UT), sternocleidomasetoid muscle (SCM), cervical erecter spinae (CES) during watching the smartphone. Craniocervical angles were measured using a sagittal-view photograph of the subject in a sitting posture. A one-way repeated analysis of variance with a significant level of 0.05 used for statistical analysis. Results: Craniocervical angle with $0^{\circ}$ visual feedback was significantly greater than $30^{\circ}$ and $60^{\circ}$. Craniocervical angle with $30^{\circ}$ visual feedback was significantly greater than $60^{\circ}$. In addition, MDF of UT muscles in $0^{\circ}$ and $30^{\circ}$ of visual feedback was significantly greater than $60^{\circ}$. Conclusion: We concluded that $0^{\circ}$ visual feedback of head angle with using a mobile posture-aware system would be beneficial to prevent or decrease forward head posture during watching a smartphone. We also could recommend using of $30^{\circ}$ visual feedback in case of caring UT muscle fatigue primarily.

• Journal of the Ergonomics Society of Korea
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• v.25 no.2
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• pp.51-62
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• 2006

In assessing risks related to working posture, pictures of postures are taken from various directions, which can be a source of observation error. Joint postures of the neck, lower back, knee, shoulder, and elbow were taken from 7 different viewing angles and 19 observers estimated joint angles by observing the pictures in 2-dimensional display. The joint angles were also measured using an optoelectronic motion measurement system. The estimation error increased as the viewing angle varies from the right side of the human body, but the patterns differ according to which joint angles were being observed. Guidelines to increase the validity of observation of joint angles were presented based on the results. In general, it is recommended to maintain the viewing angle within 20 degrees from the right side of the human body, while different ranges of viewing angle are recommended for each joint angle.

• Journal of the Korean Society of Physical Medicine
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• v.8 no.2
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• pp.193-200
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• 2013

PURPOSE: The purpose of this study was to find out variations in body posture by using the baby carrier at the front side and back side. METHODS: Thirty two healthy and young female who will bring up infants and had no musculoskeletal disorders of neck, lumbar and low limb were recruited for this study. They were each marked about ears of tragus, cervical 7th, acromion anterior end, anterior superior iliac spine, posterior superior iliac spine, greater trochanter and lateral malleolus as landmarks to measure variations of body posture when they carry infants at the front side and back side. Landmarks were regarded as the creteria in order to measure NeckFlexion angle(NF), Foreward shoulder angle(FSA), Pelvic tilt(PT), Sway angle(SA), Head displacement(HD) and Scapular displacement(SD). Variations in body posture were measured from the neutral position to the front and back side by using Image J. RESULTS: There were significance level (p<.05) in NF, PT, SA, HD and SD except for FSA in two different side. CONCLUSION: The results of this study indicate that each of the using ways of baby carrier for baby care was influenced postural responses of young women. therefore, it could be considered to apply to women who have abnormal body posture in order to minimize musculoskeletal disorders.

• Journal of Korean Neurosurgical Society
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• v.47 no.2
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• pp.107-111
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• 2010

Objective : It has been demonstrated that cervical laminoplasty is an effective and safe method of treating multi-level cervical spondylotic myelopathy and ossification of the posterior longitudinal ligament. However, recent reports have suggested that axial neck pain is frequently encountered after cervical laminoplasty. The aim of the present study was to determine clinical significance of the C7 spinous process on axial neck pain after cervical laminoplasty. Methods : A total of 31 consecutive patients that underwent cervical laminoplasty between March 2002 and December 2008 were reviewed. The authors evaluated and compared axial neck pain and lordotic angle in patients that underwent C7 spinous process preserving surgery (group 1, n=16) and in patients in which the C7 spinous process was sacrificed (group 2, n=15). Results : Severe or moderate early axial pain occurred in 56.2% of patients in group 1 and in 86.6% in group 2. Severe or moderate late axial pain occurred in 12.5% in group 1 and in 73.3% in group 2. Eighty-Six percent of patients in group 2 and 43% in group 1 experienced aggravation of their axial neck pain during the early postoperative period. Aggravation of axial neck pain during early postoperative period was less common in group 1 but not statistically significant (p=0.073). Sixty-six percent of patients in group 2 and 12% in group 1 had aggravated axial neck pain at late postoperative period and aggravation of late axial neck pain was significantly less common in group 1 (p=0.002). Conclusion : The present study demonstrates that C7 spinous process preserving laminoplasty decreases the incidence of aggravated axial neck pain after cervical laminoplasty.

• Clinics in Shoulder and Elbow
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• v.20 no.2
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• pp.95-99
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• 2017

Background: The purpose of this study was to investigate the clinical and radiological outcomes of locking plate fixation with fibular strut allograft to manage unstable osteoporotic proximal humerus fractures. Methods: We retrospectively reviewed 15 patients who underwent open reduction and locking plate fixation with fibular strut allograft for osteoporotic proximal humerus fracture between July 2011 and June 2015. For functional evaluation, we evaluated visual analogue scale (VAS) pain score, American Shoulder and Elbow Surgeons (ASES) score, University of California Los Angeles (UCLA) shoulder score, and active range of motion. For radiological evaluation, shoulder true anteroposterior (AP) and AP in $20^{\circ}$ external rotation, as well as the axillary view were taken at two weeks, six weeks, three months, six months, and one year. And the neck-shaft angle was measured on the AP view in $20^{\circ}$ external rotation view. Results: At the one-year follow-up, mean VAS pain score and all shoulder scores, including ASES score and UCLA shoulder score, exhibited satisfactory clinical outcomes. All patients obtained bone union between three and six months post-procedure. Moreover, the mean immediate postoperative neck-shaft angle was $138^{\circ}{\pm}4^{\circ}$, and at one-year follow-up, the neck shaft angle was $137^{\circ}{\pm}5^{\circ}$. There was no significant difference between the preoperative and postoperative values (p=0.105). Conclusions: For the unstable two-part and three-part osteoporotic proximal humerus fractures with medial calcar comminution, the use of fibular strut allograft with locking plate fixation was effective in maintaining the initial status of reduction and exhibiting the satisfactory functional and radiological outcomes.

• Journal of International Academy of Physical Therapy Research
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• v.11 no.3
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• pp.2119-2125
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• 2020

Background: Adults with forward head posture (FHP) often suffer from thoracic hyperkyphosis and thoracic dysfunction, and including reduction of the craniovertebral angle (CV angle) and tightening of the superficial neck muscles. In order to treat thoracic dysfunction, interventions aimed at improving thoracic mobility are necessary. Objectives: To examine the effects of maitland manual mobilization therapy on the thoracic spine in adults with FHP. Design: Single-blind randomized controlled trial. Methods: Thirty adults with FHP who met the selection criteria were randomized to the thoracic multiple joint mobilization (TMJM; n=15) group and the thoracic general joint mobilization (TGJM; n=15) group. Joint mobilizations were performed for 23 minutes a day for 4 weeks continuously, two times per week. Outcome measures were ImageJ, BTS FREE EMG 1000, neck disability Index (NDI). Results: Although changes in the left sternocleidomastoid muscle activity and NDI scores over time between the two groups differed, other variables were noted only changes observed over time. Muscle activity in the right sternocleidomastoid increased again in the TGJM group post-intervention and 2 weeks after the end of the experiment, but changes in other variables were retained or improved, confirming the lasting effects of thoracic joint mobilization. Conclusion: Thoracic multiple joint mobilization may be recommended as a more effective intervention for adults with FHP.

• Archives of Orthopedic and Sports Physical Therapy
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• v.14 no.2
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• pp.33-44
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• 2018

Purpose: The primary purpose of this study was to investigate the effects of cervical stabilization exercise (CSE) on hamstring flexibility in patients with neck pain. A secondary purpose of this study was to investigate the effects of cervical range of motion (CROM) and craniovertebral angle (CVA). Methods: This study was a single-blind, randomized, comparative trial. Twenty patients were allocated into either the cranio-cervical flexion exercise (CCFE) group or the CSE group. Before and after the intervention, we measured straight leg raise (SLR), popliteal angle (PA), CROM, and CVA in the sitting and standing positions. Fisher's exact test, the Mann-Whitney test, and Wilcoxon's signed-rank test were used to analyze our data. Results: Both groups showed significant improvements in the value of SLR, PA, cervical extension, cervical rotation, and CVA in the standing position (both, p<.05) after intervention. However, only the CSE group showed significant improvements in cervical right lateral flexion (z=-2.209; p<.01) and cervical left lateral flexion (z=-2.537; p<.05) after intervention. The CSF group showed more significant improvements in SLR, PA, both cervical lateral flexions, and both cervical rotations than the CCFE group. Conclusions: The results of this study will guide future research in identifying the effectiveness of CSE. In conclusion, it can be inferred that CSE has a positive effect on SLR, PA, CROM, and CVA in the standing position in patients with chronic neck pain.

• 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.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.