• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.21 no.2
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• pp.33-37
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• 2015

Background: The purpose of this study on the effects of deep cervical flexors strengthening exercise to forward head posture and pain of neck in patients with chronic neck pain. Method: We selected 30 subjects among neck pain patients and carried out measurements. The subjects' forward head posture was measured including head tilt angle (HTA), neck flexion angle (NFA) and forward shoulder angle (FSA), neck disability index (NDI), numeric rating scale (NRS). The subjects underwent deep cervical flexors muscle strengthening with pressure bio-feedback device for 4 weeks. Then, after intervention, the subjects' forward head posture was measured again. It was performed Wilcoxon signed-ranks test for confirming the effect of deep cervical flexor muscles strengthening exercise. Results: As a result of comparison of measurements before and after intervention, we found that there were statistically significant improvement in the subjects' NDI, NRS and forward head posture including head tilt angle, neck flexion angle and forward shoulder angle. Conclusion: We concluded that deep cervical flexors strengthening exercise has the effect of alleviation of neck pain patients and is effective for 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.

• Journal of Korean Medicine Rehabilitation
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• v.19 no.1
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• pp.125-134
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• 2009

Objectives : The purpose of this study is to find out the effects of muscle energy techniques on nuchal pain caused by traffic accidents. Methods : The 20 patients were divided into 2 groups: group A was treated except muscle energy techniques and group B was treated with muscle energy techniques. Both groups were treated with acupunture treatment, physical theraphy and herbal medication. Patients were evaluated by McGill Pain Questionnaire-Short Form(SF-MPQ), Pain Disability Index(PDI) and Neck Disability Index(NDI) in traffic accident patients. Results : 1. Both Group were significantly decreased in sensory of SF-MPQ, VAS, PDI and NDI after 7 days of treatment. 2. Group B compared with the Group A was significantly decresed in VAS, PDI after 7 days of treatment. Conclusions : We found out that muscle energy techniques is considered to be effective and useful on nuchal pain caused by traffic accidents.

• The Korean Journal of Pain
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• v.36 no.2
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• pp.242-252
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• 2023

Background: Neck pain is a common problem in the general population and second only to low back pain in musculoskeletal problems. The aim of this study is to compare three different types of exercise training in patients with chronic neck pain. Methods: This study was conducted on 45 patients with neck pain. Patients were divided into 3 groups: Group 1 (conventional treatment), Group 2 (conventional treatment plus deep cervical flexor training), and Group 3 (conventional treatment plus stabilization of the neck and core region). The exercise programs were applied for four weeks, three days a week. The demographic data, pain intensity (verbal numeric pain scale), posture (Reedco's posture scale), cervical range of motion ([ROM] goniometer), and disability (Neck Disability Index [NDI]) were evaluated. Results: In all groups, a significant improvement was found in terms of pain, posture, ROM, and NDI values in all groups (P < 0.001). Between the groups, analyses showed that the pain and posture improved more in Group 3, while the ROM and NDI improved more in Group 2. Conclusions: In addition to conventional treatment, applying core stabilization exercises or deep cervical flexor muscle training to patients with neck pain may be more effective in reducing pain and disability and increasing ROM than conventional treatment alone.

• Journal of the Korean Society of Physical Medicine
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• v.14 no.4
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• pp.93-101
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• 2019

PURPOSE: This study tries attempted to provide basic clinical data to reduce pain and improve function by comparing the muscle fatigue of the superficial neck muscles and neck disability index (NDI) by performing McKenzie exercise or passive stretching exercise for chronic neck pain patients. METHODS: Sixteen chronic neck pain patients were selected and divided into the McKenzie group (n=8) and passive stretching group (n=8). The intervention program was performed three times a week for four weeks. The time for one exercise was 30 minutes. Before the intervention, the muscle fatigue the superficial neck muscles and NDI were measured. They were measured again after four weeks using the same method. RESULTS: The median frequency of the superficial neck muscles increased significantly in the McKenzie group and passive stretching group (p<.05). The NDI of both the McKenzie group and the passive stretching group decreased significantly. A comparison of the groups, revealed a significant difference in only the median frequency values of the upper trapezius muscle and splenius capitis muscle (p<.05). The NDI values of both groups were similar. CONCLUSION: Both McKenzie exercise and passive stretching exercises showed a significant difference in the degree of fatigue and NDI. McKenzie exercise delayed the replace of the fast twitch fibers which helped improve the muscle fatigue of the upper trapezius muscle and splenius capitis muscle. On the other hand, additional studies applying more variables for the muscle function to improve the symptom of chronic neck pain patients will be needed.

• Journal of the Korean Society of Physical Medicine
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• v.10 no.1
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• pp.45-52
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• 2015

PURPOSE: The purpose of this study was to observe the effect of pain and function according to the high and low manual passive coping strategies after whiplash injury. METHODS: The study was tested with 30 patients with neck pain. Coping was measured at after 10 days using the Pain Management Inventory. Group was divided into high passive(experimental) and low passive(control) group. All patients were equally treated with the ordinary therapy. Patients attended physical therapy for 3 times a week, for 6 weeks. Visual analogue scale (VAS) for pain, Pain Disability Index (PDI), neck disability index (NDI), were recorded both before and after the intervention. RESULTS: Each coping strategy group were evaluated after 6 weeks. VAS has been significantly reduced in both groups (p <.05). PDI and NDI was significantly decreased after the experiment before. In the experimental group (p <.001), the control group showed no significant difference. In the comparison between groups VAS was significantly reduced compared with the control group (p <.05), PDI and NDI was significantly reduced compared with the control group (p <.001). CONCLUSION: Low passive coping strategy predicts neck pain and disability recovery. It may be beneficial to assess and improve coping strategy early in whiplash injury.

• Physical Therapy Rehabilitation Science
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• v.5 no.4
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• pp.178-184
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• 2016

Objective: Tension-type headache is caused by hormones, foods, irritants, stress, obesity, fatigue, and neck and head trigger points-prolonged abnormal posture. The purpose of this study was to evaluate the effects of relaxation approach on head posture, static postural stability, and headache in persons with tension-type headache. Design: Randomized controlled trial. Methods: Thirty-five persons with tension-type headache participated in this study. This study was a pretest-posttest with a control group design for a duration of 4 weeks (60 min/3 times/1 wk). The participants were randomly allocated to the relaxation approach group (n=18) and the control group with conventional rehabilitation including thermotherapy and transcutaneous electrical stimulation for the same period (n=17). Outcome measures involved forward head posture (FHP), foot pressure, neck disability index (NDI), and six-item headache impact test (HIT-6). Results: Relaxation approach and control groups improved significantly in the amount of forward head posture, neck disability index, and six-item headache impact test scores after training (p<0.05). The control group was found to be significantly different in the amount of FHP, backward foot pressure, NDI, and HIT-6 after training compared to before training (p<0.05). The relaxation approach group significantly improved in forward head posture, neck disability index, and six-item headache impact test compared with control group after training (p<0.05). Neck disability index and six-item headache impact test significantly improved after training compared with before training in the control group (p<0.05). However, the foot pressure was not significantly different between relaxation approach and control groups. Conclusions: This study suggests that treatment with relaxation approach combined with self-exercise would be effective in reducing the amount of forward head posture, neck disability and headache impacts.

• Journal of the Korean Society of Physical Medicine
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• v.19 no.1
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• pp.143-154
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• 2024

PURPOSE: The present study was conducted to improve the understanding of the Korean Standard Functional, Disability, and Health Classification (KCF) and its ease of use in the clinical domain of the musculoskeletal system by comparing, analyzing, and linking the KCF codes with items from patient-reported outcome measures (PROMs), which are currently mainly used to evaluate patients with neck, shoulder, waist, and knee pain. METHODS: The items of the most widely used PROMs, the Neck Disability Index (NDI), Disabilities of the Arm, Shoulder, and Hand (DASH) scores, Oswestry Disability Index (ODI), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and the codes of the KCF were linked by two experts according to the linking rules. RESULTS: The concordance between the items of each of the PROMs and the KCF code linked by the two experts was NDI,86.4%86.4%, DASH 83.3%, ODI 92.0%, and WOMAC 80.7%. The NDI, DASH, and WOMAC indexes were found to comprise items corresponding to physical function, activity, and participation areas, and were linked to 22, 43, and 31 KCF codes, respectively. In addition to these two areas, the ODI included items related to environmental factors and was linked to 25 codes (duplicated codes are treated as one). CONCLUSION: This research can be used by adding the KCF code to the questions of the currently used evaluation tool. This coding can be easily applied and will contribute to the easy understanding of the KCF.

• 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.

• The Journal of Korean Physical Therapy
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• v.31 no.4
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• pp.242-247
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• 2019

Purpose: This study examine the functioning level and quality of life (QoL) of people with non-specific neck pain and neck pain with radiculopathy using the neck disability index (NDI), functional rating index (FRI), and short form of health survey 36 (SF-36) and each of linked lCF code lists of those scales. Methods: Each item of the NDI, FRI, and SF-36 were linked conceptually to the ICF code, and the lCF code lists of those scales were produced as iNDI, iFRI, and iSF-36, respectively. Seventy-nine patients with neck pain filled the instruments and its linked ICF code lists. The subjects were divided into two groups based on the diagnosis, non-specific neck pain (Group1), and neck pain with radiculopathy (Group2). A group comparison was performed using an independent t-test. The Pearson correlation coefficient was also used to analyze the relationships between each scale and the linked ICF code list. Results: The participants in Group 2 experienced more difficulties in their daily activities than those in Group 2 when examined in NDI and FRI (p<0.05). This result was also found consistently in the ICF code lists, iNDI and iFRI (p=0.05). On the other hand, the QoL did not show a difference between groups (p=0.06). A strong correlation was observed between the instruments and linked ICF code lists: NDI and iNDI (r=0.90), FRI and iFRI (r=0.91), and SF-36 and iSF-36 (r=-0.61). Conclusion: These findings suggest that the concept of each item in NDI and FRI could be linked to the ICF codes when examining patients with neck pain, but the items of SF-36 were found to be linked and expressed in ICF.