Purpose: This study aimed to compare the effects of ischemic compression (IC) therapy and extracorporeal shock wave therapy (ESWT) in patients with upper trapezius myofascial pain syndrome and to present an effective treatment method for these patients. Methods: A total of 42 patients with upper trapezius myofascial pain syndrome were randomly assigned to the IC group (n = 21) and ESWT group (n = 21). IC therapy and ESWT were performed in the IC and ESWT groups, respectively. Treatment was applied to the trigger point of the upper trapezius muscle. Visual analog scales (VAS), pain pressure threshold (PPT), range of motion, neck disability index (NDI), and fear-avoidance belief questionnaire (FABQ) were evaluated before and after the intervention to compare its effectiveness. Results: Both groups showed significant differences before and after the intervention in VAS, PPT, NDI, FABQ, flexion, extension, right side bending, and left side bending (p <.05). In addition, there were significant differences in the IC group compared to the ESWT group in VAS, PPT, and NDI (p <.05). Conclusion: IC therapy and ESWT applied to patients with upper trapezius myofascial pain syndrome are mediating methods of pain, function, and psychosocial effects. In addition, IC therapy may be a more effective mediating method for pain and dysfunction than ESWT.
Background: The purpose of this study was to investigate the effects of joint mobilization and muscle strengthening exercises on neck function, range of motion, and muscle tone in patients with forward head posture. Methods: A total 32 subjects were divided into muscle strengthening exercise (n=16) and joint mobilization (n=16) who met the diagnostic criteria for the forward head posture, and the study method used the neck disability index (NDI) and BPM Pro to compare the range of motion. Results: As a result of the study, there was no significant difference between each group, and when looking at the differences before and after each group, there was a significant difference in neck pain in both groups. There was a significant difference in muscle tension in the joint mobilization group, but there was no significant difference in the muscle strengthening exercise group. In the range of joint mobilization, there was a significant difference in the range of left joint mobilization of the joint mobilization group, there was no significant difference in the range of right joint mobilization, and there was no significant difference in the range of joint mobilization of the muscle strengthening exercise group. Conclusion: The above results revealed that joint mobilization and muscle strengthening exercises were effective on neck function, range of motion, and muscle tone in forward head posture patients.
Objectives : The main purpose of this study is to investigate the efficacy of Kyejibokryong-whan(Guizhifuling-wan) and examine the blood stasis for patients with motor vehicle accident. Methods : Of the patients who have visited Dong-Shin university oriental hospital for general pan due to motor vehicle accident from June 2010 to November 2010, we enrolled 29 patients and performed blood stasis diagnosis. Patients were divided into groups according to blood stasis findings. Patients who had more than twenty blood stasis diagnosis point were classified as blood stasis group. Patients who had under twenty blood stasis diagnosis point were classified as non blood stasis group. We administered Kyejibokryong-whan(Guizhifuling-wan) to all group. The effect was assessed by VAS(visual analogue scale), SF-MPQ(short form-McGill pain questionnaire) ODI(Oswestry disability index) & NDI(neck disability index). Results : The pain & function index decreased in both groups after treatment. Conclusions : The difference between blood stasis group and non blood stasis group were not significant at after treatment stage. This data suggested that the method of classifying blood stasis is useful and the Kyejibokryong-whan(Guizhifuling-wan) can be effective means that decrease pain caused by motor vehicle accident.
Purpose : The time spent using smart devices is constantly increasing, particularly in recent times. Using smart devices for a long time with an incorrect posture may lead to cerebral palsy (CP), instability, and abnormal muscle tone. Therefore, we aimed to investigate the relationships among cervical instability, deep neck flexor (DNF) activity, range of motion (ROM), and muscle tonus. Methods : Fifty subjects with CP participated in this study, and they were physiotherapists at W Hospital in Daejeon. Those who voluntarily participated in the research were selected as candidates who fulfilled the selection criteria. According to an instability test, 25 subjects were assigned to the instability and control groups. All subjects first underwent the instability test to be allocated to the appropriate group. Those in the instability group tested positive on the instability test. The Neck Disability Index (NDI), ROM, muscle tone, and DNF activity were measured to evaluate their relationships. The DNF strength and endurance were measured using a cranio-cervical flexion test. The upper trapezius (UT), sternocleidomastoid (SCM), and suboccipital (SO) muscle tones were measured using a contact soft tissue tone measuring instrument. The statistical significance level was set to .05. Results : There were significant differences in the flexion, extension, and rotation of the cervical ROM (CROM) between the two groups (p<.05). The SCM, UT, and SO muscle tones were significantly different between the two groups (p<.05). The DNF strength and endurance showed a significant difference between the two groups (p<.05). Conclusion : We found that there were significant increases in the CROM and muscle tone and decrease in the DNF strength and endurance in the instability group. This indicated that cervical instability is affected by the DNF strength and endurance. We may recommend DNF exercises in cases of cervical instability in clinical environments.
Ha, Seung Man;Kim, Jeong Hoon;Oh, Seung Hun;Song, Ji Hwan;Kim, Hyoung Ihl;Shin, Dong Ah
Journal of Korean Neurosurgical Society
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제53권5호
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pp.288-292
/
2013
Objective : Vertebral distraction is routinely performed during anterior cervical discectomy and fusion (ACDF). Overdistraction can injure the facet joints and may cause postoperative neck pain consequently. The purpose of this study was to investigate the clinical relevance of distraction force during ACDF. Methods : This study included 24 consecutive patients with single level cervical disc disease undergoing single level ACDF. We measure the maximum torque just before the the arm of the Caspar retractor was suspended by the rachet mechanism by turning the lever on the movable arm using a torque meter. In order to turn the lever using the torque driver, we made a linear groove on the top of the lever. We compared the neck disability index (NDI) and visual analogue scale (VAS) scores between the high torque group (distraction force>6 $kgf{\cdot}cm$) and the low torque group (distraction force${\leq}6kgf{\cdot}cm$) at routine postoperative intervals of 1, 3, 5 days and 1, 3, 6 months. Results : The VAS scores for posterior neck pain had a linear correlation with torque at postoperative 1st and 3rd days ($y=0.99{\times}-1.1$, $r^2=0.82$; $y=0.77{\times}-0.63$, $r^2=0.73$, respectively). VAS scores for posterior neck pain were lower in the low torque group than in the high torque group on both 1 and 3 days postoperatively ($3.1{\pm}1.3$, $2.6{\pm}1.0$ compared with $6.0{\pm}0.6$, $4.9{\pm}0.8$, p<0.01). However, the difference in NDI scores was not statistically significant in all postoperative periods. Conclusion : Vertebral distraction may cause posterior neck pain in the immediate postoperative days. We recommend not to distract the intervertebral disc space excessively with a force of more than 6.0 $kgf{\cdot}cm$.
Objectives: The aim of this case report is to present the effects of Korean medicine treatment in a patient with left facial paraesthesia, temporomandibular joint (TMJ) pain, and post-traumatic neck pain induced by cerebral infarction. Methods: A 26-year-old male patient was treated with Cheongpa-Jeon H, acupuncture, pharmacopuncture (Shinbaro2), and Chuna Therapy for 24 days of hospitalization. Left facial paraesthesia, TMJ pain, and post-traumatic neck pain were assessed with a Numeric Rating Scale (NRS) and EuroQoL-5 Dimension (EQ-5D). Post-traumatic neck pain was assessed using the Neck Disability Index (NDI). Results: After 24 days of treatment, the patient's left facial paraesthesia and left arm tingling sensation were relieved from NRS 6 to NRS 2. Left TMJ pain was reduced from NRS 5 to NRS 2. The EQ-5D score increased from 0.138 to 0.73. The NDI score decreased from 71.11 to 37.78. Conclusion: These results show that left facial paraesthesia, TMJ pain, and post-traumatic neck pain can be relieved with Korean medicine treatment. However, further well-designed studies are required to confirm these findings.
Kang, Boram;Kim, Taikon;Kim, Mi Jung;Lee, Kyu Hoon;Choi, Seungyoung;Lee, Dong Hun;Kim, Hyo Ryoung;MA, Byol Jun;Park, Seen Young;Lee, Sung Jae;Park, Si-Bog
Annals of Rehabilitation Medicine
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제39권6호
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pp.957-963
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2015
Objective To compare the pain-reducing effect of forest bathing alone versus forest bathing in combination with stretching and strengthening exercises in patients with chronic posterior neck pain. Methods Sixty-four subjects with posterior neck pain that had lasted more than 3 months were enrolled. They were randomly divided into a forest bathing alone (FBA) group and a forest bathing with exercise (FBE) group; each group included 32 subjects. All subjects from both groups walked every morning in the forest for about 2 hours for 5 days. In the afternoon, the FBE group did a stretching and strengthening exercise for about 4 hours; the FBA group had free time in the woods. Visual analog scale (VAS) on one day, VAS over the previous week, neck disability index (NDI), EuroQol 5D-3L VAS (EQ VAS) and index (EQ index), McGill pain questionnaire (MPQ), the number of trigger points in the posterior neck region (TRPs), and the range of motion of the cervical spine were evaluated on the first and last day of the program and compared between the two groups. Results The number of TRPs were significantly reduced in the FBE group compared with the FBA group (p=0.013). However, the other scales showed no significant difference between the two groups. Conclusion When patients with chronic posterior neck pain underwent a short-term forest bathing (less than 7 days) program, FBE was more effective in the reduction of the number of TRPs than FBA. However, all other pain measurement scales we evaluated showed no statistically significant difference between the two protocols.
Objectives : We investigated the efficacy and safety of miniscalpel acupuncture (MA) treatment combined with non-steroidal anti-inflammatory drugs (NSAIDs) for chronic neck pain (CNP) in an assessor-blinded randomized controlled pilot trial to establish a basis for larger-scale randomized controlled studies on this subject. Methods : Participants (n=36) were recruited and randomly allocated to the MA group, NSAIDs and combined treatment group. The MA group received MA three times over three weeks. The NSAIDs group was administered orally with zaltoprofen 80mg t.i.d. over three weeks. The combined treatment group received MA and zaltoprofen in the same manner as MA and NSAIDs groups. The primary outcome was pain as assessed by a visual analogue scale (VAS) and the secondary outcomes were assessed using the Neck Disability index (NDI), EuroQol 5-dimension questionnaire (EQ-5D), and Patients' Global Impression of Change scale (PGIC). Assessments were made at week 0 (baseline), 1, 2, 3 (primary end point) during treatment and at week 7 (4 weeks after the end of treatment). Results : 35 participants completed the study. No serious adverse event occurred and blood test results were within normal limits. The improvement of VAS and NDI was significantly greater in combined and MA group than that in NSAIDs group (p<0.017). The combined group showed better outcomes in EQ-5D at visit 2 and 5, in PGIC at visit 4 than the NSAIDs group (p<0.017). No significant differences were found between combined and MA group. Conclusions : Our results suggest that both combined and MA group can be more effective in improving pain control than NSAIDs group. A large-scale clinical study is warranted to further clarify these findings.
Park, Jin-Hoon;Roh, Kwang-Ho;Cho, Ji-Young;Ra, Young-Shin;Rhim, Seung-Chul;Noh, Sung-Woo
Journal of Korean Neurosurgical Society
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제44권4호
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pp.217-221
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2008
Objective : Although anterior cervical discectomy and fusion (ACDF) is the standard treatment for degenerative cervical disc disease, concerns regarding adjacent level degeneration and loss of motion have suggested that arthroplasty may be a better alternative. We have compared clinical and radiological results in patients with cervical disc herniations treated with arthroplasty and ACDF. Methods : We evaluated 53 patients treated for cervical disc herniations with radiculopathy, 21 of whom underwent arthroplasty and 32 of whom underwent ACDF. Clinical results included the Visual Analogue Scale (VAS) score for upper extremity radiculopathy, neck disability index (NDI), duration of hospital stay and convalescence time. All patients were assessed radiologically by measuring cervical lordosis, segmental lordosis and segmental range-of-movement (ROM) of operated and adjacent disc levels. Results : Mean hospital stay (5.62 vs. 6.26 days, p<0.05) and interval between surgery and return to work (1.10 vs 2.92 weeks, p<0.05) were significantly shorter in the arthroplasty than in the fusion group. Mean NDI and extremity VAS score improved after 12 months in both groups. Although it was not significant, segmental ROM of adjacent levels was higher in the fusion group than in the arthroplasty group. And, segmental motion of operated levels in arthroplasty group maintained more than preoperative value at last follow up. Conclusion : Although clinical results were similar in the two groups, postoperative recovery was significantly shorter in the arthroplasty group. Although it was not significant, ROM of adjacent segments was less in the arthroplasty group. Motion of operated levels in arthroplasty group was preserved at last follow up.
Background: The purpose of this case study was to investigate into the effect of complex exercise program on the postural change, gait and balance ability in elementary school students with forward head posture. Methods: Four patients with forward head posture were recruited. They were evaluated pre-treatment, and after 6weeks, using neck disability index (NDI), numeric pain rating scale (NPRS), balance ability, foot pressure (fore foot/rear foot peak pressure ratio, F/R ratio), gait ability (cadence, toe out angle, stance phase). Results: First, the angle of forward head posture (craniovertebral angle; CVA and cranialrotation angle; CRA) was decreased in all subjects. The NPRS and NDI were decreased in all subjects. Also, The cadence, toe out angle and F/R ratio were increased in all subjects. The stance phase of gait cycle was positively change in all subjects. Lastly, the static balance ability improved in all subjects. Conclusion: According to the results above, the complex exercise program for students with forward head posture can help improve the postural change, gait and balance ability. Also, the complex exercise program was able to select interventions depending on the patient's condition and the desired goal.
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