• 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.

• Physical Therapy Korea
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• v.29 no.1
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• pp.1-10
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• 2022

Background: Neck pain is a major health problem in developed countries and has a lifetime prevalence of 50%. Major problems include a reduced cervical range of motion, muscle stiffness, dysfunction, postural changes, and decrease in psychosocial level. Objects: This study aimed to investigate the effects of applying the upper trapezius inhibition dynamic taping to patients with chronic neck pain on their neck pain, functional level, cervical range of motion, psychosocial level, and neck posture. Methods: The study design was a randomized controlled trial. A total of 40 patients with neck pain participated in this study and were randomly assigned to a Dynamic Taping group (n = 20) or Sham Taping group (n = 20). In both groups, basic intervention cervical pain control therapy and shoulder stabilization exercise program were performed. In addition, dynamic taping and sham taping were applied to participants in the Dynamic Taping and Sham Taping groups to inhibit the trapezius muscle, respectively. All interventions were performed three times a week and a total of 12 times for 4 weeks, and the participants' neck pain, functional impairment level, cervical range of motion, psychosocial level, and neck posture were measured and compared before and after the intervention. Results: Both groups showed significant differences in neck pain, functional level, cervical range of motion, psychosocial level, and neck postural before and after the intervention (p < 0.05). Moreover, there were significant differences between the two groups regarding the functional level and neck posture (p < 0.05). Conclusion: Inhibition dynamic taping of the upper trapezius muscle suppression is an effective method with clinical significance in reducing pain in individuals with chronic neck pain and improving the functional level, cervical range of motion, psychosocial level, and neck posture.

• Journal of the Korean Society of Physical Medicine
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• v.13 no.2
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• pp.89-95
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• 2018

PURPOSE: We aimed to study the effect of head-lift exercise on the neck strength and swallowing function in patients with stroke. METHODS: Our study included 20 patients with stroke hemiparesis. All patients were randomly allocated to either the head-lift exercise or the conventional swallowing therapy group, and each group included 10 patients. All patients underwent the exercise over a mean period of 30 min daily for 6 weeks. Neck strength and swallowing function were assessed prior to and 6 weeks following the training period. We used a paired t-test to compare the within-group change before and after the intervention. We used an independent t-test to compare the between-group difference. The statistical significance level was set at ${\alpha}=.05$ for all variables. RESULTS: The head-lift exercise group showed a significant within-group change in terms of the neck strength and swallowing function (p<.05). The conventional swallowing therapy group also showed a statistically significant change (p<.05). A statistically significant difference was observed between the head-lift exercise and the conventional swallowing therapy group with regard to the change in both, the neck strength and swallowing function after application of the intervention (p<.05). CONCLUSION: This study provides valuable information for future studies in this field. Further studies involving a wider range of patients and a longer experiment span are required to strengthen the results of our study.

• Physical Therapy Korea
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• v.22 no.1
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• pp.19-29
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• 2015

Impaired respiratory function is common in patients with stroke. The purpose of this study were to investigate the effectiveness of exercises and to assess forced vital capacity and peak cough flow after completion of neck stabilizing and respiratory reeducation exercises (combining diaphragmatic breathing and pursed-lip breathing exercises). The 45 participants were randomly assigned to an experimental group 1 ($n_1=15$), experimental group 2 ($n_2=15$), and a control group ($n_3=15$). All subjects performed conservative physical therapy for 30 minutes. Experimental group 1 undertook the neck stabilizing exercise and the respiratory reeducation exercise. Experimental group 2 undertook the respiratory reeducation exercise. Additional exercise did not exceed 30 minutes, five times a week for six weeks. The subjects were assessed for deep neck flexor thickness and breathing function (forced vital capacity, forced expiratory volume at one second, forced expiratory volume at one second/forced vital capacity, peak expiratory flow, and manual assisted peak cough flow) at pre-post value. The results of this study were as follows. Experimental group 1 showed a significant increase only in deep neck flexor thickness change rate (p<.05). All groups showed significant increases in forced vital capacity, forced expiratory volume at one second, and peak expiratory flow in pre-post measurement (p<.05). Experimental groups 1 and 2 showed an increase in manual assisted peak cough flow in pre-post measurement (p<.05). There was no significant difference between experimental group 1 and experimental group 2, but experimental group 1 improved more than experimental group 2 in respiratory function as a whole. In conclusion, these findings suggest that the neck stabilizing exercise in combination with the respiratory reeducation exercise can improve forced vital capacity and peak cough flow in patients with stroke.

• Journal of Korean Physical Therapy Science
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• v.29 no.4
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• pp.1-16
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• 2022

Background: This study was conducted to examine the correlation of VDT, posture and shoulder function among each group divided by according to the neck pain disorder index (NDI) scores for female patients with neck pain. Design: Cross-sectional study. Methods: Fifty adult women with neck pain voluntarily participated in this study and the neck pain disorder index questionnaire, VDT syndrome assessment tool questionnaire, craniovertebral angle, thoracic kyphosis angle, round shoulder posture, pectoralis minor length, shoulder joint hypermobility, and serratus anterior strength tests were conducted respectively. Subjects were divided into two groups where 21 subjects were allocated to the mild pain group whom have rated below 14 points on the NDI scores, and 29 subjects were in the severe pain group, whom have rated above 15 on the NDI score. Results: The study found that in the mean difference between variables in each group, VDT syndrome showed a higher mean score in the severe pain group than the mild pain group (p<0.05). In the group correlation and regression analysis, the mild pain group showed a significant negative correlation between the craniovertebral angle and round shoulder posture (r=-0.467, p<0.05), and the round shoulder posture for craniovertebral angle was shown to have significant positive influence (B=10.162, p<0.05). The severe pain group showed that the NDI and the VDT syndrome had a significant amount of correlation (r=0.520, p<0.01), the VDT syndrome showed significant positive influence (B=0.330, p<0.05), and the craniovertebral angle showed significant negative influence (B=-0.809, p<0.05). It was also shown that shoulder joint hypermobility had a significant negative correlation with the serratus anterior strength (r=-0.437, p<0.01), and that serratus anterior strength had a significant negative influence on shoulder joint hypermobility (B=-4.175, p<0.05). Conclusion: This study is of clinical significance in that it presented variables that should be considered depending on the degree of neck pain in treating patients with neck pain and that it presented patients with not only posture but also the function of the shoulder joint as factors to consider.

• The Korean Journal of Pain
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• v.37 no.2
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• pp.164-177
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• 2024

Background: Neck and jaw pain is common and is associated with jaw functional limitations, postural stability, muscular endurance, and proprioception. This study aimed to investigate the effect of jaw and neck pain on cranio-cervico-mandibular functions and postural stability in patients with temporomandibular joint disorders (TMJDs). Methods: Fifty-two patients with TMJDs were included and assessed using Fonseca's Questionnaire and the Helkimo Clinical Dysfunction Index. An isometric strength test was performed for the TMJ depressor and cervical muscles. The TMJ position sense (TMJPS) test and cervical joint position error test (CJPET) were employed for proprioception. Total sway degree was obtained for the assessment of postural stability. Deep neck flexor endurance (DNFE) was assessed using the craniocervical flexion test. The mandibular function impairment questionnaire (MFIQ) was employed to assess mandibular function, and the craniovertebral angle (CVA) was measured for forward head posture. Results: Jaw and neck pain negatively affected CVA (R² = 0.130), TMJPS (R² = 0.286), DNFE (R² = 0.355), TMJ depressor (R² = 0.145), cervical flexor (R² = 0.144), and extensor (R² = 0.148) muscle strength. Jaw and neck pain also positively affected CJPET for flexion (R² = 0.116) and extension (R² = 0.146), as well as total sway degree (R² = 0.128) and MFIQ (R² = 0.230). Conclusions: Patients with painful TMJDs, could have impaired muscle strength and proprioception of the TMJ and cervical region. The jaw and neck pain could also affect postural stability, and the endurance of deep neck flexors as well as mandibular functions in TMJDs.

• Journal of The Korean Society of Integrative Medicine
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• v.5 no.4
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• pp.31-39
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• 2017

Purpose : The purpose of this study was to examine the effects of short neck flexor strengthening in proprioceptive neuromuscular facilitation and neuromuscular electrical stimulation on swallowing function in patients with chronic stroke and to provide basic data for swallowing rehabilitation in stroke patients. Method : The study involved 30 chronic stroke patients who visited ${\bigcirc}{\bigcirc}$ General Hospital in Daegu Metropolitan City between March and July, 2017. The subjects were randomly assigned to either an experimental group (n=15) or a control group (n=15). Both groups underwent traditional swallowing rehabilitation therapy for 30 minutes five times a week over a six-week period. The experimental group performed short neck flexor exercises, which are part of the proprioceptive neuromuscular facilitation, for 30 minutes three times a week over a six-week period. The control group performed neuromuscular electrical stimulation for 30 minutes three times a week over a six-week period. Based on its results, changes in the patients' swallowing function and degree of food intake were analyzed. Result : In terms of the ASHA NOMS scale and new VFSS scale, the experimental group and the control group showed statistically significant changes in ten sub-items and six sub-items, respectively. Statistically significant differences in one sub-item were found between the groups. Conclusion : PNF-based short neck flexion exercise appear to be effective at improving swallowing function of stroke patients with dysphagia.

• Korean Journal of Applied Biomechanics
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• v.27 no.4
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• pp.263-268
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• 2017

Objective: The purpose of this study was to show differences in impact variables between treadmills with (treadmills B, C, and D) and treadmills without a shock-absorbing function (treadmill A) to propose the development of a treadmill with improved or added shock-absorbing function to reduce impact shock. Method: Thirteen male students in their twenties who had habitual rear foot strike during running ran on four treadmills at 2.67 m/sec while ankle and neck acceleration data were collected. The magnitude of the ankle and neck acceleration peaks and peak positive ankle acceleration were calculated. The power spectral density of each signal was calculated to transform the ankle and neck accelerations in the frequency domain. Results: The peak positive ankle acceleration on treadmill B was significantly lesser than that on treadmills A and D, and that on treadmill C was significantly less than that on treadmill A (p < .01). Peak positive neck acceleration was not statistically different between the treadmills. The frequencies of the peak power of the ankle and neck acceleration signal within the lower and higher frequency ranges were not statistically different between the treadmills. The signal power magnitude of the ankle in higher frequency ranges on treadmill B was significantly less than that on treadmills A, C, and D (p < .01). The signal power magnitude of the ankle in higher frequency ranges was not statistically different between the treadmills. The signal power magnitudes of the neck acceleration signal within the lower and higher frequency ranges were not statistically significantly different between the treadmills. Conclusion: Our results indicate that the shock-absorbing function of a treadmill plays a role in reducing impact shock. Therefore, in future treadmill development, shock-absorbing function should be improved or incorporated to reduce impact shock to the body.

• Physical Therapy Korea
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• v.15 no.1
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• pp.61-68
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• 2008

The aim of the study was to evaluate the effect of a disease-specific exercise (DSE) on temporomandibular joint (TMJ) function and neck mobility in TMJ dysfunction associated with ankylosing spondylitis (AS). Ten AS patients (seven males and three females) with TMJ dysfunction were recruited for this study. The DSE included exercises to correct head and neck posture and to improve the flexibility of the neck and TMJs. The patients attended treatment three times a week for 4 weeks, averaging 1 hour each session. Assessments were performed pretreatment, posttreatment, and 6 weeks after the completion of treatment. General physical status was assessed by four clinical measures (tragus-to-wall distance, modified Schober test, lumbar side flexion, and intermalleolar distance), the Bath ankylosing spondylitis function index (BASFI), and the Bath ankylosing spondylitis disease activity index. The main outcome measures included TMJ function (craniomandibular index (CMI)), and neck mobility (flexion, extension, rotation, and lateral rotation). None of the measures of general physical status, with the exception of BASFI, were significant1y different between the pretreatment, posttreatment, and 6-week follow-up (p>.05). However, CMI and all neck movements, except for extension, significant1y improved after the treatment (p<.05). These improvements were maintained during the follow-up period. The DSE used in the present study seems to be a clinical1y useful method for managing patients with symptoms from the stomatognathic system in AS. Further studies with more subjects and longer treatment times, including the follow-up period, will be conducted to validate these findings.

• 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.