• The Journal of Korean Physical Therapy
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• 제29권1호
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• pp.7-15
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• 2017

Purpose: This randomized controlled trial was conducted to compare the effectiveness of global postural reeducation to segmental stretching in subjects with neck and shoulder pain. Methods: Sixteen subjects with neck and shoulder pain were randomized into two intervention groups, a global posture reeducation group (n=8) that performed muscle chain stretching, and a segmental stretching group (n=8) that performed conventional static muscle stretching. The intervention program consisted of two 40 minutes individual sessions per week for four weeks. Subjects were evaluated pre-intervention, two-week after intervention and at a four-week follow-up appointment for pain intensity, disability and health-related quality of life. Two-way repeated analysis of variance was used for between-time and between-group comparisons. The significance level was 0.05. Results: Significant pain relief and decreasing discomfort of the neck and shoulder were observed after intervention in both groups, and there was an interaction between time lapse and groups (pain, F=10.31, neck disability, F=25.45, shoulder disability, F=12.82, p<0.05). Quality of life also improved after intervention in both groups. Moreover, the physical components score improved, and a significant interaction was observed between time and groups (F=4.85, p<0.05). However, no significant improvement in mental component score of quality of life and no significant interaction between time and groups were observed (p>0.05). Conclusion: These findings suggest that a GPR intervention in subjects with neck and shoulder pain induces greater improvement of pain and disability and quality of life than segmental stretching.

• PNF and Movement
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• 제19권1호
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• pp.137-146
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• 2021

Purpose: The study aimed to determine the effect of proprioceptive neuromuscular facilitation (PNF) lower trapezius muscle strengthening exercise on pain, cervical range of motion (ROM), and neck disability index (NDI) in patients with chronic neck pain. Methods: Following baseline measurements, the subjects (n = 30) with chronic neck pain were randomized into two groups: the PNF group (n = 15) that received PNF strength training of the lower trapezius muscles or a control group (n = 15) that received gentle palpation of the skin. Each group participated in the intervention for 30 min, three times per week for six weeks. The visual analogue scale for pain, ROM, and NDI of both groups were recorded at both pre- and post-intervention. Paired t-tests were used to determine significant changes in the post-intervention compared with pre-intervention, and independent t-tests were used to analyze differences in the dependent variables between the two groups. Results: After the six-week intervention, both groups experienced significantly decreased pain and NDI (p < 0.05) and significantly increased cervical flexion, extension, lateral flexion, and rotation ROM (p < 0.05). The PNF group that received PNF strength exercise of the lower trapezius muscles showed greater improvements in pain and NDI and cervical rotation of ROM than those of the control group (p < 0.05). Conclusion: These results suggest that the PNF lower trapezius strengthening exercise reduces neck pain and disability level and enhances cervical ROM in patients with chronic neck pain.

• The Korean Journal of Pain
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• 제37권2호
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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.

• The Journal of Korean Physical Therapy
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• 제21권3호
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• pp.1-8
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• 2009

Purpose: The purpose of this study was to examine the functional category, the item structure and the model-data fit of the neck disability index (NDI) of neck pain subjects by performing a Rasch rating scale analysis. Methods: The data was obtained from the assessments of 71 college students (males: 27, females: 44) with neck pain. The data of the NDI was applied to the Rasch's rating scale model to estimate the difficulty of items, the goodness-of-fit of each item, the separation reliability and index, and the rating scale. Results: The 'sleep' item showed misfit and nine items were founds to be fits for self-reporting of disability due to neck pain. The most difficult item of the remaining 9 items was 'work' and the easiest item was 'headache'. The transformation formula score=(logit score+7.10)/(7.10+0.11)$\times$100. The 6 response levels of the NDI were validated according to the structure of the rating scale. The item and subject reliability of the separation reliability was 0.97 and 0.85, respectively. Conclusion: We proved that the NDI for self-reporting of disability of daily activities due to mild neck pain was valid and reliable. This study suggests that individuals with mild neck pain may be assessed by using the modified NDI that does not include the 'sleep' item in the 10 items of NDI.

• Journal of Acupuncture Research
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• 제31권2호
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• pp.153-163
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• 2014

Objectives : To investigate the clinical results of patients who were diagnosed with grade II spondylolithesis treated with Korean medicine of relaxative Chuna and Gangchuk herbal medicine. Methods : We reviewed medical records of four patients diagnosed with grade II spondylolisthesis. Each patient has taken intensive Korean medical admission treatment at Mokhuri Hospital. All patients received treatments of Gangchuk herbal medicine, relaxative Chuna and acupuncture during admission period. Before treatment and every after 7-day treatment the patient's pain and walking distance without pain were assessed. The zero minimum to ten maximum pain numeric rating scale(NRS) was used to determine the degree of pain. Results : Average admission duration was 23 days. All the patients' NRS decreased from median figure of 7.5[the minimum 7 to the highest 8] to median figure of 1[the minimum 0 to the highest 2]. Walking distance without pain increased from a median of 55 m[the minimum 20 m to the highest 100 m] to median of 165 m[the minimum 100 m to the highest 250 m]. Conclusions : Intensive conservative korean medical treatment was effective in reducing pain and functional improvement for grade II lumbar spondylosisthesis patients.

• 대한물리의학회지
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• 제10권2호
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• pp.35-45
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• 2015

PURPOSE: The aim of this study is to investigate how upper thoracic manipulation and cervical stability training affects cervical range of motion and neck disability index of patients with chronic mechanical neck pain. METHODS: 30 patients with chronic mechanical neck pain, and randomly divided into the upper thoracic manipulation and the cervical stability training group. Upper thoracic manipulation group was conducted to the upper thoracic manipulation, and cervical stability training was conducted to the cervical stability training. Intervention period was 6 weeks, and 3 sessions, each of which was run for 5~10 minutes. The subjects were measured neck range of motion before and after intervention by electro-goniometer. Neck disability index was used to measure neck disability index Korean version. RESULTS: Comparison within groups, there were significant difference in neck range of motion before and after intervention, and Neck disability index significantly reduced in the cervical stability training group. The comparison between groups, there were no significant difference in neck range of motion and neck disability index. CONCLUSION: Upper thoracic manipulation and cervical stability training to the patients with chronic neck pain was helpful to improve neck range of motion and cervical stability training was helpful to improve neck disability index.

• The Korean Journal of Pain
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• 제29권2호
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• pp.96-102
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• 2016

Background: It is widely accepted that cervical interlaminar steroid injection (CIESI) is more effective in treating radicular pain than axial neck pain, but without direct comparison. And the differences of effect after CIESI according to MRI findings are inconsistent. In this retrospective study, we evaluated the therapeutic response of CIESI according to pain sites, durations, MRI findings, and other predictive factors altogether, unlike previous studies, which evaluated them separately. Methods: The medical records of 128 patients who received fluoroscopy guided CIESI were analyzed. We evaluated the therapeutic response (more than a 50% reduction on the visual analog scale [VAS] by their second visit) after CIESI by (1) pain site; neck pain without radicular pain/radicular pain with or without neck pain, (2) pain duration; acute/chronic (more than 6 month), and (3) findings of MRI; herniated intervertebral disc (HIVD)/spinal stenosis, respectively and altogether. Results: Eighty-eight patients (68%) responded to CIESI, and there were no significant differences in demographic data, initial VAS score, or laboratory findings. And there were no significant differences in the response rate relating to pain site, pain duration, or MRI findings, respectively. In additional analysis, acute radicular pain with HIVD patients showed significantly better response than chronic neck pain with spinal stenosis (P = 0.04). Conclusions: We cannot find any sole predictive factor of therapeutic response to the CIESI. But the patients having acute radicular pain with HIVD showed the best response, and those having other chronic neck pain showed the worst response to CIESI.

• Physical Therapy Rehabilitation Science
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• 제10권3호
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• pp.251-256
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• 2021

Objective: The forward head posture (FHP) is strongly related to the rounded shoulder posture (RSP), which is associated with shoulder pain. Design: Observational cross sectional study design Methods: A total of 37 were enrolled in the study, 22 individuals with FHP(experimental group) and 15 healthy adults(control group). Correlation with differences between groups was analysed through craniovertebral angle (CVA) representing FHP for both groups, neck disability index (NDI) indicating neck pain, disability of the arm, shoulder and hand (DASH) indicating shoulder pain. Results: There was a significant difference in the results of CVA, NDI, and DASH in FHP and healthy adults (p<0.05). Significant correlations were found between DASH and CVA in FHP participants (r = -0.656, p = 0.001). Also, in the regression analysis results of DASH and CVA, the regression model was found to be suitable and the variation in DASH could be explained by 43% (F = 15.118, p = 0.001). Conclusions: Shoulder pain and neck discomfort are potentially related, and an increase in shoulder pain can increase FHP.

• 대한물리의학회지
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• 제1권1호
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• pp.109-116
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• 2006

Purpose : To identify the effects of flexion-extension of stretching on the functional improvement of patients with neck myofascial pain syndrome. Methods : the present research investigated 30 patients with neck myofascial syndrome, dividing them into a group doing flexion-extension of stretching. This study examined degree of recovery from neck pain by comparing their neck myofascial pain syndrome before and after the treatment, and compared to find difference in the degree of recovery from myofascial pain syndrome. Results : The results are as follows. For the flexion of stretching, 1. For the visual analogue scale (VAS) decreased significantly for six weeks treatment, 2. For the flexion decreased significantly for six weeks treatment. and the range of motion of cervical vertebrae increased significantly(p>.05). 3. For Stretching, range of motion left rotation indicated significant difference after pre test and after two week but no significant difference after six week. 4. For the left rotation decreased significantly for six weeks treatment. and the range of motion of cervical vertebrae increased significantly(p>.05). 5. For the right rotation decreased significantly for six weeks treatment. and the range of motion of cervical vertebrae increased significantly(p>.05). Conclusion : This study suggest that flexion-extension of stretching have an effect on the functional improvement of patients with neck myofascial pain syndrome.

• The Journal of Korean Physical Therapy
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• 제28권5호
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• pp.328-333
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• 2016

Purpose: This study was to investigate the correlation between pain, disability and quality of life among adolescents and office workers with neck and shoulder pain. Methods: Twenty-four subjects (mean age=24.92 years, SD=3.94, range=20-37) with neck and shoulder pain participated in this study. The outcome measures of the study were visual analogue scale (VAS), neck disability index (NDI), shoulder pain and disability index (SPADI), short form-36 (SF-36) for neck and shoulder pain and disability, quality of life. Pearson's correlation and Speaman's rank correlation were used to measure the association between VAS and NDI, SPADI, SF-36. Results: The VAS showed a positive correlation between weak to moderate with the NDI and SPADI, but no significantly correlated (${\rho}=0.34$, ${\rho}=0.25$). The moderate positive correlation and significant correlation were observed between NDI and SPADI (${\rho}=0.43$, p<0.05). The PCS of SF-36 was significantly negative correlated with the VAS (${\rho}=-0.24$), NDI and SPADI (${\rho}=-0.63$, ${\rho}=-0.59$, p<0.05). Conclusion: The pain and disability of neck and shoulder has closely relevance. And, the pain and disability of neck and shoulder has a negative impact on the quality of life.