• Journal of Korean Neurosurgical Society
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• 제60권6호
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• pp.676-683
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• 2017

Objective : The purpose of this study is to evaluate the efficacy and safety of 3-level hybrid surgery (HS), which combines fusion and cervical disc replacement (CDR), compared to 3-level fusionin patient with cervical spondylosis involving 3 levels. Methods : Patients in the anterior cervical discectomy and fusion (ACDF) group (n=30) underwent 3-level fusion and the HS group (n=19) underwent combined surgery with fusion and CDR. Clinical outcomes were evaluated using the visual analogue scale for the arm, the neck disability index (NDI), Odom criteria and postoperative complications. The cervical range of motion (ROM), fusion rate and adjacent segments degeneration were assessed with radiographs. Results : Significant improvements in arm pain relief and functional outcome were observed in ACDF and HS group. The NDI in the HS group showed better improvement 6 months after surgery than that of the ACDF group. The ACDF group had a lower fusion rate, higher incidence of device related complications and radiological changes in adjacent segments compared with the HS group. The better recovery of cervical ROM was observed in HS group. However, that of the ACDF group was significantly decreased and did not recover. Conclusion : The HS group was better than the ACDF group in terms of NDI, cervical ROM, fusion rate, incidence of postoperative complications and adjacent segment degeneration.

• Physical Therapy Rehabilitation Science
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• 제12권2호
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• pp.105-114
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• 2023

Objective: The study examined the validity and reliability of tele-assessment of cervical range of motion (ROM) through video conferencing. Design: A cross-sectional study Methods: The study included 22 healthy adults as subjects and 10 physical therapists as evaluators. The subjects underwent both face-to-face and tele-assessment of cervical ROM. The CROM (Cervical Range of Motion) device was used for reference measurements in the face-to-face assessment. The evaluators assessed the subjects' ROM through visual inspection (VI) and using a Universal Goniometer (UG) in the tele-assessment. Results: The results showed a significant correlation between the face-to-face and tele-assessment measurements for all ROM contents. The correlation coefficients ranged from r=0.54 to 0.71 (p<0.05), indicating concurrent validity. In terms of inter-rater reliability, the ICC values for both VI and UG assessments in the tele-assessment were high, with ICCs of 0.93 and 0.92, respectively. Additionally, the study investigated the usability of the tele-assessment method and environment. The satisfaction of the participants and evaluators was assessed using the Telehealth Usability Questionnaire (TUQ), which evaluates perceptions, usability, and satisfaction with telehealth services. Conclusions: In conclusion, tele-assessment of cervical range of motion using video conferencing was valid and reliable. Also, investigated participant and evaluator satisfaction and opinions, providing insights into the clinical value of tele-assessment. It is important to note that the study was conducted only healthy adults, and further research may be needed to validate the tele-assessment method in populations with cervical dysfunction or neck pain. These findings support the potential effectiveness of telerehabilitation services in assessing and managing musculoskeletal disorders.

• 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.

• 국제물리치료학회지
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• 제8권1호
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• pp.1122-1127
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• 2017

The purpose of this case study was to identify the effects of posteroanterior (PA) mobilization on the cervical spine in a patient with chronic whiplash-associated disorder (WAD). The subject of this study was a 58-year-old woman who sustained a chronic WAD as a result of a motor vehicle accident two years prior. The subject has progressively worsening neck pain and stiffness. The subject was determined to have a grade IIb WAD the use of the Modified Quebec Classification. The intervention was central and unilateral PA mobilization on the spinous process of C4 and C5. The PA mobilizations were performed at the end of range to Maitland grade IV. The PA mobilization was conducted once daily for a total of eight days. Two sets of measurements were done one before and one after the intervention. Neck pain, cervical stiffness, range of motion and lordosis of the cervical spine were measured. Experimental intervention decreased the neck pain, and increased the neck stiffness and cervical ROM (range of motion) such as flexion, extension, lateral flexion and rotation. X-ray photographs also represented that cervical curvature increased from $35^{\circ}$ to $40^{\circ}$. This study suggested that PA cervical mobilization applied to hronic WAD is effective in decreasing pain, increasing cervical ROM and cervical curvature.

• 대한정형도수물리치료학회지
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• 제15권2호
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• pp.15-24
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• 2009

Objectives : The purpose of this study is to compare the effectiveness between myofascial release technique and ultrasound in subjects with myofascial pain syndrome. Method : Twenty subjects with myofascial pain syndrome were randomly assigned to a myofascial release technique group(n=10) or an ultrsound group(n=10). The Cervical Range of Motion(C-ROM) instrument was used to measure cervical range of motion. Electromyography(EMG) was used to measure muscle power sternocleidomastoid and upper trapezius. Result : The result of this study shows there were no significant differences in ROM increase and muscle power increase between the myofascial release technique group and the ultrasound group. In the group with Myofascial Release Technique, the average score was $61.40{\pm}11.12$ in SCM flexion of C-ROM and $127.87{\pm}4.24$ in Rt. upper trapezius extension of EMG. In the group with ultra sound, the average score was $68.60{\pm}10.02$ in SCM flexion of C-ROM and $131.50{\pm}5.45$ in Rt. upper trapezius extension of EMG. Conclusion : The results suggest that there was no significant difference between two therapeutic techniques.

• 한국전문물리치료학회지
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• 제22권1호
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• pp.58-68
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• 2015

This study aimed to determine the effect of lower trapezius muscle strengthening exercises on pain, neck disability index (NDI), cervical range of motion (ROM), and lower trapezius muscle strength in patients with unilateral neck pain. Following baseline measurements, the subjects (N=40) with unilateral neck pain were randomized into one of two 5 weeks exercise intervention groups: a experimental group (EG, $n_1=20$) that received strength training of the lower trapezius muscles or a control group (CG, $n_2=20$) that received routine physical therapy program. Each group participated in the intervention for 30 minutes, 3 times a week, for 5 weeks. All participants performed 2 repetitions of each intervention per day. The numeric pain rating scale for pain, NDI, ROM, and lower trapezius strength were recorded both pre- and post-intervention for both groups. Paired t-tests were used to determine significant changes post-intervention compared with pre-intervention and independent t-tests were used to analyze differences in the dependent variables between the 2 groups. After the 5-weeks intervention, both groups experienced significantly decreased pain and disability level (p<.05) and significantly increased cervical flexion, extension, lateral flexion, and rotation ROM (p<.05). The EG that received strength training of the lower trapezius muscles showed greater improvements in pain and functional disability level, cervical rotation, and lower trapezius strength than the CG (p<.05). These results suggest that a lower trapezius strengthening exercises reduce neck pain and neck disability level and enhance cervical ROM and lower trapezius strength level in patients with unilateral neck pain.

• 대한물리의학회지
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• 제19권1호
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• pp.107-117
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• 2024

PURPOSE: This study examined the effects of the myofascial release and cervical traction after applying conservative physical therapy to patients chronic neck pain. METHODS: Patients were randomly divided into two groups, namely myofascial release (7 subjects) and cervical traction (7 subjects). Each group performed their therapy 45 minutes per day, two times a week, for four weeks. Pain intensity was measured using the visual analog scale (VAS). Function was measured with the neck disability index (NDI). The cervical range of motion (CROM) was measured with a cervical range of motion (CROM) goniometer. RESULTS: After four weeks of therapy, the VAS (p < .05) and NDI (p < .05) significantly decreased, and ROM significantly increased in both groups (p < .05). There were also significant differences between the two groups for these three measures, except for neck flexion and neck extension(p<.05). CONCLUSION: Myofascial release and cervical traction are more effective than cervical traction alone for reducing VAS and NDI and increasing ROM in patients with chronic neck pain.

• PNF and Movement
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• 제20권3호
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• pp.451-459
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• 2022

Purpose: Temporomandibular disorder (TMD) is a common musculoskeletal problem that causes pain in and disability of masticatory muscles, the temporo-mandibular joint (TMJ), and related structures. The purpose of this study was to compare pressure pain thresholds (PPTs) of masticatory muscles, cervical ranges of motion (ROM), and pelvic mobility during gait of subjects with or without TMD. Methods: In this study, pain thresholds and changes in the mobility of the cervical vertebrae and pelvis were measured in 25 patients with TMD and 25 healthy controls. Using a pressure algometer, the pressure pain thresholds (PPTs) of the masseter and temporalis muscles were measured in both groups. A gyroscope sensor with a mobile application was used to determine cervical ROM in the frontal and sagittal planes. A 3D-motion analysis system was used to evaluate pelvic mobility in the sagittal, frontal, and transverse planes during gait. Results: The TMD group showed significantly decreased PPTs of masseter and temporalis muscles compared with the control group (p < 0.05). Cervical ROM in flexion, extension, and lateral bending were significantly decreased in the TMD group compared with the control group (p < 0.05). In addition, antero-posterior pelvic tilt was significantly decreased in the TMD group (p < 0.05). Conclusion: The results of the current study suggest that there are close anatomical and functional relationships between TMD and muscle chains related to the cervical spine and pelvis. Therefore, more comprehensive body posture assessments, especially of painful areas, should be undertaken when studying TMD patients.

• 대한통합의학회지
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• 제9권1호
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• pp.123-131
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• 2021

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.

• PNF and Movement
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• 제19권3호
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• pp.361-374
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• 2021

Purpose: The study aimed to investigate the effects of neural mobilization with joint mobilization on dysfunction, pain, and range of motion in cervical radiculopathy patients. Methods: Forty-seven cervical radiculopathy patients were recruited for the study. The subjects were randomly allocated to three groups. Group A (n=16) received a neural mobilization with joint mobilization, Group B (n=15) received a neural mobilization (NM), Group C (n=16) received a joint mobilization (JM). All groups had five sets for a day, three days a week, for four weeks. All subjects were evaluated before and after intervention by their neck disability index (NDI), numeric pain rating scale (NPRS), and range of motion (ROM). Results: The results were as follows: First, the NDI was significantly decreased in all groups (p<0.05). Group A had more significantly decreased NDI than Group B and C (p<0.05). Secondly, the NPRS was significantly decreased in all groups (p<0.05). Group A had more significantly decreased cervical NPRS than Group B (p<0.05). Groups A and B were more effective at decreasing upper extremity NPRS than Group C (p<0.05). Thirdly, the ROM was significantly increased in all the groups (p<0.05). Group A had more significantly improved cervical rotation ROM than Group B (p<0.05). Significant short-term effects of the NM with JM on dysfunction, pain, and range of motion in cervical radiculopathy patients were recorded in this study. Conclusion: These findings gave some indications that it may be feasible to include NM with JM in interventions with cervical radiculopathy patients.