• Journal of International Academy of Physical Therapy Research
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• v.10 no.4
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• pp.1914-1920
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• 2019

Background: Mobilization and cranio-cervical flexion exercise has been reported in reducing pain from cervical part and improving its motor function; also, has been represented that alleviate of neck pain and recover of neck muscles improve the normal gait performance. However, few studies have identified the effects of mobilization and exercise on pain and gait parameters with preceding issues. Objective: To examine the effects or changes of pressure pain threshold (PPT) and gait parameters in patients with chronic neck pain. Design: Cross-Sectional Clinical Trials Methods: Twenty patients with the history of neck pain (>3 months) performed the cervical mobilization and cranio-cervical flexion exercise. Gait parameters were assessed with wireless device and collected data were transmitted to the personal computer via Bluetooth. The PPT was measured posteroanterior direction at the prone position and the mean of subsequent three PPT measurements was used for the final analysis. Results: Both cervical central posteroanterior mobilization (CCPAM) (p<.000) and sling-based cranio-cervical flexion exercise (SBCCFE) (p<.000) group showed a significant increase in the PPT and the gait parameters, cadence (p<.023), was significantly increased in the CCPAM group, however slightly increased in the SBCCFE group. The comparison between the CCPAM and the SBCCFE groups after treatment did not show significant differences for the score on the PPT and gait parameters. Conclusions: This study suggests that CCPAM and SBCCFE increase PPT, cadence, and gait speed.

• PNF and Movement
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• v.18 no.3
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• pp.333-341
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• 2020

Purpose: The purpose of this study was to investigate the effect of open and closed kinetic chain exercises with a sling on neck flexor thickness during chin-in movement in office workers with forward head posture. Methods: Thirty-one selected subjects randomly performed chin-in movement in open kinetic chain and closed kinetic chain exercises using a sling. All subjects were measured for their neck flexor thickness using ultrasound measurement equipment during the performance of chin-in movement in open and closed kinetic chain exercised. A paired t-test was used to compare the thickness of the total neck flexor, superficial, and deep neck flexor, respectively, between open and closed kinetic chain exercises with chin-in movement. Results: The thickness of the superficial neck flexor diminished in size more greatly during the chin-in movement with the closed kinetic chain than the open kinetic chain, but this was not a statistically significant difference (p > 0.05). On the other hand, the thickness of the total neck flexor and deep neck flexor had more greatly increased during the chin-in movement with the closed kinetic chain than the open kinetic chain, and this was a statistically significant differences (p < 0.05). Conclusion: This study suggested that chin-in movement with a closed kinetic chain is more effective in activating the deep neck flexor than the open kinetic chain. Thus, we believe that the closed kinetic chain exercise using a sling is an effective intervention to correct the postural alignment of individuals with forward head posture.

• The Journal of Korean Physical Therapy
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• v.31 no.1
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• pp.62-66
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• 2019

Purpose: This study examined the most efficient exercise position to activate the gluteus medius (GM) and tensor fascia latae (TFL) in hip abduction in side-lying (HA-SL), clam in side-lying (CL-SL), and sling bridging in side-lying (SB-SL), which are the most representative GM exercises. Methods: Twenty-four healthy male adults aged from 20 to 40 years, whose body mass index was under 25, participated in this experiment. While all participants conducted three different positions with a counterbalanced manner, such as in AB, CL, and BR, activation of the GM and TFL was measured using 8-channel wireless EMG. Exercise was performed for 10 seconds three times in total with a five minute-break session. Results: Significant differences in GM and TFL activation were observed among the three positions (p<0.05). The highest activation of 60.69 was observed in BR followed in order by 46.03 and 12.92 in HA-SL and CL, respectively. TFL activation in HA-SL was 42.01, followed in order by 35.98 and 14.01 in BR and CL, respectively. On the other hand, there was no significant difference in TFL muscle activation between BR and HA-SL. Conclusion: These findings suggest that both BR and HA-SL in GM can be done selectively. CL has remarkably low muscle activation in GM and TFL, which makes it less valuable in GM and TFL exercise. In conclusion, selective BR and HA-SL exercise should be applied to maximally and effectively activate the GM.

• The Journal of Korean Physical Therapy
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• v.26 no.4
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• pp.274-279
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• 2014

Purpose: The aim of this study was to determine the change of static and dynamic foot pressure on trunk stabilization exercise in children with spastic diplegic cerebral palsy. Methods: This study examined five male children participants ages 10~14 years old with spastic diplegic cerebral palsy. All subjects participated in a 6-week sling exercise program for trunk stabilization; the exercise was performed three times per week and each session lasted 50 minutes. The subjects were measured for static and dynamic foot pressure and bilateral symmetry of both feet before and after the trunk stabilization exercise. Results: The static foot pressure increased significantly before and after the trunk stabilization exercise (left foot: before $0.41{\pm}0.02%BW/cm^2$ after $0.79{\pm}0.02%BW/cm^2$, right foot: before $0.14{\pm}0.03%BW/cm^2$, after $0.43{\pm}0.44%BW/cm^2$) (p<0.05) and bilateral symmetry of both feet increased (before $0.27{\pm}0.18%BW/cm^2$, after $0.37{\pm}0.05%BW/cm^2$) with more weight shift on left foot than right foot, but was not statistically significant (p>0.05). The dynamic foot pressure increased (left foot: before $2.58{\pm}0.44%BW/cm^2$, after $3.40{\pm}0.31%BW/cm^2$, right foot: before $2.75{\pm}0.19%BW/cm^2$, after $3.26{\pm}0.18%BW/cm^2$) with more weight shift on right foot than left foot, but was not statistically significant (p>0.05), and bilateral symmetry of both feet decreased (before $0.31{\pm}0.36%BW/cm^2$, after $0.13{\pm}0.20%BW/cm^2$) (p<0.05). Conclusion: The findings of this study indicated that the trunk stabilization exercise has a positive impact on static and dynamic foot pressure in children with spastic diplegic cerebral palsy.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.28 no.2
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• pp.67-75
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• 2022

Background: Scapular winging is a rare disorder that is commonly caused by nerve damage of the dorsal scapular nerve, spinal accessory nerve, or the long thoracic nerve. This affects the scapulohumeral rhythm which may cause abnormal kinetic motion of the shoulder. The purpose of this case report is to describe a self-exercise oriented management incorporating shoulder strengthening to reduce symptoms in a shoulder pain patient with winging scapular. Methods: A 45 year old male patient complained of pain in his both shoulders without any trauma. Shoulders were treated with steroid injections for supraspinatus tendonitis, but although pain improved to some extent, pain and disability continued for 3 months. Both shoulders had pain, decreased active range of motions, muscles weakness, and scapular winging. The patient underwent 9 interventional sessions over 3 months and was managed mainly by self-exercise. The intervention method involved push up plus, sling, muscle strengthening, and stabilization exercises. Loads were increased as symptoms improved. Results: Clinical outcomes were measured at every session. Pain in both shoulders reduced to 0 on a numerical pain rate scale by the 4th session, and the active range of motion was fully recovered. During the 9th session, the strength of the serratus anterior had improved from grade P to G on the right side and grade G to N grade on the left. Conclusion: In this case study, the self-exercise program was effective in reducing pain, increasing active range of motion, and improving muscle strength in subjects with scapular winging.

• PNF and Movement
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• v.10 no.2
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• pp.9-16
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• 2012

본 연구는 43세 남성 환자의 관절가동술과 슬링을 이용한 유착성 관절낭염 환자의 치료사례를 조사하여 그 과정과 결과를 알아보고자 하였다. 어깨통증장애지수(shoulder pain and disability index) 측정과 어깨관절의 굽힘(flexion), 벌림(abduction), 바깥돌림(external rotation), 안쪽돌림(internal rotation)에 대한 관절가동범위를 측정하여 비교하였으며 견관절 주위에 비스테로이드 소염진통 주사 1회, 약물치료를 병행하며 주 3회 8주간 보존적인 물리치료인 온습포(hot pack)와 간섭파(ICT), 관절가동술, 그리고 슬링을 이용한 운동치료를 실시하였다. 결과는 관절가동술과 슬링운동치료의 적용이 유착성 관절낭염 환자의 통증을 줄이고 관절가동범위를 증진시키는데 효과가 있는 것으로 판단된다.

• Journal of The Korean Society of Integrative Medicine
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• v.9 no.3
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• pp.193-201
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• 2021

Purpose : The purpose of this study was to compare the effect of pelvic exercise on the CVA and spinal curve in adults with forward head posture compared to the group using only neck exercise when pelvic exercise was performed in parallel with conventional neck exercise. Methods : GPS 400 and Formetric were used to identify craniovertebral angle (CVA), thoracic kyphosis, lumbar lordosis, and pelvic torsion and were measured by an experienced research manager. Forward head posture (FHP) was selected for people whose angle between the line connecting the ear ball and the seventh cervical spine and the horizontal line is 50 degrees or less. The 30 selected students were randomly divided into 15 experimental groups and 15 control groups. Mackenzie exercise and sling exercise were performed for neck exercise in both the experimental group and the control group, and pelvic exercise using a Swiss ball was additionally performed in the experimental group. All data collected in this study were analyzed using SPSS statistics 21.0. Cervical vetebral angle (CVA), thoracic kyphosis, lumbar lordosis, and pelvic torsion were compared at 0 weeks, 3 weeks, and 6 weeks for each measurement factor using ANOVA with repeated measures. For the statistical significance test, the significance level of α was set to .05. Results : The changes of pelvic torsion, thoracic kyphosis and CVA due to pelvic exercise using Swiss Ball and neck exercise were changed over time, but lumbar lordosis were not changed. And there were no significant differences among the groups. Conclusion : In conclusion, the pelvic correction exercise is considered to be an effective exercise for correcting the FHP and requires regular pelvic correction exercises. We expect the results to be used in clinical trials.

• Journal of the Korean Society of Physical Medicine
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• v.8 no.3
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• pp.295-302
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• 2013

PURPOSE: The purpose of this study was to investigate the effect of short-term lumbar stabilization exercise to patients suffering from chronic low back pain(CLBP) on the strength of their lumbar flexor and extensor and the postural balance of them and to suggest effective treatment duration for them. METHODS: Study subjects were 20 patients with CLBP who's been reported the pain for more than 12 weeks. For these subjects, muscle strength of both extensor and flexor of lumbar and the balancing ability were measured before and after the intervention. Lumbar stabilization exercise was composed of matt, ball and sling exercise. The intervention was applied for total 12 sessions for 4 weeks (3 times a week) and each session was for 40 minutes. RESULT: For muscle strength of both extensor and flexor of lumbar, there was significant differences after the application of lumbar stabilization exercise(p<.05). For balancing ability, stabilization shows significant differences in all of the positions except PC(eyes closed on pillows)(p<.05). Distribution of weight shows no significant differences but it was generally distributed within normal range after the exercise and Fall index shows significant differences between before and after the exercise(p<.05). CONCLUSION: These results could have positive effect on deciding different periods of therapeutic intervention.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.21 no.1
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• pp.37-42
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• 2015

Background: This study investigates the impact of the cervical musculoskeletal intervention on post-traumatic stress disorder patient's cervical pain levels and depression factor. Methods: Thrty neck pain patients diagnosed with post-traumatic stress disorder were enrolled. Neck exercise training using a sling system was applied to the experimental group and self-neck movement exercise, modification of the McKenzie exercise, was applied to the control group. Both groups were checked every week whether they performed or not. Both groups performed their exercise for 35 minutes for a time and 3 times per week. Total period of the intervention was 6 weeks. To compare the effects of interventions, threshold of cervical tenderness and depression level were measured before and after the each intervention and also measured at follow-up. Results: Painthreshold of left trapezius showed a significant difference between two groups at three points. It increased 19.71% in the experimental group after the intervention compared to before the intervention. At follow-up it also increased 20.06% in the experimental group. Pain threshold of right trapezius showed a significant difference at three points. It increased 18.35% in the experimental group after the intervention compared to before the intervention. At follow-up it also increased 15.93% in the experimental group. According to the result interaction between groups and measurement time in both side of trapezius was valid. Depression level showed significant difference in the experimental group between three points. It decreased 18.07% after the intervention compared to before the intervention and decreased 15.21% at follow-up. According to the result interaction between groups and measurement time in depression level was valid. Conclusions: This study has important implications as the therapeutic strategy, high potent of improving symptoms, shows effect to a subject who has psychological problem such as posttraumatic stress disorder (PTSD).

• Journal of the Korean Society of Physical Medicine
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• v.17 no.3
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• pp.1-10
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• 2022

PURPOSE: This study examined the effects of the resistance levels on the muscle activities around the hip and spine during bridge exercise with hip abduction resistance in patients with chronic back pain. METHODS: A cross-over study design was used. Twenty subjects with low back pain were enrolled in this study. The subjects performed bridge exercises with hip abduction resistances (20 mmHg, 40 mmHg, and 60 mmHg). A Narrow Sling was used to provide resistance. Surface electromyography was used to measure the activity of the erector spinae, biceps femoris, gluteus maximus, and gluteus medius. RESULTS: The muscle activity of the gluteus maximus and gluteus medius increased significantly with increasing resistance levels. There was a significant difference in the muscle activity of the biceps femoris with a resistance level between 20 mmHg and 40 mmHg, but there was no significant difference in the other resistance levels. There was no significant difference according to resistance level in the erector spinae. The muscle activity ratios of the gluteus medius/erector spinae and gluteus maximus/erector spinae increased significantly with increasing resistance strength. CONCLUSION: The different levels of abduction resistance for hip abduction during bridge exercise will help activate the gluteus maximus selectively in patients with chronic back pain.