• The Korean Journal of Pain
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• 제20권2호
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• pp.246-250
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• 2007

We report here on a case of right side spasmodic torticollis (ST) that was refractory to botulinum toxin type A injection and medication. The patient finally underwent a selective ramisectomy with ipsilateral sternocleidomastoid muscle (SCM) resection, but the remaining symptoms slowly aggravated, and a contralateral left side SCM spasm began. As conservative therapy for reducing the spasmodic symptoms, accessory nerve block, upper cervical plexus block and stellate ganglion block were performed twice in a week. After 6 months, the spasmodic symptoms significantly decreased. The Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS) decreased by more than 70%. After one year of serial intermittent local anesthetic blockade therapy, the patient became almost free from the original ST symptoms (TWSTRS = 1). Serial local anesthetic interventions for the ST patient may have a beneficial role on the pathological peripherocentral neural activity of the ST patient and can modulate motor-sensory integration in the patient.

• 대한두개안면성형외과학회지
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• 제16권2호
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• pp.88-91
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• 2015

In adult congenital muscular torticollis (CMT) patients, physical therapy is not as effective because the development of sternocleidomastoid muscle (SCM) muscle is complete. While surgical release can address CMT in adult patients, the risk of general anesthesia and visible postoperative scar is a concern, expecially in patients with mild symptoms. In this paper, we report our experience in treating such patients with minimal-incision myotomy under local anesthesia. A review was performed for all adult patients who had undergone the simple myotomy procedure. Surgical indication was reserved for patients with mild fibrotic band in the SCM muscle with minimal lengthdiscrepancybetween the muscles. All patients had recognizable head tiltand palpation of fibrotic band on affected side of the neck. Surgical details are described in the main body of text. Three female patients had undergone the procedure. Torticollis was resolve in all patients with complete restoration of ranage of motion. There were no postoperative complications, and patient satisfaction was high. We have reported three cases of mild CMT in adult female patients, who had undergone minimal-incision myotomy under local anesthesia. Outcomes were satisafactory with no morbidity to report. With careful patient selection, this method offers an alternate treatment option for adult CMT patients with mild symptoms.

• 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.

• 비파괴검사학회지
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• 제29권3호
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• pp.224-229
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• 2009

An experimental study was conducted to investigate the effects of turtle neck syndrome, so called, on muscular fatigue and muscle activity. Six subjects (males) participated and performed the prolonged casual computer work in the study. EMG signals from six muscles of the dominant neck-back region were acquired and recorded for 10 seconds at the beginning and the end of three hours computer work. EMG was recorded from six muscles by using a computerized data recording and analysis system. Power spectrum function of EMG was calculated off-line by means of a signal processing software package. Power spectrum functions were smoothed with a moving average filter of 21 points and normalized with respect to the maximal value achieved during the trials. Muscle activity and median frequencies of Sternocleidomastoid(SCM) in turtle neck posture was approximately 51%, which were less than those in normal neck posture. SCM also showed the biggest decrease in median frequency. Results will provide the insight into the neck-back injury mechanism of turtle neck patients. Furthermore, they will be helpful in developing rehabilitation programs for restoring patients' neck-back functions.

• 한국전문물리치료학회지
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• 제26권2호
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• pp.61-68
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• 2019

Background: Forward head posture (FHP) is a postural alignment of the cervical vertebrae that leads to increased gravitational load on cervical segmental motions. The overhead arm lift test assesses the ability to actively dissociate and control low cervical flexion and move the shoulders through overhead flexion. Objects: The purpose of this study was to explore muscle activities in the upper trapezius (UT), serratus anterior (SA), sternocleidomastoid (SCM), and lower trapezius (LT) alongside changes in head position during the overhead arm lift test in individuals with FHP. Methods: Fifteen subjects with forward head posture and fifteen subjects with normal subjcects were enrolled in this study. The patients performed the overhead arm lift test, and muscle activities of the UT, SCM, SA, and LT were measured using surface electromyography and by evaluating changes in head position. Independent t-tests were used to detect significant differences between the two groups and Cohen's d was calculated to measure the size of the mean difference between the groups. Results: The FHP group demonstrated significantly increased muscle activity of the UT ($32.46{\pm}7.64$), SCM ($12.79{\pm}4.01$), and LT ($45.65{\pm}10.52$) and significantly decreased activity in the SA ($26.65{\pm}6.15$) than the normal group. The change in head position was significantly higher in the FHP group ($6.66{\pm}2.08$) than the normal group. Effect sizes for all parameters assessed were large between the two groups. Conclusion: The subjects with excessive FHP displayed were unable to fix their heads in position during the overhead arm lift test. The overhead arm lift test can thus be used in clinical settings to confirm control of the neck in these subjects.

• 대한물리의학회지
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• 제6권4호
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• pp.497-504
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• 2011

Purpose : Chronic cervical pain is a common source of disability in society. There has been no research regarding the amount of pressure for the deep cervical flexors during cranio-cervical flexion exercise (CCFE). The purpose of this study is to determine optimal pressure levels to facilitate deep cervical muscles (longus colli & longus capitis) during cranio-cervical flexion exercise, using ultrasound measurement of the muscles. Methods : Using a cross-sectional design, the study was performed in an experimental group of 19 subjects (7 men, 12 women) with no cervical pain. Participants were instructed to perform the CCFE, and during the five incremental stages of the test, changes in thickness, as compared to resting baseline values, were measured using ultrasonography for sternocleidomastoid muscle (SCM) and deep cervical muscles (DCF). Results : Both DCF and SCM muscles demonstrated an increase in recruitment with each progressive phase of the test. In comparing the different pressure increments, the most significant changes found in DCF thickness were between phase 2 and phase 3 (p<.05). However no differences were found between pressure increments for SCM thickness (p>.05). Conclusion : The results suggest 26 mm Hg as the optimal pressure level during cranio-cervical flexion exercise for facilitation of deep cervical flexor.

• 대한물리의학회지
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• 제13권1호
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• pp.129-136
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• 2018

PURPOSE: This Study compared the level of activation of the muscles around the shoulder at the time of abduction through Pilates breathing and regular breathing by using quantified biofeedback. METHODS: Experiment was conducted on 25 healthy males and females in the age bracket of 20's~30's as the subjects. The level of activation of muscles displayed at the time of Pilates breathing were measured at intercostal (InC) muscle, transverse abdominis (TrA) muscle, internal oblique (IO) muscle and external oblique (EO) muscle by using surface electromyogram (EMG) and were provided as biofeedback. Moreover, the changes in the level of muscular activation at sternocleidomastoid (SCM) muscle, upper trapezius (UT) muscle and Deltoid (Del) muscle, which are the muscles around the shoulder, at the time of abduction of shoulder during Pilates breathing and regular breathing were measured. RESULTS: When abduction of shoulder is executed through Pilates breathing, the level of muscular activation of UT muscle was $11.56{\pm}7.10%$ at the time of exhaling of Pilates breathing and $17.54{\pm}9.57%$ at the time of exhaling of regular breathing. Del muscle also displayed lowered level of muscular activation at the time of Pilates breathing with $12.88{\pm}5.80%$ during inhaling and $15.14{\pm}5.49%$ during exhaling. CONCLUSION: In conclusion, the results could be interpreted as indicating that the muscle activities of upper trapezius and deltoid muscle were decreased based on Pilates breathing more than those on regular breathing.

• 대한기관식도과학회:학술대회논문집
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• 대한기관식도과학회 1997년도 대한이비인후과학회 종합학술대회 초록집
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• pp.117-117
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• 1997

성문하 협착과 기관 협착이 동반된 경우 이를 치유할 몇가지 방법이 시도되고 있으나 만족할만한 효과를 얻지는 못하고 있다. 저자들은 성문하와 기관협착이 동반된 27세 남자환자에서 기관 및 성문하 협착부 전면을 제거후 쇄골에 흉쇄유돌근(Sternocleidomastoid muscle: SCM)이 붙은채로 쇄골의 절반을 절제하여 수질부위를 제거후 협부점막을 부착하였다. 이렇게 얻어진 Vascularized clavicle을 성문하와 기관의 전면부 재건에 이용하여 좋은 결과를 얻었기에 문헌고찰과 함께 이를 보고하고자 한다.

• 한국산학기술학회논문지
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• 제22권2호
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• pp.659-666
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• 2021

이 연구는 정상 성인에서 머리-목 굽힘 운동 시 시선의 각도와 압력이 깊은목굽힘근의 두께변화에 미치는 영향을 알아보고자 하였다. 본 연구에는 27명이 참여하였다. 머리-목굽힘 운동하는 동안 4가지(0°, 20°, 40°, 60°)의 시선과 5가지(20mmHg, 22mmHg, 24mmHg, 26mmHg, 28mmHg)의 압력에서 목긴근과 목빗근의 근 두께는 초음파 영상을 이용해 측정하였다. 시선 각도 및 압력변화에 따른 목긴근과 목빗근의 두께 변화를 비교 분석하기 위하여 반복측정분산분석을 수행하였다. 본 연구결과, 목긴근은 20과 22mmHg에서 0°와 20°, 0°와 40°, 0°와 60°은 유의한 차이를 보였으며, 20°에서 가장 근활성도가 높았다(p<.05). 목빗근은 28mmHg에서 0°와 20°, 20°와 40°, 40°와 60°은 유의한 차이를 보였으며, 20°에서 가장 낮은 근활성도를 보였다(p<.05). 본 연구에서 머리-목 굽힘 운동 시에는 시선의 방향을 20°로 설정하는 것이 목긴근의 활성화를 높이고, 목빗근의 근활성도를 낮추어 운동의 효과를 얻을 수 있다는 것을 찾았다. 본 연구의 결과를 바탕으로 임상환경에서 머리-목 굽힘 운동시에 시선 방향을 설정하여 운동의 효과를 증대시키길 바란다.

• Journal of Korean Neurosurgical Society
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• 제60권1호
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• pp.82-88
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• 2017

Objective : We assessed the surgical results of bipolar release in 31 adult patients with uncorrected congenital muscular torticollis (CMT) and more than 12 months of follow-up. Methods : Thirty-one patients underwent a bipolar release of the sternocleidomastoid muscle (SCM) and were retrospectively analyzed. The mean follow-up period was 14.9 months (range, 12-30). The mean age at time of surgery was 30.3 years (range, 20-54). Patients were evaluated with a modified Lee's scoring system, cervicomandibular angle (CMA) measurement, and a global satisfaction rating scale using patient self-reporting. Results : The modified Lee's scoring system indicated excellent results in 4 (12.9%) patients, good in 18 (58.1%), and fair in 9 (29.0%) at the last follow-up after surgery. The improvements in neck movement and head tilt were statistically significant (p<0.05). The preoperative mean CMA was $15.4^{\circ}$ (range, 5.4-29.0), which was reduced to a mean of CMA of $6.3^{\circ}$ (range, 0-25) after surgery (p<0.05). The global satisfaction rating scale was 93.7% (range, 90-100). A transient sensory deficit on the ipsilateral lower ear lobe was noted in three cases. No significant permanent complications occurred. Conclusion : Bipolar release of the SCM is a safe and reliable technique for the treatment of CMT in adults.