• 대한정형도수물리치료학회지
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• 제12권1호
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• pp.57-67
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• 2006

Musculoskeletal neck dysfunction syndromes are common in outpatient musculoskeletal pain practice. The underlying musculoskeletal and neurologic causes of pain are variable. In the management of these patients, it is important to accurately identify and treat these pain generators to optimize patient outcome. It is the purpose of this review to discuss three main categories of functional anatomy, the role of superficial/deep muscular system and the scientific evidence for optimal physical therapy intervention for cervical dysfunction. Specifically there is evidence of lowered microcirculation in the upper trapezius muscle, morphological signs of disturbed mitochondrial function which appears to be limited to type I fibers and an increased cross-sectional area of type I muscle fibers despite a lower capillary to fiber area ratio. In acute neck pain syndrome, changes in muscle activity of painful muscles may result from segmental and supraspinal inhibitory effects. Muscle activation is closely related to the control of joint movements and postures and it is difficult to separate the influence of the two components. Both the altered muscle recruitment patterns and altered kinematics appear to be a poor adaptation for pain of the head - neck region, as they are likely to result in increased compressive loading in the cervical spine, affecting muscles, articular structures such as zygapophyseal joints, connective tissues and neural tissues which are all peripheral generators of referred pain. The rectus capitus posterior minor muscle shows that it is one of the most important muscles of the suboccipital region. In this article, i reviewed the anatomy, neurophysiology, function and dysfunction as well as the treatment of cervical dysfunction.

• Physical Therapy Rehabilitation Science
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• 제9권4호
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• pp.302-308
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• 2020

Objective: The endurance and strength of deep neck flexor (DNF) muscles have a major role on the function and stability of the cervical spine. In recent years, there has been a lack of research that have investigated the muscle tone of the superficial neck muscles. The purpose of this study was to examine the relationship of between contraction ratio of the DNF and sternocleidomastoid (SCM) muscles, DNF endurance, and muscle tension of the neck muscles. Design: Cross-sectional study. Methods: Forty-seven subjects (male=20, female=27) participated in this study. The muscle tone of the upper trapezius (UT), SCM, and suboccipital (SO) muscle was measured using a contact soft tissue tone-measuring instrument. For the contraction ratio of the SCM and longus colli muscle, the thickness of the relaxation and maximum contraction state of the SCM and longus colli muscles were assessed using a diagnostic ultrasound measuring instrument and a pressure biofeedback unit. The deep neck flexor endurance test (DNFET) was performed in a cranio-cervical flexion posture. The correlations between the measured variables were investigated. Results: The relationship between the DNFET and SO tone showed a significant negative correlation (p<0.05). The relationship between the DNFET and contraction ratio showed a significant positive correlation (p<0.01). There was no significant correlation between the DNFET and SCM and UT tone. Conclusions: This study confirmed that there is a relationship between DNF endurance, DNF activation, and SO tone. The information on the results of this study may be used as a reference that can be actively applied in the clinical environment.

• 한국산학기술학회논문지
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• 제11권11호
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• pp.4346-4353
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• 2010

본 연구의 목적은 20대의 정상 성인에서 경부의 관절가동범위와 마사지 및 정적 스트레칭이 관절가동범위에 미치는 영향을 측정하는 것이다. 근골격계와 신경계의 질환이 없는 100명(마사지그룹=50, 스트레칭그룹=50)을 대상으로 실시하였다. 마사지와 정적 스트레칭은 흉쇄유돌근, 사각근, 승모근, 반극근, 판상근, 후두하근, 다열근과 회선근에 적용되었다. 두 그룹은 주 3회의 중재를 받았다. 중재 시간은 10분이었다. 마사지그룹은 경찰법, 유날법 및 스트라이핑 마사지가 사용되었고, 스트레칭그룹은 정적 스트레칭이 사용되었다. 경부의 가동범위 측정도구는 경부의 8가지 동작(후두하 굽힘과 폄, 경부의 굽힘과 폄, 왼쪽 옆굽힘과 오른쪽 옆굽힘, 왼쪽 돌림과 오른쪽 돌림)을 분석하기 위하여 사용되었다. 통계학적 분석결과는 다음과 같다. 첫째, 정상적인 경부의 관절가동범위는 남자에서 후두하굽힘과 폄이 $2.39^{\circ}$와 38.36^{\circ}$, 경부의 굽힘과 폄이 $54.11^{\circ}$와 69.39^{\circ}$, 왼쪽과 오른쪽의 옆굽힘이 $43.50^{\circ}$와 $41.28^{\circ}$, 왼쪽과 오른쪽의 돌림이 $66.39^{\circ}$와 $65.94^{\circ}$로 나타났고, 여자에서는 후두하 굽힘과 폄이 $5.14^{\circ}$와 $36.47^{\circ}$, 경부의 굽힘과 폄이 $55.92^{\circ}$와 $71.22^{\circ}$, 왼쪽과 오른쪽의 옆굽힘이 $43.34^{\circ}$와 $41.06^{\circ}$, 왼쪽과 오른쪽의 돌림이 $69.38^{\circ}$와 $68.63^{\circ}$로 나타났다. 둘째, 후두하 굽힘, 왼쪽 돌림과 오른쪽 돌림에서 여성이 남성보다 더 높은 관절가동범위를 보였다(p<0.05). 셋째, 마사지군과 스트레칭군은 치료 후에 모든 항목에서 관절가동범위의 증가를 보였지만 두 그룹간의 비교에서는 유의한 차이를 보이지 않았다(p<0.05). 위의 결과는 마사지와 정적 스트레칭이 경부 근육의 신장 및 이완을 통해 가동범위를 증가시키는 적당한 방법이라는 것을 제시한다. 그리고 경부의 가동범위를 조사하는 연구의 기초로 제공될 수 있을 것이다.

• Journal of Oral Medicine and Pain
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• 제23권4호
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• pp.447-455
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• 1998

A 42-year old male patient was referred to the Department of Oral Medicine, Kyungpook National University Hospital due to the chief complaint of limite mouth opening. Three years ago, the patient was diagnosed as an infarction of both cerefellar hemispheres, acute obstructive hydrocephalus and acute epidural hematoma of frontal lobe at the department of neurosurgery.Both of the infarcted cerevellar hemispheres and the epidural hematoma of frontal lobe were removed with suboccipital and frontal craniectomu. After the brain surgery jaw opening range was decreased progressively and ultimately mouth opening became almost impossible. Spasmodic and rhythmic contractions of the masseter muscles occurred intermittently during daytime as well as sleeping. Food intake was available only through Levin -tube. Actibe jaw opening exercise was prescribed with the aids of tongue blades. A moist hot pack and indomethacin phonophesis were also applied 20 minutes three times a day to decrease discomfort muscle activities. After a month of treatments, the opening range was increased to 5mm at the premolar area and oral food intake was possibel. The L-tube was removed and the patient was discharged.

• PNF and Movement
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• 제22권1호
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• pp.55-70
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• 2024

Purpose: The purpose of this study was to investigate the effects of three relaxation techniques, namely, Static Stretching Exercise (SSE), Eccentric Contraction Exercise (ECE), and Suboccipital Muscle Release (SMR) on the flexibility and balance of the lower limb in adults with hamstring shortening. Methods: The participants were 45 adults in their 20s with hamstring shortening. They performed three exercises (i.e., SSE, ECE, and SMR) for two weeks. We measured flexibility, muscle tone and stiffness, proprioception, and balance before and after the intervention, applying each relaxation technique. Data were analyzed using two-way repeated measures analysis of variance (ANOVA). The significance level was set at α=0.05. Results: Flexibility increased in the SSE, ECE, and SMR groups, with the SSE group showing the greatest improvement. Muscle tone and stiffness decreased in all groups, with the ECE group exhibiting the highest reduction. Proprioception increased in the SSE, ECE, and SMR groups, with SSE demonstrating the greatest enhancement. Balance also increased in all groups, with the ECE group showing the most pronounced improvement. Conclusion: Overall, all three relaxation techniques for hamstring shortening resulted in improved flexibility, muscle tone and stiffness, proprioception, and balance of the lower limb in adults with hamstring shortening. The findings of this study underscore the importance of selecting an appropriate technique according to the purpose of treatment and the condition of the patient.

• 국제물리치료학회지
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• 제10권4호
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• pp.1897-1902
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• 2019

Background: Tension-type headaches, which make up the highest proportion of headaches, are prone to develop into chronic tension-type headaches (CTTH). The characteristic of CTTH in patients is that the active myofascial trigger point (ATrP) which causes pain in the muscles of the back of the head is increased, compared to the normal headache and moves the head position forward. Objective: The aim of this study was to investigate the effects of myofascial release (MFR) and posture correction in effectively improving neck function and sleep quality in the symptoms of CTTH patients. Design: Observer-blind study Methods: To reduce ATrP, MFR was applied and exercise was also applied to correct posture. The subjects of this study were 48 individuals randomly divided into three groups; The MFR group using the MFR technique; The MFR with exercise group subject to both the MFR technique and forward head position correction exercises (MFREx), and the control group. MFR and MFREx groups were given the relevant interventions twice a week for four consecutive weeks, and went through the number ATrPs, range of motion (ROM) of neck, Neck Disability Index (NDI) and the Pittsburgh Sleep Quality Index (PSQI) before and after the intervention. A physical therapist, who was fully familiar with the measuring methods of the equipment, was the measurer and not aware of the target's condition was blinded to take measurements only before and after intervention. Results: There was a significant improvement in the ATrP, Neck ROM, NDI and PSQI in the group of patients to whom the MFR technique and MFREx were applied. MFREx was more effective in increasing neck mobility. Conclusions: According to this study, the application of MFR is effective in improving neck movement and sleep quality in chronic tension headache patients.

• 한국컴퓨터정보학회논문지
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• 제28권5호
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• pp.95-102
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• 2023

이 연구의 목적은 전방머리자세를 가진 젊은 성인을 대상으로 슬링뉴렉안정화운동이 중재방법이 통증 및 목뼈 앞굽음각, 중력중심선에 어떠한 영향을 미치는지 알아보고자 실시되었다. 연구의 대상자는 슬링뉴렉안정화운동그룹(SNSEG) 10명, 통제그룹(CC) 10명으로 선정하였으며, 8주간 주3회 70분간 실시하였다. 이 연구 결과 슬링뉴렉안정화운동은 통증은 감소(p<.001), 목뼈 앞굽음각은 증가(p<.001)와 중력중심선은 감소에(p<.01) 유의한 효과가 나타났다. 이상의 결과 종합해 보면 슬링뉴렉안정화운동은 속근육(LM)군의 고유수용성감각 개선 및 근활성화에 효과적이며, 대근육(GM)군과 공동활성화하여 앞굽은각과 중력중심선에 개선에 효과적인 것으로 나타났다. 따라서 깊은목굽힘근과 뒤통수밑근의 재활성화는 통증 조절과 자세 정렬에 중요한 요소로 전방머리자세 개선시킬 수 있는 효과적인 중재방법으로 제안한다.

• 대한통합의학회지
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• 제11권4호
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• pp.147-155
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• 2023

Purpose: Headache is a very common disease experienced at least once in daily life, and tension-type headaches have a high and increasing prevalence. Chronic headaches can cause functional damage and huge socioeconomic impacts. This study aimed to compare the effects of myofascial release technique with manual therapy and self-myofascial release technique using a foam roller on the pain threshold and body schema in patients with chronic tension-type headaches. Methods: The study was conducted on 20 patients living in Busan with chronic tension headaches. Myofascial release technique with manual therapy was performed on the suboccipital, sternocleidomastoid, scalene, and upper trapezius muscles. The self -myofascial release technique using a foam roller was applied to the cervical and thoracic muscles. A laterality test was performed using a recognized neck application developed to evaluate body schema ability. A pressure-pain threshold test was performed using an electronic pressure algometer to compare the results before and after the myofascial release technique. Results: After applying myofascial release with manual therapy and a foam roller, the pressure-pain threshold values showed significant changes in both groups (p<.05). As a result of the laterality test, myofascial release with manual therapy and a foam roller were applied to the painful area. The values showed significant changes in both groups (p<.05), but only the group using the foam roller showed a significant difference (p<.05) in painless areas. Conclusion: The myofascial release technique with manual therapy can be the primary treatment technique for pain control in painful areas. The self-muscle release technique using a foam roller can be an effective method when there is no pain or when maintenance is needed after pain control.