• Journal of Oral Medicine and Pain
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• v.33 no.4
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• pp.339-352
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• 2008

Aims: The aims of this study were to identify the association between cervical muscle pain and TMD by pressure pain response, and to find cervical muscles showing moderate to severe pressure pain that are correlated with masticatory muscle pain. Methods: Patients(n=129, female 65.9%, mean age 28.8 years) answered a TMD questionnaire asking about headache, neck pain, emotional stress, sleep disturbance, parafunction habits, and pain intensity. A clinical examination of the masticatory system was performed. Of the neck muscles, (1) the upper sternocleidomastoid, (2) the middle sternocleidomastoid, (3) the upper trapezius, (4) the splenius capitis, (5) the semispinalis capitis, (6) the scalene medius, and (7) the levator scapulae muscles were examined by palpation. Pressure pain or tenderness of all palpation sites was scored from 0 to 3 according to the pain response. The variables of sum of pressure pain scores were calculated from pressure pain scores and were used for statistical analyses. Results: Eighty patients(62.0%) answered that they suffer from neck pain in the TMD questionnaire. More than 40% of sternocleidomastoid and upper trapezius examination sites showed moderate to severe tenderness in the cervical muscles, and 36% of middle masseter in the masticatory muscles. For the 129 patients, the sum of cervical muscle pain scores(mean=12.88, SD=8.06) and the sum of TMD pain scores(mean=5.36, SD=5.10) were moderately correlated($\rho$ = 0.502, P < 0.001). The sum of TMD pain scores tends to increase as the sum of cervical muscle pain scores increases(Y = 0.395${\cdot}$X, $R^2$ = 0.659, P < 0.001). In the patients with masticatory muscle disorders, the sum of sternocleidomastoid and upper trapezius pain scores(mean = 8.67, SD = 4.95) and the sum of temporalis and masseter pain scores(mean = 3.37, SD = 3.56) showed moderate correlation($\rho$ = 0.375, P < 0.001). Those two variables were in a proportionate relationship(Y = 0.359${\cdot}$X, $R^2$ = 0.538, P < 0.001). In a partial correlation analysis of the sum of unilateral pain scores, the sum of right cervical muscle pain scores and the sum of left cervical muscle pain scores showed the highest correlation(r = 0.802, P < 0.001). The sum of right TMD pain scores and the sum of left TMD pain scores were moderately correlated(r = 0.481, P < 0.001). For the twenty patients with unilateral TMD pain, the partial correlation coefficient between the sum of ipsilateral cervical muscle pain scores and the sum of contralateral cervical muscle pain scores was the largest(r = 0.597, P = 0.009). A partial correlation between the sum of primary TMD side pain scores and the sum of ipsilateral cervical muscle pain scores was 0.564(P = 0.015). Conclusions: TMD is associated with cervical muscle pain on condition of pressure pain response to palpation. Of the cervical muscles, sternocleidomastoid and upper trapezius frequently exhibit moderate to severe pressure pain, and they are closely related to the masticatory muscle pain. The characteristic of symmetric involvement of pain is prominent in cervical muscles; however, TMD can affect the level of cervical muscle pain to modify its symmetric nature.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.15 no.2
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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.

• The Journal of Korean Physical Therapy
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• v.18 no.6
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• pp.67-75
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• 2006

Purpose: Many kinds of musculoskeletal disease and symptom are caused by the longtime computer works. However, trapezius muscle tonus has not been established in regarding to keyboard height during typing. Therefore, this study is to evaluate the relationship between trapezius muscle tonus and the height of keyboard while typing, controling for the postures of neck, Lumbar, cervical vertebra. Methods: The experimental height of keyboard was set at elbow height, 3cm higher, 6cm higher, 9cm higher, than elbow. We studied trapezius tonus with the mean value for 2 minutes by EMG in 15 males and 15 females worker of hospital in seoul, who did not have a history of muscle disease, neurological signs, nerve damage. Results: In this experimental, as the height of the keyboard went up, the trapezius tonus significantly increased with shoulder abduction of brachium. Second, right and left trapezius tonus appeared similar while typing. Third, the best height that release the trapezius tonus the was as high as elbow and 3cm higher than elbow. Conclusion: With these above results, we suggest that the appropriate height of keyboard during typing to release the trapezius tonus most is the height of the elbow and 3cm higher than elbow. The study has important implications for focusing on the height of VDT worktable and complaining of a pain by oneself which are useful to establish a method of prevention of musculoskeletal disorder in work in the future.

• Journal of the Korean Society of Physical Medicine
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• v.14 no.4
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• pp.93-101
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• 2019

PURPOSE: This study tries attempted to provide basic clinical data to reduce pain and improve function by comparing the muscle fatigue of the superficial neck muscles and neck disability index (NDI) by performing McKenzie exercise or passive stretching exercise for chronic neck pain patients. METHODS: Sixteen chronic neck pain patients were selected and divided into the McKenzie group (n=8) and passive stretching group (n=8). The intervention program was performed three times a week for four weeks. The time for one exercise was 30 minutes. Before the intervention, the muscle fatigue the superficial neck muscles and NDI were measured. They were measured again after four weeks using the same method. RESULTS: The median frequency of the superficial neck muscles increased significantly in the McKenzie group and passive stretching group (p<.05). The NDI of both the McKenzie group and the passive stretching group decreased significantly. A comparison of the groups, revealed a significant difference in only the median frequency values of the upper trapezius muscle and splenius capitis muscle (p<.05). The NDI values of both groups were similar. CONCLUSION: Both McKenzie exercise and passive stretching exercises showed a significant difference in the degree of fatigue and NDI. McKenzie exercise delayed the replace of the fast twitch fibers which helped improve the muscle fatigue of the upper trapezius muscle and splenius capitis muscle. On the other hand, additional studies applying more variables for the muscle function to improve the symptom of chronic neck pain patients will be needed.

• The Journal of Churna Manual Medicine for Spine and Nerves
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• v.2 no.2
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• pp.141-150
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• 2007

Objectives : The purpose of this study was to investigate the correlation of stress and meridian muscle electrography in Korean adult males. Methods : Sixty-nine volunteers suffering from stress participated in this study. Physical examination, stress survey and meridian muscle electrography were performed. Each variable was compared with each other by correlation analysis. Results : Correlation between stress response inventory and fatigue of trapezius muscle right upper portion was statistically significant. In relationship between sub scales of stress response inventory and meridian muscle electrography, fatigue of trapezius muscle right upper portion was statistically significant with tension, depression, and frustration. Contraction power of left sternocleidomastoid muscle was significant with somatization and others were not significant. Conclusions : In Korean adult males, trapezius muscle shows more fatigue under more stress. This suggests that stress influences muscle fatigue. Although meridian muscle electrography is not a typical method for the evaluation of pain nor stress, this is referential method to clinical evaluation of painful shoulder caused stress.

• The Journal of Korean Physical Therapy
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• v.26 no.6
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• pp.379-385
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• 2014

Purpose: This study was to determine the immediate effects of pulsed magnetic field (PMF) in subjects with upper trapezius (UT) trigger point (TrP). Methods: Fifteen subjects with UT TrP were recruited for the study's PMF group (pain threshold=$2.29kg/cm^2$), and 15 age-, weight-, and gender-matched subjects with UT TrP were recruited for control group (pain threshold=$2.25kg/cm^2$). Pressure algometer was used to measure pressure pain threshold on UT TrP and, cervical range of motion (ROM) inclinometer was used to measure cervical ROM. Surface electromyography was used to record UT, lower trapezius, and serratus anterior muscle activity and relative ratio during scapular plane abduction between pre- and post-treatment. Results: The PMF effectively improved pain threshold and concurrently increased ROM (rotation to the painful side, lateral flexion to the nonpainful side). In addition, the PMF may effectively deactivate UT activity during abduction and the muscle activity ratio between UT and serratus anterior. Conclusion: These findings provided empirical evidence that PMF can be an effective treatment method to reduce pain threshold, to increase cervical ROM, and deactivate UT activity in individuals with TrP.

• The Journal of Korean Physical Therapy
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• v.26 no.3
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• pp.140-146
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• 2014

Purpose: Differences in scapular kinematics and muscle activity appear in the forward head and rounded shoulder posture (FHRSP). Thus, the aim of this study was to investigate the following effects according to different postures on scapular kinematics and muscle activity around scapular region in individuals with and without FHRSP during overhead reaching task. Methods: Thirty pain-free subjects with/without FHRSP participated in this study. All subjects were positioned into three positions: habitual head posture (HHP), self-perceived ideal head posture (SIHP) and therapist-perceived neutral head posture (TNHP). Muscle activities of upper trapezius (UT), lower trapezius (LT) and serratus anterior (SA) were measured during overhead reaching task. Results: Muscle activity of trapezius muscle (UT and LT) during HHP was significantly higher than SIHP and TNHP in FHRSP group (p<0.05), but there was no difference between SIHP and TNHP. SA also significantly increased muscle activity in HHP more than SIHP and TNHP in FHRSP group (p<0.05), but there was no significant difference between SIHP and TNHP. In Non-FHRSP group, although there was a tendency of different muscle activities among three postures, it was not statistically significant. Conclusion: This result demonstrates that muscle activity associated with overhead reaching task is increased in HHP which affects the scapular kinematics and SIHP contributes changed scapular kinematics and proper recruitment of muscle activity in FHRSP similarly to TNHP.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.27 no.3
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• pp.1-15
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• 2021

Objective: The purpose of this study was to examine the differences in joint position sense (JPS), force sense (FS), and performance level of the upper extremities according to the injury and pain experiences of Korean elite archers. Methods: A total of 15 subjects were briefed about the purpose of this study and agreed to participate voluntarily. JPS was evaluated using the laser-point attached to the wrist while aiming at the target. The difference when relocating while aiming was used as JPS factor. FS was evaluated using load cell through reproduces same muscle strength. Fear-Avoidance Beliefs Questionnaire (FABQ) was used to evaluate psychosocial factors, Kerlan-Jobe Orthopedic Clinic overhead athlete scores (KJOC) and numerical rating scale (NRS) was used to evaluate pain. and performance was evaluated by tournament match score. Results: There is a strong correlation between the current pain and KJOC. Moreover, moderate correlation between KJOC and FABQ also current pain and both upper trapezius and lower trapezius in elite archers. The mean (SD) between groups based on current pain display relatively large margin in force sense than without pain group. The result presents that there is a significant difference in performance and pain. There is a significant difference in the force sense of the upper and lower trapezius and pain. Conclusions: Result present there is a significant difference in functional level in the average comparison between groups according to the presence of absence of current pain. There is a significant difference in the force sense of the upper trapezius as well as lower trapezius and without pain group present a relatively low joint position sense error compared to the groups.

• PNF and Movement
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• v.19 no.3
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• pp.401-412
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• 2021

Purpose: The study aimed to determine the effect of the proprioceptive neuromuscular facilitation (PNF) lower trapezius muscle strengthening exercise on pain, shoulder range of motion, and shoulder pain and disability index (SPADI) in patients with frozen shoulder. Methods: Following baseline measurements, 30 subjects (n=30) with frozen shoulder were randomized into two groups: the PNF group (n=15), which received PNF strength training of the lower trapezius muscles, and the control group (n=15), which received gentle palpation of the skin. Each group participated in the intervention for 30 minutes, three times per week, for six weeks. The visual analogue scales for pain, range of motion, and SPADI of both groups were recorded at both pre- and post-intervention. Paired t-tests were used to determine significant changes in the post-intervention period 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 SPADI (p < 0.05) and significantly increased shoulder flexion, abduction, internal rotation, and external rotation range of motion (p < 0.05). The PNF group that received the PNF strength exercise of the lower trapezius muscles showed greater improvements in pain and range of motion than those of the control group (p < 0.05). Conclusion: These results suggest that the PNF lower trapezius strengthening exercise reduces shoulder pain and disability levels and enhances shoulder range of motion in patients with frozen shoulder.

• Journal of the Korean Society of Physical Medicine
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• v.9 no.4
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• pp.433-438
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• 2014

PURPOSE: The purpose of our study was to compare a 975-nm, 500-mW GaAlAs low-level laser therapy versus placebo low-level laser therapy with regard to the immediate changes on the myofascial trigger point of the dominant upper trapezius muscle in subjects with rounded shoulder posture. METHODS: Thirty-two male college students with rounded shoulder posture and shoulder pain consented to participate in the experiment. The subjects were randomly assigned to a 2-minute procedure with either an active GaAlAs low-level laser or a placebo GaAlAs low-level laser. The pressure-pain threshold and visual analog scale on tenderness at 3 kg were measured with an algometer before and after the laser treatments. RESULTS: The active GaAlAs low-level laser group showed significant changes in pressure-pain threshold and visual analog scale on tenderness at 3 kg (p<0.05). The placebo GaAlAs low-level laser group showed no significant changes in either pressure-pain threshold or visual analog scale on tenderness at 3 kg (p>0.05). CONCLUSION: An immediate effect was observed in pressure-pain threshold and visual analog scale on tenderness at 3 kg following a 2-minute application ($857.14J/cm^2$) of a 975-nm, 500-mW GaAlAs low-level laser to the myofascial trigger point of the dominant upper trapezius muscle in patients with rounded shoulder posture.