• Journal of the Korean Society of Physical Medicine
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• v.11 no.4
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• pp.27-32
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• 2016

PURPOSE: This study compared the immediate effect of a passive mobilization of upper cervical spine (Kaltenborn's joint mobilization) and an active upper cervical stretching (Olaf's Auto-stretching) on patients with neck pain and ROM. METHODS: Twenty-three subjects were randomized selected in the passive group (Kaltenborn's joint mobilization) included twelve subjects and the active group (Olaf's Auto-stretching) included eleven subjects. VAS (Visual Analogue Scale) was measured before and after neck rotation performance. DUALER IQ PRO (JTECH Medical, U.S.A.) was used to measure the neck ROM. Mean value of double measurement was used before performance and after performance. SPSS version 18 was used to compare values independent t-test and paired t-test were used to compare pain and ROM. RESULTS: There are significant difference in the pain and the ROM in both of two group (p<.05). But there are no significant difference pain and ROM between two groups. CONCLUSION: Both of the passive mobilization of upper cervical spine and the active upper cervical stretching are effected on symptom improvement of patients with neck pain reduction and ROM increasing. Especially active upper cervical stretching is more economical, because it has similar effects with the passive mobilization, help to maintain the treatment effect of therapist by themselves and can help to save medical expenses of patients.

• Physical Therapy Korea
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• v.27 no.2
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• pp.102-110
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• 2020

Background: There is an opinion that improper postures of the head and cervical spine are associated with temporomandibular joint (TMJ) disorders (TMDs). Objects: The aim of this study was to investigate the proportions among the cervical kyphotic angle, physical symptoms including the pain intensity level of the TMJ, and severity of TMD disability in patients diagnosed with TMD. Methods: Sixty-two subjects participated in the study. The evaluation tools included measurements of the cervical kyphotic angle based on the Ishihara index, pressure pain threshold (PPT) on the TMJ, maximal mouth opening (MMO) without pain, current pain intensity level of the TMJ measured using the Quadruple Visual Analogue Scale (QVAS), Korean TMD (KTMD) disability index, KTMD Symptom Frequency/Intensity Scales (SFS/SIS), and Korean Headache Impact Test-6. Correlation analysis was conducted to investigate the correlations between the cervical kyphotic angle and parameters related to TMJ symptoms. Results: Variables that were significantly correlated with the cervical kyphotic angle were the PPT around the TMJ (r = 0.259, p < 0.05), current pain intensity level of the TMJ based on the QVAS (r = -0.601, p< 0.01), and usual pain intensity level based on the SIS (r = -0.379, p < 0.01). The level of TMD functional disability was significantly correlated with the degree of headache (r = 0.551, p < 0.01), level of PPT of the TMJ (r = -0.383, p < 0.01), pain-free MMO (r = -0.515, p < 0.01), pain intensity level of the TMJ based on the QVAS (r = 0.393, p < 0.01), TMD symptom frequency (r = 0.739, p < 0.01), usual pain intensity of the TMJ (r = 0.624, p < 0.01), and most severe pain intensity of the TMJ (r = 0.757, p < 0.01). Conclusion: There is a positive correlation between the cervical kyphotic angle and PPT and a negative correlation between the current and usual pain intensity levels of the TMJ. The cervical kyphotic angle was a predictor of the pain level, tenderness threshold, and intensity of pain in the TMJ.

• The Journal of Churna Manual Medicine for Spine and Nerves
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• v.1 no.2
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• pp.111-123
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• 2006

Objectives: This study is performed to evaluate the clinical effect of chuna therapy on the neck pain associated with kyphotic cervical curvature. Methods: This study carried out on three patients with neck pain & kyphotic cervical curvature who have received treatment in Depar1ment of Oriental Rehabilitation Medicine, Daejon Oriental Hospital of Daejon University from 28th July 2006 to 3th November 2006. Pre and post treatment, We evaluated the cervical angle, Jackson's angle, Jochumsen method, Ishihara index, VAS and effective score of treatment. Results & Conclusions: Two patients who received Chuna treatment recovered cervical curvature and improved neck pain. But One patient who dosen't received Chuna treatment was no improvement in cervical curvature & neck pain.

• The Korean Journal of Pain
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• v.23 no.3
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• pp.202-206
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• 2010

Magnetic resonance image (MRI) is the most sensitive imaging test of the spine in routine clinical practice. Unlike conventional x-ray examinations and computed tomography scans, high-quality magnetic resonance images can be assured only if patients are able to remain perfectly still. However, some patients find it uncomfortable to remain still because of pain. In that condition, interlaminar cervical epidural injections can reduce pain and allow the procedure. When using air with the "loss of resistance" technique in epidural injections to identify the epidural space, there is the possibility of injected excessive air epidurally to mimic a herniated disc. We describe a case report of epidural air artifact in a cervical MRI after cervical epidural injections.

• Women's Health Nursing
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• v.18 no.2
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• pp.126-134
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• 2012

Purpose: This research was done to compare obstetric pain, anxiety and cervical dilatation between an epidural analgesia group and a control group. Methods: Participants were assigned to the experimental or control group depending on their decisions for pain relief. Subjective / objective obstetric pain, anxiety level and cervical dilatation were measured and ANOVA was used for comparison of groups and paired t-test to make pre-post comparisons. Results: Homogeneity of pain, anxiety and cervical dilatation were assessed at the latent phase. Cervical dilatation was larger in the control group than the experimental group, at both the active and the transitional phase (F=22.9, p<.001; F=39.9, p<.001 respectively). The degree of pain and anxiety were not significantly different between the groups. Within the experimental group, subjective / objective pain and anxiety level were significantly lower post-analgesia compared to pre-analgesia in the active phase. All variables, except for sweating in the objective pain measurement, changed significantly at the transient phase. Conclusion: The results of this evidence-based research indicate that epidural analgesia while effective in relieving pain and anxiety may have an adverse effect on the cervix during labor stage I. Epidural analgesia should be used carefully during cervical dilatation in labor stage I.

• PNF and Movement
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• v.20 no.3
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• pp.371-381
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• 2022

Purpose: Forward head posture (FHP) is known to cause pain, limit range of motion, and reduce quality of life. Joint mobilization is commonly used to correct FHP. However, no study has compared cervical, thoracic, and combined cervical and thoracic joint mobilization for FHP. The aim of this study was to investigate and compare the effects of each mobilization technique on range of motion in the sagittal plane and pain in patients with FHP. Methods: Forty-five patients were recruited and randomly divided into three groups: the mobilization group (CM; n = 15), the cervical and thoracic mobilization group (CTM; n = 15), and the thoracic mobilization group (TM; n = 15). Each intervention was performed in sets of three and repeated six times. Range of motion and pain were assessed pre- and post-intervention. The cervical range of motion was evaluated using a goniometer, and pain was evaluated using a visual analogue scale and pain thresholds of the suboccipital and upper trapezius muscles. Results: All groups showed an increase in range of motion post-intervention, but the increase in the CTM group was significantly greater than in the CM and TM groups (p < 0.05). Pain measured using the visual analogue scale decreased in all groups, but the decreases in the CM and CTM groups were significantly greater than in the TM group (p < 0.05). The pain thresholds of the suboccipital and upper trapezius muscles increased in all groups, but the increase in the CTM group was significantly greater than in the CM and TM groups (p < 0.05). Conclusion: Overall, our findings suggest that CTM may be more effective than CM or TM for improving cervical range of motion in the sagittal plane and pain in patients with FHP.

• Journal of The Korean Society of Integrative Medicine
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• v.6 no.2
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• pp.107-115
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• 2018

Purpose : The purpose of this study was to determine the effects of the McKenzie cervical exercise program on cervical pressure pain and balance in industrial workers. Method : The subjects, who consisted of 26 industrial workers, were randomly divided into two groups. The control group (n=13) went about their daily living routines. The other group (n=13) used the McKenzie cervical exercise program for 6 weeks (2 to 3 times/day). Pressure threshold and balance ability tests were completed before and after the experiment. The balance test was performed both with the eyes open and closed in a standing position. Result : There were significant improvements in the pressure threshold and balance ability test for the McKenzie cervical exercise program group (p<.05), while the control group showed no significant changes (p>.05). Conclusion : The above results revealed that the McKenzie cervical exercise program is effective in improving balance and cervical pressure pain.

• 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.

• Physical Therapy Rehabilitation Science
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• v.1 no.1
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• pp.40-48
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• 2012

Objective: The aim of this study was to compare sling exercise group to McKenzie exercise group in patients with chronic neck pain. Design: Two group pretest-posttest design. Methods: Twenty subjects who have chronic neck pain were randomly divided into sling exercise group (n=10) and McKenzie exercise (n=10). Sling exercise group (n=10) received sling exercise for 30 minutes per day, twice a week over a 4 week period. And the other group were exercised McKenzie exercise (n=8) for 30 minutes per day, twice a week over a 4 week period. Neck disability index (NDI), Visual analog scale (VAS), algometer, digital manual muscle tester (MMT) and cervical muscle strength and cervical range of motion (ROM) are closely measured to identify the effect of sling exercise and McKenzie exercise. Results: For NDI, VAS, algometer on both trapezius, both rotation of cervical muscle strength, both lateral flexion of cervical muscle strength, cervical extension of ROM and both lateral flexion of ROM were significantly increased after intervention in sling exercise group (p<0.05), For VAS, algometer on both trapezius, left (Lt.) rotation of cervical muscle strength, Lt. lateral flexion of cervical muscle strength, cervical flexion and extension of ROM and Lt. lateral flexion of ROM were significantly increased after than before intervention in McKenzie exercise group (p<0.05). Conclusions: These study outcomes clearly support the notion that sling and McKenzie exercise improved pain, Muscle strength and ROM of patients with chronic neck pain. These results suggest that sling and McKenzie exercise program is suitable for chronic neck pain.

• The Korean Journal of Pain
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• v.24 no.1
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• pp.36-43
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• 2011

Background: Nucleoplasty is a minimally invasive spinal surgery using a $Coblation^{(R)}$ technique that creates small voids within the disc. The purpose of this study was to evaluate the efficacy of cervical nucleoplasty in patients with cervical disc disorder. Methods: Between March 2008 and December 2009, 22 patients with cervical disc disorders were treated with cervical nucleoplasty after failed conservative treatment. All procedures were performed under local anesthesia, and fluoroscopic guidance and voids were created in the disc with the $Perc^{TM}$ DC Spine $Wand^{TM}$. Clinical outcomes were evaluated by the Modified Macnab criteria and VAS score at preprocedure, postprocedure 1 month, and 6 months. Results: Six patients had one, eight patients had two and eight patients had three discs treated; a total of 46 procedures was performed. Mean VAS reduced from 9.3 at preprocedure to 3.7 at postprocedure 1 month and to 3.4 at postprocedure 6 months. There was no significant complication related to the procedure within the first month. Outcomes were good or excellent in 17/22 (77.3%) cases. Postprocedure magnetic resonance imaging was acquired in two patients after two months showing morphologic evidence of volume reduction of protruded disc material in one patient but not in the other. Conclusions: Percutaneous decompression with a nucleoplasty using a $Coblation^{(R)}$ technique in the treatment of cervical disc disorder is a safe, minimally-invasive and less uncomfortable procedure, with an excellent short-term clinical outcome.