• 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.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.27 no.3
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• pp.69-78
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• 2021

Background: Approximately 30% of people suffer from chronic neck and shoulder pain. Chronic neck and shoulder pain arise due to the exposure to continuous low loading and monotonous work. This is a common musculoskeletal disorder in a society. As physical therapists, we should give appropriate treatment to these people. Methods: A total of 26 patients with chronic neck and shoulder myalgia were randomly allocated into two experimental groups. First, 13 patients received shoulder strength training, while the other 13 patients received cervical mobilization. Outcome measures included bilateral pressure pain threshold by using an algometer at upper trapezius, visual analogue scale (VAS) to express their pain scale, and muscle tension by using myoton pro device pre-intervention and after the final treatment. Results: The VAS and muscle tension in upper trapezius significantly decreased (p<.05) in both groups; however, no differences between two groups were observed (p>.05). The pressure pain threshold in upper trapezius significantly increased (p<.05) in both groups; yet, again, the differences between the groups did not reach statistical significance (p>.05). Conclusion: As methods of treatment, shoulder-specific strength training and cervical mobilization can be appropriate approaches to the treatment of neck and shoulder musculoskeletal disorder.

• 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 Korean Academy of Orthopedic Manual Physical Therapy
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• v.25 no.2
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• pp.1-10
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• 2019

Background: The purpose of this study was to determine the effects of cervical extension-traction exercise on cervical alignment, pain, and neck disability in patients with mild turtle syndrome. Methods: Thirty two outpatients with mild turtle neck syndrome were recruited and randomly divided into two groups. Participants in the experimental group was applied cervical extension-traction exercise (CETE, n=16) and in the control group applied cervical stabilization exercise (CSE, n=16) for three times a week for 4 weeks. Results: Cobb angle and Jochumsen depth were CETE showed significant difference within the group post test (p<.05). And the CETE was significantly higher than the CSE. In the pressure pain threshold, both CETE and CSE showed significant differences within post test (p<.05). And the CETE was significantly higher than the CSE. Neck disability index were significant (p<.05) in the CETE post test. There was no significant difference between the two groups. Conclusion: Our results of this study showed that applying cervical extension-traction exercise to patients with mild turtle syndrome improved cervical alignment, pain and neck dysfunction.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.21 no.2
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• pp.33-37
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• 2015

Background: The purpose of this study on the effects of deep cervical flexors strengthening exercise to forward head posture and pain of neck in patients with chronic neck pain. Method: We selected 30 subjects among neck pain patients and carried out measurements. The subjects' forward head posture was measured including head tilt angle (HTA), neck flexion angle (NFA) and forward shoulder angle (FSA), neck disability index (NDI), numeric rating scale (NRS). The subjects underwent deep cervical flexors muscle strengthening with pressure bio-feedback device for 4 weeks. Then, after intervention, the subjects' forward head posture was measured again. It was performed Wilcoxon signed-ranks test for confirming the effect of deep cervical flexor muscles strengthening exercise. Results: As a result of comparison of measurements before and after intervention, we found that there were statistically significant improvement in the subjects' NDI, NRS and forward head posture including head tilt angle, neck flexion angle and forward shoulder angle. Conclusion: We concluded that deep cervical flexors strengthening exercise has the effect of alleviation of neck pain patients and is effective for forward head posture.

• Journal of Korea Entertainment Industry Association
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• v.13 no.7
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• pp.461-468
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• 2019

The purpose of this study was to investigate effect of upper cervical stabilization exercise on Temporomandibular Disorder(TMD) and pressure pain threshold. 36 subjects were divided into two groups: upper cervical stabilization exercise group(UCSEG) and control on three times a week for a total of four weeks. The upper cervical stabilization group showed more significant effect than the control group (p <.01, 95% CI: 8.074, 16.899). (p <.01, 95% CI: .826, 3.243). In the change of pressure pain threshold, the upper cervical stabilization group showed significant improvement in both the masticatory muscle(p <.01, 95% CI: .251, 1.382) and masticatory muscle(p <.01, 95% CI: .462, 1.826).The results of this study showed that the upper cervical stabilization exercise was effective that TMD. It will be able to provide more effective interventions for patients suffering from TMD, and to suggest new approaches for TMD patients.

• Physical Therapy Korea
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• v.18 no.4
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• pp.1-10
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• 2011

This study compared the stability of the cervical spine according to the presence of neck pain and deep neck flexor performance. Thirty subjects with neck pain, and thirty subjects without neck pain were recruited for this study. The Cranio-cervical flexion (CCF) test was applied using a pressure biofeedback unit to classify the subjects into four subgroups; no cervical pain and good deep neck flexor performance (NG group), no cervical pain and poor deep neck flexor performance (NP group), cervical pain and good deep neck flexor performance (PG group), and cervical pain and poor deep neck flexor performance (PP group). The head sway angle was measured using a three-dimensional motion analysis system. A 3-kg weight was used for external perturbation with the subject sitting in a chair in the resting and erect head positions with voluntary contraction of the deep neck flexors. A one-way analysis of variance (ANOVA) was performed with a Bonferroni post hoc test. The deep neck flexor performance differed significantly among the four groups (p<.05). The NG group had significantly greater deep neck flexor performance than NP and PP groups. The stability of the cervical spine also differed significantly among the four groups in the resting head position (p<.05). The head sway angle was significantly smaller in NG group as compared with the other groups. The PP group had the greatest head sway angle in the resting head position. However, there was no significant difference in the stability of the cervical spine among the groups in the erect head position with voluntary contraction of deep neck flexors (p=.57). The results of this study suggest that the deep neck flexor performance is important for maintaining the stability of cervical spine from external perturbation.

• Physical Therapy Korea
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• v.21 no.3
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• pp.28-37
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• 2014

The purpose of this study was to investigate the effects of smartphone use on muscle fatigue and tenderness in the cervical erector spinae (CES) and the upper trapezius (UT) and on the cervical range of motion among subjects with and without neck muscle pain. The subjects were 30 smartphone users in their 20 s who -were assigned to either an experimental group with neck muscle pain or a control group without neck muscle pain. Muscle fatigue and tenderness in the CES and the UT as well as the subjects' cervical range of motion were measured before and after 20-min smartphone sessions in a sitting position. In a between-group comparison of muscle fatigue, the experimental group showed a significantly greater decrease in median frequency in the CES and the right UT after smartphone use (p<.05). Regarding the assessment of muscle tenderness after smartphone use, the experimental group showed a statistically significant decrease in the pressure-pain threshold (PPT) in all muscles (p<.05), whereas the control group showed a significantly decreased PPT in the right CES and the UT (p<.05). The assessment of the cervical range of motion revealed a statistically significant reduction in the cervical flexion-extension and left lateral flexion in the experimental group (p<.05) after smartphone use. However, there was no significant change in the cervical range of motion in the control group (p>.05) after smartphone use. When compared with the control group, the experimental group demonstrated greater changes in cervical extension, lateral flexion, and rotation, except for cervical flexion (p<.05). In conclusion, when smartphone users have pre-existing neck muscle pain, the use of a smartphone further increased muscle fatigue and tenderness in the neck and reduced PPT and the cervical range of motion.

• Journal of The Korean Society of Integrative Medicine
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• v.2 no.4
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• pp.9-17
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• 2014

Purpose : The purpose of this study was to ascertain the effects of air-pressure cervical traction on the tension headache in the adults. Method : All subjects were treated with air-pressure cervical traction while 15 minutes a day, 3 times per week, for 4 weeks. The effects of air-pressure cervical traction were evaluated by HIT-6(headache impact test), VAS, and flexion, extension, left right flexion, left right rotation of cervical ROM. The measured data were analyzed by using repeated ANOVA. Especially in order to investigate the effect of air-pressure cervical traction. The comparison with among three measurement time. Results : The results of this study were as follows; 1) Prior and two weeks measurement did not show significant differences. The head forward posture than before the experiment, each experimental group was significantly increased(p<.05). 2) Prior and two weeks measurement did not show significant differences. The experimental group than ever cervical ROM of the movable range increased significantly(p<.05). 3) The experimental group was significantly lower than before the VAS(p<.05). 4) HIT score of the experimental group was significantly lower than before(p<.05). Conclusion : These findings suggest that air-pressure cervical traction had effect on the tension headache in the adults.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.16 no.2
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• pp.18-27
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• 2010

Purpose: This study is to identify the muscle fatigue and pain by various cervical positions in the VDT work. Methods: Twenty two volunteers (11 males and 11 females) participated in this study. Each subject gazes monitor in front of them for thirty minutes in the three cervical positions (neutral, 30 degree flexed, and 30 degree extended positions). Visual analogue scale (VAS) for the pain and pressure pain threshold(PPT) of the trapezius and levator scapula for the muscle fatigue were measured every fifteen minutes. Results: VASs after 15 minutes were $1.23{\pm}0.43$ in neutral, $3.0{\pm}0.93$ in flexed, and $5.27{\pm}1.03$ in extended position respectively and increased to $1.5{\pm}0.67$, $4.59{\pm}1.26$, and $7.73{\pm}0.98$ after 30 minutes. The order of magnitude of VAS was extended, flexed, and neutral position(p<0.01). PPTs in both sides of upper trapezius and levator scapula muscles were decreased at the three positions after 15 and 30 minutes respectively(p<0.01). There were no statistical differences of PPTs in neutral and flexed positions after 15 and 30 minutes(p<0.01). Extended position showed lowest PPTs in both side of upper trapezius and levator scapula muscles after 15 and 30 minutes(p<0.01). There were statistical differences of PPTs in extended position and the other two positions after 15 and 30 minutes(p<0.01). Conclusion: The cervical position that has the most influence on the cervical muscle fatigue and pain in the VDT work is extended position.