• Journal of The Korean Society of Integrative Medicine
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• v.11 no.3
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• pp.195-204
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• 2023

Purpose : This study applied general training (control group) or cranio-cervical flexor training (experimental group) using a pressure biofeedback unit along with general training for 4 weeks to secondary school teachers with moderate to severe neck pain and forward head posture. After that, we tried to compare the effects through differences in neck pain intensity (using numberical rating scale), functional performance (using neck disability index), and cranio-vertebral angle change. Methods : All 50 subjects were randomly assigned to either the "experimental group (n= 25)" or the "control group (n= 25)", and the measurements were evaluated in the same way before the intervention (baseline) and after the intervention (4 weeks). During the intervention period, the subject visited the physiotherapy center and made a reservation three times a week at a fixed time as much as possible, and each training session was thoroughly conducted under the 1:1 guidance of the therapist in charge so that the correct movement and number of times could be performed without compensatory action. Results : As a result of the homogeneity analysis on the general characteristics of the subjects, there were no significant differences between the groups in all variables (p>.05). Compared to the "control group", the "experimental group" showed significant improvement after intervention in all measured variables of neck pain intensity, functional performance, and cranial-vertebral angle (p<.05). Conclusion : For secondary school teachers with forward head accompanied by neck pain, cranio-cervical flexor training using a compression biofeedback unit is an excellent method to show superior pain reduction and functional performance improvement compared to general training alone. In addition, it can be presented as a more effective intervention method that can promote recovery of forward head posture, which is an essential element of the solution.

• 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 Academy of Orthopedic Manual Physical Therapy
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• v.28 no.1
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• pp.39-51
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• 2022

Background: The purpose of this study is to investigate the effect of neck and shoulder self-stretching exercise using audiovisual media on neck pain, postural alignment, and joint position error in women with chronic neck pain. Methods: The subjects included 20 women that gave consent to participate in the study voluntarily. They performed the self-stretching exercises using audiovisual media was carried out 20 minutes 5 times a week during 3 weeks. Neck disability index (NDI) and visual analogue scale (VAS) were used to measure the functional disability and pain, A pressure pain threshold was measured using an algometer, and a cervical range of motion (CROM) measurement tool was used to measure the range of motion and error of proprioceptive position sense of the cervical spine. To assess posture alignment, forward head angle (FHA), forward shoulder angle (FSA) were measured using image J software. Results: The neck pain intensity was statistically significantly within group (p<.05). Neck and shoulder functional disability were a statistically significant difference within group (p<.05). Splenius capitis and upper trapezius pressure pain threshold were statistically significant difference in within group (p<.05). The postural alignment was statistically significantly within group (p<.05). The cervical range of motion in neck extension, right and left lateral flexion were statistically significantly within group (p<.05). The joint position error in neck flexion, extension, right and left lateral flexion decreased statistically significantly within group (p<.05). Conclusion: Self-stretching exercise using audiovisual media increased the mobility of the neck, decreased neck pain and joint position error, and improved posture alignment. As a result, there was a positive effect by applying the self-stretching exercise using audiovisual media to people with neck pain. Based on this, it is thought that it can be used as the basis for research related to home training programs for healthy self-management.

• Journal of Korean Physical Therapy Science
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• v.28 no.1
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• pp.46-53
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• 2021

Background: The purpose of this study was to investigate the effect of taping applied to the lower trapezius on the upper trapezius muscle tone, pain intensity, cervical rotation range of motion in chronic upper trapezius pain patients. Design: Case-control study. Methods: Twenty subjects with chronic upper trapezius pain were classified into an experimental group and a control group. The experimental group applied lower trapezius facilitation taping and the control group applied sham taping. Taping Before and after the application of taping, muscle tone, pain intensity, and cervical rotation range of motion of the upper trapezius were measured. Results: In the experimental group, there were significant differences in the pressure pain threshold and muscle tone before and after taping. In the comparison between groups, there was a significant difference in muscle tone between the experimental group and the control group. Conclusion: The application of the lower trapezius facilitation taping was found to be effective in reducing the pressure threshold and muscle tone of the upper trapezius. Therefore, it is expected that more effective treatment can be provided by adding lower trapezius facilitation taping to the treatment protocol for patients with chronic shoulder pain.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.30 no.1
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• pp.15-27
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• 2024

Background: This study examined the effects of the muscle energy technique and cervical traction after applying conservative physical therapy to patients with cervical radiculopathy. Methods: Twenty-six patients with cervical radiculopathy were randomized into two groups: the experimental group (n=13) and the control group (n=13). The two groups performed the muscle energy technique and for 4 weeks, 3 times a week, in 70-minute sessions. Pain, range of motion, function, and muscle performance were assessed using the visual analogue scale (VAS), cervical range of motion (CROM) goniometer, neck disability index (NDI), and stabilizer pressure biofeedback, before and after training. Results: After four weeks of therapy, the VAS (p<.001), NDI (p<.01), and the maximum strength of the deep neck flexion muscles significantly decreased (p<.01) and CROM significantly increased in both groups (p<.05). Conclusion: The muscle energy technique and therapeutic modalities such as cervical traction are effective in reducing VAS and NDI and increasing CROM and muscle performance in patients with cervical radiculopathy.

• The Journal of Korean Physical Therapy
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• v.31 no.1
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• pp.1-6
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• 2019

Purpose: This paper proposes proper and effective neck exercises by comparing the deep and superficial cervical flexor muscle activities and thickness according to the pressure level during cranio-cervical flexion exercises between a normal posture group and forward head posture group. Methods: A total of 20 subjects (8 males and 12 females) without neck pain and disabilities were selected. The subjects' craniovertebral angles were measured; they were divided into a normal posture and a forward head posture group. During cranio-cervical flexion exercises, the thickness of the deep cervical flexor neck muscle and the activity of the surface neck muscles were measured using ultrasound and EMG. Results: The results showed that the thickening of the deep cervical flexor was increased significantly to 28 and 30 mmHg in the forward head posture group. The sternocleidomastoid muscle activity increased significantly to 24, 26, 28, and 30 mmHg in the forward head posture group. The anterior scalene muscle activity increased significantly to 26, 28, and 30mmHg in the forward head posture group. A significant difference of 26, 28, and 30 mmHg in the sternocleidomastoid and anterior scalene muscles was observed between two groups. Conclusion: To prevent a forward head posture and maintain proper cervical curve alignment, the use of the superficial cervical flexor muscles must be minimized. In addition, to perform a cranio-cervical flexion exercises to effectively activate the deep cervical flexor muscles, 28 and 30 mmHg for normal posture adults and 28 mmHg for adults with forward head postures are recommended.

• Journal of Oral Medicine and Pain
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• v.22 no.2
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• pp.327-339
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• 1997

This study aimed at evaluating tile relationship between pressure pain threshold(PPT) and electromyographic(EMG) activity in 30 healthy volunteers and 30 patients with temporomandibular disorders. PPTs were determined with electric pressure algometry over masseter, temporalis anterior, sternocleidomastoid, and trapezius muscle during resting and clenching. To obtain more reliable result, two examiners measured PPTs two times on each muscles, randomly. Resting and clenching EMG activity and tenderness of all muscles were measured to evaluate the relationship with PPTs. The collected data were processed by SAS/STAT program. The obtained results were as follows : 1. Pressure pain thresholds in tendered muscles were lower than those in non-tendered muscles. This tendency was more prominant in masticatory muscles than in cervical muscles and in clenching than in resting. 2. There ware a tendency of higher PPTs in unaffected side than in affected side, but there were no significant difference statistically. 3. There wert no difference of PPTs between in preferred side and in ipsilateral side, significantly. 4. There was a significantly positive correlation between resting and clenching PPTs, but there were no correlation between PPTs and EMG activities. 5. Comparison of EMG activity between in higher group and in lower group by resting PPTs didn't show any significant difference. But resting EMG activity in the higher group of clenching PPTs were lower, on the contrary, clenching activity were higher than those in lower groups of clenching PPTs. From this results, the author concluded that the clenching PPTs was more important than resting PPTs in diagnosis of muscle dysfunction. And the author recommanded that all of three following test were performed for the proper diagnosis and treatment of orofacial Pain : muscle tenderness, EMG activity, and PPT.

• Journal of the Ergonomics Society of Korea
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• v.30 no.2
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• pp.339-347
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• 2011

Objective: The purpose of this study was to evaluate of various material of pillows by using biomechanical variables such as the cervical stability, head pressure distribution, and muscle activity. Method: Eight subjects participated in the experiment. Three different materials such as polyester sponge, memory foam and the buckwheat shell used for Korean traditional pillow were tested. Electro-goniometer, six channels of electromyography(EMG), ten channels of the head pressure sensors were used to measure the biomechanical responses. Surface electrodes were attached to the right/left semispinals capitis(RSC, LSC), the right/left sternocleidomastoid(RSM, LSM), the right/left upper trapezius(RUT, LUT). The cervical stability was evaluated by the angle deviated from the standing neck position. The head pressure distribution was evaluated by the pressure per unit area recorded on the sensors and the intensity of peak pressure. Electromyography(EMG) data were analyzed by using root mean square(RMS) and mean power frequency(MPF). Results: The buckwheat shell material showed a higher stability in the cervical spine then the other pillows during spine position. In terms of head pressure distribution, the memory form indicated the lowest pressure at supine position, buckwheat shell material indicated the lowest pressure during lying down to side, and polyester cushion recorded the highest pressure at all postures. Conclusion: The buckwheat shell material has a biomechanical advantage to maintain a healthy neck angle and reduce the pressure on the head, which means the buckwheat shell is a potential material for ergonomic pillow design. The pillow with memory form showed second best biomechanical performance in this study. Application: The shape of the buckwheat shell pillow and the characteristics of materials can be used to design the pillow preventing neck pain and cervical disk problems.

• Journal of Oral Medicine and Pain
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• v.22 no.1
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• pp.183-192
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• 1997

Pressure pain thresholds are routinely used in orofacial pain research to evaluate the response of deep orofacial tissues to mechanical stimulation. Like other psychophysical measurements, however, this technique must stimulate cutaneous tissues before stimulating deeper tissues. This study aimed at evaluating the influence of the cutaneous hypoesthesia on the pressure pain threshold in 30 healthy volunteers. PPTs were determined with electric pressure algometry over masseter, temporalis anterior, sternocleidomastoid, and trapezius muscle before and after skin hypoesthesia. A local anesthetic cream and a control cream were applied following a placebo-controlled double-blind design and PPTs were reassessed. Two examiners measured PPTs two times on each muscles, randomly. And the EMG activity of all muscles were measured to evaluate the relationship with PPTs. The collected data were processed by SAS/STAT program. The obtained results were as follows : 1. There were a tendency to increase PPTs after than before cutaneous hypoesthesia, but, there were no significant difference statistically. 2. PPTs were consistently higher in anterior temporalis than in masseter muscle. 3. In all occasions, PPTs were higher in males than in females(p<0.001). 4. A statistically significant correlation was obtained from values of intra-examiners and inter-examiners in all measured muscles. 5. A significantly positive correlation was not found between PPT and functional EMG activity.

• Journal of The Korean Society of Integrative Medicine
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• v.3 no.3
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• pp.25-33
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• 2015

Purpose : The purpose of this study was to find out objective and scientific grounds on the effect of Spiral Balanced Taping(SBT) by examining physiological change according to pain reduction and understanding the relationship physiological change and pain. Method : 32 female students who was from 20 to 25 years old($22.06{\pm}1.13$). Regarding the range of pain, each 16 female students ranged in the right and the left. The subjects selected the most comfortable method of six taping methods related with trapezius. They were examined with four measurement methods(Visual Analogue Scale : VAS, Algometer, Digital Infrared Thermograph Imaging(DITI), and Cervical Range of motion : CROM) and measured before treatment, right after treatment, 30 minutes later after treatment and 60 minutes later after treatment. Result : According to the result of Repeated measure ANOVA, there was a significant difference with all four methods before and after treatment. In addition there was a significant difference in proportion to time. As a result of stepwise regression, VAS was the highest with Digital Infrared Thermograph Imaging(r2=0.136) and pressure pain threshold was the highest in the range of cervical motion. Conclusion : There was the effect of SBT to all four measurement method and it was effective with measuring VAS and DITI, or Algometer and CROM together.