• The Journal of Korean Physical Therapy
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• 제34권6호
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• pp.321-325
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• 2022

Purpose: Temporomandibular disorder (TMD) is a condition defined as pain and dysfunction of temporomandibular joints and masticatory muscles. Abnormal interconnections between temporomandibular muscles and cervical spine structures can cause the changes of postural alignment and balance ability. The aim of this study was to investigate changes in static balance ability in subjects with painrelated TMD. Methods: This study conducted on 25 subjects with TMD and 25 control subjects with no TMD. Pressure pain thresholds (PPTs) of the masseter and temporalis muscles were measured using a pressure algometer. Static balance ability was assessed during one leg standing using an Inertial Measurement Unit (IMU) sensor. During balance task, the IMU sensors measured motion and transfer movement data for center of mass (COM) motion, ankle sway and hip sway. Results: PPTs of masseter and temporalis muscles were significantly lower in the TMD group than in the control group (p<0.05). One leg standing, hip sway, and COM sway results were significantly greater in the TMD group (p<0.05), but ankle sways were not different between group. Conclusion: We suggest pain-related TMD is positively related to reduced PPTs of masticatory muscles and to static balance ability. These results should be considered together with global body posture when evaluating or treating pain-related TMD.

• 대한물리의학회지
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• 제11권4호
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• pp.139-146
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• 2016

PURPOSE: The purpose of this study was to determine the effect of craniocervical flexion exercise with masticatory muscle contraction in patients with neck pain. Patients with neck pain also experience muscle weakness and limitation of activities of daily living. Craniocervical flexion exercise with masticatory muscle contraction may increase the thickness of the deep cervical flexor muscles, thereby reducing pain and limitations on activities of daily living. METHODS: Twenty-six volunteers participated in this study. The subjects were randomly divided into an experimental group (n=13) and a control group (n=13). Both groups performed craniocervical flexion exercise using a pressure biofeedback unit; the experimental group performed craniocervical flexion exercise with masticatory muscle contraction for 20 minutes, 3 times a week for 4 weeks. Assessment tools included ultrasonography for measurement of muscle thickness and the Neck Disability Index for the level of pain and function. RESULTS: The rate of change in muscle thickness in both groups significantly increased (p<.05), with a significantly greater increase in the experimental group than in the control group (p<.05). The Neck Disability Index score significantly improved (p<.05) in both groups, with significantly greater improvement in the experimental group compared with the control group (p<.05). CONCLUSION: These results suggest that craniocervical flexion exercise with masticatory muscle contraction can be effective in increasing muscle thickness and improving the Neck Disability Index score in patients with neck pain.

• Journal of Oral Medicine and Pain
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• 제45권4호
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• pp.97-109
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• 2020

Purpose: Cervicogenic headache (CGH) is pain referred to the head/ face from the structures in vicinity of upper cervical spinal nerves via trigeminocervical pathway. Ponticulus Posticus (PP) and Elongated Styloid Process (ESP) are anatomical structures that cause compression of vasculature present around upper cervical nerve plexus. Recently, computational fluid dynamics (CFD) has shown to play an essential role in identification of these high-pressure zones in the brain. The aim of this research is to study the association of ESP and PP in patients with CGH and to develop a hypothesis by CFD to analyse vertebrobasilar insufficiency as a contributing factor in occurrence of CGH. Methods: Retrospective analysis of 4500 full skull CBCT scans was done for the presence of partial or complete PP and length of Styloid Process (SP). Research was divided into two phases; In first Preliminary Phase, 150 scans that showed the presence of PP and ESP were analysed, and only 134 patients gave consent to fill the questionnaire containing 96 question items pertaining to symptoms associated with CGH. In the second phase, simulation of Vertebral and Carotid Artery was done using Fluent 14.5 Software and by CFD, pressure distribution on arteries was obtained that helped to identify high pressure regions. Results: Both PP and ESP showed a statistically significant association with CGH (p<0.001). By CFD analysis, both steady and transient phases of simulation showed drop in pressure due to constriction of internal carotid and vertebral artery by ESP and PP respectively and were found to decrease the volume of blood reaching the brain, 0.12 /0.13 mL and 0.06 mL respectively. Conclusions: Our analysis proves ESP and PP as contributing factors towards CGH. Hence for proper diagnosis and management of headache disorders, clinicians should have adequate knowledge about these anatomical structures and their resulting clinical symptoms.

• 대한정형도수물리치료학회지
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• 제28권3호
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• pp.51-59
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• 2022

Background: This study aimed to investigate the effect of mobilization with movement (MWM) applied to the ankle joint, on the craniovertebral angle (CVA), pressure pain threshold, and neck disability index (NDI) in asymptomatic adults with a forward head posture (FHP). Methods: A total of 32 subjects with FHP were assigned to either the MWM group (N=16) or the cranio-cervical flexion exercise (CCFE) group (n=16). The CVA, pressure pain threshold and NDI were measured before and 4 weeks after the intervention. Results: A significant improvement in the CVA was observed in the MWM group (p<.05), whereas no significant changes (p>.05) were observed in the CCFE group. Both groups showed significant differences in the pressure pain threshold and NDI before and after the intervention (p<.05). Conclusion: The results of the study suggest that MWM applied to the ankle joint can effectively improve the CVA, pressure pain threshold, and NDI of adults with a forward head posture. Based on this study, the ankle MWM technique for dorsiflexion can be used as an objective research method for additional studies targeting FHP patients in the future.

• 대한통합의학회지
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• 제12권1호
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• pp.125-138
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• 2024

Purpose: The aim of this study was to apply suboccipital muscle inhibition combined with neck muscle stabilization exercise to 20~30s IT industry employees who suffer from chronic non-specific neck pain. Methods: This study was designed as single-blind and randomized controlled trial. The study participants were 20~30s IT industry employees with chonic non-specific neck pain (VAS 3/10) who were divided into an experimental group (n= 20) subjected to suboccipital muscle inhibition with neck muscle stabilization exercise, and control group (n= 20); suboccipital muscle inhibition only. The intervention was applied three times per week for eight weeks. The neck pain·pressure pain threshold·range of motion, and disability index were measured at the 1st, 8th, and 10th week at follow up, then analyzed with an analysis of variance(ANOVA) using the SPSS program. Results: The total number of study participants was 37 (experimental group 19, mean age 34.6±5.3, control group 18, mean age 35.7±4.9). The comparison and analysis of change in VAS, the pressure pain threshold, and the range of motion except the extension (p>.05) revealed a statistically significant decrease between groups over eight weeks and follow up measurement (p<.01). Regarding the within the group differences, the right side of the neck pressure pain threshold showed a statistically significant decrease over eight weeks in the control group (p<.01). The right and left lateral flexion, and the right and left rotation were statistically significant for the experimental group over eight weeks and follow up measurement, but only the left lateral flexion (p<.05) for the control group over eight weeks. The neck disability index showed a slight decrease but this was not satistically significant for the between-grop or the within-group differences (p>.05). Conclusion: The intervention of suboccipital muscle inhibition and a neck muscle stabilization exercise are more beneficial for neck pain and the range of motion than the application of suboccipital muscle inhibition alone.

• 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.

• 대한물리의학회지
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• 제7권3호
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• pp.329-337
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• 2012

Purpose : The purpose of this study was to assess more effective exercise prescription for the people with chronic neck pain by comparing stretching exercise and isometric exercise about strength and pain. Method : The research design of the study was that 20 young adults with mild neck disability (5-14 out of 50 in Neck Disability Index) were randomized into 2 groups and underwent stretching exercise(10 peoples) and isometric exercise(10 peoples) at 3 times a week for 5weeks. Measures of pain scale (Visual Analog Scale) and Muscle strength of deep neck flexor (Pressure Biofeedback) were assessed before and after intervention. The pre and post exercise results were compared using paired t-test and the effectiveness of intervention of two groups were compared using Independent t test. Results : The results of this study were that pain reduction was seen after stretching and isometric exercise and significantly difference. There was significantly improvement of cervical flexor strength after stretching and isometric exercise. But, there was no significant difference between stretching and isometric exercise groups. Conclusion : The stretching and isometric exercise for chronic neck pain patients may use according to preference of patient because the effects of treatment was same. Further studies are needed to analyzed psycho social factors, cost effects, group approach.

• 한국방사선학회논문지
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• 제1권3호
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• pp.35-40
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• 2007

본 연구에 참여한 대상자는 서산시에 거주하는 자로 2007년 1월 1일부터 2007년 11월 31일까지 본원에 내원한 환자 중 방사선 경추 전 후면, 측방향 촬영을 실시하여 총 113명(40세 이하)을 대상으로 조사하여 다음과 같은 결과를 얻었다. 1) 연령의 분포는 14~40세 까지로 남자 57명(50.4%), 여자 56명(49.6%)이었으며, 연령그룹이 30~40세 80명(70.8%), 20~29세 27명(23.9%)에서 많은 빈도를 나타냈다. 2) 경부통의 발생 원인으로는 교통사고, 실족, 원인 모름이 대부분으로 조사 되었는데 원인 알 수 없음이 81명(71.7%)으로 가장 많이 나타났으며, 증상 발현되는 시기는 만성 87명(77%)적으로 발현되는 것으로 나타나 경부통의 발생원인과 증상발현과의 통계적 유의성이 있는 것으로 나타났다. 3) 전체 113명 중 20~29세 27명(23.9%), 30~40세 80명(70.8%)로 증상발현이 급성, 만성 모두 높은 분포를 보였다. 4) 본 연구자는 전체 113명 중 왼쪽 견부 39명(34.5%), 경추부위 31명(27.4%), 양쪽 견부 20명(17.7%)에서 각각 주요 통증이 있음을 알 수 있었고, 측만된 방향으로는 왼쪽측만 62명(54.9%)이 가장 많은 빈도로 나타났다. 5) 전 후 만곡방향에서 전만곡 48명(42.5%)으로 나타났으며, 수축기 혈압에서는 160mmHg에서 전만곡 19명(16.8%), 이완기 혈압에서는 총 69명(61.0%)이 전만곡 31명(27.4%)이 100mmHg으로 나타났다.

• Journal of Acupuncture Research
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• 제26권2호
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• pp.59-70
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• 2009

Objectives : Although CTTH is one of the most common symptom in primary headache, the mechanism and treatment is not definite. The purpose of this study is to research about clinical characteristic and roentgenographic finding of the cervical spine in CTTH to determine relationship between the cervical spine and headache. Methods : This study was carried out on 93 patients with CTTH. By roentgenographic finding, they were classified into four groups - HNP, Spondylosis, Sprain, Normal. Then the HNP group was divided again into two groups - singer type and multiple type. Results: 1. Among 93 patients with CTTH, 69(74.19%) patients had abnormal cervical spine by roentgenographic finding. 2. There were HNP, spondylosis, sprain in abnormal roentgenographic finding. And a great majority of the patients were diagnosed as cervical sprain. 3. There were no significant difference between four groups on sex, weight, height, blood pressure, pulse, respiratory rate. But on ages, the HNP group showed the highest average while the sprain group showed the lowest. 4. The patients in HNP group had more frequent, severe pain, longer onset and higher onset-age than those of the other three group. 5. The patients in Multiple-type HNP group had severe pain, longer pain-duration, longer onset, more pre-symptoms and younger onset-age than those of the Single-type HNP group. Conclusions : A great majority of the patients with CTTH had abnormal cervical spines. Also, we found out that the worse the grade of HNP, heavier the level of headache.

• 한국융합학회논문지
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• 제11권9호
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• pp.277-285
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• 2020

본 연구는 헤드 마운티드 디스플레이(Head-Mounted Display; HMD) 사용이 건강한 젊은 성인들의 목관절가동범위(CROM)와 목 근육 두께 및 통증에 미치는 영향을 분석하였다. HMD 군(남자 16명, 여자 7명)은 HMD를 착용하고 30분 동안 정해진 영상을 시청하도록 하였다. 대조군(남자 15명, 여자 8명)은 HMD군과 동일한 자세로 HMD 착용없이 30분 동안 앉아있게 하였다. 실험 전·후에 목관절가동범위, 위등세모근과 어깨올림근의 두께와 압력통증역치를 측정하고 대응표본 t검정과 독립 t검정으로 분석하였다. HMD 군의 목관절가동범위와 양쪽 위등세모근과 어깨올림근의 압력통증역치는 사전 검사 보다 유의하게 감소하였고(p<.05), 양쪽 위등세모근의 두께는 유의하게 증가하였고(p<.05). 반면에, 대조군은 목관절가동범위, 근육 두께 및 압력통증역치에서 유의한 차이가 없었다(p>.05). 분석 결과, 장시간 HMD 사용은 목관절가동범위와 압력통증역치를 감소시키고 근육을 비대하게 하여 목과 어깨의 근골격계 질환을 야기할 수 있으므로, 본 연구는 올바른 자세를 유지하며 적절한 시간 동안만 HMD를 사용할 것을 권장한다.