• PNF and Movement
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• v.16 no.3
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• pp.333-343
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• 2018

Purpose: The purpose of this study was to investigate the effects of a neck exercise using a proprioceptive neuromuscular facilitation (PNF) neck flexion and extension pattern on body balance in a progressive range of positions (supine, prone on elbow, and sitting), on numbness in the upper extremities, and on neck flexion motions in cervical myelopathy patients. Methods: One participant who was diagnosed with cervical myelopathy participated in this study. A reversal design (A-B-A') was used. The A and A' were the baseline period (no intervention), and B was the intervention period. The intervention used a neck extension pattern with a hold-relax technique and a neck flexion pattern with a combination of isotonic techniques in the supine position. Then, neck flexion and extension patterns were applied together with a reversal technique for stabilization, followed by a neck extension pattern with a combination of isotonic techniques in the prone position on the elbows. Finally, a neck flexion and extension pattern was used with a stabilizing reversal technique, and a neck extension pattern was applied with a combination of isotonic techniques in the sitting position for 60 minutes per day, 3 times per week for 8 weeks. To measure balance, numbness, and neck motion during neck flexion, the one-leg stand test and the visual analogue scale were used. Results: The right and left one-leg stand tests showed increased balance ability in the intervention phase. Upper extremity numbness was decreased in the intervention phase, and neck flexion motion was increased in the intervention phase. These increases were maintained after the intervention (Baseline II). Conclusion: These results suggest that a neck exercise using a PNF neck pattern with additional techniques in a progressive range of positions has a positive effect on cervical myelopathy patients for balance, numbness, and neck motion.

• Journal of the Korean Society of Physical Medicine
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• v.11 no.1
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• pp.71-82
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• 2016

PURPOSE: The purpose of this case report was to determine the effect of therapeutic exercise on posture, pain, and muscle activity in two patients with forward head posture (FHP). METHODS: A-31-year-old male (patient A) and a 19-year-old women (patient B) presented with FHP, neck pain, and headache. The therapeutic exercise program consisted of cervical mobilization, deep cervical flexors strengthening, and cervical extensors stretching, for 40 min/d, 2 d/week, for 8 weeks. Neck pain (VAS), neck disability (NDI), cervical range of motion (CROM), lateral view of cervical spine X-ray (indicating the FHP), and asymmetrical neck and shoulder muscular activity ratio were measured before, after 4 weeks, and after 8 weeks of corrective exercise. RESULTS: VAS and NDI decreased in patients A and B after exercise compared to before the program. CROM increased in patients A and B at flexion, extension, side bending, and rotation after exercise compared to before the program. FHP decreased in patients A and B at distance after exercise compared to before the program. In addition, asymmetrical neck and shoulder muscles activity ratio improved in patients A and B after exercise compared to before the program. CONCLUSION: We demonstrated in a case report that therapeutic exercise increases ROM, decreases pain and disability of neck, FHP, and asymmetry muscle activity ratio in patients with FHP. These finding have clinical implications for therapeutic exercise in patients with FHP.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.19 no.2
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• pp.23-29
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• 2013

Background: People who have painful neck have reduced proprioception in the neck. Reduced proprioception in the neck is related to the muscle spindle activity in the deep neck flexors. The aim of this study was to know that proprioception in the neck was increased by strengthening exercise of the deep neck flexors. Methods: Thirty subjects with chronic neck pain were randomly assigned to the experimental group (n=15) and the control group (n=15). Deep neck flexor muscle exercise with stabilizer were conducted for the study group three times a week for six weeks. Relocation errors in 30 degree rotation to the left were measured three times before and after intervention each. Results: Neck disability index were decreased in the experimental group (p<.05) but not in the control group (p>.05). Relocation errors were decreased in the experimental group after intervention (p<.05), but not in the control group (p>.05). Conclusions: Proprioception in the neck can be increased by the strengthening exercise of deep neck flexors in the subject with chronic neck pain.

• Journal of the Korean Society of Physical Medicine
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• v.1 no.1
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• pp.93-108
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• 2006

Purpose : To evaluate effects of McKenzie exercise on the functional recovery and forward head posture of chronic neck pain patients. Methods : The subjects were consisted of fifteen patients who had abnormal neck posture, mild neck pain (28 males, 17 females; mean aged 21.9) from 19 to 33 years of age(mean age 21.9). All subjects were received McKenzie exercise for 35 minutes with clinical massage per day three times a week during 4 weeks period. Neck disability index was used to measure functional disability level. Visual analogue scale(VAS) was used to measure subjective pain level. craniovetebral angle(CVA), cranial rotation angle(CRA) was used to measure forward head posture with digital camera. All measurements of each patients were measured at pre-treatment and after 2 week, after 4 week, post-treatment on 2 week. Result : The VAS of McKenzie exercise was significantly reduced between pre-treatment and post-treatment (p<.05) and effects of pain reduce was continued follow 2 weeks. The Neck Disability Index of McKenzie exercise was significantly reduced between pre-treatment and post-treatment (p<.05) and effects of pain reduce was continued follow 2 weeks. The CVA of McKenzie exercise was significantly reduced between pre-treatment and post-treatment (p<.05) and effects of pain reduce was continued follow 2 weeks. The CRA of McKenzie exercise was not significantly reduced between pre-treatment and post-treatment (p<.05). Conclusion : McKenzie exercise improved pain and function of Chronic neck pain patients.

• 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 the Korean Society of Physical Medicine
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• v.16 no.3
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• pp.55-64
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• 2021

PURPOSE: The purpose of this study was to apply dynamic neuromuscular stabilization (DNS) to subjects with forward head posture (FHP) and to compare its effects on respiratory function as against the conventional neck stabilization exercise and neck stretching and extensor strengthening exercises. METHODS: The whole-body posture measurement system was used to measure the degree of FHP, and a spirometer and a respiratory gas analyzer were used to measure the respiratory function. After the intervention was completed, the changes over time were analyzed in the DNS group, the neck stabilization exercise group, and the neck stretching and extensor strengthening exercise group. The inter-group difference in the changes was also analyzed. A repeated ANOVA was performed to compare the respiratory function according to the period between the three groups, and the least significant difference (LSD) method was used for the post hoc test. RESULTS: After the 6-week exercise period, respiratory functions, such as forced vital capacity (FVC), forced expiratory volume for 1 second (FEV1), forced expiratory volume for 1 sec/forced vital capacity (FEV1/FVC), maximum oxygen intake (VO₂max), and the volume of expired gas (VE), significantly improved according to the period (p < .05), but no inter-group differences were found. CONCLUSION: DNS is an effective training method, and can be applied along with neck stabilization exercise and neck stretching and extensor strengthening exercises, which are widely used in clinical practice, to people with FHP who cannot directly perform neck exercises to improve their respiratory function.

• Journal of the Korean Society of Physical Medicine
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• v.4 no.2
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• pp.73-78
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• 2009

Purpose：The purpose of this study was to investigate effects of therapeutic exercise on the grip strength of chronic neck pain patients. Methods：Sixteen chronic neck pain patients were recruited this study(8 females. 8 males) from 21 to 30 years of age(mean aged 24.44). The experimental group received contraction-relax exercise for more than 3-5 times with therapeutic massage for 15minutes per day and three times a week during 5 weeks period. Grip strength was measured by Grip Strength Dynamometer(Model: T.K.K, 5101, Japan) at pre, 3weeks, 5weeks and follow-up 2weeks. Statistical analysis was used repeated ANOVA to know difference within period. Results：The grip strength was significantly increased within treatment period(p<.05), among them significantly increased within pre-treatment and follow-up 2weeks(p<.05). Conclusion：These results indicate that therapeutic exercise increased grip strength of chronic neck pain patients. Grip strength was more increased at follow-up 2weeks. In the future, we suggest that studies of therapeutic exercise regarding chronic neck pain patient be further studied and an appropriate therapeutic exercise will be indicated.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.23 no.1
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• pp.53-58
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• 2017

Background: The purpose of this study was to effect of action observation with deep neck flexors strengthening exercise on pain and function in patients with chronic neck pain. Methods: Thirty patients with chronic neck pain were randomly action observation with deep neck flexors strengthening exercise group (AOT group; n=15) and deep neck flexors strengthening exercise group (FSE group; n=15). The intervention was applied for 50 minutes a day, 5 times a week for a total of 4 weeks. The intervention effect were evaluated before and after the intervention. visual analogue scale (VAS), pressure pain threshold (PPT), and Korea neck disability index (KNDI). Results: As a result of comparing within group, AOT group showed pre and post test, VAS (p<.01), PPT (p<.01), KNDI (p<.01) and FSE group VAS (p<.01), PPT (p<.05), KNDI (p<.01) significantly. In the comparison between the two groups, AOT group than FSE group in VAS, PPT and KNDI significantly (p<.05). Conclusion: Action observation with deep neck flexors strengthening exercise were founded to effective in reducing pain and improving function in patients with chronic neck pain. It is suggested as basic data of clinical intervention.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.29 no.3
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• pp.43-53
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• 2023

Background: Patients with neck pain develop instability due to muscle imbalance, decreased proprioception, and balance disorders. Studies have examined various exercise methods as treatment methods, but few studies have compared the effects of cervical stabilization exercise and dynamic balance exercise. The purpose of this study was to investigate the effects of dynamic balance exercise on pain, functional level, and psychosocial level in patients with non-specific chronic neck pain. Methods: Thirty-four non-specific chronic neck pain patients were randomly assigned to the experimental group (EG, n=17) and control group (CG, n=17); the cervical stabilization exercise and dynamic balance exercise program were applied to the EG; and only the cervical stabilization exercise program was applied to the CG. The intervention was conducted twice a week, for six weeks. Assessment items evaluated pain, dysfunction (Korean version neck disability index), range of motion, craniocervical flexion test, cervical deep flexor endurance test, and psychosocial level. Data analysis was performed using intention-to-treat analysis as assigned. To analyze differences in the items assessed in the two groups, we used a repeated measures analysis of variance with an interaction between group (EG, CG) and time point (baseline, 6 weeks, 12 weeks). Results: The endurance of the cervical flexor muscles between the group and the measurement point after intervention (p<.05). Both groups showed significantly improved endurance between time points after the intervention (p<.05), with the EG showing a greater change than the CG. None of the other measurement items differed in the pattern of change between measurement points. Conclusion: In conclusion, the EG applying a cervical stabilization exercise and a dynamic balance exercise experienced a significant difference in muscle endurance improvement compared to the CG. We propose an exercise intervention program that includes stabilization exercises and dynamic balance exercises for patients with chronic cervical pain who lack muscle endurance.

• Journal of the Korean Society of Physical Medicine
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• v.6 no.1
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• pp.81-92
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• 2011

Purpose : The purpose of this study was to compare combined exercise program group to conventional physiotherapy for patients with chronic neck pain. Methods : Participants were randomly allocated to two groups by experimental(n=17) and control(n=17). Combined exercise program group involved stretching, stability, strengthening and endurance, proprioceptive exercises along with an educational programme. Patient attended for 60min, three times a weeks. Control group was treated as conventional physiotherapy on 40 min, three times a weeks. Outcome variables included pain, disability, range of motion, fatigability at 0 and 6 weeks. Results : Pain, Disability Index, Fatigability significantly decreased(p<.05) and Range of motion improved significantly after active exercise program(p<.05). In conclusion. Combined exercise program improves pain and disability, range of motion, fatigability. Conclusion : These results suggest that combined exercise program is suitable for chronic neck pain.