• 한국전문물리치료학회지
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• 제26권3호
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• pp.42-56
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• 2019

Background: Individuals with mechanical neck pain show biomechanical and neurophysiological changes, including cervical spine muscle weakness. As a result of deep muscle weakness, it causes stability disability and reduced upper thoracic spine mobility, which finally leads to functional movement restriction such as limited range of motion and dysfunction. Recent studies have shown that thoracic spine manipulation and mobilization could reduce symptoms of mechanical neck pain in patients. Objects: The purpose of this study was to investigate the effects of thoracic mobility exercise on cervicothoracic function, posture feature, and pain intensity in individuals with mechanical neck pain. Methods: The study subjects were 26 persons who were randomly assigned to the experimental (with thoracic mobility exercise) and control groups (without thoracic mobility exercise), with 13 subjects in each group. The cervicothoracic function (neck functional disability level and cervicothoracic range of motion), posture feature, and pain rating (using a quadrupled visual analogue scale [QVAS]) were measured before, after 3 weeks, and after 6 weeks. Results: Statistically significant group-by-time interactions were found with repeated analyses of variance for the Korean neck disability index (KNDI), all cervical range of motion (CROM), all thoracic range of motion (TROM), cranial rotation angle, sagittal shoulder posture (SSP), and QVAS (p<.05). All groups showed significant improvements from all times in all the evaluated methods. The KNDI, CROM, TROM of left rotation, and SSP in the experimental group showed significant improvements after 3 weeks, and the TROM of the right rotation and QVAS in the experimental group showed significant improvements after 6 weeks when compared with the control group. Conclusion: Thoracic mobility exercise during 6 weeks might be effective intervention to improve the functional level, posture feature, and QVAS pain rating for managing individuals with mechanical neck pain.

• Clinics in Shoulder and Elbow
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• 제20권2호
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• pp.95-99
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• 2017

Background: The purpose of this study was to investigate the clinical and radiological outcomes of locking plate fixation with fibular strut allograft to manage unstable osteoporotic proximal humerus fractures. Methods: We retrospectively reviewed 15 patients who underwent open reduction and locking plate fixation with fibular strut allograft for osteoporotic proximal humerus fracture between July 2011 and June 2015. For functional evaluation, we evaluated visual analogue scale (VAS) pain score, American Shoulder and Elbow Surgeons (ASES) score, University of California Los Angeles (UCLA) shoulder score, and active range of motion. For radiological evaluation, shoulder true anteroposterior (AP) and AP in $20^{\circ}$ external rotation, as well as the axillary view were taken at two weeks, six weeks, three months, six months, and one year. And the neck-shaft angle was measured on the AP view in $20^{\circ}$ external rotation view. Results: At the one-year follow-up, mean VAS pain score and all shoulder scores, including ASES score and UCLA shoulder score, exhibited satisfactory clinical outcomes. All patients obtained bone union between three and six months post-procedure. Moreover, the mean immediate postoperative neck-shaft angle was $138^{\circ}{\pm}4^{\circ}$, and at one-year follow-up, the neck shaft angle was $137^{\circ}{\pm}5^{\circ}$. There was no significant difference between the preoperative and postoperative values (p=0.105). Conclusions: For the unstable two-part and three-part osteoporotic proximal humerus fractures with medial calcar comminution, the use of fibular strut allograft with locking plate fixation was effective in maintaining the initial status of reduction and exhibiting the satisfactory functional and radiological outcomes.

• The Korean Journal of Pain
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• 제9권1호
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• pp.98-101
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• 1996

Background: Lumbar epidural steroid injection for relief of low back pain and sciatica has become a popular procedure. further, cervical epidural steroid injection with nerve block (CESNB) is known to be effective for the management of acute and chronic pain of neck, shoulder and arm. However, many anesthesiologists are not familiar with CESNB. Methods: Charts of 34 patients who had undergone 60 cervical epidural steroid injections over a three year period, 1993 to 1995, were reviewed. We studied the followings: initial visit and department, injected interspaces, personal characteristics, indications for injection and complications. Results: Patients' first visits were mainly to orthopaedics (11 patients) and neurosurgery (10 patients). Epidural injection sites were: C7-T1 interspace (29 patients) and C6-C7 interspace (6 patients). Mean age of patients were 50.1 years. range 21~73 years. There were twenty male and fourteen female patients. Complications varied from dizziness after CESNB (1 patient). loss of consciousness with transient apnea (2 patients), and local infection with suspicious meningitis (1 patient). Conclusion: We conclude from the above data that CESNB is a good, safe and conservative form of therapeutic procedure in the management of patients suffering from cervical radiculopathy, and neck and shoulder pain.

• 대한정형도수물리치료학회지
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• 제29권2호
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• pp.59-67
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• 2023

Background: The purpose of this study is to analyze the effect of shoulder and neck stabilization exercise using a gym ball for healthy women in their 20s with round shoulder and forward head posture, it is intended to try and find improvement for posture. Methods: The subjects of the study were 25 women who understood the purpose of the research and voluntarily agreed to participate in the experiment. They carried out the shoulder and neck stabilization exercise program using a gym ball, which was conducted for 35 minutes, 3 times a week for 4 weeks. The position of the round shoulder and shoulder bones was measured using an tape measurement and were recorded in both at pre, 2 weeks, and post intervention. The craniovertebral angle (CVA) and craniorotational angle (CRA) was measured using an image J. Results: The round shoulder posture left was statistically significantly different within group (p<.05); however, the round shoulder posture right wasn't statistically significantly different (p>.05). As a result of this contrast, test were significant different in both at pre, 2 weeks and post. The scapular position on the left and right were statistically significantly different within the group (p<.05). As a result of the contrast, test were significant different in both at pre, 2 weeks and post (p<.05). The CVA and CRA on the left and right were statistically significantly different within the group (p<.05). As a result of the contrast, test were significant different in both at pre, 2 weeks and post (p<.05). Conclusion: The gym ball exercises improved the posture of women in their 20s. Therefore, gym ball exercises can help improve the quality of life of those with shoulder and neck pain.

• The Korean Journal of Pain
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• 제32권2호
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• pp.120-128
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• 2019

Background: We aimed to explore the American College of Rheumatology (ACR) 1990 and 2011 fibromyalgia (FM) classification criteria's items and the components of Fibromyalgia Impact Questionnaire (FIQ) to identify features best discriminating FM features. Finally, we developed a combined FM diagnostic (C-FM) model using the FM's key features. Methods: The means and frequency on tender points (TPs), ACR 2011 components and FIQ items were calculated in the FM and non-FM (osteoarthritis [OA] and non-OA) patients. Then, two-step multiple logistic regression analysis was performed to order these variables according to their maximal statistical contribution in predicting group membership. Partial correlations assessed their unique contribution, and two-group discriminant analysis provided a classification table. Using receiver operator characteristic analyses, we determined the sensitivity and specificity of the final model. Results: A total of 172 patients with FM, 75 with OA and 21 with periarthritis or regional pain syndromes were enrolled. Two steps multiple logistic regression analysis identified 8 key features of FM which accounted for 64.8% of variance associated with FM group membership: lateral epicondyle TP with variance percentages (36.9%), neck pain (14.5%), fatigue (4.7%), insomnia (3%), upper back pain (2.2%), shoulder pain (1.5%), gluteal TP (1.2%), and FIQ fatigue (0.9%). The C-FM model demonstrated a 91.4% correct classification rate, 91.9% for sensitivity and 91.7% for specificity. Conclusions: The C-FM model can accurately detect FM patients among other pain disorders. Re-inclusion of TPs along with saving of FM main symptoms in the C-FM model is a unique feature of this model.

• The Journal of Korean Physical Therapy
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• 제31권5호
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• pp.304-310
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• 2019

Purpose: This study examined the work-related musculoskeletal pain and quality of life of hospital workers. Methods: Self-reported questionnaires were sent to 350 hospital workers at Seoul and Gyeonggi-do, of which 341 were returned. The questionnaire had four items that covered the demographic information, areas of musculoskeletal problems, pain rating scale, and quality of life. The analysis was completed using descriptive statistic, and the differences between pain and demographic variables were identified using a chi-square test. The differences between the type of occupation and quality of life were analyzed by one-way analysis of variance and a Kruskal-Wallis test. Results: The 12-month prevalence of work-related musculoskeletal pain was 86.1% of physical therapists, 86.5% of occupational therapists, 77.1% of dental hygienists, and 75.8% of nurses. A significant difference in the general and work related variables was observed between the subject with a physical burden and type of occupation. The most affected pain sites of the physical therapist included low back, hand and wrist, shoulder, and neck. The occupational therapists included the hand and wrist, shoulder, neck, but the nurses and dental hygienists reported the shoulder, back, hand and wrist. A significant difference in the quality of life was noted between the subjects in physical therapists and dental hygienists and the subjects in the nurses and occupational therapists (p=0.00). Conclusion: These findings show that hospital workers appear to be high risk for work-related musculoskeletal pain, and the quality of life of physical therapists and nurses was higher than that of dental hygienists and occupational therapists.

• 대한물리치료과학회지
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• 제12권3호
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• pp.27-34
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• 2005

The purpose of this study is to find out factors(shoulder level, acromion-occipital length, spine alignment, spine-scapula inferior angle length) of pain of neck & shoulder by 3 Dimensional Moire Scanner. 50 female student s aged 20 to 25 years old participated who lived in Sun-cheon si Jeonnam. They were examined with three measurement methods(Visual Analogue Scale : VAS, Algometer, 3 Dimensional Moire Scanner(IBS-2000). According to the results of multiple regression analysis. 1) There was a significant difference with shoulder level and spine-scapula inferior angle based on VAS. 2) There was a significant difference with shoulder level based of Algometer measurement value in Rhomboid muscles.

• The Korean Journal of Pain
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• 제28권2호
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• pp.129-136
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• 2015

Background: Pain is one of the most important consequences of spinal cord injury (SCI). It may affect several aspects of life, especially the quality of life (QoL). Hence, this study was conducted to establish an understanding of pain and its correlates and effects on patients with SCI in our community. Methods: In a cross-sectional study, 58 male veterans suffering from SCI were admitted to our center for a regular follow-up. Demographic and SCI-related descriptive information were gathered using a self-reported questionnaire. To evaluate the patients' pain quality and the effect of pain on daily life, a questionnaire in 3 parts of lumbar, cervical and shoulder pain was administered. EuroQoL questionnaire and General Health Questionnaire (GHQ) 12 were also used to assess the patients' QoL. Results: The mean age of the participants was $45.91{\pm}6.69$ with mean injury time of $25.54{\pm}5.91$. forty-four patients (75.9%) reported pain, including lumbar pain (63%), cervical pain (39%) and shoulder pain (51%). The presence of pain was associated with lower QoL. Patients with lumbar pain reported a significant amount of pain affecting their daily life and this effect was higher in patients with lower GHQ score or anxiety/depressive disorder. Conclusions: Musculoskeletal pain, is a common complaint in veterans with SCI and is inversely associated with functioning and general health status. Lumbar and shoulder pain affects patient's daily living more than cervical pain.

• Journal of Korean Neurosurgical Society
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• 제57권4호
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• pp.283-288
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• 2015

Objective : This study aims to visualize the subjective symptoms before and after the treatment of whiplash injury using infrared (IR) thermography. Methods : IR thermography was performed for 42 patients who were diagnosed with whiplash injury. There were 19 male and 23 female patients. The mean age was 43.12 years. Thermal differences (${\Delta}T$) in the neck and shoulder and changes in the thermal differences (${\Delta}dT$) before and after treatment were analyzed. Pain after injury was evaluated using visual analogue scale (VAS) before and after treatment (${\Delta}VAS$). The correlations between ${\Delta}dT$ and ${\Delta}VAS$ results before and after the treatment were examined. We used Digital Infrared Thermal Imaging equipment of Dorex company for IR thermography. Results : The skin temperature of the neck and shoulder immediately after injury showed $1-2^{\circ}C$ hyperthermia than normal. After two weeks, the skin temperature was normal range. ${\Delta}T$ after immediately injuy was higher than normal value, but it was gradually near the normal value after two weeks. ${\Delta}dT$ before and after treatment were statistically significant (p<0.05). VAS of the neck and shoulder significantly reduced after 2 week (p=0.001). Also, there was significant correlation between ${\Delta}dT$ and reduced ${\Delta}VAS$ (the neck; r=0.412, p<0.007) (the shoulder; r=0.648, p<0.000). Conclusion : The skin temperature of sites with whiplash injury is immediately hyperthermia and gradually decreased after two weeks, finally it got close to normal temperature. These were highly correlated with reduced VAS. IR thermography can be a reliable tool to visualize the symptoms of whiplash injury and the effectiveness of treatment in clinical settings.

• 한국전문물리치료학회지
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• 제23권2호
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• pp.57-66
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• 2016

Background: For the treatment of forward head posture (FHP) and forward shoulder posture, methods for strengthening scapular retractors and deep cervical flexors and stretching pectoralis and upper cervical extensors are generally used. No study has yet assessed whether suboccipital release (SR) followed by cranio-cervical flexion exercise (CCFE) (SR-CCFE) will result in a positive change in the shoulders and neck, showing a "downstream" effect. Objects: The purpose of this study was to investigate the immediate effects of SR-CCFE on craniovertebral angle (CVA), shoulder abduction range of motion (ROM), shoulder pain, and muscle activities of upper trapezius (UT), lower trapezius (LT), and serratus anterior (SA) and LT/UT and SA/UT muscle activity ratios during maximal shoulder abduction in subjects with FHP. Methods: In total, 19 subjects (7 males, 12 females) with FHP were recruited. The subject performed the fifth phase of CCFE immediately after receiving SR. CVA, shoulder abduction ROM, shoulder pain, muscle activities of UT, LT, and SA, and LT/UT and SA/UT muscle activity ratios during maximal shoulder abduction were measured immediately after SR-CCFE. A paired t-test and Wilcoxon signed-rank test were used to determine the significance of differences in scores between pre- and post-intervention in the same group. Results: The CVA (p<.001) and shoulder abduction ROM (p<.001) were increased significantly post-versus pre-intervention. Shoulder pain was decreased significantly (p<.001), and LT (p<.05) and SA (p<.05) muscle activities were increased significantly post- versus pre-intervention. The LT/UT muscle activity ratio was increased significantly post- versus pre-intervention (p<.05). However, there was no significant change in UT muscle activity and SA/UT muscle activity ratio between pre- and post-intervention (p>.05). Conclusion: SR-CCFE was an effective intervention to improve FHP and induce downstream effect from the neck to the trunk and shoulders in subjects with FHP.