Lee, Jae-Doo
(Department of Physical Therapy, Graduate School of Health and Medicine, Daejeon University)
,
Shin, Won-Seob
(Department of Physical Therapy, Graduate School of Health and Medicine, Daejeon University)
Objective: This study aimed to investigate the immediate effects of intervention using neuromuscular control, self-stretching (SS), and neck stabilization exercises (NSEs) on neck pain, range of motion (ROM), and proprioception of position sense in adults with neck discomfort. Design: Three-group pr...
Objective: This study aimed to investigate the immediate effects of intervention using neuromuscular control, self-stretching (SS), and neck stabilization exercises (NSEs) on neck pain, range of motion (ROM), and proprioception of position sense in adults with neck discomfort. Design: Three-group pretest-posttest design. Methods: Forty-four adults who complained of neck pain participated in the experiment. They were randomly assigned to the following groups: neuromuscular control exercise (NMCE) group (n=15), SS group (n=14) and NSE group (n=15). The NMCE group did rolling with only upper limb pattern on both sides. The SS group performed neck stretching on each side, 3 sets of 30 seconds for each muscle. The NSE group had the pressure biofeedback applied with increases in pressure by 2 mmHg at a time from 20-30 mmHg while in the hook-lying position. All groups performed exercises for 10 minutes. Neck pain, ROM, and proprioception were measured to determine differences between the intervention methods. Results: Intra-group comparisons showed significant improvement after exercise in pain, ROM, and proprioception in the NMC group (p<0.05). In the comparison between groups, the NMC group had a significant decrease in pain compared to the other two groups (p<0.05). There was no difference in ROM between the groups but the NMC group showed significant improvement in left rotation compared to the stabilization exercise group (p<0.05). For proprioception, the NMC group had significantly lower error than the other two groups (p<0.05). Conclusions: NMCEs through upper extremity pattern rolling exercise is effective in improving neck pain, ROM, and proprioception.
Objective: This study aimed to investigate the immediate effects of intervention using neuromuscular control, self-stretching (SS), and neck stabilization exercises (NSEs) on neck pain, range of motion (ROM), and proprioception of position sense in adults with neck discomfort. Design: Three-group pretest-posttest design. Methods: Forty-four adults who complained of neck pain participated in the experiment. They were randomly assigned to the following groups: neuromuscular control exercise (NMCE) group (n=15), SS group (n=14) and NSE group (n=15). The NMCE group did rolling with only upper limb pattern on both sides. The SS group performed neck stretching on each side, 3 sets of 30 seconds for each muscle. The NSE group had the pressure biofeedback applied with increases in pressure by 2 mmHg at a time from 20-30 mmHg while in the hook-lying position. All groups performed exercises for 10 minutes. Neck pain, ROM, and proprioception were measured to determine differences between the intervention methods. Results: Intra-group comparisons showed significant improvement after exercise in pain, ROM, and proprioception in the NMC group (p<0.05). In the comparison between groups, the NMC group had a significant decrease in pain compared to the other two groups (p<0.05). There was no difference in ROM between the groups but the NMC group showed significant improvement in left rotation compared to the stabilization exercise group (p<0.05). For proprioception, the NMC group had significantly lower error than the other two groups (p<0.05). Conclusions: NMCEs through upper extremity pattern rolling exercise is effective in improving neck pain, ROM, and proprioception.
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제안 방법
The interventions were performed for 10 minutes in each group. After intervention, all three groups had undergone reevaluation of neck pain levels, ROM, and proprioception.
Next, once the subjects were allowed to align the laser to a new center point with their eyes opened, they were instructed to close their eyes while maintaining this position for 5 seconds in order to remember the new location. After the subjects were instructed to perform maximal left cervical rotation and then return to facing the front, the distance between the intersection and the laser point was measured. This procedure was performed 10 times and the average was obtained.
Subjects complaining of neck discomfort were randomly drawn from the numbers on the Neck Disability Index test during the selection process with 15 subjects assigned to the NMCE group, 14 subjects assigned to the self-stretching (SS) group, and 15 subjects assigned to the NSE group. All three groups were assessed for neck pain levels, ROM, and proprioception. The interventions were performed for 10 minutes in each group.
Among subjects with neck discomfort, this study was conducted to compare the effects of performing the upper extremity pattern rolling exercise, in which this exercise is known to improve spinal stability and head-neck coordination ability, through the NMCE group, and to compare with the effects of SS, and NSE on neck pain, joint ROM, and proprioception.
Exclusion conditions were those with upper body rotation of less than 50 degrees in a seated posture, pain during upper limb pattern rolling exercises, cervical fracture, arthritis, tumor, muscle disease, osteoporosis, severe neck instability, radiation pain due to compression of nerve tissue, and psychiatric issues that may cause difficulty in comprehending the procedures of the study. Those who understood the purpose of this study agreed to participate in writing.
In order to set the zero point for the along the horizontal plane for the HRA measurement, after performing maximal cervical extension with eyes closed, when the subject faced the front, the head was adjusted by moving the center of the intersection line to the location of the laser point.
In this study, subjects were selected by the manual shoulder bone raising test [36], which is used to screen for mechanical problems of the neck and shoulder muscles. It can be seen that more dynamic changes can be made to the muscles around the back [36].
The age distribution of each group was homogeneously distributed by age group and the contents are shown in Table 1. The conditions for selecting subjects were those who scored from 5 to less than 15 points on the Neck Disability Index, those who experienced neck pain lasting more than 3 months within the past year, those with neck discomfort within 7 days before this study, and those with a positive Passive Scapular Elevation Test.
, Armonk, NY, USA). The general characteristics of the subjects were presented as descriptive statistics and mean and standard deviation values. The homogeneity was confirmed by the Chi-square test and One-way ANOVA.
Subjects were seated in a backless chair with the back straightened and hands placed comfortably on the thigh. The subjects wore a band with a laser point (Motion Guidance, West Valley City, UT, USA) on their head and the distance between the subject and the target was adjusted to 90 cm.
Therefore, in this study, in order to find out whether NMCE using upper limb pattern rolling exercise can affect not only the hip but also the neck, this study was conducted to investigate whether there is a significant difference in neck pain, ROM, and proprioception of individuals with complaints of neck discomfort.
대상 데이터
A total of 44 subjects participated in this study, including the NMCE group (n1=15), the SS group (n2=14), and the stabilization exercise group (n3=15).
Subjects complaining of neck discomfort were randomly drawn from the numbers on the Neck Disability Index test during the selection process with 15 subjects assigned to the NMCE group, 14 subjects assigned to the self-stretching (SS) group, and 15 subjects assigned to the NSE group. All three groups were assessed for neck pain levels, ROM, and proprioception.
The target was made from a 60 mm×80 cm piece of graph paper based on a 1 mm scale and the intersection of horiztonal and vertical lines was drawn.
데이터처리
For the normality test of all variables the Shapiro-Wilks test was performed. For comparisons of preand post intervention results within the group the paired t-test was conducted and analyzed. Post-hoc analysis was performed using the Bonferroni correction.
The general characteristics of the subjects were presented as descriptive statistics and mean and standard deviation values. The homogeneity was confirmed by the Chi-square test and One-way ANOVA. For the normality test of all variables the Shapiro-Wilks test was performed.
이론/모형
The homogeneity was confirmed by the Chi-square test and One-way ANOVA. For the normality test of all variables the Shapiro-Wilks test was performed. For comparisons of preand post intervention results within the group the paired t-test was conducted and analyzed.
Pain levels were assessed using the Visual Analogue Scale (VAS). On an unmarked score card, the subjects indicated the extent of pain they were currently experiencing.
For comparisons of preand post intervention results within the group the paired t-test was conducted and analyzed. Post-hoc analysis was performed using the Bonferroni correction. The statistical significance of this study was set to α=0.
성능/효과
After being on 4 weeks of a shoulder stabilization exercise program, the study had found that there were significant differences in pain levels, dysfunction levels, and neck ROM in those who’ve tested positive compared to those who’ve tested negative on the Passive Scapular Elevation Test [35].
As a result of comparing the pre and post change between groups, the neuromuscular control group had more significant effects than the SS and the stabilization exercise group (p<0.01).
Based on the comparisons of pre- and post-group changes, neuromuscular control was more effective than SS and stabilization exercise for right and left cervical proprioception (p<0.01) (Table 2).
In comparison of the pre and post changes between the three groups, the NMCE was more effective than the stabilization exercise group for left cervical rotation range (p<0.05).
In comparison of the pre- and post-variable changes among the three groups, the NMCE group had a greater significant effect on left cervical movement range compared to the stabilization exercise group (p<0.05).
In comparison of the preand post-changes between the three groups, NMCEs were observed to be more effective compared to the SS and stabilization exercises (p<0.01).
[34] found that 4 weeks of performing stretch exercises significantly improved neck flexion, extension, and left-right rotation ROM in elderly patients. In this study, performing self-stretches also showed significant improvement in cervical joint flexion, extension, and left-right rotation range.
In contrast, no significant difference was found between cranial injury patients and normal subjects when they measured cranio-cervical flexion and immediately measured joint position sense [38]. The experimental results were partially in agreement with the results of no significant difference in neck stabilization through cranial neck bending. As a result of comparing the pre and post change between groups, the neuromuscular control group had more significant effects than the SS and the stabilization exercise group (p<0.
참고문헌 (38)
Gordon SJ, Trott P, Grimmer KA. Waking cervical pain and stiffness, headache, scapular or arm pain: gender and age effects. Aust J Phys 2002;48:9-15.
Health Insurance Review & Assessment Service. 2016 National health insurance statistical yearbook. Seoul: Health Insurance Review & Assessment Service; 2017.
Jette DU, Jette AM. Physical therapy and health outcomes in patients with spinal impairments. Phys Ther 1997;76:930-41; discussion 942-5.
Olson SL, O'Connor DP, Birmingham G, Broman P, Herrera L. Tender point sensitivity, range of motion, and perceived disability in subjects with neck pain. J Orthop Sports Phys Ther 2000;30:13-20.
Silverman JL, Rodriquez AA, Agre JC. Quantitative cervical flexor strength in healthy subjects and in subjects with mechanical neck pain. Arch Phys Med Rehabil 1991;72:679-81.
Kim GE, Yun DU, An YJ, Park DS, Ham JH. Reliability and validity of new evaluation methods using static surface electromyography in persons with neck pain. Phys Ther Rehab Sci 2019; 8:1-7.
Cheng CH, Wang JL, Lin JJ, Wang SF, Lin KH. Position accuracy and electromyographic responses during head reposition in young adults with chronic neck pain. J Electro Kines 2010;20:1014-20.
Jung JM, Gu JS, Shin WS. The effect of different sitting postures on range of motion, strength and proprioceptive sense of neck. J Korea Acad Ind Coop Soc 2012;13:2212-8.
Lee CJ. The effects of recovery trials of stretching on physiological fatigue variables during high-intensity weight training [Master thesis]. Daegu: Keimyung University; 2006.
Jeong HM, Shim JH, Hye RS. The passive stretching, massage, and muscle energy technique effects on range of motion, strength, and pressure pain threshold in musculoskeletal neck pain of young adults. Phys Ther Rehabil Sci 2017;6:196-201.
Childs JD, Cleland JA, Elliott JM, Teyhen DS, Wainner RS, Whitman JM, et al. Neck pain: clinical practice guidelines linked to the international classification of functioning, disability, and health from the orthopedic section of the American Physical Therapy Association. J Orthop Sports Phys Ther 2008;38:A1-A34.
Ferreira PH, Ferreira ML, Maher CG, Herbert RD, Refshauge K. Specific stabilisation exercise for spinal and pelvic pain: a systematic review. Aust J Physiother 2006;52:79-88.
Lee S, Park J, Lee D. Effects of bridge exercise performed on an unstable surface on lumbar stabilizing muscles according to the knee angle. J Phys Ther Sci 2015;27:2633-5.
Kim GC, HwangBo PN. Effects of cervical stabilization exercise using pressure biofeedback on neck pain, forward head posture and acoustic characteristics of chronic neck pain patients with forward head posture. J Korean Soc Phys Med 2019;14:121-9.
Seo SC, Choi JY, Joo MY, Kim JH, Chang SK. Effects of sling exercise and McKenzie exercise program on neck disability, pain, muscle strength and range of motion in chronic neck pain. Phys Ther Rehabil Sci 2012;1:40-8.
Kwon JH, Cho MJ, Park MC, Kim SY. Cervical stabilization exercise using the Sling system. J Korean Acad Orthop Man Ther 2002;8:57-71.
Jull GA, Falla D, Vicenzino B, Hodges PW. The effect of therapeutic exercise on activation of the deep cervical flexor muscles in people with chronic neck pain. Man Ther 2009;14:696-701.
Hoogenboom BJ, Voight ML, Cook G, Gill L. Using rolling to develop neuromuscular control and coordination of the core and extremities of athletes. N Am J Sports Phys Ther 2009;4:70-82.
Clark N, Voight ML, Campbell AM, Pierce S, Sells P, Cook R, et al. The relationship between segmental rolling ability and lumbar multifidus activation time. Int J Sports Phys Ther 2017;12:921-30.
Boonstra AM, Schiphorst Preuper HR, Reneman MF, Posthumus JB, Stewart RE. Reliability and validity of the visual analogue scale for disability in patients with chronic musculoskeletal pain. Int J Rehabil Res 2008;31:165-9.
Lee C, Song H, Lee J, Chang M. Usefulness of smart phone application to measure cervical range of motion. J Korean Soc Community Based Occup Ther 2017;7:17-24.
Rix GD, Bagust J. Cervicocephalic kinesthetic sensibility in patients with chronic, nontraumatic cervical spine pain. Arch Phys Med Rehabil 2001;82:911-9.
Wibault J, Vaillant J, Vuillerme N, Dedering A, Peolsson A. Using the cervical range of motion (CROM) device to assess head repositioning accuracy in individuals with cervical radiculopathy in comparison to neck- healthy individuals. Man Ther 2013;18:403-9.
Wang WT, Olson SL, Campbell AH, Hanten WP, Gleeson PB. Effectiveness of physical therapy for patients with neck pain: an individualized approach using a clinical decision-making algorithm. Am J Phys Med Rehabil 2003;82:203-18; quiz 219-21.
Jun DH. A prospective investigation into the effects of workplace stress and working postures on work-related neck pain in office workers. PNF Mov 2019;17:253-61.
Kjellman G. Neck pain: analysis of prognostic factors and treatment effects [Master thesis]. Linkoping: Linkoping University;2001.
Hwang BG, Kim GC, Park YK. Effects of self-stretching exercise and upper thoracic joint mobilization on range of motion and pain of the patients with chronic neck pain. J Korean Soc Phys Med 2012;7:509-14.
Jeon HY, Lee SY, Bae SS, Jang C, Lee GC. Effect of stretching exercise on cervical ROM in elderly. J Korean Soc Phys Med 2009;4:57-62.
Kim HY, Kim SY, Jang HJ, Joo MK. Effect of scapular stabilization exercise on patients with neck pain classified according to passive scapular elevation test. Phys Ther Korea 2012;19:51-60.
McDonnell MK, Sahrmann SA, Van Dillen L. A specific exercise program and modification of postural alignment for treatment of cervicogenic headache: a case report. J Orthop Sports Phys Ther 2005;35:3-15.
Ravi CN, Dibyendunarayan BD, Ramalingam TA. Effectiveness of proprioceptive exercises in chronic nonspecific neck pain patients. Indian J Phys Occup Ther 2016;10:143-8.
Armstrong BS, McNair PJ, Williams M. Head and neck position sense in whiplash patients and healthy individuals and the effect of the cranio-cervical flexion action. Clin Biomech (Bristol, Avon) 2005;20:675-84.
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