만성 역학적 목 통증을 가진 환자에게 도수치료만 적용할 때와 도수치료와 안정화운동을 함께 적용할 때 목 통증과 신체기능에 미치는 효과 비교 = A Comparison of The Effects of Manual Therapy Plus Stabilization Exercise with Manual Therapy Alone in Patients with Chronic Mechanical Neck Pain

다국어 초록 (Multilingual Abstract)

PURPOSE: This study aimed to compare the effects of manual therapy with stabilization exercises to manual therapy alone, on neck pain and body functions in patients with chronic mechanical neck pain.
METHODS: Twenty patients with chronic mechanical neck pain were recruited and randomly allocated into two groups. A control group(n = 10) was given the manual therapy alone and an experimental group(n = 10) was given the manual therapy with stabilization exercises. The intervention was carried out 3 days per week for 4 weeks. The cervical resting pain, the most painful motion pain, craniocervical flexor endurance, forward head posture and neck disability index were used to assess participants at baseline and after 4 weeks.
RESULTS: A comparison of the parameters before and after the intervention showed that both groups experienced significant improvements in the resting pain, the most painful motion pain, craniocervical flexor endurance, and forward head posture except for the forward head posture in the control group. A comparison of the parameters between the groups did not show a significant difference.
CONCLUSION: The results of this study suggest that the combined intervention of manual therapy with stabilization exercise does not seem to be more effective than manual therapy alone for improving neck pain, craniocervical flexor endurance, forward head posture, and the neck disability index in patients with chronic mechanical neck pain.

참고문헌 (Reference)

• 1 이남용 ; 송현승 ; 김선엽, "급성 역학적 경부 통증 환자에서 관절가동술 적용 자세가 경부 통증과 기능과 치료 만족도에 미치는 영향" 대한물리의학회 10 (10): 69-80, 2015
• 2 이은우 ; 신원섭 ; 정경심 ; 정이정, "경통 환자 평가를 위한 Neck Disability Index의 신뢰도와 타당도" 한국전문물리치료학회 14 (14): 97-106, 2007
• 3 Jull G, "Whiplash, Headache and Neck Pain: Research-evidenced Directions for Physical Therapies" Churchill Livingstone 2008
• 4 Jesus-Moraleida FR, "Ultrasonographic analysis of the neck flexor muscles in patients with chronic neck pain and changes after cervical spine mobilization" 34 (34): 514-524, 2011
• 5 Krauss JR, "Translatoric spinal manipulation for physical therapists" Lakeview Media LLC 41-58, 2006
• 6 Panjabi MM, "The stabilizing system of the spine. Part II. Neutral zone and instability hypothesis" 5 (5): 390-396, 1992
• 7 Aprill C, "The prevalence of cervical zygapophyseal joint pain. A first approximation" 17 (17): 744-747, 1992
• 8 Schroeder J, "The outcomes of manipulation or mobilization therapy compared with physical therapy or exercise for neck pain: a systematic review" 4 : 30-41, 2013
• 9 Hoy DG, "The epidemiology of neck pain" 24 (24): 783-792, 2010
• 10 Rogers R, "The effects of spinal manipulation on cervical kinesthesia in patients with chronic neck pain: a pilot study" 20 : 80-85, 1997
• 11 Gong W, "The effects of cervical joint manipulation, based on passive motion analysis, on cervical lordosis, forward head posture, and cervical rom in university students with abnormal posture of the cervical spine" 27 (27): 1609-1611, 2015
• 12 Domenech MA, "The deep neck flexor endurance test: Normative data scores in healthy adults" 3 (3): 105-110, 2011
• 13 Fanselow Ms, "The Midbrain Periaqueductal Gray Matter" Plenum Press 151-173, 1991
• 14 Brunton J, "Reliability of measuring natural head posture using the craniovertebral angle" 37-41, 2003
• 15 Harris KD, "Reliability of a measurement of neck flexor muscle endurance" 85 (85): 1349-1355, 2005
• 16 Wagner DR, "Reliability and utility of a visual analog scale for the assessment of acute mountain sickness" 8 (8): 27-31, 2007
• 17 Falla D, "Recruitment of the deep cervical flexor muscles during a postural-correction exercise performed in sitting" 12 (12): 139-143, 2007
• 18 Cleland JA, "Psychometric properties of the neck disability index and numeric pain rating scale in patients with mechanical neck pain" 89 (89): 69-74, 2008
• 19 Albright J, "Philadelphia panel evidence-based clinical practice guidelines on selected rehabilitation interventions for neck pain" 81 (81): 1701-1717, 2001
• 20 Falla DL, "Patients with neck pain demonstrate reduced electromyographic activity of the deep cervical flexor muscles during performance of the craniocervical flexion test" 29 (29): 2108-2114, 2004
• 21 Schmid A, "Paradigm shift in manual therapy? Evidence for a central nervous system component in the response to passive cervical joint mobilisation" 13 (13): 387-396, 2008
• 22 Bovim G, "Neck pain in the general population" 19 (19): 1307-1309, 1994
• 23 Winters JM, "Multiple Muscle Systems: Biomechanics and Movement Organisation" Springer-Verlag 461-480, 1990
• 24 Sahrmann, S, "Movement System Impairment Syndromes of the Extremities, Cervical and Thoracic Spine" Elsevier Health Science 61-100, 2006
• 25 Koltyn KF, "Mechanisms of exercise-induced hypoalgesia" 15 (15): 1294-1304, 2014
• 26 Porterfield JA, "Mechanical Neck Pain:Perspectives in Functional Anatomy" W.B. Saunders Company 1995
• 27 Fredin K, "Manual therapy, exercise therapy or combined treatment in the management of adult neck pain-A systematic review and meta-analysis" 31 : 62-71, 2017
• 28 Miller J, "Manual therapy and exercise for neck pain: A systematic review" 15 (15): 334-354, 2010
• 29 Hing WA, "Manipulation of the cervical spine" 8 (8): 2-9, 2003
• 30 Hurwitz EL, "Manipulation and mobilization of the cervical spine. A systematic review of the literature" 21 (21): 1746-1759, 1996
• 31 Maitland GD, "Maitland’s Vertebral Manipulation" Elsevier Butterworth Heinemann 61-242, 2001
• 32 Harsulkar SG, "Effectiveness of gong’s mobilization in cervical spondylosis: A prospective comparative study" 2 (2): 38-44, 2015
• 33 Sakshi N, "Effect of muscle energy technique and deep neck flexors exercise on pain, disability and forward head posture in patients with chronic neck pain" 8 (8): 43-48, 2014
• 34 Katavich L, "Differential effects of spinal manipulative therapy on acute and chronic muscle spasm: A proposal for mechanisms and efficacy" 3 (3): 132-139, 1998
• 35 Jull GA, "Deep cervical flexor muscle dysfunction in whiplash" 8 (8): 143-154, 2000
• 36 Carroll LJ, "Course and prognostic factors for neck pain in the general population: Results of the bone and joint decade 2000-2010task force on neck pain and its associated disorders" 32 (32): 13-, 2009
• 37 Gross AR, "Conservative management of mechanical neck disorders: A systematic review" 34 (34): 1083-1102, 2007
• 38 Vernon H, "Chronic mechanical neck pain in adults treated by manual therapy: A systematic review of change scores in randomized clinical trials" 30 (30): 215-227, 2007
• 39 Edmondston SJ, "Changes in mechanical load and extensor muscle activity in the cervico thoracic spine induced by sitting posture modification" 54 (54): 179-186, 2011
• 40 Cooper G, "Cervical zygapophysial joint pain maps" 8 (8): 344-353, 2007
• 41 Sterling M, "Cervical mobilisation:Concurrent effects on pain, sympathetic nervous system activity and motor activity" 6 (6): 72-81, 2001
• 42 Wyke B, "Articular neurology and manipulative therapy" Canadian Memorial Chiropractic College 1982
• 43 Dewitte V, "Articular dysfunction patterns in patients with mechanical neck pain: A clinical algorithm to guide specific mobilization and manipulation techniques" 19 (19): 2-9, 2014
• 44 Danna-Dos-Santos A, "Anticipatory control of head posture" 118 (118): 1802-1814, 2007
• 45 Vicenzino B, "An investigation of the interrelationship between manipulative therapyinduced hypoalgesia and sympathoexcitation" 21 (21): 448-453, 1998
• 46 McDonnell MK, "A specific exercise program and modification of postural alignment for treatment of cervicogenic headache: A case report" 35 (35): 3-15, 2005
• 47 Hurwitz EL, "A randomized trial of chiropractic manipulation and mobilization for patients with neck pain: clinical outcomes from the UCLA neck-pain study" 92 (92): 1634-1641, 2002
• 48 Chiu TT, "A randomized controlled trial on the efficacy of exercise for patients with chronic neck pain" 30 (30): E1-E7, 2005
• 49 Danneels L, "A didactical approach for musculoskeletal physiotherapy: The planetary model" 19 (19): 218-224, 2011
• 50 Gross AR, "A Cochrane review of manipulation and mobilization for mechanical neck disorders" 29 (29): 1541-1548, 2004