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RISS 인기검색어
- 검색키워드
- 발행기관 : University of Sydney Faculty of Health Sciences (L (검색결과 1 건)
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이해정 University of Sydney Faculty of Health Sciences (L 2004 해외박사
The aim of this thesis was to identify the physical characteristics of those subjects who experience neck pain but do not seek treatment (sub-clinical neck pain), and to do this using common clinical measurement tools. Although neck pain is common, it is generally benign and self-limiting. This is borne out by the fact that many of those who say they are experiencing neck pain do not seek treatment. The sub-clinical neck pain condition considered in this thesis is important, however, as its characteristics are relevant not only to the design of management programs but also to strategies for prevention of the development of more serious neck pain and disability. Physical impairment was assessed, based on Panjabi’s model for joint stability, with; structural measures (studies 1, and 2), range of motion (ROM) and muscle strength measures (studies 1, 2, 4, and 5), and a proprioceptive sensitivity measure (studies 3, and 4). Data on pain and functional status were collected using pain and disability questionnaires in studies 2, 4, and 5. Study 1 (chapter 3) found decreased neck muscle endurance time, reduced left rotation and extension ranges (sensitization), but greater range (stretch) of retraction at second testing in sub-clinical neck pain subjects compared to asymptomatic subjects. Subjects with no pain and sub-clinical and clinical neck pain groups comprised study 2 (chapter 4) with the finding that on second test, asymptomatic subjects had greater ROM compared with the first test. Conversely, both the subclinical and clinical subjects demonstrated decreased endurance time and lower ROM on the second test. The clinical subjects reported higher affective scores on the Short Form McGill Pain Questionnaire (SFMPQ) and on disability questionnaires compared to the sub-clinical group. A cervicocephalic kinesthetic sensitivity device was developed to test neck proprioceptive sensitivity. Using a protocol derived from classical psychophysical methods, a measure of sensitivity to differences in the extent of neck movements was obtained. The apparatus, which could test ability to discriminate extent differences in each of left/right rotation, flexion/extension and retraction/protraction directions, is described in Chapter 5. In the third study (chapter 6) the apparatus was utilized in the measurement of neck movement discrimination in an asymptomatic sample. Greater sensitivity was observed for neck retraction movements than for either left or right rotation movements. In chapter 7, the process of language and cross-cultural adaptation for a Korean version of three neck pain and disability questionnaires is described and a pilot test is reported on these translated versions of the questionnaires. Korean students who had sub-clinical neck pain or who were asymptomatic were divided into three groups based on their frequency of symptoms in study 4 (chapter 8). More frequent sufferers were found to score higher on the SFMPQ and three disability questionnaires while ROM was once again found to be lower on second test in subclinical pain subjects, this group was found to have greater sensitivity to rotation extent of movement. In the last study (chapter 9), a relationship between the location of sub-clinical neck pain, as indicated on pain drawings, and two physical impairments was observed. Rotation away from the painful side was significantly reduced on second testing while neck muscle endurance time was decreased in all pain location groups compared to the group with no pain. Even though it is not clear whether the changes observed in these studies are a cause of or an effect of neck pain, early management of neck muscle dysfunction focusing on strength and flexibility but not proprioception may be suggested as logical interventions at the sub-clinical neck pain stage, when the goal is preventing development of more severe or on-going neck pain.
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