Earticle

Purpose: McKenzie is a widely-used and conventional clinical therapeutic exercise for patients with mechanical lower back pain. It is a well-designed assessment and classification system for the spine. Main issue: Patients with mechanical lower back pain are classified into one of three mechanical syndromes (posture, dysfunction, or derangement syndrome) by mechanical loading strategies. These methods evaluate symptomatic and mechanical responses during repeated end-range movement and sustained postures. The goal of McKenzie mechanical syndrome diagnosis is to determine directional preferences. Directional preference is a phenomenon of preference for posture or movement in one direction, which reduces or centralizes pain. However, in Korea, there is a lack of awareness of basic McKenzie mechanical syndromes diagnostic concepts. Koreans tend to think of the McKenzie method as a simple lumbar extension exercise. However, an accurate diagnosis of a mechanical syndrome must precede the application of McKenzie exercise. Conclusions: Thus, in this study, I present a classification method of McKenzie mechanical syndrome diagnosis and clinical characteristics of each mechanical syndrome.

Purpose: The purpose of this study was to observe the effects of sport massage and McKenzie stretch exercise on forward head posture. To understand the effect, this study measured and analyzed body alignment of the neck. Methods: In this study, a total of 14 subjects with forward head posture were analyzed. Subjects were divided into two groups: group 1 (n=7) received a McKenzie stretch exercise and group 2 (n=7) received a McKenzie stretch exercise and a sport massage. The McKenzie stretch exercise was performed three times a week, for four weeks, while the sport massage was performed once a week. The body alignment of the neck (CVA, CRA) was measured using a goniometer. Results: The improvements in neck body alignments (CVA, CRA) after the McKenzie stretch exercise and sport massage were both significant (group 1: p<0.05; group 2: p<0.05), whereas the between-group comparison found no significant differences. Conclusions: In conclusion, our study confirmed that the McKenzie stretch exercise and sport massage had a significant positive effect on the body alignment of the neck. However, a study that included a greater number of subjects and a long-term treatment period is needed to generalize these results.

Prolonged sitting is a high-risk factor for chronic neck pain. McKenzie exercises are commonly used in clinics. Mobile app-based care is increasingly popular, and providesaccess to health information. This study examined the effect of mobile app-based McKenzie exercise on pain intensity, functional disability, exercise adherence, fear avoidance, and quality of life. Twenty graduate students participated in the study to completion. Neck exercise was performed as directed by the mobile app in the workplace environment for at least 10 min/day, 3 days/week for 8 weeks. The Visual Analog Scale (VAS) score for pain intensity, the Neck Disability Index (NDI) for functional disability, the level of exercise adherence, the Fear-Avoidance Belief Questionnaire (FABQ), and the 36-Item Short-Form Health Survey (SF-36) for the quality of life were used to evaluate outcomes. After an 8-week intervention, the VAS (p < .001) and NDI(p < .001) scores were significantly improved with app-based neck exercise. The work-related subscale (p = 0.023) in the FABQ and physical component summary (p < .001) of the SF-36 showed significant improvement in psychological and physical health. The exercise adherence rate was 87.5 %. In conclusion, this study showed that app-based neck exercise can reduce pain intensity and functional disability.

Objective: This study examined the effects of McKenzie & Williams exercise and pelvic floor muscle exercise after applying conservative physical therapy to chronic low back pain patients. The patients were evaluated for their pain intensity, muscle strength, and muscle endurance. Method: Sixty-eight outpatients were divided into a McKenzie & Williams exercise group and a pelvic floor muscle exercise group. Each group performed its own exercise 30 minutes per day, three times per week, for 8 weeks. Pain intensity was measured by the McGill Pain Questionnaire and the Oswestry Disability Index. Muscle strength and endurance were also measured. Measurements were made at baseline, and again at four weeks and eight weeks after the intervention. Results: The McGill Pain Questionnaire scores, Oswestry Disability Index scores, muscle strength, and muscle endurance for each group showed significant changes at baseline, and at four and eight weeks after the intervention (p<.05). Significant differences were also evident between the two groups for these four measurements (p<.05). Conclusion: Pelvic floor muscle exercise is more effective than McKenzie & Williams exercise for reducing pain intensity and increasing muscle strength and endurance in chronic low back pain patients.

Background: Many people are suffering from neck and shoulder pain due to muscle weakness, muscle fatigue, lack of exercise and accidents during exercise. In this study we compared the effects of McKenzie method and Mulligan technique method. Method: we randomly selected men(10) and women(10) and they are the 20s students of Busan material K college. We divided for McKenzie exercise group and Mulligan exercise group. McKenzie exercise and mulligan exercise applied cervical area three times a week for three weeks. We compared with pre-experiment and after 1∼3 week through measuring the electromyography (EMG) change and neck range of motion (ROM). Results: The changes in the EMG at each exercise group, there was a statistically significant difference in each week. Although there was a significant difference after 1 week between the exercise group, the changes in the neck ROM at each exercise group there was no statistically significant difference. Conclusion: After experiment, EMG and neck ROM were increased in McKenzie exercise group and Mulligan exercise group. But Mulligan exercise group showed the change better than McKenzie exercise group in early stage. We suggest the Mulligan exercise method for recovering in early stage of neck ROM.

Background: Neck pain is recognized as one of the common and important musculoskeletal disorders in modern society. There are many studies proving that manual therapy is one of the effective treatment methods for treating neck pain. This study compared the treatment effects of the Mulligan technique and the McKenzie technique which are widely used in clinical practice to treat neck pain, through changes in neck pain and range of motion. Methods: Forty-five sub-acute patients with mechanical neck pain were randomly divided into groups as Mulligan technique group (n=22) and McKenzie technique group (n=23). The two groups were treated 8 times for 4 weeks. The participants in both groups received home exercise program. Pain (Visual Analog Scale) and range of motion were measured before and after the treatment program. Results: In both group, the pain intensity and range of motion in all direction improved significantly (p<.001). The Mulligan technique was superior to the McKenzie technique in neck extension, lateral flexion, and rotation (p<.01), but there was no difference in neck flexion and pain intensity. Conclusion: Both the Mulligan technique and McKenzie technique were effective on neck pain and ROM in patients with mechanical neck pain. The Mulligan technique is more useful than the McKenzie technique to improve neck extension, lateral flexion, and rotation.

본 연구의 목적은 거북목을 가진 사람에게 메켄지 폄운동과 어깨안정화운동이 앞쪽머리자세에 미치는 영향에 대 해 알아보는 것이다. 연구대상자는 30명의 거북목을 가진 평범하고 건강한 사람들로 이루어져 있다. 대상자는 어깨안정 화운동과 메켄지 폄운동으로 나누어(인원=30, 남자 15명, 여자 15명) 무작위로 나누어 6주 동안 실시되었다. 본 연구는 마름근, 아래등세모근의 운동프로그램과 깊은목굽힘근, 위등세모근, 어깨올림근의 신장프로그램을 통한 목뼈의 머리척추 각(Cervical Vertebra Angle) 값과 각 근육별 근전도의 차이를 알아보았다. 앞쪽머리자세와 경우에는 목과 등근육의 활 성도가 감소하고 피로도는 증가함을 보였다. 이러한 결과는 목과 머리의 불안정한 상태를 안정시키기 위해서는 위등세 모근, 깊은목굽힘근, 어깨올림근의 신장과 마름근, 아래등세모근의 운동을 통해 거북목의 개선에 긍정적인 변화를 줄 것 으로 보인다. 이러한 근육들의 불균형한 수축과 과도한 긴장으로 근육의 경직과 피로가 누적되며 이러한 상태가 계속 유지되게 되면 만성화상태가 되어 근육의 불균형으로 인해 통증을 유발할 수 있으며, 피로의 누적으로 인하여 자극에 대한 반응과 근력을 약화시켜서 목 디스크가 발생할 확률이 높아질 것으로 사료된다.

The purpose of this study was to investigate the effects of cervical vertebral height and shoulder stabilization on anterior head posture in people with turtle neck. The subjects of this study consisted of normal and healthy people with 30 turtle necks. Subjects were randomly assigned to shoulder stabilization exercise and cervical vertebrae exercise (30 men, 15 men and 15 women, height: 168.67 ± 6.51, 22.33 ± 8.27, 65.03 ± 11.98, and 28.66 ± 1.91), In the experimental group, shoulder stabilization exercise and cervical spine exercise were performed for 4 weeks. Deep neck flexor, leavator scapular, upper trapezius, rhomboid, and lower trapezius showed significant differences in shoulder stabilization and cervical vertebrae before and after the experiment. As a result, the CVA value decreased significantly and the muscle activity value increased significantly when exercise and Mckenzie program were applied. These results show that exercise and Mckenzie programs have a positive effect on turtle neck improvement.

Background: To determine the correlation Between forward head posture and plantar pressor in a McKenzie Exercise. Methods: This study had a cross-sectional design. There are included 20 participants with forward head posture. We measured the craniovertebral angle (CVA), cranial rotation angle (CRA) by image obtained digital camera and the plantar pressure, static balance using Gait Analyzer each before and after McKenzie Exercise. Results: There was negative correlation between CVA and CRA (p<.05). There was negative correlation between CVA and fore foot(p<.05). There was positive correlation between CRA and both fore foot (p<.05). There was negative correlation between CVA and static balance(p<.05). There was positive correlation between CRA and static balance (p<.05). Conclusions: There is a correlation between the change a mount of forward head position and plantar pressure in the McKenzie Exercise.

Background: This study investigated the effects of face-to-face and non-face-to-face McKenzie exercises and elastic band strengthening exercises on falls and fitness in older adults. Methods: A total of 44 subjects were divided into a face-to-face group (FG; n=22) and a non-face-to-face group (NFG; n=22) who met older adults. Both groups used McKenzie exercises and strength training with elastic bands The fall efficacy scale (K-FES) and glycosylated hemoglobin (HbA1c) Pro were used to compare the senior fitness test (SFT). Results: No significant differences were detected between the two groups before the intervention; however, a significant difference was noted in the K-FES scores after the intervention. The change in HbA1c after the intervention was not statistically significant in the FG or the NFG, and no significant difference was detected between the two groups. The change in lower limb muscle strength in the elderly physical fitness test showed no significant difference between the two groups before or after the intervention. The change in upper limb flexibility after the intervention was not significantly different in the FG or NFG, indicating no significant difference between the two groups. The change in the 3-meter round-trip test after the intervention was significantly different in both the FG and NFG groups, but the difference between the groups was not statistically significant. The change in the grip strength test of the dominant hand showed no significant difference after the intervention in the FG or the NFG, and the difference between the FG and NFG groups was not statistically significant. The dominant foot external standing after the intervention was significantly improved in the FG, but no significant difference was detected in the NFG, and the difference between the two groups was not statistically significant. Conclusion: The study findings revealed that FG and NFG McKenzie exercises and elastic band strengthen exercises were equally effective at preventing falls and improving fitness in older adults.

Objectives : We evaluated the effect of Mckenzie method treatment by participating two patients suffering from Tortipelvis by lumbar disc herniation. Methods : Two patients were diagnosed as Tortipelvis by lumbar disc herniation through CT scan and X-ray examination. We used Mckenzie method and measured VAS(Visual analogue scale). Results and Conclusions : After using Mckenzie method treatment, We found out a recovery from both patients suffering from Tortipelvis by lumbar disc herniation. The result, through our study, suggests that Mckenzie method treatment was effective to cure the Tortipelvis by lumbar disc herniation. It also was effective to reduce the low back pain and to stabilize the lumbar disc herniation.

동학은 서학(가톨릭)을 반대하여 창립되었고 기독교(프로테스탄트)에 대해서도 반대하였다. 동학교도들은 교조신원운동을 진행하면서 척왜양(斥倭洋)의 기치를 들어 서양종교에 대한 반대 입장을 분명히 하였다. 그러나 양자는 직접적인 충돌을 일으킨 적은 거의 없다. 동학군이 외세를 배격했기 때문에 서양인은 봉기의 현장을 회피하였다. 그런데 황해도 동학농민군 속에서 7개월을 머물며 견뎌낸 기독교 선교사가 있었다. 캐나다 출신의 매켄지가 바로 그 사람이다. 그는 동학농민군과 소통하면서 기독교와 동학이 하나님의 개념이나 교리의 측면에서 유사한 점이 적지 않다는 사실을 발견하였다. 동학농민군 중에도 신약성경을 가지고 다니며 깊은 이해에 도달한 자가 없지 않았다. 매켄지도 동학경전을 구하여 동학의 교리를 탐구하였다. 양자의 유사성은 개종의 유리한 조건이 되었다. 황해도 동학농민군은 외세의 축출, 체제의 개혁을 위해 봉기하였고, 매켄지는 조선선교의 사명을 지고 입국하였다. 두 주체는 상이한 목표와 방향성을 지닌 콘텍스트 속에 놓여 있다가 1894년 가을 황해도 장연지방이라는 시공간에서 조우하였다. 양자는 타자를 자기의 콘텍스트로 편입시켜야 할 대상으로 간주하였지만, 이때의 접촉과 소통은 이후 민족적 위기 속에서 두 종교간 연대의 가능성을 내재하였다.

The Tonghak [Eastern Learning] was founded opposing the western learning, especially the Catholic belief, and it also criticized Christianity, protestant churches. While Tonghak followers requested the rehabilitation of their founder and sought the expulsion of foreigners, they made clear the anti-western stance. However, there was no direct confrontation between those two forces because westerners, fear of anti-western movements, avoided the confrontational spots. Interestingly, there was a Christian missionary who spent seven months among the Tonghak peasant army. The missionary was William J. McKenzie who came from Canada. He found that Christianity and the Tonghak have some common grounds in terms of the concept of God and religious doctrines. Even he noticed that some persons among the Tonghak peasant army arrived at the deep understanding of Christian doctrines while carrying the New Testament Bible. McKenzie also sought and studied the Tonghak canons. The similarity between two belief systems provided the favorable conditions for religious conversion. The Tonghak peasant army arose for the eviction of foreign forces and for the regime reform while Christian missionaries like McKenzie came to Korea for Christian mission. Two forces had very different aims and purposes and met each other in Changy?n Country, Hwanghae province in fall 1894. Two parties considered each other to be absorbed into each circle. However, their encounter and communication implied the possible communality between two religions in the context of Korean national crisis.

Objective: The aim of this study was to compare sling exercise group to McKenzie exercise group in patients with chronic neck pain. Design: Two group pretest-posttest design. Methods: Twenty subjects who have chronic neck pain were randomly divided into sling exercise group (n=10) and McKenzie exercise (n=10). Sling exercise group (n=10) received sling exercise for 30 minutes per day, twice a week over a 4 week period. And the other group were exercised McKenzie exercise (n=8) for 30 minutes per day, twice a week over a 4 week period. Neck disability index (NDI), Visual analog scale (VAS), algometer, digital manual muscle tester (MMT) and cervical muscle strength and cervical range of motion (ROM) are closely measured to identify the effect of sling exercise and McKenzie exercise. Results: For NDI, VAS, algometer on both trapezius, both rotation of cervical muscle strength, both lateral flexion of cervical muscle strength, cervical extension of ROM and both lateral flexion of ROM were significantly increased after intervention in sling exercise group (p<0.05), For VAS, algometer on both trapezius, left (Lt.) rotation of cervical muscle strength, Lt. lateral flexion of cervical muscle strength, cervical flexion and extension of ROM and Lt. lateral flexion of ROM were significantly increased after than before intervention in McKenzie exercise group (p<0.05). Conclusions: These study outcomes clearly support the notion that sling and McKenzie exercise improved pain, Muscle strength and ROM of patients with chronic neck pain. These results suggest that sling and McKenzie exercise program is suitable for chronic neck pain.

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.

PURPOSE: The aim of this study was to determine the effect of device considering Mckenzie type for the subjects with forward head posture (FHP). METHODS: The subjects were 35 patients with FHP (mean age was $23.7{\pm}2.8$ years; mean height; $172.1{\pm}11.7$, mean weight; $65.8{\pm}13.9$, mean NDI(Neck Disability Index; $3.7{\pm}3.2$, mean FHP; $6.7{\pm}2.2$). We measured the posture with the Body style S-8.0(LU Commerce, South Korea) to evaluate the FHP. We collected the surface EMG(Myosystem 1400, Noraxon, USA) data to quantify changes in normalized activation levels of muscles in SternoCleidoMastoid muscle(SCM), Scalenus Anterior(SA), Trapezius upper fiber(TU) and Splenius Cervicis(SC), during the subjects were instructed to glide their head into a "chin-in" position for a retraction without and with device. RESULTS: The condition with device significantly decreased the %RVC of SA($90.84{\pm}40.54$), SCM($74.98{\pm}43.65$) and TU($67.60{\pm}47.83$) compared to the condition without device(SA;$100.39{\pm}56.32$, SCM;$119.03{\pm}109.26$, Trapezius;$80.55{\pm}39.27$). But the %RVC of capitis($65.87{\pm}47.83$) with device was increased($70.82{\pm}52.78$). There was significant difference in the %RVC between SCM and Trapezius muscle in two conditions. CONCLUSION: New device for FHP reduces the EMG activities of the TU, SCM and SA muscle. We have to develop the function of feedback to facilitate the motion in the future.

Background: This study was to confirm the positive effect of McKenzie exercise group and Diaphragmatic breathing exercise group on CVA and pulmonary function improvement in adults in their 20s with forward head posture in modern society where computers and cell phones are mainly used. Design: Randomized Controlled Trial. Methods: Twenty-four study participants were randomly divided into a McKenzie exercise group and a Diaphragmatic breathing exercise group. Subjects were selected as adults in their 20s with forward head posture and those with cranial vertebral angles of 31 to 59 degrees. The each group exercised for a total of 18 times for six weeks. Results: Although improvements were shown in the each groups before and after each group of exercise comparisons, FVC showed significant differences only in the Mackenzie exercise group(p<0.05). there was no significant difference in dependent variables in between-group comparisons(p>0.05). Conclusion: After 6 weeks of exercise, improvement of pulmonary function and CVA were observed in both exercise groups. If the study is conducted by supplementing the limitations in the future through this study, more results on respiratory function and CVA are expected.

본 연구는 일자목이 있는 성인을 대상으로 멀리건기법과 맥켄지 운동 중 목 통증과 관절가동범위에어떤 운동이 더 효과적인지 알아보고자 하였다. 일자목이 있는 성인 26명이 본 연구에 참여하였으며, 멀리건 집단과 맥켄지 집단으로 13명씩 무작위 배정되었다. 멀리건 집단은 목의 굽힘, 폄, 왼쪽 굽힘, 오른쪽 굽힘, 왼쪽 돌림, 오른쪽 돌림에 대한 지속인 자연스러운 척추 유동술을 수행하였고, 맥켄지 집단은목의 6가지 움직임을 유지하는 운동을 수행하였다. 두 집단은 12주간, 주 3회, 회당 30분 동안 운동을수행하였다. 결과측정은 통증강도를 평가하기 위하여시각상사척도와 목 장애지수를 사용하였으며, 목의관절가동범위를 측정하기 위하여 목 관절가동범위측정기를 사용하여 평가하였다. 연구결과, 멀리건 집단은 중재 전과 후로 통증강도, 목의 폄, 왼쪽 굽힘, 오른쪽 굽힘, 목 장애지수에서 유의한 향상을 보였다(p<.05). 맥켄지 집단은 중재 전과 후로 통증강도, 좌측 회전, 목 장애지수에서 유의한 향상을 보였다(p<.05). 두 집단 간 변화량 비교에서 멀리건 집단은맥켄지 집단보다 목의 폄과 왼쪽 굽힘, 오른쪽 굽힘에서 유의하게 더 큰 향상을 보였다(p<.05). 본 연구의 결과는 일자목이 있는 성인에게 멀리건 기법이맥켄지 운동보다 목의 관절가동범위 향상에 더 효과적인 중재방법이 될 수 있음을 시사한다.

The purpose of this study was to investigate the effect of exercise on the neck pain and range of motion of the Mulligan and McKenzie exercise in adults with reduced cervical lordosis. 26 adults with reduced cervical lordosis participated in this study. All subjects were randomly assigned to the McKenzie group(n=13) and Mulligan group(n=13). The Mulligan group performed cervical flexion, extension, left and right side bending, rotation for sustained natural apophygeal glides and the McKenzie group performed for 6 types of cervical exercise. The both groups performed the exercise for 12 weeks, 3 times a week, 30 mins per sessions. The range of motion of cervical were assessed using cervical of range motion instrument, visual analog scale and neck disability index(NDI) for pain intensity. The Mulligan group showed a significant improvements in pain intensity, neck extension, left lateral flexion, right lateral flexion, and NDI before and after intervention(p<.05). The McKenzie group showed a significant improvements in pain intensity, left rotation, and NDI before and after intervention(p<.05). The Mulligan group showed a significantly greater improvement in neck extension, left lateral flexion and right lateral flexion than the McKenzie group(p<.05). The results of this study suggest that the Mulligan exercise in adults with reduced cervical lordosis can be a more effective intervention for improving the range of motion of cervical than McKenzie exercise.

Purpose : The purpose of this study was to examine the effect of therapeutic massage and Mckenzie exercise on pain and range of motion in chronic neck pain patient: a case study. Method : A Twenty-year old female subject with chronic neck pain was selected, she received therapeutic massage and Mckenzie exercise for 30 minutes a day, three days a week for five weeks. Pain was measured visual analog scale(VAS), neck disability index(NDI) and the Copenhagen neck functional disability scale (CNFDS). Range of motion was measured using a goniometer(shoulder joint) and the CROM Deluxe(cervical range of motion instrument). Result : VAS, NDI and CNFDS were decreased 3 score, 4 score and 6 score(respectively) than before the training. The range of motion was increased in shoulder joint and neck movement than before the training. Conclusion : The massage and Mckenzie exercise increased range of motion in shoulder joint and neck movement, and decreased neck pain in chronic neck pain patient. Additional research on therapeutic massage and Mckenzie exercise for improving pain and range of motion is need.