목 통증 환자에 운동치료 시 물리치료사의 구두적 및 수동적 자세교정 방법과 자가 운동에 따른 통증, 기능장애, 심리사회적 수준에 미치는 영향 비교: 사전 연구
A Pilot Study Comparing the Effects of Verbal and Manual Postural Correction by Physical Therapists and Self-Exercise on Pain, Disability, and Psychosocial Factors in Patients with Neck Pain
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Background: Forward head posture, present in approximately 60% of individuals with neck pain, is commonly associated with muscular imbalances, including weakness of the deep neck flexors and overactivity of the cervical extensors and superficial neck flexors, which may compromise cervical spine stability. This pilot study compared therapist-guided postural correction (using manual or verbal cues) with self-directed exercise on pain, disability, cervical alignment, and psychosocial outcomes in individuals with neck pain. Methods: Twenty-one participants with neck pain were randomly assigned to one of three groups (n=7, each): manual guidance (MG), verbal guidance (VG), or self-exercise (SE). All participants completed 12 intervention sessions over four weeks (three sessions per week). Outcomes were assessed pre- and post-intervention using the numeric rating scale for pain, the Korean neck disability index, craniovertebral angle for postural assessment, and the 12-Item short form health survey (SF-12) for psychosocial status. Results: All three groups showed significant improvements in pain and functional disability after the intervention (p<.05). However, CVA significantly improved only in the MG and VG groups, both pre- and post-intervention (p<.05). Additionally, the degree of change in these variables differed significantly among the groups (p<.05), with the MG group showing significantly greater improvements than the SE group (p<.05). Conclusion: All interventions were effective in reducing pain and improving physical function. However, therapist-led exercise relieves pain and improves function, and postural correction—particularly with manual guidance—was associated with a greater tendency toward cervical alignment improvement. These results suggest that professional involvement in postural retraining may provide additional benefits for individuals with neck pain.
Abstract
Background: Forward head posture, present in approximately 60% of individuals with neck pain, is commonly associated with muscular imbalances, including weakness of the deep neck flexors and overactivity of the cervical extensors and superficial neck flexors, which may compromise cervical spine stability. This pilot study compared therapist-guided postural correction (using manual or verbal cues) with self-directed exercise on pain, disability, cervical alignment, and psychosocial outcomes in individuals with neck pain. Methods: Twenty-one participants with neck pain were randomly assigned to one of three groups (n=7, each): manual guidance (MG), verbal guidance (VG), or self-exercise (SE). All participants completed 12 intervention sessions over four weeks (three sessions per week). Outcomes were assessed pre- and post-intervention using the numeric rating scale for pain, the Korean neck disability index, craniovertebral angle for postural assessment, and the 12-Item short form health survey (SF-12) for psychosocial status. Results: All three groups showed significant improvements in pain and functional disability after the intervention (p<.05). However, CVA significantly improved only in the MG and VG groups, both pre- and post-intervention (p<.05). Additionally, the degree of change in these variables differed significantly among the groups (p<.05), with the MG group showing significantly greater improvements than the SE group (p<.05). Conclusion: All interventions were effective in reducing pain and improving physical function. However, therapist-led exercise relieves pain and improves function, and postural correction—particularly with manual guidance—was associated with a greater tendency toward cervical alignment improvement. These results suggest that professional involvement in postural retraining may provide additional benefits for individuals with neck pain.