1)

Effect of Stretching Exercise on

Cervical ROM in Elderly

Ho-young Jeon, PT, MS, Sang-yeol Lee, PT, MS*, Sung-soo Bae, PT, PhD1
Geon-cheol Lee, PT, PhD, Chel Jang, PT, MS2

Major in Physical Therapy, Department, of Rehabilitation Science, Graduate School, Daegu University,
1
Department of Physical Therapy College of Rehabilitation Science, Daegu University,
2
Kyungnam College of Information and Technology

노인환자의 스트레칭 운동이 목 가동범위에 미치는 영향

1 2
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<Abstract>
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방법 ,
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결과 4 , , , , .
결론
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핵심단어 , ,

. INTRODUCTION rate of the elderly is estimated to double up to

14.4% and Korea will enter the aged society.
As of year 2000, Korea has become the aging (National Satistical Office, 2001).
society since the number of people aged over 65 in Aging in general refers to the physical imbalance
Korea is now approximately 3.37 million which is and gradual resistance of the body structure and
over 7.1% of the whole population. In 2019, the function that makes it difficult to adopt to the

, E-mail: sjslh486@hanmail.net
2008 11 17 / 2008 11 30 / 2008 12 1
internal and external environment(Bae, et al., 1996). (Lee & Jo, 2005).
As aging process advances, not only all the For elderlies, stretching not only increases the
functions but also the range of motion decreases as flexibility but also relieves the tension in the
well(Kim & Shim, 1996; Engsberg, et al., 1993). muscles and prevents muscles from adhering too
Among those aging people, the number of people much. In addition, it expedites blood circulation and
with neck pain is now increasing and neck pain is respiratory functions and improves environment
becoming a problem as serious as the back adaptability(Park & Park, 2004).
pain(Park, 2000). Therefore, the purpose of this study is to
If neck pain is not properly treated when it is properly and safely adopt cervical motion using the
limited only in the neck area, it spreads to the stretching exercises to the elderly patients with neck
lower parts such as back, arms and even fingers. pain and identify the changes in cervical angle and
Or, it causes pain in upper part of the neck such pain before and after the treatment.
as pain in the back of the head, migraine, dizziness
and tinnitus(Lee, 1999). Therefore, many scholars
. METHODS
recommend low-intensity stretching that is interesting
and easy to do in order for the elderly to prevent
1. Subject
their joints from declining and maintain their
flexibility and strength of their joints to a certain The subjects of this study are twenty patients
level(Kim et al., 1995; Chappelear, et al., 1985). with myofascial pain syndrom who are in their 70s
Stretching activities are effective for musculoskeletal and 80s and went through the physical therapy
system disorders since it increases the coordination sessions from March 2008 to May 2008 in 'H'
between the nerve muscles and reduces the pain in hospital located in Namhaegun, Kyeongsangnamdo.
the muscles that are overused(Sun & Park 1997). Average age of 20 volunteers(10 male, 10 female)
The fundamental principle of stretching is to is 73.30±6.38.
expand the muscles more than the normal status by The subjects were neck pain patients in the
extending the length and it should be extended subacute stage without other ailments such as
more than 10% compared to the natural length in herniated intervertebral disc, spondyloarthropathies
order to improve the flexibility. When moving the and past surgical operations. The subjects were able
fingers, actual resistance of the tissues can be felt to fully understand the directions from the researcher
while superficial tissues are adhered to the deep and provide full cooperation.
tissues and this is how mobility of the tissues in
the area is increased(Park & Park, 2005; Bae, et
2. Method of experiment
al., 2002; Kim & Kim, 2002).
Static stretching which is the most-generally used They were classified randomly and treated three
method among all the stretching methods is to times a week with 15 minutes of hot pack, 10
gradually and slowly extend the muscles and joints minutes of ultrasonic waves and ten minutes of
to the maximum and stay at that point for about transcutaneous electrical nerve stimulation and
five to ten seconds. It is also called ‘Slow stretch’ stretching activities. The ultrasonic wave treatment
and it has been used for a long period of time. It was provided as 1MHz, 1.5W/ 12 times in 4
is known to be effective in increasing the flexibility weeks. The part treated was the trapezius muscle.
 Effect of stretching exercise on cervical ROM in elderly

Before measuring the angle, they were told to do (p<.05)<Table 1>.

a light exercise that will not affect the results. They
were also told to mark on the visual analogue 2. The change of the cervical flexion, cervical
scale: VAS every time they are measured for pain extension, left rotation, right rotation range
evaluation. of motion
The maximum scale was 10 and minimum was 0.
In terms of the changes in the flexion along
with the period of stretching treatment, the average
3. Data Analysis
and standard deviation was 54.35±5.35 and changed
SPSS(12.0 for Window) was used for the to 55.59±4.62 after four weeks of treatment which
analysis and t-test was used as the statistic analysis showed significant difference(p<.05). In terms of the
to identify the changes in neck pain and cervical changes in the extension along with the period of
angle after four weeks of stretching treatment. stretching treatment, the average and standard
deviation was 61.45±6.28 and changed to 62.52±5.84
after four weeks of treatment which showed
. RESULT
significant difference(p<.05).
In terms of the changes in the Left Rotation
1. The change of the pain
along with the period of stretching treatment, the
In terms of the changes in the pain along with average and standard deviation was 66.89±5.15 and
the period of stretching treatment, the average and changed to 67.64±4.95 after four weeks of treatment
standard deviation was 6.05±1.64 and changed to which showed significant difference(p<.05). In terms
3.25±1.92 after four weeks of treatment which of the changes in the right rotation along with the
showed significant difference. The average difference period of stretching treatment, the average and
between before and after the treatment was(p<.00) standard deviation was 66.50±4.72 and changed to
and it also showed statistically significant difference 67.35±4.48 after four weeks of treatment which showed
significant difference(p<.05) <Table 2> <Fig. 1>.
Table 1. The change of the pain

VAS scale (mean±SE) t p

. DISCUSSIONS
Pre 6.05±1.64
7.34 .00*
Post 3.25±1.92 The positive effects of stretching can be
p<0.5 understood in the same context with many studies

Table 2. The change of the cervical flexion, cervical extension, left rotation, right rotation range of motion
(Unit : °)
Motion pre-range (mean±SE) post-range (mean±SE) t p
Flexion 54.35±5.35 55.59±4.62 -2.85 .010*
Extension 61.45±6.28 62.52±5.84 -4.12 .001*
Left Rotation 66.89±5.15 67.64±4.95 -3.55 .002*
Right rotation 66.50±4.72 67.35±4.48 -4.20 .000*
p<.05
 Fig 1. The change of the cervical flexion, cervical extension, left rotation, right rotation range of motion

(Worrel, et al, 1994; Godges, et al, 1993) on the joints while reducing the muscle tone and adhesion,
accidental training effective in muscle functions, expedites blood circulation, improves environment
range of motion and performance of the elite adaptability and increases range of motion. Regular
athletes. and low-intensity stretching exercises are being
Oddis(1996), Krug, et al.(1994) recommended recommended(Chappelear & Landin, 1985).
stretching as the exercise to increase the range of Anderson(1990) mentioned that stretching is very
motion and as the method to prevent arthritis. effective in increasing the range of motion, relaxing
In this study, among the twenty patients in their both mentally and physically and preventing
70s and 80s with myofascial pain syndrom, ten of damages such as rupture of the muscles. He also
them were males and ten were females which had pointed out that stretching has advantage of helping
no significant statistically difference by the gender. the body coordination, improving the perception,
In this study, an experiment was conducted to expediting blood circulation and increasing the
examine the effects of stretching. The pain and flexibility.
range of motion was measured before and after the The results of the comparison in flection, extension,
four weeks of treatment. left turn and right turn after the treatment are as
As a result, level of pain was 6.05±1.64 before follow. The flection was 54.35±5.35 before the
the treatment and 3.25±1.92 after the treatment treatment and changed to 55.59±4.62 after four
which showed statistically significant reduction. weeks. The extension was 61.45±6.28 before the
In the studies done by Revel, et al(1994) and treatment and changed to 62.52±5.84 after four
Kim(2003), the group treated with sports therapy weeks. The left turn was 66.89±5.15 before the
had significant improvement in the pain. This study treatment and changed to 67.64±4.95 after four
showed similar results. weeks. The right turn was 66.50±4.72 before the
Stretching increases the strength and flexibility of treatment and changed to 67.35±4.48 after four
 Effect of stretching exercise on cervical ROM in elderly

weeks. All of those showed significant difference. Bae SS, Choi JW, Lee KH, et al. Diagnosis and
In the biomechanic aspect, stretching changes the Treatment of Connective Tissue Massage. The
characteristics of viscoelasticity in the muscle fibers Journal of Korean Society of Physical Therapy.
and increases the body flexibility by changing the 2002;14(4):231-9.
length of the fibers. It reduces the damage in Burkner P, Khan K. Clinical Sports Medicine. Mc
skeltal muscles and relieves the anxiety and depression Graw-Hill Book Company. 1993.
for those suffering from the pain. Therefore, Chappelear J, Lindin RJ, Linnemeier TJ, et al.
stretching is recommended during the rest time in Exercise testingand training of the elderly patient.
work(Ku, et al, 2003) since it satisfies psychological Cardiiovasc Clinic. 1985;15 (20);201-18.
needs and provides stability (Nicolakis, et al, 2002). Engsberg JR, Grimstom SK, Hanley DA, et al.
Toilson and Michael(1998) mentioned that exercise Differences in ankle joint complex range of
can have indirect effects as well by reducing the motion as a function of age, The Foot AnKle,
stress, chronic muscle pains that patients had before. May, 1993;14(4):215-22.
This results were as same as the study done by Godges, JJ, Macrae, PG, Engelke KA. Effects of
Burkner and Khan(1993) that stretching therapy was exercise on hip range of motion,trunk muscle
effective in increasing the range of motion. performance, and gait economy. Pysical Therapy.
By the results of this study, it is confirmed that 1993;73:468-77.
stretching is effective in increasing the range of Kim, HJ. The Effects of Joint Mobilization on Neck
motion and reducing the pain for patients with Pain. Daegu University. Graduate School of
myofascial pain syndrom. Therefore, the therapists Rehabilitation Science. 2003.
should develop various techniques by making the Krug HE, Mahowald ML, Yetterberg SR. Exercise
best efforts and learning the patterns in order to for arthritis. BalllieresClinical Rheumatoid. 1994;
have the maximum effects for the patients. Feb,8(1):161-89.
Hwang JY, Shim DW, Kim WS. Measurement on

. CONCLUSION the sargent jump of Decade in korea. The Korean

society of sports medicine. 1996;14(1):208-15.
The present research investigated 20 patients with Kim JI. 30 Days method by stretching diet. Ilsong-
neck myofascial syndrome, dividing them into a media. 2002.
doing of stretching. This study examined degree of Kim JT. Power up stretching diet by photo. Seoul;
recovery from neck pain by comparing their neck Samhomedia. 2002.
myofascial pain syndrome before and after the Kim MH, Kim YS, Kim EH, et al. An exercise
treatment, and compared to find difference in the program to improve fitness and health of the
degree of recovery from myofascial pain syndrome. elder. report on athletics and science research.
1995;1-45.
Lee HH. The effects of Evjenth-Hamberg stretching
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