Outcome measures
depression, shoulder girdle, flexion, external rotation, pain
ADVERSE EVENTS, CERVICAL SPONDYLOSIS, SHOULDER ARTHRITIS
This study assessed both subjective and objective symptoms associated with neck and shoulder discomfort.Subjective symptoms were assessed using the visual analog scale (VAS), which consists of a 10-cm horizontal straight line with 0 at one end and 10 at the other end. The VAS defined 0 as no pain, no discomfort, and no difficulty in moving and 10 as the maximum imaginable pain, maximum imaginable discomfort, and maximum imaginable difficulty in moving based on pain, discomfort, and difficulty in moving, respectively. Participants rated their condition on the day of testing by marking a vertical line.As an objective measure, joint ROM was assessed using a digital goniometer (easyangle, Ito Co., Ltd., Tokyo, Japan) for the cervical joint (flexion, extension, lateral flexion, and rotation), shoulder joint (flexion, external rotation, internal rotation, and abduction), and shoulder girdle (flexion, extension, elevation, and depression). The participants moved their joints, and ROMs were measured by an experienced physical therapist. The physician (MS) attended the measurement by the therapist (MN) and confirmed that the participants did not have active shoulder arthritis or active cervical spondylosis. The measurement was based on a standardized method [Safety was assessed by recording adverse events.