Background: Several studies have found an association between cervical spinal mobilizations (CSMob) and cervical spinal manipulations (CSM) on pain perception, disability, and satisfaction. However, choosing the proper technique continues to be a challenge for many practitioners. Objectives: To study the effects of a single session of cervical spinal mobilization versus cervical spinal manipulation on pain, disability, and satisfaction. Design: Randomized clinical trial. Methods: 36 subjects with acute and non-specific mechanical neck pain were randomly assigned to one of 3 groups (CSMob, CSM, or control). Outcome measures using the Neck Disability Index (NDI), Numeric Pain Rate Scale (NPRS), and Global Rate of Change (GROC) were quantified at baseline, 5-minutes post, and 4 days post corresponding intervention. Results: The CSM group showed significant increase in GROC (p=0.025) compared to the CSMob and control groups (p=0.472 and p=0.176 respectively) over time. There was a significant decrease in NPRS for the CSM and CSMob groups (p=0.002 and p=<0.001) and a non-significant decrease in NPRS (p=0.642) in the control group over time. Similarly, there was a significant decrease in NDI for the CSM and CSMob groups (p=<0.001 and p=<0.001) and a non-significant decrease in NDI (p=0.084) in the control group over time. Conclusion: Our study findings suggest that skilled manual therapy interventions can be a viable and effective treatment option for reducing neck pain, disability, and perceived favorable change following a single session on subjects with acute, non-specific mechanical neck pain.

Background: Mild pain can affect movement leading to disability, and impaired neck proprioception. Transcutaneous electrical nerve stimulation (TENS) has been recommended as an intervention for chronic and subacute neck pain with mobility deficits. Objective: The purpose was to investigate the effects of transcutaneous electrical nerve stimulation (TENS) for improving cervical spine proprioception and reducing pain, anxiety, and disability in young adults with mild neck pain. Methods: Twenty-two participants were recruited between the ages of 20-40 years old and randomized into control and intervention groups. Participants had chronic mild neck pain and not receiving pain treatment or medication, and did not have electrotherapy contraindications. The intervention group received a 30-minute TENS intervention and were instructed in a 2-week daily home-based TENS intervention. Outcome measures were visual analog scale, neck disability index, state-trait anxiety inventory, active range of motion (AROM) and joint position error (JPE). Results: Participants reported reduction in pain, disability, and anxiety post 30-minute intervention. Increase in right lateral flexion AROM and decrease in mean JPE extension post 30-minute intervention. Post 2-week intervention, reduction in pain, an increase in right lateral flexion AROM, and a reduction in mean JPE extension were also detected. Conclusion: People with chronic mild neck pain had a reduction in pain, anxiety, and disability post 30-minutes TENS treatment. Reduction in anxiety and disability with TENS treatment suggests that TENS may be beneficial in reducing pain, anxiety, and improving neck proprioception in young adults with mild neck pain.

Objective: This study investigated whether the acromion-table distance is associated with trapezius activity patterns during shoulder movements and the upper quarter Y-balance test (UQYBT). Additionally, it was to determine the correlation between upper, middle, and lower trapezius muscle activity. Design: Cross-sectional study Methods: Twenty-eight healthy young males participated in this study. Outcome measures included: (1) acromion-to-table distance, which assesses the scapular position, (2) trapezius muscle activity during shoulder flexion and abduction, and (3) the UQYBT, a measure of upper extremity function measured. Results: A significant negative correlation was observed between the acromion-table distance and the inferior-lateral direction reach distance of UQYBT (r=-0.499 and p=0.007). There were negative correlations between the upper and lower trapezius during shoulder flexion (r=-0.901, p < 0.001) and abduction (r=-0.661, p < 0.001), respectively. There was also a negative correlation between the upper and middle trapezius during shoulder abduction (r=-0.466, p=0.012). Conclusions: The acromion-table distance was related to the UQYBT. Anterior tilt of the scapula and limited range of motion of the shoulder may occur as the acromion-table distance increases. In addition, the acromion-table distance reflects the pectoralis minor muscle shortening, suggesting that the scapula position or the pectoralis minor shortening may influence the upper limb function. Therefore, these factors should be considered when assessing upper limb function using the UQYBT.

Objective: The objective of this study is to evaluate the effects of radial shock wave therapy (RSWT) targeting multiple myofascial trigger points (MTrPs) along myofascial chains on shoulder pain, function, range of motion, and muscle strength in patients with bicipital tendinopathy. While traditional treatments primarily focus on a single MTrP, this study aims to achieve better clinical improvement by simultaneously treating multiple MTrPs along the myofascial chains. Design: A randomized controlled trial. Methods: Twenty-eight patients with bicipital tendinopathy were randomly assigned to either an experimental group (n=14) or a control group (n=14). The experimental group received RSWT targeting multiple MTrPs along myofascial chains, while the control group received RSWT focused on a single MTrP in the biceps brachii. Both groups underwent three treatment sessions over a nine-day period, with one session every three days. Outcomes, including shoulder pain, function, range of motion, and muscle strength, were measured before and after treatment to assess therapeutic effects. Results: Both groups showed significant improvements in shoulder pain, function, range of motion, and muscle strength (p<0.05). However, the experimental group demonstrated significantly greater improvements in all outcome measures compared to the control group (p<0.05). Conclusions: RSWT targeting multiple MTrPs along myofascial chains showed significantly greater effects in relieving shoulder pain, improving function, enhancing range of motion, and strengthening muscles in patients with bicipital tendinopathy compared to treatment targeting a single MTrP. Therefore, this study proposes that a comprehensive treatment strategy considering the entire myofascial pathway may be more effective in the rehabilitation of patients with bicipital tendinopathy.

Objective: This study aimed to investigate the association of explosive strength with muscle mass and muscle function measured using traditional methods such as peak torque (PT) and joint angular velocity (PAV). Design: Cross-sectional study Methods: Twenty-nine healthy adults (14 males and 15 females) participated in this study. Body mass index and appendicular skeletal muscle index (ASMI) were measured using bioelectrical impedance analysis. The explosive strength of the knee extensors was evaluated by measuring the rate of torque development (RTD) and rate of velocity development (RVD). RTD was analyzed by dividing it into early (0-50 ms) and late (100-200 ms) muscle contraction phases. In addition, PT and PAV were measured as traditional methods for assessing muscle function. Results: According to regression analysis, PAV accounts for 24.7% and 66.9% of the variance of RTD 0-50 (p=0.006) and RVD (p<0.001), respectively. On the other hand, ASMI (p=0.035) and isometric PT (p=0.001) explained 49.2% of the RTD 100-200. Conclusions: Early RTD is mainly predicted by PAV, which is thought to be a result of muscle fiber type. Therefore, PAV presents the possibility of an alternative method to evaluate explosive performance. Late RTD seems to be related to ASMI or isometric PT. The findings of this study are expected to contribute to musculoskeletal rehabilitation and evaluation in that they revealed factors contributing to early and late muscle contraction.

Objective: This study aimed to investigate the effects of active and passive soft tissue mobilization and active stretching on pain, functional disability, and flexibility in patients with nonspecific low back pain (NS-LBP). Specifically, it compared the effectiveness of these interventions when applied to the hamstring muscles. Design: A randomized controlled trial Methods: A total of 45 participants (mean age: 23.03±3.90 years) with NS-LBP were randomly assigned into three groups: active soft tissue mobilization (ASM) group (n=15), passive soft tissue mobilization (PSM) group (n=15), and hamstring active stretching (AS) group (n=15). The interventions were conducted for 20 minutes, three times a week, for four weeks. Outcome measures included pain assessed by the Numeric Pain Rating Scale (NPRS), functional disability measured by the Oswestry Disability Index (ODI), and flexibility assessed using the Sit and Reach Test and Passive Straight Leg Raise (PSLR) test. Results: The ASM group showed a significant reduction in NPRS scores (p<0.01) and ODI scores (p<0.01) compared to the PSM and AS groups. The ASM group also demonstrated significant improvements in flexibility in both the Sit and Reach Test (p<0.01) and PSLR test (p<0.01) compared to the other groups. Conclusions: Active soft tissue mobilization was more effective than passive soft tissue mobilization and active stretching in reducing pain, improving functional disability, and enhancing flexibility in patients with NS-LBP. These findings suggest that active interventions should be prioritized for managing NS-LBP.

Objective: This study aimed to explore the effects of a novel training program that integrates ultrasound technology to enhance the palpation skills of physical therapy students. The program was designed to support students in developing more precise palpation techniques by using ultrasound as a supplementary tool for anatomical identification. Design: A randomized controlled trial. Methods: A total of twenty students, all enrolled in the physical therapy department at S University, who met the specified selection criteria, were randomly assigned to one of two groups: the experimental group (EG, n=10) or the control group (CG, n=10). The experimental group participated in an ultrasound-assisted palpation training program, while the control group did not receive this intervention. Results:The experimental group demonstrated significant improvements in their ability to accurately palpate anatomical landmarks, specifically the long head of the biceps brachii (LHBT) and the lateral joint line of the knee (LJLK), as well as an increased level of confidence in their palpation skills (p<0.05). A comparative analysis of changes from pre- to post-training revealed statistically significant differences between the two groups (p<0.05). Conclusions: The findings of this study suggest that the ultrasound-assisted training program can provide valuable educational benefits, offering foundational data to enhance the development of palpation skills in physical therapy students and making a meaningful contribution to educational research within the field.

Objective: With the proportion of the elderly population in Korea reaching 17.5% in 2022 and projected to increase to 20.6% by 2025, 30.1% by 2035, and 43% by 2050, the accelerated aging of the population is raising societal concerns about elderly care. Maintaining mobility is crucial for a healthy and independent old age. Design: Cross-sectional study Methods: This study investigates the effects of dual-task performance on gait variables and cognitive function in older adults. This cross-sectional study involved 60 older adults aged 65 and above, categorized into a dementia group (Korean version of Montreal Cognitive Assessment (MoCA-K) score ≤ 22) and a control group (MoCA-K score ≥ 23). Cognitive and gait functions were assessed using the GAITRite system (GAITRite system, CIR Systems Inc., USA), measuring gait variables (speed, stride length, etc.) before and after dual-task performance. The assessments were conducted under a single-blind condition, and data were analyzed using SPSS (ver. 25.0, SPSS Inc., USA). Results: The dementia group scored lower on cognitive assessments compared to the control group (p<0.05). In dual-task performance evaluations, the dementia group exhibited longer total task times and lower accuracy than the control group (p<0.001), while reaction times were longer but not statistically significant. GAITRite system analysis revealed that the dementia group had reduced gait speed and stride length compared to the control group (p<0.05). However, the difference in gait time was not statistically significant. The study results indicate that older adults with dementia show significant differences in cognitive function and gait performance, with notable impacts under dual-task conditions. Conclusions: These findings underscore the effect of cognitive decline on gait and provide valuable insights for predicting gait and cognitive function deterioration in dementia, which can aid in developing fall prevention strategies.

Objective: Long-term imbalances in the muscles around the neck could the functional resting length of the muscles, resulting in a chronic forward head posture. This study aimed to assess the effects of combining posture correction exercises with extracorporeal shockwave therapy on muscle activity, neck function and pain in adults with forward head posture. Design: Pretest-posttest two groups design. Methods: A total of 22 adults, diagnosed with forward head posture, participated in the study. Random assignment allocated 11 participants to the posture correction exercise (PCE) group, while the other 11 were assigned to the posture correction exercise group combined with extracorporeal shockwave therapy (ESWT). In the combined group, ESWT was administered twice a week for four weeks, delivering 1,000 impulses in a radial pattern to the levator scapulae and upper trapezius muscles. The PCE group performed a exercise program for approximately 30 minutes, three times a week, over the same four-week period. The PCE focused on strengthening weakened muscles and stretching of shortened muscles. Results: Both the PCE group and the combined group with ESWT exhibited a significant increase in lower trapezius muscle activity within groups (p<0.05). Moreover, the craniovertebral angle and neck disability index showed significant improvements in both groups (p<0.05). While the pressure pain thresholds tended to increase only in the combined group, the difference was not statistically significant (p>0.05). Conclusions: This suggests that both the PCE program and the combination with ESWT can be effective in enhancing posture and reducing pain in individuals with forward head posture.

Objective: The purpose of this study was to investigate the effect of Kaltenborn-Evjenth concept functional glide (KEFG) on shoulder pain, range of motion (ROM), upper extremity dysfunction in breast cancer patients. Design: Cross-sectional study. Methods: In this study, 42 subjects were randomly assigned and distributed to 21 subjects in the KEFG group and 21 subjects in the Mulligan technique (MWM) group. Results: After the application of joint mobilization, pain decreased significantly in both groups, and there was no significant difference between the two groups. The ROM of the joint was significantly increased in both groups, and there was no significant difference between the two groups. The SPADI pain was significantly decreased in both groups, and the disability and total components were significant only in the KEFG group, and there was no significant difference between the two groups. Conclusions: KEFG and MWM were found to be effective in improving shoulder pain, ROM and upper extremity dysfunction in breast cancer patients. KEFG is thought to be an intervention that can yield positive outcomes among breast cancer patients with upper extremity dysfunction.

Objective: This study investigates the influence of femoral and knee torsion angles on toe in-out orientation in adults. Design: Cross-sectional study design. Methods: We measured the passive internal and external rotation range of motion (ROM) of the hip and knee joints in 21 participants using a goniometer. Toe in-out orientation was assessed with the GaitRite gait analysis system during slow and fast walking trials over a 6-meter walkway. Pearson correlation analysis was used to examine the relationship between joint ROM and gait angle at both walking speeds. Intra- and inter-rater reliability were assessed, and simple linear regression was conducted to explore these relationships. Results: Intra-rater reliability demonstrated high reliability (0.84<ICC<0.94), while inter-rater reliability (0.44<ICC<0.83) exhibited moderate to high reliability. Significant correlations were found between the hip joint's range of motion and the gait angle at slow walking speed. Similar results were observed at fast walking speed for the hip joint. Multiple regression analysis revealed that the neutral angle of the hip joint (β=0.660, p<0.001) and the neutral angle of the knee joint (β=0.284, p=0.034) significantly contributed to the toe-out angle. Conclusions: Our findings indicate a significant correlation between the range of motion of the hip joint and toe in-out orientation. A decrease in the hip joint internal rotation angle was associated with a decrease in toe in-out, while an increase in the mid-angle was associated with an increase in toe in-out.