• Physical Therapy Rehabilitation Science
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• v.9 no.2
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• pp.90-97
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• 2020

Objective: This study investigated the effects of combining both mobilization and hold-relax (HR) technique on the function of post-surgical patients with shoulder adhesive capsulitis. Design: Randomized controlled trial. Methods: Forty-five surgical patients with shoulder adhesive capsulitis participated in this study and were randomly divided into three groups; both mobilization with movement (MWM) and HR technique (HR-MWM) group (n=15), the MWM group (n=15), and control group (n=15). All participants received three different interventions; 1) MWM combined with HR technique in PNF stretching on the shoulder, 2) MWM on the shoulder, 3) general physical therapy and intervention with neither MWM or HR stretching. Pre- and post-intervention, each subject was randomly evaluated for shoulder flexion range of motion (ROM), shoulder flexor muscle strength, Visual Analogue Scale (VAS), and the Korean version of the Shoulder Pain And Disability Index (SPADI). Results: The MWM combined with HR technique group had significant effects on shoulder flexion ROM, shoulder flexor muscle strength, VAS and SPADI compared to the MWM and control group (p<0.05). The MWM group showed a significantly greater increase in shoulder flexion ROM compared to the control group (p<0.05). Conclusions: These findings suggest that combining both the MWM and HR technique on the shoulder may more effectively improve shoulder function than MWM alone or without MWM&HR technique. Therefore, combining both the MWM and HR technique is a suggested intervention for increasing function due to shoulder adhesive capsulitis after surgery.

• Journal of The Korean Society of Integrative Medicine
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• v.10 no.1
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• pp.61-72
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• 2022

Purpose : This study was to verify the effect of eccentric training and suggest a specific application method by comparing the effects of acromohumeral distance (AHD), supraspinatus tendon thicknees (STT), pain intensity and functional performance after MWM and eccentric training (MWM-ET) or general exercise (MWM-GE) in chronic subacromial impingement syndrome (SAIS) patients. Methods : A total of 55 participants were randomly assigned to each group, and according to the intervention method, "MWM-ET group (n=28)" vs. "MWM-GE group (n=27)" was divided into two groups. AHD, STT, pain intensity, and functional performance were measured before intervention, and both groups were re-measured 3 times a week after 6 weeks of intervention in the same way. Results : The AHD was significantly increased in MWM-ET group compared to MWM-GE group. No significant difference was observed between the groups in the STT, but Pain intensity was significantly lower in MWM-ET group than in MWM-GE group, and functional performance was significantly increased in MWM-ET group compared to MWM-GE group. Conclusion : As a result of MWM-ET intervention that further increases AHD compared to MGE, it can be clinically presented as a more effective intervention method for faster recovery from injury due to pain reduction and smooth return to daily life due to improved functional performance.

• Journal of The Korean Society of Integrative Medicine
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• v.10 no.4
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• pp.219-228
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• 2022

Purpose : The purpose of this study was to suggest a more effective method by comparing the effects of changes in pain intensity, muscle strength, and athletic performance after applying a 6-week eccentric training program (ET-MWM) or concentric training program (CT-MWM) with MWM for high school baseball players with shoulder internal impingement (SII). Methods : A total of 75 participants were randomly assigned to each group and divided into two groups, "ET-MWM group (n=35)" and "CT-MWM group (n=32)" according to the intervention method. Pain intensity, muscle strength (external rotation, internal rotation), and athletic performance were first measured before the intervention, and after the intervention 3 times a week for a total of 6 weeks, both groups were re-measured in the same way. Visual analog scale (VAS) was used for pain intensity, biodex dynamometer for muscle strength (60 °/sec.), and Kerlan-Jobe orthopedic clinic shoulder & elbow score (K-KJOC) for athletic performance. Results : As a result of analyzing the homogeneity of the pre-intervention characteristics and initial measurement variables of the study subjects, there was no significant difference between the two groups in all variable values. Pain intensity (VAS) was significantly reduced in the ET-MWM group than in the CT-MWM group (p<.05). In addition, the maximum muscle strength of external rotation & internal rotation of the shoulder (60 °/sec.) and athletic performance (K-KJOC) were significantly increased in the ET-MWM group than in the CT-MWM group (p<.05). Conclusion : Compared with the CT-MWM training program, the ET-MWM training program reduced shoulder joint pain and further increased the muscle strength required for throwing motion in high school baseball players. As the result showed better athletic performance improvement, the ET-MWM training program can be clinically recommended as a more effective intervention.

• Physical Therapy Korea
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• v.29 no.1
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• pp.70-78
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• 2022

Background: Individuals with calf muscle shortening may have decreased dynamic balance. Objects: This study aimed to investigate the effect of mobilization with movement (MWM) and myofascial release (MFR) on kinematic changes in dynamic balance in individuals with calf muscle shortening. Methods: Thirteen participants were randomly assigned to the MWM or the mobilization with movement added myofascial release (MWM-MFR) group. The MWM group received treatment with only MWM, whereas the MWM-MFR group was treated with MWM and MFR. Pre- and post-intervention passive range of motion (PROM), maximum reaching lengths, and modified star excursion balance test (MSEBT) results were compared for all participants. Wilcoxon signed-rank test and Mann-Whitney U test were used for statistical analysis. Results: The results showed significant within-group differences in ankle PROM, but no significant between-group differences. The maximum reaching length in the MWM-MFR group in the posterolateral direction was significantly different before and after the intervention (p = 0.005). This group also showed significantly reduced ankle abduction in MSEBT during the posteromedial direction section 3 (p = 0.007) and posterolateral direction section 5 (p = 0.049) compared with the MWM group. Conclusion: Combined MWM and MFR intervention improves ankle stability in the coronal plane during the posteromedial and posterolateral forward movement in dynamic balance compared with only MWM in individuals with calf shortening.

• The Journal of Korean Physical Therapy
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• v.28 no.5
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• pp.303-307
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• 2016

Purpose: This study was conducted to determine the effects of Mulligan's mobilization with movement (MWM) on changes in the talofibular interval in the sagittal plane in subjects with chronic ankle instability (CAI). Methods: Sixteen subjects with chronic ankle instability participated in this study. The talofibular intervals were measured from US images, and the weight-bearing lunge test was used to assess dorsiflexion of the ankle joint. Each dependent variable were measured on the both affected side and sound side in three trials in pre- and post-MWM. Dependent variables were examined with a two-way mixed-design analysis of variance (ANOVA). The two factors were side (sound side versus affected side) and intervention (pre- versus post-intervention). For post hoc analysis, paired t-tests were performed to compare the dependent variables. A p<0.05 was considered to indicate significance. Results: Dorsiflexion and talofibular interval differed significantly pre- and post-intervention (p<0.05). Post-hoc analysis revealed that the talofibular interval post-MWM was significantly less than that pre-MWM on the both the affected and sound side (p<0.05). The ankle dorsiflexion in the post-MWM group was significantly greater than that in the pre-MWM group on the affected side and the sound side (p<0.05). Conclusion: The Mulligan's MWM decreased the talofibular interval in subjects with CAI. These findings suggest that the MWM technique can change the position of the talus relative to the fibular in the weight bearing position.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.28 no.3
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• pp.69-77
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• 2022

Background: Ankle sprains, and the resulting ankle instability worsen to chronic due to recurrent ankle injuries or sprains, 78% of which are accompanied by posture instability and damage due to changes in the position of the talus of the ankle. The purpose of this study is to investigate the immediate effect of applying MWM taping on the patient's muscle strength and balance ability in patients with chronic ankle instability. Methods: 15 people with MWM taping and 15 people with Kinesio taping were applied, and after applying the taping of the ankle, 10 minutes of walking treadmill and 10 times of forward lunge operation, the change in ankle muscle strength and balance ability was confirmed. The strength test of the ankle was performed using a test device called Biodex system 4 (USA) for the movement of the dorsi-flexion and plantar flexion of the foot, and the balance of the two groups was measured using Biodex balance system (USA) to test balance ability. Results: The comparison of muscle strength changes in the ankle does not show a significant increase in the group applying MWM compared to the group applying kinesio taping (p<.05). In the comparison of equilibrium capabilities, the MWM taping group also showed a significant increase in the MWM taping group compared to the kinesio taping group (p<.05). Conclusion: When applying MWM taping and kinesio taping to patients with chronic ankle instability, there was no significant difference in comparison of muscle strength changes, but there was a significant difference in comparison of balance ability.

• Physical Therapy Rehabilitation Science
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• v.10 no.3
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• pp.257-262
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• 2021

Objective: Patients with stroke generally diminished ankle range of motion, which decreases balance and walking ability. This study aimed to determine the effect of ankle self-mobilization with movement (s-MWM) on ankle dorsiflexion passive range of motion, timed up and go test, and dynamic gait index in patients with chronic stroke. Design: Randomized controlled trial design Methods: Twenty-four post-stroke patients participated in this study. The participants were randomized into the control (n = 12) and self-MWM groups (n = 12). Both groups attended standard rehabilitation therapy for 30 minutes per session. In addition, self-MWM group was performed 3 times per week for 8 weeks. All participants have measured ankle dorsiflexion passive range of motion, timed up and go test, and dynamic gait index in before and after the intervention. Results: After 8 weeks of training, self-MWM group showed greater improvement in ankle dorsiflexion passive range of motion, timed up and go test, and dynamic gait index than in the control group (p<0.05). Further, self-MWM group had significantly improvement in all dependent variables compared to the pre-test (p<0.05). Conclusions: Our investigation demonstrates that self-MWM is beneficial for improving functional ability. Also, self-MWM was superior to control with respect to improving ankle dorsiflexion passive range of motion, timed up and go test, and dynamic gait index.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.22 no.1
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• pp.59-64
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• 2016

Background: This study was to investigate the effect of cervical HVLA technique and mulligan MWM technique on patients with lateral epicondylitis. Methods: 36 participants were randomly allocated to the two groups; group I involved high velocity low amplitude (HVLA) cervical mobilization technique, mulligan mobilizations with movement (MWM) technique (n=18). group II mulligan MWM (n=18). Patient attended for three times a week for six weeks. Results: The change of visual analogue scale (VAS) was statistically and significantly decreased in both of the group I and the group II. The change of patients rated tennis elbow evaluation (PRTEE) was statistically and significantly decreased in both of the group I and the group II. The change of pressure pain threshold (PPT) was statistically and significantly increased in both of the group I and the group II. Nevertheless, There is no statistical differences between group I and group II. Conclusion: After experiment, pressure pain threshold and visual analogue scale, patients rated tennis elbow evaluation were improved in both group. But Cervical HVLA group does not showed the change better than mulligan MWM group.

• Journal of the Korea Organic Resources Recycling Association
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• v.30 no.1
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• pp.13-21
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• 2022

Mushroom waste medium refers to the waste biomass generated after mushroom cultivating. And, the burden of treatment on mushroom farmhouse is increasing due to the absence of appropriate treatment method and increase of treatment costs of the mushroom waste medium. In this study, in order to assess the energy value of mushroom waste medium by an anaerobic digestion, methane potential and anaerobic organic matter decomposition characteristics were investigated. The theoretical methane potential(B_th) of mushroom medium(MM) was 0.481 Nm³-CH₄/kg-VS_added, and the B_th of mushroom waste medium(MWM) was 0.451 Nm³-CH₄/kg-VS_added. The biochemical methane potential(B_u-exp) of MWM was increased by 18% from 0.155 for MM to 0.183 Nm³-CH₄/kg-VS_added for MWM. In the reaction kinetics analysis by the Modified Gompertz model, the maximum methane production rate(R_m) was increased from 4.59 for MM to 7.21 mL/day for MWM and the lag growth phase time(λ) was decreased from 2.78 for MM to 1.96 days for MWM. In the reaction kinetics analysis by the parallel first order kinetics model, the easily degradable organic matter(VS_e) content was increased by 5.89% and the persistently degradable organic matter(VS_p) content was 2.03% in MWM, and the non-degradable organic matter(VS_NB) content was decreased by 7.85%. Therefore, it was evaluated that the anaerobic digestion efficiency of MWM was increased. The anaerobic digestion efficiency of MWM was assessed to be more improved than that of MM.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.26 no.1
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• pp.37-46
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• 2020

Background: The present study aimed to investigate the immediate effects of Soft Tissue Mobilization (STM) before Mobilization with Movement (MWM) on ankle ROM, pennation angle, balance in stroke patients. Methods: A total of 22 subjects were randomly assigned to one of two groups: the experimental group and the control group. The experimental group received intervention STM before MWM. STM was applied for one minute, MWM was applied one set of six times, in a total 3 sets. The passive ankle joint range of motion (ROM) was measured using a goniometer, the pennation angle was measured using RUSI, and the balance was measured using Timed Up & Go Test. Results: The ROM of the ankle dorsi-flexion, muscle tissue (pennation angle) and balance were significantly increased. Conclusion: In this study, it was confirmed that the ankle dorsi-flexion ROM, pennation angle of the medial gastrocnemius muscle, and balance were significantly improved in the group where STM was performed before the MWM intervention. Therefore, the physiotherapists should consider these results in their intervention. If MWM is applied to stroke patients, applying STM first is a better intervention.