• 디지털융복합연구
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• 제11권10호
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• pp.549-556
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• 2013

본 연구는 만성 뇌졸중으로 인한 편마비 환자를 대상으로 런지자세에서 자가신장과 움직임을 동반한 가동술을 적용후에 하지근육 근활성도와 안정성한계에 미치는 영향을 알아보는데 있다. 대상자 16명을 무작위 추출하여 실험군과 대조군으로 분류하였다. 실험군은 런지자세에서 자가신장을 중재하였고, 대조군은 런지자세에서 움직임을 동반한 가동술을 중재하였다. 중재는 8주 동안 주 5회, 1회 20분의 중재를 시행하였다. 통계학적 처리는 반복 측정분산분석을 이용하여 실시하였다. 결과는 실험군과 대조군의 그룹간 하지근육 근활성도(%MVIC)와 안정성 한계(LOS)는 통계학적 유의성이 없었다(p>.05). 하지만 실험군과 대조군의 그룹 내의 근활성도와 안정성 한계는 통계학적으로 유의하였다(p<.05). 따라서 뇌졸중으로 인한 편마비 환자들에게 런지자세에서 자가신장이 근력 및 균형에 긍정적인 영향을 줄 수 있을 것으로 생각된다.

• The Journal of Korean Physical Therapy
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• 제28권5호
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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.

• 국제물리치료학회지
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• 제9권2호
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• pp.1508-1512
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• 2018

This study was conducted to examine the effect of joint mobilization on forward head posture and to propose an effective method to improve correct body posture and balance. A total of eight patients from a Maitland-applied group (n=8) received mobilization therapy to increase the mobility of the cervical joint, with Maitland's movement grade III intensity for 30 seconds of treatment and 30 seconds of rest, for ten intervals, three times a week for four weeks. The craniovertebral angle (CVA) changes before and after the intervention with the Maitland technique were measured as $56.85{\pm}2.31^{\circ}$ before, $63.23{\pm}2.23^{\circ}$ two weeks after, and $64.98{\pm}1.27^{\circ}$ four weeks after joint intervention. There were significant CVA changes before and after the Maitland technique (P <.05). The results of this study suggest that the Maitland technique is useful for improving the head vertebral angle in patients with forward head posture.

• Physical Therapy Rehabilitation Science
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• 제10권3호
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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.

• Physical Therapy Rehabilitation Science
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• 제10권4호
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• pp.450-456
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• 2021

Objective: Studies confirming the lumber spine kinematics of direct or indirect segmental mobility under the application of joint mobilization, which induces passive force on the spine, are insufficient.Therefore, this study aims to obtain the underlying clinical data by identifying direct or indirect segmental mobility produced by Maitland's PA mobilization technique. Design: Randomized controlled trial design. Methods: Thirty subjects with no back pain participated in this study. X-ray testing equipment (SIG-40-525, Ecoray Inc., Korea) was used to verify the segmented movement of their lumbar. Joint mobilization was performed by physiotherapists with more than 10 years of experience in prescription therapy, and radiography was performed once without PA joint mobilization and once without the mobilization for comparing the lumbar vertebrae before and after the mobilization. The radiographs taken were analyzed using the picture archiving and communication system (PACS) program to measure the spinal displacement, intervertebral height, intervertebral angle, and lumbar lordosis angle. Results: Significant differences were observed in the lumbar displacement, intervertebral angle, and lumbar lordosis angle in all lumbar vertebrae before and after the mobilization. The intervertebral height indicated significant differences in all ventral vertebrae and only in L3-L4 and L4-L5 in dorsal vertebrae. Conclusions: This study suggests that the segmental mobility produced through indirect approaches plays an important role in inducing therapeutic effects in patients with back pain.

• 국제물리치료학회지
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• 제10권1호
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• pp.1711-1716
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• 2019

Background: Previous researchers have investigated the mechanical and neurophysiological effects of manual mobilization, however little research has been done on muscle tone and muscle stiffness. Objective: To compare the effects of posterior-anterior (PA) mobilization with weight bearing on sling and conventional PA mobilization on the bed. Design: Randomized controlled trial (single blind) Methods: The subjects were 16 male university students and randomized to sling mobilization group (SMG, n=8) or conventional mobilization group (CMG, n=8). SMG received PA mobilization using a sling and CMG received traditional mobilization on the bed during lumbar mobilization. Results: Both left and right muscle tones of SMG increased, but left muscle tone of SMG were increased and right muscle tone was decreased after intervention. In addition, both left and right muscle stiffness of SMG were also increased, however left muscle stiffness of SMG was increased and right muscle stiffness was decreased. The muscle tone and muscle stiffness of SMG were higher than those of DMG, especially the right side was statistically significantly higher. Extension of SMG, extension and flexion of CMG were increased statistically significantly except for Flexion of SMG (p<.05). There were no significant differences between the groups in Extension and Flexion. Conclusions: This study suggests that lumbar spine PA mobilization using sling is beneficial in improving muscle tone, muscle stiffness, and trunk movement.

• Physical Therapy Rehabilitation Science
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• 제12권3호
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• pp.240-250
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• 2023

Objective: The purpose of this study was to characterize the movement of adjacent segments that occurred when posteroanterior joint mobilization was applied to the 3rd lumbar and thereby to provide basic clinical data. Design: Randomized controlled trial design. Methods: While the subjects were receiving posteroanterior joint mobilization of the 3rd lumbar vertebra, LD (lumbar displacement), LID (lumbar intervertebral distance), LIA (lumbar intervertebral angle), and LLA (lumbar lordosis angle) were measured using X-ray, and the data were then analyzed. Changes before and after posteroanterior joint mobilization were analyzed using a paired-sample t-test, and a one-way ANOVA of variance was performed to determine the difference between segmental movements. In addition, Pearson's correlation analysis was performed to determine the correlation between segmental movements. Results: The results revealed that there was a significant change in LD before and after the application of joint mobilization of the 3rd lumbar in all lumbar vertebrae (p<0.000), among which the 2nd lumbar vertebra, an adjacent segment, showed the most significant change. A significant change in LIA angle was observed in all segments (p<0.000), with the most significant change observed between the 2nd and 3rd lumbar vertebrae. There was a significant change in LLA before and after the application of posteroanterior joint mobilization (p<0.000). The correlation analysis showed a high correlation between displacement of the 3rd lumbar vertebra and displacement of all the other lumbar vertebrae. Conclusions: The presence of kinematic movements of the lumbar vertebrae when segmental movements were generated through the application of posteroanterior joint mobilization of the 3rd lumbar vertebra.

• 국제물리치료학회지
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• 제9권4호
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• pp.1651-1656
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• 2018

The purpose of this study was to assess the changes in balance and proprioception of adults with limited ankle joint dorsiflexion, after the application of talocrural joint mobilization. The subjects of this study included 23 college students in their twenties with limited ankle joint dorsiflexion. The students were randomly assigned to the ankle joint mobilization group (AJMG, n=12) and the control group (CG, n=11). After 2 weeks of intervention using grade III talocrural joint mobilization in the anterior-posterior movement, the balance and proprioception of the subjects were assessed. Static/dynamic balance capabilities and ankle proprioception were analyzed using paired t-test and independent t-test. The dynamic balance and proprioception of AJMG were significantly improved after intervention (p<.05), In the comparison between the groups after the intervention, the dynamic balance and proprioceptive sense of AJMG were significantly improved compared to the control group (p<.05). This study suggests that AJMG can help improve the dynamic balance and proprioception.

• 국제물리치료학회지
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• 제11권3호
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• pp.2113-2118
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• 2020

Background: Patients with stroke have core muscle weakness and limited rib cage movement, resulting in restrictive lung disease. Objectives: To examine the comparison of effects of rib cage joint mobilization combined with diaphragmatic breathing exercise and diaphragmatic breathing exercise on the pulmonary function and chest circumference in patients with stroke. Design: A cluster randomized controlled trial. Methods: Twenty-four patients were randomly assigned to an experimental group (rib cage joint mobilization combined with diaphragmatic breathing exercise group) and control group (diaphragmatic breathing exercise group). Patients in the experimental group underwent rib cage joint mobilization for 15 min and diaphragmatic breathing exercise for 15 min. The control group underwent diaphragmatic breathing exercise for 30 min. Both groups underwent exercise thrice a week for 4 weeks. The pulmonary function and chest circumference were measured using the MicroLab spirometer and a tape measure, respectively. Results: After the intervention, the pulmonary function and chest circumference significantly improved in both groups. These improvements were significantly higher in the experimental group than those in the control group. Conclusion: Rib cage joint mobilization combined with diaphragmatic breathing exercise improves pulmonary function and chest circumference in patients with stroke.

• 한국전문물리치료학회지
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• 제29권1호
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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.