• Physical Therapy Korea
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• v.26 no.3
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• pp.42-56
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• 2019

Background: Individuals with mechanical neck pain show biomechanical and neurophysiological changes, including cervical spine muscle weakness. As a result of deep muscle weakness, it causes stability disability and reduced upper thoracic spine mobility, which finally leads to functional movement restriction such as limited range of motion and dysfunction. Recent studies have shown that thoracic spine manipulation and mobilization could reduce symptoms of mechanical neck pain in patients. Objects: The purpose of this study was to investigate the effects of thoracic mobility exercise on cervicothoracic function, posture feature, and pain intensity in individuals with mechanical neck pain. Methods: The study subjects were 26 persons who were randomly assigned to the experimental (with thoracic mobility exercise) and control groups (without thoracic mobility exercise), with 13 subjects in each group. The cervicothoracic function (neck functional disability level and cervicothoracic range of motion), posture feature, and pain rating (using a quadrupled visual analogue scale [QVAS]) were measured before, after 3 weeks, and after 6 weeks. Results: Statistically significant group-by-time interactions were found with repeated analyses of variance for the Korean neck disability index (KNDI), all cervical range of motion (CROM), all thoracic range of motion (TROM), cranial rotation angle, sagittal shoulder posture (SSP), and QVAS (p<.05). All groups showed significant improvements from all times in all the evaluated methods. The KNDI, CROM, TROM of left rotation, and SSP in the experimental group showed significant improvements after 3 weeks, and the TROM of the right rotation and QVAS in the experimental group showed significant improvements after 6 weeks when compared with the control group. Conclusion: Thoracic mobility exercise during 6 weeks might be effective intervention to improve the functional level, posture feature, and QVAS pain rating for managing individuals with mechanical neck pain.

• Physical Therapy Korea
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• v.27 no.1
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• pp.19-29
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• 2020

Background: Stretch-oriented home exercise programs are often used as treatments for patients with adhesive capsulitis; however, there is lack of research on home exercise programs to strengthen rotator cuffs. Objects: The aim of this study is to investigate the effect of home exercise programs for rotator cuff strengthening on pain, range of motion (ROM), disability level, and quality of life in patients with adhesive capsulitis. Methods: Twenty-two patients with adhesive capsulitis volunteered to participate in this study. The subjects were randomly divided into an experimental group (n = 11) and control group (n = 11). For the experimental group, manual therapy and home exercise programs for rotator cuff strengthening were applied for 6 weeks; for the control group, only manual therapy was applied for 6 weeks. Shoulder pain (quadruple visual analogue scale, QVAS), ROM, disability (shoulder pain and disability index-Korean version, SPADI), and quality of life (world health organization quality of life scale-Korean version, WHOQOL-BREF) were evaluated at baseline, after 3 weeks, and after 6 weeks of intervention. The changes in the measurement variables were analyzed by using repeated measure analysis of variance. Results: Significant differences were observed between the experimental group and control group in the QVAS; SPADI-pain scores; SPADI-disability scores; SPADI-total scores; flexion, abduction, internal and external rotation ROM of the glenohumeral joint; and WHOQOL-BREF total, overall, physical health, and psychological scores. All groups displayed statistically significant improvements as observed in the QVAS, SPADI, flexion, abduction, external and internal rotation ROM of the glenohumeral joint, and WHOQOL-BREF. Conclusion: Home exercise programs for rotator cuff strengthening had a positive impact on shoulder pain, shoulder ROM, disability level, and quality of life in patients with adhesive capsulitis. Therefore, we propose the use of home exercise programs for rotator cuff strengthening in the exercise rehabilitation of patients with adhesive capsulitis.

• Journal of the Korean Society of Physical Medicine
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• v.19 no.2
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• pp.29-45
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• 2024

PURPOSE: This study aimed to compare the effects of pain level, lower back pain dysfunction level, psychosocial level, hip abductor strength (HAS), number of positive lumbar instability tests, and dynamic balance (DB) by applying lumbar stabilization exercises according to the presence or absence of gluteus medius muscle weakness in chronic lower back pain (CLBP) patients with lumbar instability. METHODS: Thirty-five CLBP patients with lumbar instability were divided into the gluteus medius weakness (n = 18) and gluteus medius non-weakened (n = 17) groups using the gluteus medius manual muscle test. Intervention applied conservative physical therapy and lumbar stabilization exercises to both groups that lasted three times a week for four weeks. To compare the intervention effects, the quadruple visual analog scale (QVAS), the Korean version of the Oswestry disability index (K-ODI), fear-avoidance beliefs questionnaire (FABQ), HAS, lumbar instability tests positive response counter (LIC), and DB were measured. RESULTS: Significant differences were shown for QVAS, K-ODI, FABQ, HAS, LIC, and DB for both groups pre- and post-intervention (p < .05). Compared to the gluteus medius weakness group, the gluteus medius non-weakened group showed a significant difference (p < .05) in the changes in QVAS, K-ODI, FABQ-W, FABQ-total, and HAS. CONCLUSION: In CLBP patients with lumbar instability, having gluteus medius weakness was less effective in improving lumbar stabilization exercise than gluteus medius non-weakness regarding pain level, lower back pain dysfunction level, psychosocial level excluding physical activity, and hip abductor strength. Therefore, additional gluteus medius strengthening exercises are necessary for patients with lumbar instability and gluteus medius muscle weakness.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.22 no.2
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• pp.15-20
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• 2016

Background: The purpose of this study was to compared of scapular position between operation side and non-operation side to the rotator cuff surgery. Methods: This study was carried out with a total 34 patients: male (n=14), female (n=20). Shoulder range of motion (ROM), the quadruple visual analogue scale (QVAS), the shoulder pain and disability index (SPADI), and the scapular index (SI) were used to assess shoulder posture and function. SI was the resting position of the scapular was determined by measuring the distance from the mid-point of the sternal notch (SN) to the medial aspect of the coracoid process (CP) and the horizontal distance from the posterolateral angle of the acromion (PLA) to the thoracic spine (TS) with a soft tape measure. The SI was calculated using the equation: [(SN to CP/PLA to TS) ${\times}$ 100]. Results: There were no significant difference in ROM, QVAS to rotator repair patients according to SI (p>.05). There were significant differences in SI between the operation side and the non-operation side (p<.01). Conclusions: Scapular position was operation side more internal rotation, protraction, abduction than non-operation side. Therefore, health professionals managing for rotator cuff tear repair patients should consider scapular position.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.24 no.2
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• pp.17-27
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• 2018

Background: This study investigated the effects of pelvic floor stabilization exercise of pain, disfunction, psychosocial, electromyography (EMG) activity on the lower back pain with postpartum. Methods: The study included 20 postpartum women who were randomly assigned to a sling exercise group (SEG, n=10) or a general physical therapy group (GPTG, n=10). Outcomes were assessed using to lower back pain with postpartum the quadruple visual analogue scale (QVAS), the Korean version of the Oswestry disability index (KODI), the fear avoidance belief questionnaire (FABQ), the inventory of functional status after childbirth (IFSAC), the edinburgh postnatal depression scale-Korean (EPDS-K), and trunk muscle activity before and after a 4-week exercise intervention. Statistical analysis were performed using a mean, standard deviation, crosstab test, paired t-test, independent t-test. Kolmogorove-Smirnov test was used for test of normality. Results: Compared to the GPTG, the SEG showed significant improvement in the QVAS, KODI, FABQ, IFSAC, and EPDK-K scores (p<.05) after 4 weeks. Conclusion: Postpartum pelvic strengthening exercise proved to have a positive effect.

• Physical Therapy Rehabilitation Science
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• v.11 no.2
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• pp.189-197
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• 2022

Objective: The purpose of this study was to investigate the effect of a lower trapezius strengthening exercise program on an unstable support surface on pain, neck dysfunction, psychosocial factors, and postural alignment in neck pain patients with forward head posture. Design: A randomized controlled trial Methods: A total of 36 neck pain patients participated in this study. Screening tests were performed and assigned to experimental group (n=18) and control group (n=18) using randomization program. Both groups performed the lower trapezius strengthening exercise program. In addition, in the experimental group, an exercise program for lower trapezius muscle strengthening was performed on an unstable support surface. All interventions were performed 3 times a week, for a total of 5 weeks. quadruple visual analogue scale (QVAS), neck disability index (NDI), short form (SF)-12, and postural alignment were measured before and after the intervention to compare their effectiveness. Results: Both groups showed significant differences in QVAS, NDI, SF-12, and postural alignment before and after intervention (p<0.05). In addition, the experimental group showed significant differences in NDI and postural alignment compared to the control group (p<0.05). Conclusions: The lower trapezius strengthening exercise program on unstable support surfaces is an effective intervention method with clinical significance in improving neck disability and postural alignment in patients with neck pain with forward head posture.

• Physical Therapy Korea
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• v.27 no.2
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• pp.102-110
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• 2020

Background: There is an opinion that improper postures of the head and cervical spine are associated with temporomandibular joint (TMJ) disorders (TMDs). Objects: The aim of this study was to investigate the proportions among the cervical kyphotic angle, physical symptoms including the pain intensity level of the TMJ, and severity of TMD disability in patients diagnosed with TMD. Methods: Sixty-two subjects participated in the study. The evaluation tools included measurements of the cervical kyphotic angle based on the Ishihara index, pressure pain threshold (PPT) on the TMJ, maximal mouth opening (MMO) without pain, current pain intensity level of the TMJ measured using the Quadruple Visual Analogue Scale (QVAS), Korean TMD (KTMD) disability index, KTMD Symptom Frequency/Intensity Scales (SFS/SIS), and Korean Headache Impact Test-6. Correlation analysis was conducted to investigate the correlations between the cervical kyphotic angle and parameters related to TMJ symptoms. Results: Variables that were significantly correlated with the cervical kyphotic angle were the PPT around the TMJ (r = 0.259, p < 0.05), current pain intensity level of the TMJ based on the QVAS (r = -0.601, p< 0.01), and usual pain intensity level based on the SIS (r = -0.379, p < 0.01). The level of TMD functional disability was significantly correlated with the degree of headache (r = 0.551, p < 0.01), level of PPT of the TMJ (r = -0.383, p < 0.01), pain-free MMO (r = -0.515, p < 0.01), pain intensity level of the TMJ based on the QVAS (r = 0.393, p < 0.01), TMD symptom frequency (r = 0.739, p < 0.01), usual pain intensity of the TMJ (r = 0.624, p < 0.01), and most severe pain intensity of the TMJ (r = 0.757, p < 0.01). Conclusion: There is a positive correlation between the cervical kyphotic angle and PPT and a negative correlation between the current and usual pain intensity levels of the TMJ. The cervical kyphotic angle was a predictor of the pain level, tenderness threshold, and intensity of pain in the TMJ.

• Physical Therapy Rehabilitation Science
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• v.9 no.3
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• pp.140-148
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• 2020

Objective: The purpose of this study was to examine the effectiveness of pelvic displacement when self-hamstring muscle stretches were applied to persons with low back pain. Design: Three-group pretest-posttest design. Methods: Forty persons with low back pain participated in this study. Pelvic tilt angle, hamstring flexibility, Quadruple Visual Analogue Scale (QVAS), Fear Avoidance Beliefs Questionnaire (FABQ), Korea version of the Oswestry Disability Index (KODI) and pelvic mobility were measured at pre-post. All participants were divided into either the pevic anterior tilt group (PAT group, n=12), pelvic midrange group (PMR group, n=18), or the pelvic posterior tilt group (PPT group, n=10). Self-stretching was performed using the pilates ring three times a week for a total of four weeks and the post-test was conducted and compared with the pre-test. Results: Hamstring flexibility, QVAS, KODI scores were significantly different compared to before the intervention (p<0.05). The changes in hamstring flexibility of the three groups were significantly different (p<0.05). Changes in KODI and FABQ results of the three groups were not significant. The pelvic posterior tilt range were significantly different in the PMR and PPT groups (p<0.05). The pelvic anterior tilt ranges showed significant differences after stretching in the PPT group (p<0.05). Conclusions: A large amount of change of hamstring flexibility, pelvic mobility of anterior and posterior tilt test in the PPT group was observed. Furthermore, therapists should consider pelvic displacement of the participant when applying intervention, which may, accordingly, have different effectiveness.

• Journal of the Korean Society of Physical Medicine
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• v.13 no.4
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• pp.149-162
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• 2018

PURPOSE: The aim of this study was to investigate the effect of scapular dynamic taping on pain, disability, upper body posture, and range of motion (ROM) in the postoperative shoulder. METHODS: Twenty-two patients who underwent acromioplasty and rotator cuff repair surgery volunteered for this study. The subjects were randomly divided into an experimental group (EG, n=11) and a control group (CG, n=11). For the EG, exercise therapy, manual therapy, and scapular dynamic taping were applied for 6 weeks; for the CG, only exercise therapy and manual therapy were applied for 6 weeks. Shoulder pain, disability, upper body posture, and ROM were evaluated at baseline, after 3 weeks of intervention, and after 6 weeks of intervention. Assessment tools included quadruple visual analog scale (QVAS) for level of pain; shoulder pain and disability index (SPADI) for functional disability level; forward head angle (FHA), forward shoulder angle (FSA), and pectoralis minor index (PMI) for upper body posture; and ROM testing. RESULTS: Significant differences were observed between the EG and CG in SPADI total scores; internal rotation and external rotation ROM of the glenohumeral joint ; FSA ; and PMI. All groups showed statistically significant improvement in QVAS; SPADI; flexion; abduction; external rotation and internal rotation ROM of the glenohumeral joint; FSA; and PMI. CONCLUSION: These results suggest that, for patients who have undergone acromioplasty and rotator cuff repair surgery, the addition of scapular dynamic taping during therapy is effective for improvement of shoulder disability level, ROM, and upper body posture.

• Journal of The Korean Society of Integrative Medicine
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• v.10 no.2
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• pp.73-83
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• 2022

Purpose : Low back pain (LBP) is reported as a risk of experiencing musculoskeletal disorders due to muscle stiffness and hypokinetics. The lumbar spine in an unstable state causes imbalance and lumbar instability. Therefore, This study examined the effects of lumbar stabilization exercise and self-complex exercise program on pain, function, psychosocial level, static balance ability, and transverse abdominal muscle (TrA) thickness and contraction ratio in patients with lumbar instability. Methods : The design of this is a randomized controlled trial (RCT). Twenty-six LBP patients participated in this study. Screening tests were performed and assigned to the experimental group (n=13) and control group (n=13) using a random allocation program. Both groups underwent a lumbar stabilization exercise program. In addition, the experimental group implemented the self-complex exercise program. All interventions were applied three times per week for four weeks. The quadruple visual analog (QVAS), the Korean version of the Oswestry disability index (K-ODI), Korean version of fear-avoidance belief questionnaire (FABQ), static balance ability, TrA thickness, and contraction ratio were compared to evaluate the effect on intervention. Statistical significance was set at 𝛼=.05. Results : Both groups showed significant differences before and after the intervention in QVAS, K-ODI, FABQ, static balance ability, and TrA thickness in contraction (p<.05). In addition, significant differences in K-ODI and FABQ were observed between the experimental group and control group (p<.05). Conclusion : A lumbar stabilization exercise and self-complex exercise program resulted in reduced dysfunctions, psychosocial stability in patients with lumbar instability. Therefore, Lumbar stabilization exercise and self-complex exercise program for patients with lumbar instability are effective method with clinical significance in improving the function and psychosocial stability.