• Journal of International Academy of Physical Therapy Research
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• v.12 no.1
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• pp.2302-2307
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• 2021

Background: Patients with lumbar spinal stenosis show abnormal changes in muscle activity due to pain and limited range of motion of the lumbar spine. Excessive increased muscle tone and decreased muscle activity patterns threaten the patients' quality of life. However, there have been a few studies showing how to improve muscle performance in patients with lumbar spinal stenosis. Among these, joint mobilization is one way of improving muscle performance through pain relief and increasing the range of motion. Objectives: To investigate the effect of lumbar mobilization by orthopedic manual physical therapy on paravertebral muscle activity and tone in patients with lumbar spinal stenosis. Design: A randomized controlled trial. Methods: In this study, 24 patients with lumbar spinal stenosis were randomized (1:1 ratio) into two groups. The experimental group underwent lumbar posteroanterior mobilization, and the control group underwent conventional physical therapy (conventional transcutaneous electrical nerve stimulation) for 15 minutes each. For outcome measures, Myoton^®PRO was used to evaluate muscle tone when resting of the paravertebral muscle in the pain area. For muscle activity evaluation, the reference voluntary contraction of the paravertebral muscle was evaluated using surface electromyography. Results: Muscle tone and activity were significantly improved after intervention in both the experimental and control groups. In addition, the experimental group showed more significant decrease in muscle tone and activity than the control group. Conclusion: These results suggest that lumbar mobilization improving muscle performance in patients with lumbar spinal stenosis.

• Journal of International Academy of Physical Therapy Research
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• v.9 no.1
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• pp.1393-1397
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• 2018

The purpose of this study was to examine the effects of combined respiratory physical therapy on respiratory function, spinal curve and spinal mobility for community-dwelling elderlies with restrictive lung diseases. In total, 10 patients participated in an 8-week intervention program of thoracic cage mobilization and breathing exercise in combination. The results of the study are as follows: for respiratory function, the forced expiratory volume in 1 second (FEV1), forced vital capacity(FVC), and FEV1/FVC were significantly improved to $.30{\pm}0.31{\ell}$, $.46{\pm}.42{\ell}$, and $18.10{\pm}11.39%$, respectively (p<.05). For spinal curve, the thoracic curve and the lumbar curve were improved significantly to $-2.20{\pm}1.40^{\circ}$ and $-1.20{\pm}1.14^{\circ}$, respectively (p<.01). For spinal mobility, the thoracic flexion ($3.40{\pm}2.99^{\circ}$), thoracic extension ($3.50{\pm}1.43^{\circ}$), lumbar flexion ($4.50{\pm}4.74^{\circ}$), and lumbar extension($-1.50{\pm}1.84^{\circ}$) were all significantly improved (p<.05). These findings indicate that thoracic cage mobilization and breathing exercise in combination improve the respiratory function, spinal alignment, and spinal mobility in elderly people with restrictive lung diseases.

• Journal of the Korean Society of Physical Medicine
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• v.15 no.4
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• pp.55-65
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• 2020

PURPOSE: This study examined the effects of breathing exercises via joint mobilization on the lung function and spinal alignment of 30 straight-necked women in their 20 s and 30 s. METHODS: The participants were divided into two groups: an experimental group who performed breathing exercises via joint mobilization, and a control group who performed general stretching exercises. The differences between the two groups were measured and compared at three points in time: during the pre-examination, after four weeks of intervention, and after a four-week maintenance period. The changes in each group were measured before and after the intervention and after a one-month maintenance period and compared. For data analysis, the SPSS 22 was used to obtain the mean and standard deviation with a significance level of α = .05. RESULTS: Eight weeks of breathing exercises via joint mobilization and general stretching exercises positively impacted the lung function and spinal alignment in straight-necked patients. In particular, the experimental group showed more significant differences in spinal alignment after four weeks period of intervention and four weeks of maintenance. CONCLUSION: Breathing exercises via joint mobilization can be considered an effective intervention that can improve the respiratory volume and spinal alignment for patients with straight necks.

• Journal of International Academy of Physical Therapy Research
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• v.7 no.2
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• pp.1006-1010
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• 2016

This study aimed to examine the effects of thoracic cage mobilization on the respiratory function, spinal curve and spinal movement in patients with restrictive lung diseases. The subjects were ten community-dwelling elderly with a restrictive lung diseases when measured using a spirometer($FEV1/FVC{\leq}65%$, FVC<80%). They received an intervention over an eight-week period: three times a week and for 30 minutes a day. SPSS for Windows(ver. 19.0) was used to analyze all the collected data. Independent t-tests were used to examine changes before and after the intervention. The study's results showed statistically significant improvement(p<.05) in forced expiratory volume in 1 second(chage rate: .$24{\pm}.25$), thoracic curve(chage rate: $-2.50{\pm}2.76$), lumbar curve(chage rate: $-.80{\pm}1.32$), thoracic flexion(chage rate: $2.10{\pm}1.52$), thoracic extension(chage rate: $-2.00{\pm}1.25$), lumbar flexion(chage rate: $2.40{\pm}3.13$) and lumbar extension(chage rate: $-1.30{\pm}1.42$). The results of this study suggest that the thoracic cage mobilization contribute to improve pulmonary function in patients with restrictive lung disease.

• Journal of International Academy of Physical Therapy Research
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• v.10 no.1
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• pp.1746-1749
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• 2019

Background: Surgery has been known as an inefficient approach to reduce back pain in patients with lumbar spinal stenosis; therefore, non-surgical treatments are necessary. However, there has been little research to analyze the effect of non-surgical treatments on lumbar spinal stenosis pain. Objective: To identify the effectiveness of 2 physiotherapeutic treatment approaches to relieve pain due to lumbar spinal stenosis. Design: Randomized controlled trial Methods: The participants were 36 lumbar spinal stenosis patients who were randomized in the joint mobilization group (JMG) and transcutaneous electrical nerve stimulation group (TENSG). Joint mobilization (JM) was conducted at the posteroanterior joint in the spinous process of the lumbar spine with stenosis. Transcutaneous electrical nerve stimulation (TENS) was applied on the lumbar spine with stenosis at a high frequency and intensity. Results: Visual analog scale (VAS) pain score significantly decreased in both groups, and the VAS value decreased more after JMG than that after TENSG. The pain thresholds of both groups also significantly increased, and that of JMG increased more compared to TENSG. In both the groups, significant improvements in VAS and pain thresholds were found, and JMG showed better results than TENSG. Conclusions: JM and TENS showed significant relief in both pain threshold and painpain, and JM showed more advanced relief compared to TENS.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.13 no.2
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• pp.55-68
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• 2007

Object: to evaluate the effects of two different treatments-joint mobilization and therapeutic exercise on difference for length of lower limbs. Method: The subjects were participated twenty six who has difference for length of lower limbs more 10mm. All subjects randomly assigned to Joint mobilization group(n=13) and therapeutic exercise group. Joint mobilization group received joint mobilization for 2 minutes, Therapeutic exercise group received for 15 minutes per day and 3 times a week during 4 week period. Tape measure method was used to measure the difference for length of lower limbs. Biodex was used to measure the muscle power of lower limbs(Knee flexion, extension). Finger to floor test was used to measure the mobility of spinal column. All measurement of each subjects were measured at pre-experiment, after 2weeks and post-experiment. Result: The result of this study were summarized as follows : 1. Both treatment decreased difference for length of lower limbs while joint mobilization more decreased difference for length of lower limbs than therapeutic exercise. 2. Both treatment increased mobility of spinal column while joint mobilization more increased mobility of spinal column than therapeutic exercise. 3. Joint mobilization increased muscle power while therapeutic exercise decreased muscle power. Conclusion: in a group-wise comparison joint mobilization is more effective than therapeutic exercise.

• Applied Microscopy
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• v.45 no.3
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• pp.135-143
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• 2015

The aim of this study was to investigate effects on joint mobilization in neurochemical changes of nicotinamide adenine dinucleotide phosphate-diaphorase (NADPH-d) and nitric oxide synthase (NOS) of the spinal cord neurons after right knee joint immobilization (RKJI) and in ultrastructural changes of the femoral nerves innervating the muscles acting on RKJI. A total of 15 guinea pigs were used and divided into 5 groups. Immunohistochemistry was performed to detect NADPH-d and NOS. NADPH-d and NOS were not expressed in the ventral horn of control and experimental groups, but were expressed or not in the dorsal horn according to the duration of release after RKJI and the presence or absence of joint mobilization. Ultrastructures of the femoral nerves in experimental groups had partial demyelination and condensed clumps in axon. Effects on manipulative therapy after RKJI were confirmed from expression of NADPH-d and NOS in the dorsal horn of the lumbosacral spinal cord. Manipulative therapy was more effective against a long-term immobilization than a short-term immobilization.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.16 no.2
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• pp.53-60
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• 2010

Purpose : Neck pain is commonly experienced by both adolescents and adults. The purpose of this study was to measure neck disability index(NDI) and the cervical range of motion(CROM) following spinal manipulation and mobilization techniques. Methods : Thirty participants(manipulation=15, mobilization=15) with mild neck disability volunteered for this study. It was used to measure NDI with NDI questionnaire and six motions(neck flexion and extension, left and right lateral flexion, left and right rotation) with the CROM instrument. Independent t-test and paired t-test were used to estimate NDI and CROM, and compared left with right motions. Results : A significant decrease in NDI were found after spinal manipulation and mobilization treatment(p<.05). A trend toward increase in all cervical motions(flexion, extension, left and right lateral flexion, left and right rotation), after interventions, were revealed(p<.05). The significant differences were not found on NDI and CROM between the group(p<.05). It was presented asymmetric motions in cervical lateral flexion(p<.05) before and after treatment. Conclusions : Our results suggest that manipulation and mobilization probably provide at least short-term benefits for patients with mild neck pain. It is needed to be studied the factors and preventive methods influencing the asymmetric cervical motion.

• Physical Therapy Rehabilitation Science
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• v.13 no.3
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• pp.261-273
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• 2024

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.

• Journal of International Academy of Physical Therapy Research
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• v.11 no.2
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• pp.2090-2095
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• 2020

Background: Spinal Mobilization is one of the manual therapy technique that clinicians have used to treat pain, however, there is still a lack of research on changes in strength in healthy people. Objectives: To investigate the effect of posterior-anterior lumbar mobilization on lower limb strength in healthy individuals. Design: Two-group pretest-posttest design. Methods: In this study, 23 healthy subjects aged 20 years were assigned to 12 lumbar mobilization group (LMG) and 12 sham group (SG) to perform intervention and measurement through pre- and post-design. Intervention was performed in LMG with grade III~IV on L3-5 of the lumbar spine, and lumbar mobilization was performed for each segment. After intervention, knee flexion and extension strength were measured. To measure the main effect on muscle strength, a comparative analysis was conducted using paired t-test and independent t-test. Results: In LMG, knee flexor and extensor strength were increased significantly at 60°/s (P<.05). In addition, the extensors of LMG and SG were significantly different only at 60°/s, and the flexors were significantly different between groups at both 60°/s and 180°/s (P<.05). Conclusion: In healthy individuals, lumbar mobilization results in improvement of strength of knee flexor and extensor, and additional experiments on the effect of mobilization on the lumbar spine on functional changes in the lower limbs will be needed.