• Journal of International Academy of Physical Therapy Research
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• v.8 no.2
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• pp.1201-1205
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• 2017

The purpose of this case study was to investigate the effects of thoracic mobilization and manipulation on a patient with upper thoracic pain. The subject had been complaining of upper thoracic pain for the last 4 months. On the X-ray, T3 and T4 spinous process were located on the left side of the vertical axis. First, transverse mobilization was applied from left to right at the T3-T4 and then thoracic manipulation was performed. The intervention methods of mobilization and manipulation were based on the concept of Maitland manual therapy. The subject underwent a total of 20 sessions (five times per week for four weeks). The thoracic pain and vertebral rotation angle were measured to examine the effect of the intervention. The thoracic pain score decreased (from 4.0 to 1.5) and the angle of thoracic vertebral rotation decreased (from $70{\underline{\circ}}$ to $4.0{\underline{\circ}}$). These results suggest that applied mobilization and manipulation in patients with a primary complaint of thoracic pain decreasing the thoracic pain and vertebral rotation angle.

• Journal of the Korean Society of Physical Medicine
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• v.10 no.2
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• pp.35-45
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• 2015

PURPOSE: The aim of this study is to investigate how upper thoracic manipulation and cervical stability training affects cervical range of motion and neck disability index of patients with chronic mechanical neck pain. METHODS: 30 patients with chronic mechanical neck pain, and randomly divided into the upper thoracic manipulation and the cervical stability training group. Upper thoracic manipulation group was conducted to the upper thoracic manipulation, and cervical stability training was conducted to the cervical stability training. Intervention period was 6 weeks, and 3 sessions, each of which was run for 5~10 minutes. The subjects were measured neck range of motion before and after intervention by electro-goniometer. Neck disability index was used to measure neck disability index Korean version. RESULTS: Comparison within groups, there were significant difference in neck range of motion before and after intervention, and Neck disability index significantly reduced in the cervical stability training group. The comparison between groups, there were no significant difference in neck range of motion and neck disability index. CONCLUSION: Upper thoracic manipulation and cervical stability training to the patients with chronic neck pain was helpful to improve neck range of motion and cervical stability training was helpful to improve neck disability index.

• Journal of The Korean Society of Integrative Medicine
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• v.8 no.3
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• pp.43-52
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• 2020

Purpose : The aim of this study was to investigate the change of the respiratory function of chronic low back pain patients after the thoracic manipulation and the trunk stability exercise on chronic low back pain patients. Methods : For this study, the group of the experiment was consisted of 44 patients suffering from the low back pain chronically. The participants were divided into two groups: the control group, which was assigned for core stabilization exercise (CSE), and the experimental group, which was randomly assigned for core stabilization exercise after thoracic manipulation (CSE+TM). Both groups carried out each assigned treatment on three times a week for 8 weeks. To study the change related to measurement variable from each test groups before and after intervention, paired t-test was performed. Further, the statistics for an intergroup comparison was analyzed by covariance analysis, ANCOVA. The measurement was conducted by the respiratory function, the respiratory function was measured by forced vital capacity (FVC) and forced expiratory volume in one second (FEV₁). Results : As a result, forced vital capacity (FVC) and forced expiratory volume in one second (FEV₁) showed significant differences not only by each groups but also between those groups before and after the test. Conclusion : In conclusion, both experiments, the core stabilization exercise and the core stabilization exercise conducted after thoracic manipulation, on chronic low back pain patients resulted in the significant level of difference in the respiratory function. This result indicates that the thoracic manipulation is an efficient treatment for improving the respiratory function for chronic low back pain patients.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.22 no.1
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• pp.17-25
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• 2016

Purpose: This study was aimed to determine the effects of thoracic spine thrust manipulation on muscle activities of the scapular upward rotators and middle deltoid, active range of motion (AROM), shoulder pain, and rounded shoulder posture in young adults with rounded shoulder. Methods: The subjects were 30 young adults (14 males, 16 females) with rounded shoulder. Thirty subjects were randomly assigned to an experimental (manipulation) and control (placebo) groups of fifteen subjects respectively. The manipulation group received the manipulation (high velocity, low amplitude), which was performed by a physical therapist with the subject in the supine position and with the arms crossed over the chest and hands passed over the shoulders. For the sham group, the same procedure was performed, with the exception that the high-velocity thrust was not applied. Measurements were taken before and after the intervention. Muscle activity of upper and lower trapezius, serratus anterior, middle deltoid was measured using surface electromyography. Visual analog scale (VAS) was used for shoulder pain. Goniometry was used for shoulder abduction active range of motion (AROM). Straight edge was used for supine rounded shoulder posture (RSP) distance. Results: The muscle activity of the upper trapezius, lower trapezius and middle deltoid muscle increased significantly after the intervention (p<.05). However, no significant difference was observed in serratus anterior muscle (p>.05). The VAS was significantly decreased and AROM significantly increased after the intervention (p<.05). The distance of RSP were not significant (p>.05). The control group showed no differences before and after the intervention (p>.05). Conclusion: The results of this study suggest that thoracic spine thrust manipulation can be an effective component of treatment plan to improve pain and function.

• Journal of International Academy of Physical Therapy Research
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• v.12 no.2
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• pp.2345-2353
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• 2021

Background: This study evaluated the effectiveness of upper thoracic manipulation (UTM) and proprioceptive training versus proprioceptive training alone on forward head posture (FHP) and cervicocephalic joint position sense (CJPS) in asymptomatic university students during a short interval of time. Objectives: To evaluate whether the suggested combination would provide greater benefit, and be superior to proprioceptive training alone in improving proprioceptive acuity and head posture. Design: A single-blind randomized controlled trial. Methods: Thirty-three university student volunteers with asymptomatic FHP were recruited. Subjects were randomly assigned to a manipulation group (n=16) receiving UTM combined with proprioceptive training or a proprioception group (n=17) receiving proprioceptive training only. The intervention period lasted 5 weeks in total, and consisted of one 15 to 20-minute session per week. FHP and CJPS were assessed before and after the intervention. Results: A significant pre- to post-intervention decrease in FHP and joint position error was identified in both groups (P<.05). Subjects in the manipulation group demonstrated greater improvements in CJPS and head posture compared to the proprioception group (P<.05). Conclusion: These findings support employing either intervention for treating asymptomatic students with FHP. However, the addition of UTM to proprioceptive training was more effective than proprioceptive training alone in reducing joint position errors and improving head posture.

• Journal of the Korean Society of Physical Medicine
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• v.16 no.2
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• pp.115-123
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• 2021

PURPOSE: This study aimed to investigate the benefits of thoracic manipulation and the trunk stability exercises on spine trunk flexibility and the pain index of chronic low back pain patients. METHODS: The study included 44 patients suffering from chronic low back pain. The participants were divided into two groups: the first group was assigned for trunk stability exercises (TSE), and the second group was randomly assigned TSE and thoracic manipulation at the same time (TSE+TM). Both groups carried out each assigned treatment thrice a week for 8 weeks. The study outcome was based on assessment of spine trunk flexibility and the pain index. Spine trunk flexibility was measured by spine flexion and extension through a range of motion and thoracic cage circumference. The pain index was measured using a visual analog scale (VAS). RESULTS: Spine flexion and extension range of motion showed a significant difference within each group and between the groups before and after the treatment. The measurement of the thoracic cage circumference also showed a notable difference within each group and between the groups before and after the treatment. There was no change in the pain index. CONCLUSION: These results indicate that thoracic manipulation with the trunk stability exercises is an efficient treatment for improving the spine trunk flexibility and soothing pain for chronic low back pain patients.

• The Journal of Churna Manual Medicine for Spine and Nerves
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• v.9 no.1
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• pp.103-114
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• 2014

Objectives : The purpose of this study was to report clinical effects of Lumbar flexion-distraction manipulation and Sitting position thoracic and lumbar vertebra adjustment manipulation on patient with Juvenile idiopathic scoliosis Methods : The patients have been treated with the above two Chuna manual manipulations. We measured Cobb's angle, VNRS before and after treatment Results : After treatment, we confirmed these transition : In first case, Cobb's angle of T-spine changed from 27 to 23 : Cobb's angle of L-spine changed from 17 to 10 : VNRS changed from 6 to 2. In second case Cobb's angle of T-spine changed from 30 to 21 : Cobb's angle of L-spine changed from 16 to 16 : VNRS chagned from 6 to 3 Conclusion : The result suggests that these two Chuna manual manipulations were effective treatment on patients with Juvenile idiopathic scoliosis.

• The Journal of Korean Physical Therapy
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• v.29 no.4
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• pp.158-163
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• 2017

Purpose: The purpose of this study was to investigate the relationship among pain, range of motion of the neck, neck disability index and grip strength after thoracic manipulation and cervical stabilization training in patients with chronic neck pain. Methods: In this study, twelve subjects with chronic neck pain were included. All participants had thoracic manipulation and cervical stabilization training. Intervention was conducted three times per a week, for 4 weeks. The visual analogue scale (VAS), range of motion of neck, neck disability index (NDI), as well as the grip strength before and after intervention were measured in all participants. Paired t-test was used to compare variables before and after intervention. Pearson correlation analysis was used to identify the correlations between the variables. Results: All variables after the intervention were significantly improved. There was a significant negative correlation between VAS and flexion angle of the neck (r=-0.669, p<0.05). Moreover, there was a significant positive correlation between NDI and VAS (r=0.636, p<0.05), and a significant negative correlation between NDI and flexion angle of the neck (r=-0.692, p<0.05). Conclusion: Patients with reduced pain following therapeutic intervention illustrated that there would be an improvement in the flexion angle rather than the extension angle of the neck, and that those with increased flexion angle would have less restriction of activities in daily living.

• The Journal of Churna Manual Medicine for Spine and Nerves
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• v.1 no.1
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• pp.45-50
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• 2006

Objectives : A rare case of dural tear ensuing after a cervical Chuna Manipulation Treatment leading to cerebrospinal fluid (CSF) leakage in the lower cervical and upper thoracic spine was found, so we report it. Methods : A 32-year-old woman presented with back and neck pain in 1 days earlier. The patient undertook a cervical Chuna Manipulation Treatment. After this maneuver, the patient complained of an orthostatic headache with nausea. The patient's headache worsened, and lying down gave the only measure of limited relief. In Brain CT and MRI study, nonspecific finding was detected. In Cistemography study, CSF leakage at lower cervical or upper thoracic area was detected. Results and Conclusions : It is supposed that this patient suffered a dural tear and CSF leakage secondarily due to a cervical Chuna Manipulation Treatment. From this case, we can understand the etiology of dural tear to some extent and consider the complication of Chuna Manipulation Treatment. In the future, more study, research and prospective trial for complications of a cervical Chuna Manipulation Treatment is needed.

• Journal of Chest Surgery
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• v.47 no.4
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• pp.434-436
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• 2014

Left ventricular thrombus is a common complication related to acute myocardial infarction. Removing this with an incision of the free wall of the left ventricle may cause fatal cardiac dysfunction or arrhythmias. Furthermore, performing incision and suture on the fragile myocardium of an acute myocardial infarction patient may cause serious bleeding complications. If there is a patient with left ventricular thrombus who needs thoracotomy for another reason, the case is attempted with the thought that if effective intraventricular visualization and manipulation can be done, fatalities caused by incision and suture may be reduced. For patients undergoing cardiopulmonary bypass, if intracardiac manipulation is required, an endoscope can be used, and given the potential complications after the incision and suturing of the infarcted tissue, the benefits are deemed sufficient.