• Journal of International Academy of Physical Therapy Research
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• v.11 no.4
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• pp.2191-2196
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• 2020

Background: Incorrect postures of adolescents caused by the use of smart devices have been noted as a factor causing spinal diseases. Objectives: To examine the effect of joint mobilization and stretching on Cobb's angle and respiratory function in adolescent idiopathic scoliosis (AIS). Design: Cluster-randomized controlled trial. Methods: A total of 22 subjects with AIS were enrolled. They were allocated to two groups: the joint mobilization (n=11) and the stretching (n=11). All interventions were conducted for 30 minutes, three times a week for six weeks. Outcome measures were the Cobb's angle and respiratory function. The Cobb's angle and respiratory function measured using the X-ray and Micro-Quark. Results: Joint mobilization group showed significant differences in Cobb's angle and respiratory function, but stretching group showed significant differences Cobb's angle. The differences in peak expiratory flow (PEF) between the two groups were significant. Conclusion: This study proved that joint mobilization is a more effective intervention for AIS to improve Cobb's angle and respiratory function, when compared to stretching.

• 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 the Korean Society of Physical Medicine
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• v.2 no.2
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• pp.113-124
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• 2007

Purpose : The purpose of this study was to investigate the effects of joint mobilization on the rang of motion and pain of patient with chronic low back pain. Methods : The subjects were consisted of thirty patients with chronic low back pain(19 females, 11 males ; mean aged 59.93) from 50 to 71. All subjects randomly assigned to the modalities treatment group, joint mobilization group. Modalities treatment group received hot pack used thermal therapy for 20minutes and ICT used electrical therapy for 15minutes, joint mobilization group received modalities treatment with sustained natural apophyseal glides(SNAGS) techniques of Mulligan for 10minutes per day and three times a week during 2 weeks period. Visual Analogue Scale(VAS) was used to measure subjective pain level. Remodified Schober test(RST) was used to measure range of motion of lumbar spine. All measurements of each patients were measured at pre-treatment and 2 weeks post-treatment. Results : The results of this study were summarized as follows : 1. VAS was joint mobilization group showed significantly decreased more than modalities treatment group (p<.05). 2. The lumbar flexion range of motion was joint mobilization group showed significantly decreased more than modalities treatment group(p<.05). 3. The lumbar extension range of motion was joint mobilization group showed significantly decreased more than modalities treatment group(p<.05). 4. The lumbar left lateral flexion range of motion was joint mobilization group showed significantly decreased more than modalities treatment group(p<.05). 5. The lumbar right lateral flexion range of motion was joint mobilization group showed significantly decreased more than modalities treatment group(p<.05). Conclusion : These data suggests that SNAGS of Mulligan is beneficial treatment for chronic low back pain.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.20 no.1
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• pp.9-14
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• 2014

Background: Cervical radiculopathy is the result of cervical nerve root pathology that may lead to chronic pain and disability. Although manual therapy interventions including cervical traction and neural mobilization have been advocated to decrease pain and disability caused by cervical radiculopathy, their analgesic effect has been questioned due to the low quality of research evidence. The purpose of this paper is to present the effect of manual therapy on pain, ROM, disability in a patient experiencing cervical radiculopathy. Methods: In this study, 30 participants who met the diagnostic criteria for cervical radiculopathy were randomized into two groups: group I (nerve mobilization group) & group II (Mckenzie exercise group). The experimental group was performed manual cervical traction and neural mobilization technique. The control group was performed manual cervical traction and cervical retraction, extension exercise. Assessments were performed to 30 participants before and after 4 weeks therapy. The components of assessments were pain intensity (PI), cervical rotation ROM (CR) and neck disability index (NDI). Results: After 4 weeks therapy, PI, CR and NDI were significantly reduced in both groups (p<.01). The PI, CR and NDI were no significantly reduced between group I and group II (p>.01). Conclusions: Manual therapy could reduce the symptoms of cervical radiculotpathy.

• Journal of The Korean Society of Integrative Medicine
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• v.6 no.4
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• pp.139-148
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• 2018

Purpose : The purpose of this study was to examine the effects of waist mobilization technique intervention for patients with chronic back pain on balance and the low back pain disability index. Methods : The subjects were 30 patients with chronic back pain. They were sampled and divided into a manual therapy group and a spinal decompression group. 15 subjects were randomly assigned to each group. Each training in this study participated for 6 weeks, 5 times a week, once a day, 15 minutes a day. Balance ability was measured with a balance analyzer, and the low back pain disability index was measured using the Oswestry Disability Index (ODI). Results : In the balance abilities, there was a significant difference in the manual therapy group compared to the spinal decompression group. In the low back pain disability index, there was a significant difference in the manual therapy group compared to the spinal decompression group. Conclusion : The analysis results of the effect of 6 weeks of waist mobilization technique intervention on the balance and low back pain disability index for patients with chronic back pain revealed that the manual therapy is more effective for static and dynamic balance ability and the low back pain disability index. In the future, we can promote independent life skills and expect a rapid recovery of patients with chronic back pain. Based on this study, further studies are needed on the effects of balance, the mechanical properties of muscle, and the low back pain disability index depending on various manual therapy techniques.

• Journal of International Academy of Physical Therapy Research
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• v.9 no.3
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• pp.1521-1527
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• 2018

The original focus of this study was to investigate the immediate effects of lumbar rotational mobilization on the one-legged standing ability. Fifteen subjects (6 men and 9 women, mean age = 22.77 (SD = 1.21), mean height = 165.46cm (SD = 11.65), mean weight = 61.46kg (SD = 8.29) volunteers from healthy individuals were recruited and randomized to a lumbar rotational mobilization (LRM) group and a trunk rotational exercise (TRE) group. Mobilization (grade 3 or 4) was applied to the LRM group on the lumbar spine (L1 to L5) in a side-lying, and trunk twist exercise (left and right side) was applied the to the TRE group with lunge position. Center of pressure (COP) and the velocity of the center of pressure (VCOP) of each participant were measured as a balance ability through one leg standing position. Results are as follows. In within-group difference, the COP of the LRM group reduced during standing with the right foot, but the VCOP change of the LRM was not statistically significant. In between-groups difference, COP of TRE group was decreased compared with LRM group only during left leg standing in the eyes (p <.05). The results of this study suggest that LRM is more effective than TRE in improving balance ability.

• Journal of International Academy of Physical Therapy Research
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• v.11 no.3
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• pp.2119-2125
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• 2020

Background: Adults with forward head posture (FHP) often suffer from thoracic hyperkyphosis and thoracic dysfunction, and including reduction of the craniovertebral angle (CV angle) and tightening of the superficial neck muscles. In order to treat thoracic dysfunction, interventions aimed at improving thoracic mobility are necessary. Objectives: To examine the effects of maitland manual mobilization therapy on the thoracic spine in adults with FHP. Design: Single-blind randomized controlled trial. Methods: Thirty adults with FHP who met the selection criteria were randomized to the thoracic multiple joint mobilization (TMJM; n=15) group and the thoracic general joint mobilization (TGJM; n=15) group. Joint mobilizations were performed for 23 minutes a day for 4 weeks continuously, two times per week. Outcome measures were ImageJ, BTS FREE EMG 1000, neck disability Index (NDI). Results: Although changes in the left sternocleidomastoid muscle activity and NDI scores over time between the two groups differed, other variables were noted only changes observed over time. Muscle activity in the right sternocleidomastoid increased again in the TGJM group post-intervention and 2 weeks after the end of the experiment, but changes in other variables were retained or improved, confirming the lasting effects of thoracic joint mobilization. Conclusion: Thoracic multiple joint mobilization may be recommended as a more effective intervention for adults with FHP.

• Journal of International Academy of Physical Therapy Research
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• v.10 no.2
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• pp.1803-1809
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• 2019

Background: Cervical mobilization has been applied mainly for the improvement of arm and neck movements and pain reduction, and little research has been done to improve the executive function. Since this kind of so-called mechanical neck pain is one of most common symptoms, there are controversial issues about this with spine alignment. Posteroanterior (PA) mobilization from the Maitland concept is a process of examination, assessment, and treatment of neuromusculoskeletal disorder by manipulative physical therapy. Objective: To examine the short-term benefits of mobilization for patients with non-specific neck pain. Design: Dual-group Pretest-Posttest Design from the Quasi-Experimental research Methods: Fourteen participants (male 8, female 6; 20's of their age) with non-specific neck pains which are distributed all the unilateral or bilateral body side were recruited. Participants were categorized to Neck Pain with Movement Coordination Impairments (NPMCI) and Neck Pain with Mobility Deficits (NPMD) groups according to the results of physical examination. Professional physical therapist who has over 15-years-of clinical experience applicated manipulative therapy for the neck pain, an occupational therapist only conducted evaluations; K-NDI (Korean version of the Neck Disability Index), VAS (Visual Analog Scale), BDS-K (Korean version of Behavioral Dyscontrol Scale) for decreasing possible adverse effects; there were no person who reported other symptoms followed 4 weeks from the trial. Results: In the NPMCI group, data analysis indicated statistical differences between the PA mobilization interventions in NDI and BDS-K; even though, pain was reduced in VAS, this is not a significantly differ. In the NPMD group, data analysis represented statistical differences between the PA mobilization interventions in NDI, VAS and BDS-K; the scores were represented to be increased or the pain got relief. Conclusions: PA mobilization techniques according to Maitland concept have beneficial effects in patients with neck pain and other clinical positive effects which included neck disability, pain itself and motor function of upper extremity.

• The Journal of Korea CHUNA Manual Medicine
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• v.2 no.1
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• pp.111-120
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• 2001

We reviewed literatures of western and oriental medicine about postoperative management of spine. Traditionally, with orthoses and bed rest, many physicians restricted activity of daily life and back exercises of patients who had taken spine surgery. More aggressive early mobilization, however, such as strengthening exercise and stretching after 4 weeks of surgery gets grounds nowadays. Physical therapies including manipulation, TENS, MENS, ultrasound and cryotherapy are being used as helpful treatment modalities of postoperative pain and swelling. Failed back surgery syndrome occurs due to wrong patient, diagnosis and surgery and is managed with conservative treatment or reoperation. In oriental medicine, treatments of musculoskeletal injuries including surgical wound are based on the balance of chi(氣) and blood(血).

• Physical Therapy Korea
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• v.22 no.3
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• pp.50-60
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• 2015

The purpose of this study was to apply the joint mobilization technique to the level of segments with pain and to the level of segments with hypomobility respectively and compare the immediate effects of the joint mobilization technique on the pain, the active cervical range of motion (ROM), and treatment satisfaction of patients with acute mechanical neck pain. After the baseline assessment, forty-two patients were randomized into two groups: a painful group ($n_1=21$) that received joint mobilization at the most painful cervical spine level and a hypomobile group ($n_2=21$) that received joint mobilization at the most hypomobile cervical level. The patients received an intervention that applied unilateral posterior-anterior gliding for 5 minutes and two repetitions of 10 times of active extension motion with distraction. In the Wilcoxon signed-rank test, the painful group and the hypomobile group were improved significantly in all pain variables (p<.001), while the painful group was improved significantly in the active cervical flexion (p<.001), extension (p<.001), left side-bending (p<.01), right side-bending (p=.001), left rotation (p<.001), and right rotation (p<.001). The hypomobile group was significantly improved in active cervical flexion (p=.001), extension (p<.001), left side-bending (p<.05), right side-bending (p=.001), left rotation (p=.001), and right rotation (p<.01) after intervention. In the Mann-Whitney U test, there was no significant difference in any of the dependent variables after the intervention between the two groups, but the painful group was slightly superior to the hypomobile group in all variables except for the right lateral flexion ROM and treatment satisfaction. These outcomes suggest that the cervical joint mobilization may be applied to either the level of painful segments or the hypomobile segments for the treatment of patients with acute mechanical neck pain.