Earticle

Background: Chronic neck pain (CNP) is associated with weakness in the deep neck flexor muscles, a shortening of the neck extensors, and a reduction in endurance. In addition, muscle imbalance can lead to neck pain and musculoskeletal dysfunction. This study compared neck extensor muscle fatigue, muscle strength, and muscle endurance time between patients with CNP and healthy adults during isometric neck extension. Methods: Thirty participants (15 patients with CNP and 15 healthy adults) were recruited in this research. The outcome measures included splenius capitis (SC) muscle fatigue, isometric neck extensor strength, and muscle endurance. The independent T-test was used to compare the continuous dependent variables between the CNP group and the healthy group. Results: The independent T-test indicated that muscle fatigue in the left SC differed significantly between the CNP group and the healthy group. A significant difference was also noted in the isometric neck extensor and neck extensor strength between the groups. Conclusion: Our results provided promising clinical evidence that patients with CLP have reduced neck extensor strength and endurance and increased SC muscle fatigue, which results in neck pain.

Background: This study investigated the effects of sustained natural apophyseal glides (SNAGS) technique on lower back pain and pain disability among university students with lower back pain. Methods: A total thirty 20~30 year old university students with lower back pain were divided into two groups. A lumbar flexibility exercise was applied to the control group (n=15). The SNAGS technique group (n=15) received L1~L4 segment mobilization using SNAGS technique. Intervention was implemented for 20 minutes, 3 times a week for 3 weeks. The SNAGS were performed using belt with flexion and extension, whereas lumbar flexibility exercise included lumbar flexion and extension. Lower back disability was measured using the Korean Oswestry disability index (KODI), and pain sensitivity was measured by pain pressure threshold (PPT). The groups were assessed for lower back pain disability and pain, before and after the intervention. Results: There were significant improvements in both the KODI and PPT of the SNAGS technique group (p<.05), while the lumbar flexibility exercise group showed no significant change (p>.05). In addition, the SNAGS technique group had a statistically significant difference in KODI and PPT compared to the lumbar flexibility exercise group (p<.05). Conclusion: SNAGS technique is more effective than lumbar spine joint flexibility exercise in the improvement of lower back pain disability and pain among university students with lower back pain.

Background: The purpose of this study is to investigate basic data about the effects of muscle energy technique on the shoulder complex range of motion and posture alignment in the round shoulder posture. Methods: The subjects included 15 women that gave consent to participate in the study voluntarily. They performed the muscle energy technique for 30 minutes twice. The round shoulder posture was measured with a straight edge ruler. The shoulder complex range of motion was measured with the apley scratch test. The forward head posture was measured with ImageJ. The pectoralis minor muscle length was measured with a tape measure. Results: There were statistically significant differences in the round shoulder posture both right and left (p<.05). The experiment group showed statistically significant differences in the pectoralis minor muscle length (p<.05). There were significant differences in the shoulder complex range of motion including flexion, left lateral flexion, right lateral flexion, left side bending, and right side bending (p<.05), but no significant differences were found in extension (p>.05). The forward head posture showed significant differences in CVA changes (p<.05) and no significant differences in CRA changes (p>.05). Conclusion: These findings demonstrate that the muscle energy technique relaxed muscles around the shoulders and increased the shoulder complex range of motion. The technique is also expected to prevent pain in the neck and shoulders and lower injury risk. In conclusion, the muscle energy technique can be applied as an effective intervention for round shoulder posture.

Background : Prone hip extension (PHE) is commonly used for exercises and tests in patients with low back pain. Previous studies have shown that pelvic compression belts (PCB) and non-elastic taping (NET) contribute greatly to improvements in lumbopelvic stability. This study aimed to compare the effect of two lumbopelvic stability methods such as PCB and NET on the trunk and hip extensor muscle activities during PHE tests. Methods: Subjects who experienced low back pain (low back pain group, LBPG; n=20) and those who did not experience low back pain (non-LBPG; n=20) participated in this study. The subjects were instructed to perform PHE with and without a PCB and NET. PHE tests were performed in the condition wherein the two stabilization methods were applied, and the actions of the muscles at that time were measured using surface electromyography (EMG). EMG data were collected from the hamstring, gluteus maximus, erector spine (ES), and multifidus (MF) muscles. The data were collected three times for 5 s with a 1-min rest between each of the three sets. Results: In the LBPG, EMG of the ES muscle was significantly reduced when NET or a PCB was applied (p<.05). There was no difference in the change in the ES muscle activity when NET and a PCB were applied. The ratio of MF/ES muscleactivity showed a significant increase in the LBPG with NET (p<.05). Conclusion: Both NET and PCB applied to subjects who experienced low back pain significantly reduced the ES muscle activity during PHE exercises and helped control the balance of the superficial and deep trunk extensor muscles.

Background: The purpose of this study is to compare and analysis the changes in strength and endurance of the knee extensor muscles after Anterior cruciate ligament reconstruction. Methods: Twelve male subjects with ligament injury were seated on Biodex and the hip joint was flexed at 110°, and torso, lower extremities, and legs were fixed using Velcro. The resistance device was placed at a point 3cm above the ankle, and measurements were taken before and a surgery at 60°/sec and 180°/sec when the knee was maximally extended. The postures ingeniously combine forward-bending poses countered with backward-bending ones. Results: There was no significant difference in the comparison of muscle strength of 60°/sec and 180°/sec before surgery. But there was a significant difference after surgery. There was significant difference in muscle endurance both before and after surgery. There was a significant difference in the pre- and post- operative comparison values of muscle strength and endurance in isokinetic movements at 60°/sec and 180°/sec during knee extension on the injured side. Conclusion: For cruciate ligament tears, Orthopedic reconstruction is recommended. Correct alignment of the knee ligament after surgery can enhance the strength and endurance of the quadriceps femoris during knee extension rejuvenated.

Background: The purpose of this study was to investigate the effects of flexi-bar exercise on shoulder pain, dysfunction, quality of life, and range of motion of women with breast cancer surgery. Methods: A total of 42 female patients who had breast cancer were included in this study. By drawing lots, subjects were divided into a flexi-bar exercise group (FBG, n=21) and a general breast cancer group (GBG, n=18). The effects of flexi-bar exercise on patients were evaluated in terms of the visual analogue scale (VAS), the shoulder pain and disability index (SPADI), the European organization for the research and treatment of cancer quality of life questionnaire (EORTC QLQ-C30), the breast cancer specific EORTC quality of life questionnaire (EORTC QLQ-BR23), and range of motion (ROM), all of which were measured pre- and post- intervention followed by evaluation. Results: A significant increase was pain, functional disability level, quality of life, ROM within the two groups (p<.01). There were pain, functional disability level, quality of life, ROM post test then invention were significant between the two groups(p<.01). Conclusion: The flexi-bar exercise has a positive treatment effect on breast cancer patients.

Background: This study aimed to use the muscle energy technique (MET) with total knee replacement (TKR) during the chronic phase in a clinical setting and confirm its effects on the knee extensor strength and ROM, balance, and walking ability. Methods: A total of 20 female patients who underwent TKR 1~4 years ago were assigned to two groups (Control: Q setting exercise+general physical therapy, n=10; Exp: MET+general physical therapy, n=10). Interventions were performed three times a week for 4 weeks. The strength of the knee extensor was evaluated using an aneroid sphygmomanometer, and ROM was evaluated using degrees at the end range on active knee flexion. The main balance outcomes were evaluated using two standard scale (TSS) and timed up and go (TUG) test, whereas the walking ability was evaluated using the 10 meter walk test (10MWT). Results: Analysis showed that both groups had significant increases in strength, ROM, TSS, TUG, and 10MWT. Differences in all variables were significant between the control and Exp groups at the post-intervention evaluation (p<.05). However, no significant difference was observed in strength and TUG. Conclusion: Results of this study demonstrated that MET would help improve the strength, ROM, balance, and walking ability of patients with chronic TKR who want to enhance their abilities and performance in activities of daily living.

Background: Degenerative arthritis accounts for a large portion of the elderly, causing a lot of inconvenience in daily life. Total knee replacement (TKR) are performed to relieve pain in the knee joint. The purpose of this study was to determine whether knee joint stabilization exercises are effective in improving balance and walking ability in degenerative arthritis patients who have undergone TKR. Methods: A total of 30 TKR patients participated in this study. They were assigned to two groups. The experimental group, the group that underwent knee stabilization exercises, joint mobilization and general physical therapy. On the other hand, and the controlled group, the group that underwent joint mobilization and general physical therapy. All exercises were conducted thrice a week, for four weeks. The main balance outcomes were evaluated using the posture balance training system, while walking ability was assessed using a wireless 3-axis accelerometer. Results: The experimental group had significantly higher scores in postural stability testing (PST), limits stability testing, and waling ability. The post-intervention evaluation, there were significant differences in all variables between the two groups. However, no significant difference was noted in the foam eyes closed test in PST. Conclusion: This study suggests that knee joint stabilization exercises effectively improve the balance and walking ability of TKR patients. Thus, it could be presented as useful in clinical practice.

BACKGROUND: This study aimed to determine the changes in muscle strength and walking ability in patients who complained of knee instability due to excessive pronation of the foot. METHODS: Twenty patients (ten men and ten women) who complained of instability of the knee joint due to excessive pronation of the foot participated in the experiment. In the experimental group, the internal rotation of the tibia caused by excessive adduction of the foot was maintained as external rotation, and the joint state was to recognize the movement of the joint position changed through maintenance of the muscle. This exercise was performed five times for each patient, and the muscle strength maintenance was performed for 20 seconds. In the control group, stretching and range of motion (ROM) exercises were performed. For the stretching exercise, one specific motion was performed for 20 second, and the ROM exercise was performed to confirm the change in muscle strength in the knee joint area and walking ability. RESULTS: The knee flexion and extension strength in the patients with excessive pronation of the foot differed significantly from those in the subjects from the control group (p<.05). Further, the before-after comparison of the step time and length in the evaluation of walking ability, which affects overall postural movement due to knee joint instability, revealed a significant difference between the experimental and control groups (p<.05). CONCLUSION: The patients that were subjected to manual therapy and ROM exercise for the knee joint showed improved knee joint muscle strength and walking ability compared to the subjects from the control group.

Purpose: This study aimed to investigate the effects of myofascial release technique on pain threshold and hormonal changes in patients with adhesive capsulitis of the shoulder. Methods: Eight patients with adhesive capsulitis were treated with the myofascial release technique. Myofascial release is a form of manual therapy that involves the application of a low load, long duration stretch to the myofascial complex, intended to restore optimal length, decrease pain, and improve function. Blood tests and pressure pain threshold (PPT) examinations were performed on their first visit. On their second visit, the myofascial release technique was applied to the shoulder for 20 min. Then, blood tests and PPT were re-evaluated to determine the effects of the myofascial release technique on pain threshold and hormonal changes. Results: Pain threshold increased from 2.92 to 24.13 lb after treatment. Epinephrine decreased from .13 to .08 ng/mL whereas norepinephrine increased from .25 to .41ng/㎖ after treatment. Conclusion: Myofascial release technique in patients with adhesive capsulitis increased pain thresholds, norepinephrine and decreased epinephrine levels.