Earticle

Background: Chronic ankle instability can result in balance and gait impairments because of weakness in the ankle muscles and reduced proprioceptive function. Barefoot walking is distinct from walking in shoes with regard to kinematics, kinetics, and muscle activity. Moreover, outdoor walking exhibits significant differences from indoor walking across eight environmental factors, including variations in surrounding conditions, ground characteristics, external physical loads, and attentional demands. Community‑based barefoot walking leverages natural terrain and minimal equipment to provide an accessible, low‑cost intervention that may more effectively stimulate ankle sensorimotor pathways. This study examined the effects of barefoot walking exercises on proprioception, muscle activity, and balance in adults with chronic ankle instability. Methods: Thirty participants with chronic ankle instability were recruited and randomly assigned to one of two groups: an experimental group (barefoot walking exercise) and a control group (shoe walking exercise). The participants in both groups engaged in their respective exercises for six weeks, with sessions conducted five times per week for 40 minutes each. The assessments were performed before and after the intervention. Results: After the intervention, significant improvements in proprioception were observed in the experimental group for dorsiflexion and plantar flexion (p<.05). Regarding muscle activity, the experimental group showed significant changes in the tibialis anterior and peroneal muscles (p<.05), while no significant differences were observed in the gastrocnemius muscle (p>.05). The balance variables showed significant improvements in all measured directions (p<.05). Conclusion: Community‑based barefoot walking exercise is effective in enhancing proprioception, selectively augmenting ankle muscle activation, and improving dynamic balance in adults with chronic ankle instability. This simple, low‑resource intervention may be readily incorporated into rehabilitation programs to optimize functional outcomes.

Background: Chronic ankle instability is common among basketball players, leading to repeated lateral sprains, impaired proprioception, balance deficits, and persistent pain. Rehabilitation typically emphasizes proprioceptive, neuromuscular, and balance training to restore function and prevent recurrence. However, the strategy of restricting healthy‑side movement to intensify neuromuscular focus on the affected limb has received little attention. This study therefore investigated whether balance and stabilization exercises incorporating healthy‑side movement restrictions could yield superior improvements in dynamic balance, reduce ankle instability, and alleviate pain in amateur basketball players with chronic lateral ankle instability. Methods: The participating subjects were 30 amateur basketball players in Daegu with chronic ankle instability. The subjects were randomized into the experimental (n=15) and control groups (n=15). The experimental group performed balance and stabilization exercises using healthy side restrictions, while the control group performed them without restrictions. The exercise was conducted three times a week for four weeks. The YBT was used to measure balance ability and the CAIT was used to measure ankle instability. Results: Both groups demonstrated significant within‑group improvements in YBT reach distances, enhanced CAIT scores, and reduced VAS pain ratings (p < .05). Notably, the experimental group achieved significantly greater gains in composite reach scores, larger increases in CAIT scores indicating reduced instability, and more pronounced pain reductions compared to the control group (p < .05). Conclusion: Incorporating healthy‑side movement restrictions into balance and stabilization training produces superior enhancements in functional balance, proprioceptive stability, and pain relief in basketball players with chronic ankle instability. This novel approach may augment existing rehabilitation protocols, offering a targeted strategy to prevent recurrence and optimize lower‑limb function.

Background: Myofascial pain syndrome (MPS) is a prevalent musculoskeletal disorder characterized by localized trigger points within taut bands of skeletal muscle fascia, leading to chronic pain, restricted range of motion, and impaired function. Although both ischemic compression and Kinesio taping have been individually applied to alleviate MPS symptoms, the potential synergistic benefits of their combined use remain underexplored. This study therefore investigated whether simultaneous application of ischemic compression and Kinesio taping would produce superior immediate improvements in pain relief, cervical function, and muscle mechanical properties compared to Kinesio taping alone. Methods: Thirty MPS patients from a Cheongju orthopedic clinic were randomized into an experimental group (n=15) receiving a 10‑minute session of ischemic compression followed by standardized Kinesio taping, and a control group (n=15) receiving only Kinesio taping. Cervical active ROM, neck disability index (NDI), pain intensity (VAS), and upper trapezius muscle tone, stiffness, and elasticity were measured before and immediately after intervention. Within‑ and between‑group comparisons were made using paired and independent t‑tests (α = .05). Results: Both groups showed significant improvements in cervical range of motion, except for extension in the control group, and in NDI scores. Post-intervention pain was significantly lower in the experimental group than in the control, with only the experimental group showing a notable pre-post improvement in muscle tone. Conclusion: A single session of combined ischemic compression and Kinesio taping yields greater immediate pain relief and muscle tone reduction than Kinesio taping alone, while offering comparable improvements in cervical function. These findings support a synergistic, multimodal approach to MPS management. Future research should explore optimal dosing, long‑term effects, and efficacy across varying pain severities in larger cohorts.

Background: Non‑specific low back pain is frequently linked to impaired motor control and altered sensory processing across spinal segments. Although lumbar stabilization exercises are commonly prescribed, recent evidence suggests that adjacent regions—particularly the thoracic spine—may play a critical role in modulating pain and function. This study compared the effects of thoracic versus lumbar movement control exercise interventions on pain intensity, sensory discrimination ability, mechanical sensitivity, and functional disability in patients with non‑specific low back pain. Methods: A total of 15 participants were recruited and assigned to either the thoracic movement control (TMC) group (7 participants) or the lumbar movement control (LMC) group (8 participants). All participants received electrical therapy and functional massage (15 minutes each) to manage low back pain. The TMC performed spinal movement control exercises for 15 minutes, while the LMC performed LMC exercises for the same duration. Both groups underwent interventions twice a week for 4 weeks, totaling 45 minutes of intervention. The outcomes were measured in pain, sensory discrimination, mechanosensitivity, and body function before and after the interventions. Results: There were significant within group reductions in the numeral rating pain scale (NRPS) and fear-avoidance beliefs questionnaire (FABQ) in both thoracic and the lumbar movement control groups (p<.05). Furthermore, the TMC demonstrated a more significant difference in the NRPS and the FABQ in the between-groups comparison (p<.05). Conclusion: This study confirmed that thoracic and lumbar movement control exercises are effective interventions for improving pain, sensory discrimination, the pressure pain threshold, and lumbar function in patients with non-specific low back pain.

Background: Prone shoulder extension exercises are commonly used to strengthen the scapular stabilizers, particularly the trapezius muscle. While previous studies have examined the effects of shoulder abduction angle and rotation alone, the combined influence of cervical and glenohumeral rotations on activation of the upper (UT), middle (MT), and lower trapezius (LT) remains unclear. Clarifying these interactions is essential for optimizing rehabilitation programs that target specific trapezius subregions through muscle length–tension modulation. Methods: Twelve healthy male adults performed nine variations of prone shoulder extension combining three neck positions with three shoulder rotations. Surface electromyography recorded trapezius activity, normalized to %MVIC. Each condition was held briefly and repeated with adequate rest to minimize fatigue. Repeated‑measures ANOVA and Bonferroni post‑hoc tests were used to compare activation across conditions (α = .05). Results: Upper trapezius activation was significantly higher in the neck contralateral rotation with shoulder external rotation position compared to the neck ipsilateral rotation with shoulder internal rotation position (p<.05). No significant differences were observed in middle trapezius activation across all exercise variations (p>.05). Lower trapezius activation was significantly higher in the neck neutral with shoulder neutral position compared to the neck ipsilateral rotation with shoulder internal rotation position (p<.05). Conclusion: Cervical and shoulder rotations distinctly modulate UT activation via alterations in muscle length, whereas MT remains stable and LT shows selective sensitivity under fully neutral positioning. These findings highlight the importance of considering coupled neck–shoulder kinematics to selectively target trapezius subregions in rehabilitation, and suggest that incorporating trunk rotation warrants further investigation for MT and LT modulation.

Background: This study examined the correlation between smooth pursuit eye movements and lower limb muscle activity, based on the movement distance of a target moving horizontally. Given the role of ocular motor control in balance and coordination, investigating the influence of smooth pursuit eye movement on lower‐limb muscle activation may inform novel, non‐invasive therapeutic interventions. Methods: Following the approval of Daegu University's Institutional Review Board (1040621-202109-HR-050), the experiment was conducted at D University from July 1 to July 31, 2024, with 33 participants who met the inclusion criteria: no visual or auditory impairments and no other neurological or musculoskeletal disorders. Each participant practiced smooth pursuit eye movement for 30 minutes. The participants wore an eye tracker, focused on an object three meters in front of them, and minimized neck movement by wearing a neck collar. They observed and tracked an object moving horizontally up to five meters to the left and right. For muscle activity in the lower limbs, this study measured the tibialis anterior, gastrocnemius, vastus medialis, and biceps femoris muscles. Results: Significant differences in the lower limb muscle activity were observed in the tibialis anterior, gastrocnemius, vastus medialis, and biceps femoris at the ranges of 0m vs. 5m and 3m vs. 5m (p<.05). Conclusion: These findings indicate that smooth pursuit eye movement may serve as a novel rehabilitation paradigm to enhance lower‐limb muscle activation in patients with neurological disorders such as stroke and Parkinson’s disease. Future studies should explore long‐term effects of repeated eye‐tracking interventions in larger and clinical populations to validate these preliminary results.

Background: This study conducted a meta-analysis of domestic randomized controlled trials to evaluate how various manual therapy techniques influence neck disability. Although manual interventions such as Maitland, McKenzie, Mulligan, Kaltenborn, and chiropractic methods are routinely used for non-specific neck pain, their aggregate effects on pain reduction, functional improvement, and cervical range of motion remain unclear. Methods: The five domestic databases were used to implement literature searches independently. A total of 19 out of 925 selected articles were used to analyze, except those overlapped (n=219), those irrelevant to neck disability (n=364), those consisting of the abstract and presentation notes alone (n=19), those without manual therapy intervention or dealing with other types of intervention (n=298), and those making it possible to apply the same kind of intervention to other sites (n=6). The intervention followed the guidelines presented as five types of manual therapy, and used the risk of bias in Cochrane library to assess the quality of the literature. Results: An uncertain risk was ‘random sequence generation' in three articles and ‘non-public grouping' in fifteen articles. ‘Blinding of the subjects and the researcher' was mentioned in only one article, and no article mentioned ‘blinding for result assessment'. Seven articles were at high risk of ‘incomplete results,' and one was at high risk of ‘selective result report'. Conclusion: Current domestic evidence indicates that manual therapy methods significantly alleviate pain, decrease neck-related disability, and enhance cervical mobility in patients with neck dysfunction. To strengthen these findings, future trials should employ rigorous blinding, standardized intervention protocols, and larger samples. Integrating manual therapy into multidisciplinary rehabilitation programs is supported by this meta-analysis as an effective approach for managing neck disability.

PURPOSE: This study aimed to investigate the effects of Pilates stabilization exercise and breathing re-education training on pain, disability index, and psychological factors in patients with chronic lower back pain. The assessment was conducted based on the Visual Analog Scale (VAS) scores, the Korean Oswestry Disability Index (KODI) scores, and the Fear-Avoidance Beliefs Questionnaire (FABQ) scores. METHODS: In total, 36 patients with lower back pain were recruited and randomly divided into the experimental group (EG: n=18) and the control group (CG: n=18, participants in the EG received breathing re-education training and Pilates stabilization exercises). For 50-minute sessions of Pilates stabilization exercises three days a week for 4 weeks, while those in the CG only performed Pilates stabilization exercises. The VAS, KODI, and FABQ scores of the patients were measured before and after exercise. RESULTS: After 4 weeks of intervention, the VAS, KODI, and FABQ scores before and after the intervention differed significantly in both groups (p<.01). In addition, there was a statistically significant difference in VAS and KODI scores between the EG and CG groups after the intervention (p<.05). There was no statistically significant difference in FABQ scores between the EG and CG groups after the intervention. CONCLUSION: Our results showed that the VAS, KODI, and FABQ scores improved in patients who underwent Pilates stabilization and breathing re-education training. Therefore, Pilates stabilization exercise combined with breathing re-education can be effectively utilized in clinical practice to treat and prevent chronic lower back pain. Therefore, Pilates stabilization exercise combined with breathing re-education can be effectively utilized in clinical practice to treat and prevent chronic lower back pain.