Earticle

Purpose: The purpose of this study was to examine changes in plantar pressure, balance, and posture by applying the Bruegger exercise using a Thera Band in adults with flexible flat feet, in order to verify the effects of the Bruegger exercise and provide basic data for physical therapy practice. Methods: The study included a total of 26 participants, who were divided into the Bruegger exercise group (13 participants) and the short-foot exercise group (13 participants) as the experimental and control groups, respectively. Each group performed exercises for 30 minutes per day, five times a week, for two weeks, with measurements taken before and after the intervention. The Kolmogorov-Smirnov test was used to verify the normal distribution of each variable, and paired t-tests were used to examine differences in navicular height, plantar pressure, balance ability, and posture before and after the exercise within each group. Independent t-tests were conducted to compare the changes between groups, and the significance level was set at .05 to analyze statistical significance. Results: Both groups showed significant improvements in static plantar pressure and balance, with the experimental group demonstrating greater improvements in both static and dynamic balance. There were no significant differences between the experimental and control groups in any variable. Conclusions: The findings suggest that Brugger's exercise improves plantar pressure distribution and balance in young adults with flexible flat feet. Incorporating functional exercises with Thera Bands strengthens foot muscles, enhancing balance and reducing injury risk. Future research should examine the long-term effects and include a more diverse participant pool.

연구 배경: 다양한 요인에 의해 발생하는 요통(LBP)은 척추 안정화 근육의 근지구력과 근력을 저하시키고 몸통 연 부 조직의 손상을 야기하며, 이는 요추 불안정성으로 이어질 수 있다. 인체의 중심에 위치한 고관절은 기능적 움 직임을 통해 요추와 생체역학적으로 직접 연결되어 있다. 고관절 가동성의 제한은 요추의 과도한 움직임을 유발 하여 보상 작용과 그에 따른 기능 장애를 일으킬 수 있다. 또한, 최근의 임상적 관점인 ‘지역적 상호의존성 (Regional Interdependence)’은 고관절의 기능 장애나 가동성 제한이 요추의 안정성과 전반적인 척추 기능에 직접적인 영향을 미칠 수 있음을 강조하고 있다. 본 연구는 요추 불안정성을 동반한 요통 환자를 대상으로 고관 절 가동술이 통증, 몸통 유연성, 근지구력 및 요부 장애지수에 미치는 영향을 조사하였다. 연구 방법: 연구 대상자는 대조군(n=28)과 실험군(n=28)으로 무작위 배정되었다. 두 그룹 모두 4주 동안 주 3회 요 추 안정화 운동을 수행하였으며, 실험군은 추가적으로 4주 동안 주 3회 고관절 가동술을 받았다. 측정은 중재 전과 중재 종료 후(4주 후)에 실시되었다. 연구 결과: 평가 지표로 시각적 아날로그 척도(VAS), 몸통 유연성, 근지구력 및 한국어판 오스웨스트리 장애지수 (KODI)를 사용하였다. 중재 후, 두 그룹 모두 모든 평가 항목에서 통계적으로 유의미한 개선을 보였다(p<.01). 그룹 간 비교에서는 몸통 유연성 항목에서만 유의미한 차이가 관찰되었다(p<.01). 결론: 본 연구 결과는 고관절 가동술이 요추 불안정성을 동반한 요통 환자의 몸통 유연성을 향상시키는 데 유익한 중재가 될 수 있음을 시사한다.

Background: Prolonged smartphone use is a primary cause of wrist pain and functional limitations, leading to a global increase in musculoskeletal disorders. While Mulligan's mobilization with movement (MWM) is an established manual therapy, research on its patient-applied variant, Self-MWM, for this condition remains limited. This study determined the effects of Self-MWM on pain, grip strength, and function in patients with chronic wrist pain from smartphone use. Methods: Forty adults with chronic smartphone-related wrist pain were randomized into a Self-MWM group and a control group performing general stretching and strengthening. Both groups received basic physical therapy (heat and electrical therapy) for 30 minutes, three times weekly for 6 weeks. Outcomes were measured preand post-intervention using the visual analog scale (VAS) for pain, a hand-held dynamometer for grip strength (GS), and the disabilities of the arm, shoulder and hand (DASH) questionnaire for function. Results: After 6 weeks, both the Self-MWM and control groups showed statistically significant improvements in pain, grip strength, and function. However, the Self-MWM group demonstrated markedly greater improvements across all measures. Pain reduction, grip strength gain, and functional enhancement were substantially more pronounced in the Self-MWM group, with the differences in improvement between the groups being highly significant (p<.001). Conclusion: Integrating Self-MWM into a standard physical therapy protocol is significantly more effective for managing pain, improving grip strength, and restoring function in patients with smartphone-induced wrist pain. This approach offers a practical, powerful self-management tool for this prevalent musculoskeletal concern.

Background: The purpose of this study to investigate the effects of an exercise program to improve scapular dyskinesis in breast cancer patients with scapular dyskinesis on body function and quality of life. Methods: Thirty female breast cancer patients with scapular dyskinesis were randomly divided into the scapular dyskinesis improvement exercise program group (SIG; n=15) and the body function improvement exercise program group (BGG; n=15). The study was conducted for a total of 4 weeks, 3 times a week, 50 minutes per session. The evaluation was measured pain was measured using a visual analogue scale (VAS), shoulder range of motion (ROM) was measured, and upper extremity function was measured using the shoulder pain and disability index (SPADI). Quality of life was compared using the functional assessment cancer therapy-breast (FACT-B). Results: After the intervention, there was a significant improvement in VAS (p<.01), shoulder ROM (p<.01), SPADI (p<.01), and FACT-B (p<.01) in both groups after the intervention compared to before. In comparison between groups, SIG showed more significant changes than BGG in shoulder joint ROM in flexion(p<.05), abduction (p<.01), external rotation (p<.01) and SPADI (p<.01), FACT-B (p<.01). Conclusion: This study confirmed the scapular dyskinesis improvement exercise program was an effective intervention for the shoulder range of motion, upper extremity function, and quality of life in breast cancer patients with scapular dyskinesis and the findings suggest that this program can be used as basic data in clinical practice.

Background: Postoperative low back pain (LBP) is a common complication after total knee arthroplasty (TKA), affecting patients’ recovery and quality of life. Pelvic alignment may influence LBP and functional outcomes in TKA patients. This study aimed to evaluate the effects of pelvic reset exercise on pain, pelvic stability, and functional mobility in TKA patients with chronic LBP. Methods: Forty patients with chronic LBP (>6 months) post-TKA were randomly assigned to two groups: the experimental group (pelvic reset exercise, n=20) and the control group (abdominal drawing-in exercise using biofeedback, n=20). Both groups performed 30-minute sessions, three times per week for four weeks. Outcome measures included the quadruple visual analogue scale (QVAS) for pain, hip stability isometric test (Hip SIT), timed up and go (TUG) test for mobility, Korean Oswestry disability index (KODI), and SF-12 for quality of life. Statistical analysis was conducted using paired and independent t-tests. The significance level was set at α = .05. Results: Both groups showed significant within-group pain reduction (p<.001), with a significantly greater decrease in the experimental group (p<.05). Hip SIT improved significantly only in the experimental group (p<.001), with significant between-group differences (p<.01). TUG scores improved in both groups, with a greater change in the experimental group (p<.05). Improvements in KODI and SF-12 were also more notable in the experimental group, all were statistically significant between groups (p<.05). Conclusion: Pelvic reset exercise is effective in reducing pain, improving hip stability, enhancing functional mobility and quality of life in TKA patients with chronic LBP. It may be considered a beneficial intervention for postoperative rehabilitation in this population.

Background: The purpose of this study was to compare the immediate effects of the Mulligan concept bridge technique mobilization and Maitland mobilization applied to the cervicothoracic junction in patients with neck pain accompanied by mobility restrictions. Methods: One hundred and one individuals with neck pain were randomly assigned to two groups. The experimental group (n=51) received the Mulligan concept bridge technique applied to the cervicothoracic junction, while the control group (n=50) received direction-specific Maitland mobilization. To assess the effects of the interventions were assessed by measuring the cervical range of motion (ROM), muscle tone, and pain levels were measured before and after the treatment. An independent t-test and a paired t-test was were used for between-group comparisons, and a paired t-test was used for and within-group comparisons, respectively. Results: The results showed that the experimental group demonstrated significantly greaterimprovements in cervical extension (p<.01), lateral flexion (p<.05),and rotation range of motion (p<.05), as well as greater reductions inmuscle tone (p<.01) and pain levels (p<.01) compared with the control group, whereas no significant differences were found in flexion or stiffnessbetween the groups. Conclusion: The Mulligan concept bridge technique applied to the cervicothoracic junction demonstrated immediate improvements in cervical range of motion, muscle tone, and pain in patients with restricted neck mobility. These results suggest that this technique may be an effective intervention for patients with neck pain accompanied by movement limitations.

Background: Flexible flatfoot is a condition in which the medial longitudinal arch collapses under weight-bearing despite appearing normal at rest. This structural change may result in muscle imbalances and impaired foot function. Short foot exercises (SFE) are often used to strengthen intrinsic foot muscles and improve arch stability. Prior studies have demonstrated that combining hip abduction with SFE enhances abductor hallucis activation and supports medial arch correction. However, the effects of different levels of hip abduction resistance on this mechanism remain unclear. Methods: Twelve adults (mean age 27.92 years) with flexible flatfoot participated. Participants performed SFE under four randomized hip abduction resistance conditions (0㎏, 5㎏, 10㎏, 15㎏). The muscle activity of the abductor hallucis (Abd.H), tibialis anterior (TA), peroneus longus (PL), and gluteus medius (G.med) was measured using Noraxon Ultium surface EMG. Each condition was repeated three times with a one-minute rest between contractions and a three-minute rest between conditions. Data were analyzed using repeated measures ANOVA and LSD post-hoc analysis (α=.05). Results: Abductor hallucis showed a statistically significant increase in muscle activation as resistance increased (p<.001), with the largest increase between 0㎏ and 5㎏. No significant differences were observed among the higher resistance levels. Tibialis anterior activity also significantly increased under the 5㎏ and 10㎏ conditions compared to 0㎏ (p=.023, p=.033). The peroneus longus and gluteus medius showed no significant overall differences, although PL approached significance between 0㎏ and 10㎏ (p=.061), and G. med displayed a quadratic trend (p=.030). Conclusion: Hip abduction resistance during SFE significantly enhances abductor hallucis activity in individuals with flexible flatfoot, especially at 5㎏ resistance. This suggests that minimal resistance can effectively promote intrinsic foot muscle activation, offering a targeted intervention strategy for arch support and rehabilitation.

Background: This study examined the effects of the combined interventions of manual therapy and community health exercise programs for pain, balance ability, and functional improvement in the rural elderly through a randomized controlled trial. The aim was to provide a scientific basis for developing effective intervention programs for promoting elderly health in rural areas. Methods: The study subjects were 26 rural elderly people aged 65 years or older in S-gun, Chungnam Province. They were assigned randomly to a control and experimental group and received a six-week intervention. The control group (n=13) received a health exercise program, and the experimental group (n=13) received manual therapy in addition to the health exercise program. Pain, balance ability, and function were evaluated before and after the intervention. Pain was measured using a visual analog scale (VAS). balance ability was measured using the timed up & go test (TUG), and the function was measured using the modified Barthel index (MBI). Results: The pain decreased and the balance ability increased significantly in the health exercise program group and the combined manual therapy and health exercise program group (p<.05), with a significant difference in the changes between the two groups (p<.05). In addition, the function improved significantly in both groups (p<.05), but the changes were similar in the two groups (p>.05) Conclusion: The effectiveness of the combined manual therapy and health exercise program was confirmed, showing that it can be effective even when modified to suit the characteristics of older adults in rural areas.

Background: The aging population and the rise in chronic diseases have become major public health concerns worldwide. These challenges highlight the need for effective and accessible health promotion strategies. Remote exercise programs offer a feasible solution, but empirical evidence for their effectiveness in elderly individuals with chronic conditions remains limited. Methods: A one-group pretest-posttest design was used to evaluate the impact of a 12-week remote exercise program on the physical function in older adults with chronic diseases. A total of 30 participants were recruited from a community welfare center in Korea. The intervention consisted of weekly live exercise sessions conducted via the Zoom platform and guided by a trained instructor. The program included chair-based strength training, upper and lower extremity resistance exercises, flexibility exercises, and breathing exercises, all designed to enhance overall mobility, strength, and endurance. The physical function was measured before and after the intervention using chair stand repetitions and grip strength (right and left hands). Results: After completing the program, participants showed significant improvements in chair stand repetitions and right-hand grip strength. Although left-hand grip strength also increased, the change was not statistically significant. Participants additionally reported feeling more confident in performing daily activities, experiencing enhanced physical well-being, and perceiving improvements in overall functional ability. Conclusion: These findings suggest that remote exercise programs can effectively improve physical function and support the well-being of older adults with chronic diseases. This approach may provide a practical alternative to in-person interventions, especially during periods of restricted mobility, public health emergencies, or social distancing. Future research should explore long-term effects, adherence, and the scalability of such programs to broader populations.

Background: This study aimed to compare trunk and lower limb muscle activity between healthy adults and older adults during the bird-dog exercise performed under visual occlusion conditions. Age-related declines in sensory integration and neuromuscular control may influence postural stabilization strategies, particularly during dynamic core exercises performed on unstable support surfaces. However, limited evidence exists regarding age-related differences in muscle activation patterns under visually constrained conditions. Methods: Thirty participants (15 adults, 15 older adults) performed the exercise for 20 s on an unstable surface under eyes-open and eyes-closed conditions. Each trial was maintained for 20 seconds and repeated three times with sufficient rest between trials. Surface electromyography was used to measure the activity of the rectus abdominis, external oblique, erector spinae, and gluteus maximus muscles. Electromyographic signals were normalized to maximal voluntary isometric contraction values for between-group comparisons. Results: The adult group showed significantly higher muscle activity in all the measured muscles compared to the older adult group (p<.05). Within-group analysis revealed that the gluteus maximus activity significantly increased under visual occlusion in the adult group, whereas rectus abdominis activity significantly increased in the older adult group (p<.05). Correlation analysis showed a significant positive correlation only in the rectus abdominis for the adult group, while the older adult group demonstrated significant positive correlations across all muscles. Conclusion: Adults primarily relied on selective muscle activation strategies to maintain stability, whereas older adults adopted a compensatory neuromuscular strategy characterized by simultaneous activation of multiple muscles. These findings demonstrate age-related differences in neuromuscular control during visually constrained core stabilization tasks and support the development of age-specific core stabilization training programs.

Background: Although the benefits of exercise programs after a lumbar discectomy are well-documented, they are not widely implemented in clinical practice. In particular, there is a lack of research focusing on patients who continue to experience low back pain after surgery. This case report outlines the effects of a structured exercise program on pain, disability, and structural changes in the paraspinal muscles in a patient with persistent low back pain following percutaneous endoscopic lumbar discectomy (PELD). Methods: A 32-year-old male underwent PELD for a herniated disc at the right L4-5 level, but continued to experience low back and radiating pain. Starting four weeks postoperatively, he participated in a rehabilitation program that consisted of spinal stabilization exercises, trunk and hip strengthening, and aerobic exercises performed twice daily. Results: At three months post-surgery, the patient’s pain intensity (NPRS) decreased from 5 to 1, and his disability score (ODI) decreased from 28 to 5. At six months post-surgery, the cross-sectional area (CSA) of the psoas muscle increased, while the CSA of the multifidus and erector spinae muscles decreased. However, asymmetry between the right and left paraspinal muscles was reduced. Additionally, the grade of intramuscular fat infiltration, as measured by the Goutallier classification, showed improvement. Conclusion: This case report shows that a structured exercise program can be effective in reducing pain and disability and improving muscle balance and composition in a patient with persistent low back pain after PELD. These findings support the inclusion of rehabilitation programs in postoperative care for patients with such conditions.