Earticle

Cervical spinal cord injuries (cervical SCI) at high cervical levels often lead to severe respiratory compromise, necessitating tracheostomy for prolonged ventilatory support. While conventional tools such as nasopharyngolaryngoscopy and bronchoscopy are integral to airway evaluation, their limitations can hinder accurate diagnosis during decannulation planning. This case study highlights the role of neck Computed Tomography (CT) in addressing these diagnostic gaps, specifically for patients with tracheostomy-dependent respiratory failure. We describe a 61-year-old male with C4 SCI who underwent successful decannulation following identification of airway obstructions via neck CT, which conventional methods failed to detect. The findings emphasize the value of incorporating neck CT into routine work-ups to ensure safer and more effective decannulation outcomes. The case underscores the need for advanced imaging techniques as a complementary tool in managing tracheostomy patients, particularly those with complex anatomical or pathological changes.

This study aimed to evaluate the effects of side walking training (SWT) using sandbags on the balance and walking abilities of stroke patients. The participant was a 72-year-old male diagnosed with a stroke. A single-subject experimental design combining an ABC design and a crossover treatment design (single-subject alternating treatments design) was utilized. The outcome measures included the timed up and go test (TUG) and the modified functional reach test (mFRT) for assessing balance, as well as the 10-meter walk test (10MWT) and the dynamic gait index (DGI) for evaluating walking ability. The intervention consisted of SWT with sandbags applied to the affected leg, incorporating both affected and unaffected side walking. Post-intervention results showed a decrease of 6.17 seconds in TUG, an increase of 3.67 cm in mFRT, a decrease of 7.49 seconds in 10MWT, and an increase of 3 points in DGI. These findings suggest that SWT using sandbags may assist in improving the balance and walking abilities of stroke patients. Further research in this area is warranted.

Ankylosing spondylitis (AS) is a chronic inflammatory disease that primarily affects the axial skeleton, leading to pain, stiffness, and reduced functional capacity. This study aimed to systematically review the effects of exercise therapy on patients with AS, with a focus on its role in enhancing spinal mobility, reducing pain, and improving functional independence and psychosocial well-being. A comprehensive literature review was conducted using databases including PubMed, Embase, Cochrane Library, CINAHL, and KoreaMed. Studies published between January 2000 and May 2025 were screened based on predefined inclusion and exclusion criteria. The methodological quality of selected studies was assessed using standardized tools, and a narrative synthesis was performed. A total of 8 studies were included. The findings consistently demonstrated that various forms of exercise including stretching, strengthening, aquatic therapy, and home-based programs were effective in improving spinal mobility, reducing disease activity, and enhancing quality of life in AS patients. Group-based and aquatic exercises were particularly beneficial for functional improvement and adherence. Exercise therapy plays a critical role in the management of AS and should be considered an essential component of long-term care. Future high-quality randomized controlled trials and meta-analyses are needed to further establish optimal exercise modalities and quantify their effectiveness. Multidimensional interventions that incorporate psychosocial and functional aspects are also recommended.

Sarcopenia and falls are major public health concerns in aging populations. This study aimed to investigate the individual and relative associations of the three core components of sarcopenia—low muscle mass, low muscle strength, and low physical performance—with the risk of falls in older Korean adults. This cross-sectional study analyzed data from 1,556 adults aged 65 and older from the 9th Korea National Health and Nutrition Examination Survey (2023). Sarcopenia components were defined according to the Asian Working Group for Sarcopenia 2019 (AWGS2019) criteria. Multivariable logistic regression analysis, accounting for the complex survey design, was performed to assess the association between sarcopenia components and self-reported falls in the past year. After adjusting for multiple confounders, low muscle mass (OR=2.463, p=.064) and low physical performance (OR=2.115, p=.088) showed a trend toward an increased risk of falls, although these associations did not reach the conventional level of statistical significance (p<.05). In contrast, low muscle strength was not significantly associated with fall risk. Our findings suggest that low muscle mass and impaired physical performance are more critical determinants of fall risk than low muscle strength in the older Korean population. Therefore, fall prevention strategies should prioritize preserving muscle mass and enhancing overall physical function.

Adolescent idiopathic scoliosis (AIS) is a three-dimensional deformity of the spine that commonly manifests during puberty and may result in cosmetic, functional, and cardiopulmonary complications. Although surgical intervention is generally reserved for severe cases, non-operative treatments especially therapeutic exercises are increasingly recognized as effective approaches for managing mild to moderate scoliosis. This review seeks to synthesize the current evidence regarding exercise-based interventions for AIS and to assess their efficacy in managing spinal curvature and enhancing functional outcomes. A systematic literature search was performed using Medline, CINAHL, and the Cochrane Library to identify studies published between 1990 and 2024. Studies were included if they focused on AIS populations, employed therapeutic exercise as the primary intervention, and reported outcomes related to the Cobb angle. Eight randomized controlled trials (RCTs) met these inclusion criteria. Scoliosis-specific exercise programs, such as the Schroth method and the Scientific Exercise Approach to Scoliosis (SEAS), demonstrated significant reductions in Cobb angles and improvements in posture, balance, and quality of life. Interventions combining exercise with bracing were more effective than bracing alone. Additionally, breathing exercises contributed to enhanced thoracic mobility and pulmonary function. Therapeutic exercise appears to be a safe and effective conservative treatment modality for AIS. When integrated with bracing, it may further promote curve stabilization and functional performance. Nonetheless, further standardized, long-term studies are warranted to optimize exercise protocols and validate these outcomes.

This study evaluated the effects of myofascial release combined with nerve block on pain and quality of life in adults with lumbar disc herniation. Twenty-four patients who met the inclusion criteria were randomly assigned to either the myofascial release combined with nerve block group or the nerve block-only group. The level of lower back pain was assessed using a numeric rating scale (NRS), while the Korean version of the 36-item Short Form Health Survey (SF-36) was used to evaluate quality of life. The modified-modified Schober test (MMST) was employed to assess the subjects’ range of lumbar flexion motion. The intervention was applied twice a week for two weeks, with each session lasting 60 minutes. The experimental group received a combination of nerve block, myofascial release, and general pain treatment, whereas the control group received only nerve block and general pain treatment. The results demonstrated significant differences between the experimental and control groups in the two domains of the SF-36, with the experimental group showing greater improvement in physical activity after the intervention. Both the NRS and MMST showed significant changes, but the experimental group exhibited a more substantial decrease of the measurement compared to the control group. This study concluded that applying myofascial release techniques in combination with physical agent therapy, rather than relying on physical treatment alone, is an effective intervention for reducing pain and improving the quality of life of subjects diagnosed with herniated intervertebral discs and who receive nerve block.

The study aimed to determine the effect of the thoracic mobility exercise with 8-figure shoulder brace on pain, range of motion (ROM), craniovertebral angle (CVA) in neck pain patients with forward head posture. Following baseline measurements, 22 subjects (n=22) with chronic neck pain were randomized into two groups: the experimental group (n=11), which received thoracic mobility exercise with figure 8 shoulder brace, and the control group (n=11), which only thoracic mobility exercise. Each group participated in the intervention for three times per week, for four weeks. The numeric pain rating scale (NPRS) for pain, ROM and CVA of both groups were recorded at both pre- and post-intervention. Paired t-tests were used to determine significant changes in the post-intervention period compared with pre-intervention, and independent t-tests were used to analyze differences in the dependent variables between the two groups. After the four weeks intervention, both groups experienced significantly decreased NPRS (p<.05) and significantly increased ROM and CVA (p<.05). The experimental group that received the thoracic mobility exercise with figure 8 shoulder brace showed greater improvements in pain, ROM and CVA than those of the control group (p<.05). These results suggest that the thoracic mobility exercise with figure 8 shoulder brace reduces neck pain and enhances ROM and CVA in neck pain patients with forward head posture.

This study compared the effect of pillow heights on forward head posture, respiratory function and discomfort of patients with forward head posture when lying on a supine position. The study involved 23 subjects with forward head posture who provided prior consent. This study recruited subjects using a google online questionnaire. It examined three pillow heights (0, 6, 12cm) and measured the forward head posture using craniovertebral angle (CVA), respiratory function using Pony FX and discomfort using discomfort score at each pillow height. The CVA significantly decreased with the 12cm pillow compared to the 6cm and 0cm pillows, and it also significantly decreased with the 6cm pillow compared to the 0cm lows (p<.05). Respiratory function significantly decreased when using the 12cm pillow compared to the 0cm and 6cm pillows (p<.05). Discomfort significantly increased with the 12cm pillow compared to the 0cm and 6cm pillow (p<. 05). The results showed that the 12cm pillow worsen forward head posture, respiratory function, and discomfort. Therefore, it is advised to avoid high pillows to minimize forward head posture and discomfort while maintaining optimal respiratory function.

The purpose of this study was to investigate the effects of self-myofascial release of the thoracolumbar fascia (SMR-TLF) using a foam roller, combined with cervical and scapular stabilization exercises, on craniovertebral angle (CVA) and muscle tone (suboccipital muscles, upper trapezius, and erector spinae). Forty participants, with an average age of 22.3 years (SD = 1.59), were enrolled. Forward head posture was defined as a CVA of less than 51 degrees. CVA was measured using Image J, while muscle tone and stiffness on the dominant side were assessed with a Myoton PRO. Participants were randomly assigned to either a stabilization exercise group (control) or a combined stabilization exercise and SMR-TLF group (experimental). Post-intervention measurements followed the same sequence as pre-intervention measurements. A significant decrease in CVA was observed in both groups (p<.05). The Experimental group demonstrated a significant reduction in muscle tone and stiffness of the suboccipital muscles and erector spinae (p<.05). Comparisons between groups revealed a significant difference in erector spinae stiffness only (p<.05). In conclusion, cervical and scapular stabilization exercises effectively improve CVA, and the incorporation of SMR-TLF further reduces muscle tone in the suboccipital muscles and erector spinae.

This study aimed to investigate the effect of stance width on lower limb muscle activation during lunge exercise. A total of 20 healthy adults with no musculoskeletal or neurological disorders participated in the study. The participants performed lunge exercises with two different stance widths, set at 50% and 70% of their leg length, for three repetitions each. Surface electromyography (EMG) was used to measure the muscle activation of the vastus medialis (VM), vastus lateralis (VL), rectus femoris (RF), and gluteus medius (GM) during both concentric and eccentric contractions. An independent t-test was conducted to compare the muscle activation between the two stance width conditions, with a significance level set at 0.05. The results showed no significant differences in muscle activation across the measured muscles between the 50% and 70% stance width conditions (p>0.05). These findings suggest that stance width does not have a substantial impact on lower limb muscle activation during lunge exercises. Clinically, this indicates that lunge exercises can be performed effectively without the necessity of a specific stance width, allowing for a more flexible approach based on individual comfort and stability. This study contributes to the understanding of lunge exercise mechanics and suggests that individualized adjustments in stance width may be appropriate in exercise prescription and rehabilitation programs.

The purpose of this study tried to find out the difference in muscle thickness and fatigue of the adductor pollicis muscle according to the pencil grip type using ultrasonography and goniometer. This study involved 32 men and women in their 20s who were divided into four groups according to each pencil grip type and participants repeatedly wrote the national anthem from verse 1 to verse 4 for 10 minutes of writing, the muscle thickness of the adductor pollicis muscle was measured using an ultrasonography, and the range of motion of thumb abduction and extension of the thumb's abduction and extension was measured using a goniometer. After 10 minutes of writing, there were significant changes in the muscle thickness of the adductor pollicis muscle and the range of motion of the extension and abduction, but two groups (Dynamic Quadrupod and Lateral Quadrupod) showed greater differences than the other two groups (Dynamic Tripod and Lateral Tripod) This study suggests that although all four pencil grip type affect the muscle thickness and fatigue of adductor pollicis muscle, two groups, Dynamic Quadrupod and Lateral Quadrupod, can have a much greater impact.

The purpose of this study is to compare and analyze the effects of squat and jump squat exercises on quadriceps muscle activation and Sargent jump performance in university students in their 20s. 27 university students in their 20s were randomly divided into a squat exercise group (n=13) and a jump squat exercise group (n=14). Both groups performed 30-minute exercises three times a week for 4 weeks. The squat exercise program consisted of body weight squats, wall squats, Thera-Band squats, and dumbbell squats. The jump squat exercise program consisted of double leg vertical jumps, Paulie squat jumps, two-foot ankle hops, and step box jumps. Muscle activation and Sargent jump height were measured before and after the intervention. Surface electromyography (EMG) and a Sargent jump measuring device were used for measurement. The jump squat exercise group showed a significant improvement in quadriceps muscle activation and sargent jump performance compared to the squat exercise group (p<.05). Jump squat exercise was found to be a more effective method than squat exercise for enhancing quadriceps muscle activation and sargent jump performance.

This study aimed to investigate the effects of kegel and dead-bug exercises combined with the abdominal draw-in maneuver on abdominal muscle thickness in young adults. Thirty healthy adults who voluntarily participated were divided into three groups of 10 each: abdominal draw-in maneuver, kegel exercises with the abdominal draw-in maneuver, and dead-bug exercises with the abdominal draw-in maneuver. Ultrasound imaging equipment and a pressure biofeedback unit were used to measure abdominal muscle thickness before and after the exercise. Data analysis was conducted using one-way analysis of variance (ANOVA), and post hoc tests were performed using the Bonferroni correction. The external oblique, internal oblique, and transverse abdominis muscles showed significant differences between groups (p<.05). For the external oblique muscles, significant differences were found between the groups using the abdominal draw-in maneuver combined with dead-bug exercises and the other two methods (abdominal draw-in maneuver alone and combined with kegel exercises) (p<.05). Although the internal oblique and transverse abdominis muscles showed no significant differences between the groups, the group that performed the abdominal draw-in maneuver combined with dead-bug exercises showed the greatest increase in thickness. The most effective exercise method for increasing abdominal muscle thickness is the abdominal draw-in maneuver combined with dead-bug exercises. Therefore, to enhance the abdominal muscle thickness in clinical practice, the abdominal draw-in maneuver combined with dead-bug exercises is recommended rather than the abdominal draw-in maneuver alone or in combination with kegel exercises.

The purpose of this study was to compare the immediate effects of a core exercise using a pressure biofeedback device and the dead bug exercise on heart rate and respiratory function. A total of 30 healthy adults were randomly assigned to two groups in a crossover design, with both groups performing a core exercises using a pressure biofeedback device and the dead bug exercise. The immediate effects on heart rate, forced vital capacity (FVC), forced expiratory volume in one second (FEV1), peak expiratory flow (PEF), maximum inspiratory pressure (MIP), and maximum expiratory pressure (MEP) was assessed before and immediately after the intervention. The results showed no significant differences between the two exercise groups (p>.05). However, heart rate and PEF exhibited significant main effects over time as well as a time × group interaction (p<.05). Both exercises resulted in significant changes in heart rate and MEP before and after the intervention (p<.05), whereas PEF and MIP showed significant improvements only in the dead bug exercise group (p<.05). These findings suggest that both exercises have an immediate positive impact on cardiorespiratory function. Notably, the dead bug exercise may have greater potential for improving respiratory function over time compared to a core exercise using a pressure biofeedback device. Further validation through long-term studies involving diverse populations is recommended.

This case study aimed to investigate the effects of plantar fascia stretching on ankle dorsiflexion range of motion (ROM), dynamic balance, walking endurance, and fall efficacy in a patient with chronic stroke. A 61-year-old male patient diagnosed with chronic ischemic stroke participated in the study. The intervention consisted of plantar fascia stretching performed using a Fasciitis Fighter device for six weeks, five times per week, with 3 sets of 15 repetitions per session. Standard inpatient rehabilitation was concurrently provided. Outcome measures included ankle dorsiflexion ROM (using a digital inclinometer), dynamic balance (timed up and go test, TUG), walking endurance (6-minute walk test, 6MWT), and fall efficacy (falls efficacy scale-international, FES-I), assessed before and after the intervention. Post-intervention, ankle dorsiflexion ROM improved by 2.4°, TUG performance time decreased by 3.8 seconds, 6MWT distance increased by 34 meters, and FES-I score decreased by 6 points, indicating reduced fear of falling. Plantar fascia stretching demonstrated positive effects on ankle mobility, balance, walking endurance, and fall efficacy in a patient with chronic stroke. These findings suggest that plantar fascia stretching may serve as a beneficial component of rehabilitation programs for improving lower limb function and fall prevention in this population. Further studies with larger sample sizes are recommended to validate these results.

Premature infants in neonatal intensive care units, especially those from multiple births, have higher incidences of developmental disorders such as cerebral palsy and face increased risks of abnormal development. Early physical therapy intervention is crucial to promote normal behavioral responses and growth. However, physical therapy interventions using multisensory stimulation remain limited. The purpose of this study was to improve normal behavioral and reflex responses in premature infants born in multiple births through a multisensory physical therapy intervention based on Neonatal behavioral assessment scale (NBAS) evaluation. Three premature infants with pathological diagnoses participated in the study. A pre-test assessment using NBAS was conducted, followed by a 2-weeks multisensory physical therapy program consisting of kinesthetic, oral, and skin stimulation. After the intervention, a post-test behavioral assessment was conducted. Results showed the greatest improvement in interaction and supplementary items, with all three infants demonstrating positive changes in six areas: interaction, habituation, mobility, state organization, supplementary items, and reflex responses. It has a significant impact on the general neurobehavior of premature infants. The study demonstrates the effectiveness of multisensory physical therapy in premature infants from multiple births. Future research should expand the participant pool and assess the sustainability of these effects through long-term follow-up.

The Sideways walk Test is an essential functional movement in daily activities and balance control, yet its assessment has been relatively underexplored in individuals with subacute stroke. The purpose of this study is to analyze the relative reliability (test-retest agreement) of the sideways walk test (SWT), investigate its absolute reliability (SEM, MDC, MDC%), and validate its concurrent validity to determine whether SWT is an appropriate assessment tool for individuals with subacute stroke. This study was designed as a cross-sectional analysis involving 28 stroke patients. The test-retest reliability of the SWT was assessed using the intraclass correlation coefficient (ICC 3,1) based on a fixed two-way mixed-effects model for agreement between two raters. Absolute reliability was evaluated by calculating the standard error of measurement (SEM), minimal detectable change (MDC), and MDC percentage (MDC%). concurrent validity of SWT was determined through its correlation with fugl-meyer assessment- lower extremity (FMA-LE), 10-meter walk test (10MWT), berg balance scale (BBS), and timed up and go (TUG) using spearman's coefficient. The ICC for SWT time was 0.916 (95% CI: .819∼.961) for the paretic side and 0.958 (95% CI: .910∼.981) for the non-paretic side, while the ICC for SWT step count was 0.878 (95% CI: .736∼.943) for the paretic side and 0.915 (95% CI: .816∼.961) for the non-pareric side, indicating high agreement. The MDC values were 4.18 seconds for paretic-side time, 2.3 seconds for non-paretic side time, 2.18 steps for paretic side step count, and 1.38 steps for non-paretic side step count, all within 20%, demonstrating acceptable reliability. The completion time and step count of the SWT were significantly correlated with the following measures: FMA-L/E (r=-0.596∼.750, p<.001), 10mWT (r=-0.503∼-0.717, p<.006∼.001), BBS (r=-0.489∼-0.549, p<.002∼.008), TUG (r=.621∼.681, p<.001). The SWT can be utilized as a simple yet reliable and valid clinical tool for assessing sideways walking ability in individuals with subacute stroke.

This study aimed to analyze the impact of adolescents' daily health status and lifestyle habits on physical imbalance. From July 1 to September 5, 2023, 1,763 adolescent students residing in Gangwon Province were assessed using automated physical imbalance measurement tools, and lifestyle habit surveys were conducted with the same group. However, due to incomplete or inconsistent responses, only 801 survey results were included in the analysis. The survey included factors such as posture, exercise habits, smartphone usage time and posture, and sleep habits.Results indicated that a significant proportion of adolescents exhibited physical imbalances, particularly in shoulder and pelvic alignment. Incorrect smartphone usage posture, improper sleeping positions, and prolonged sitting were closely associated with physical imbalance. Notably, high school students showed the highest imbalance in shoulder alignment, whereas middle school students had the highest prevalence of pelvic asymmetry. Additionally, as grade levels increased, participation in physical activities declined, suggesting a correlation between reduced physical activity and worsening musculoskeletal alignment. These findings highlight the importance of promoting proper posture, sleep habits, and physical activity among adolescents to prevent long-term musculoskeletal issues. Therefore, school-based intervention programs focusing on posture education and increased physical activity participation are urgently needed.

This study was conducted at a time when online education has become widespread in the aftermath of COVID-19. It aimed to analyze the learning strategies, perceived usefulness and ease of use, and satisfaction levels of health science students in order to enhance satisfaction with online education. A survey was administered to 387 students from the Department of Health Sciences at University B. The results showed significant differences in learning strategies and satisfaction depending on students’ proficiency in using digital devices; in particular, students with higher digital proficiency reported greater satisfaction with online education. Additionally, a relationship was found between students’ academic performance in the previous semester and their learning strategies. Higher levels of perceived usefulness and ease of use were also associated with increased satisfaction with online education. Based on these findings, this study suggests the need for universities to improve students’ digital literacy, enhance the quality of online lecture content, and strengthen the stability of online systems. These efforts may contribute to increasing student satisfaction with online education in the post-COVID era and to nurturing individuals who can successfully adapt to future society.

This study analyze the current status of clinical practice among physical therapy students in three-year and four-year programs in the honam region and to assess the students' satisfaction with their clinical practice experiences. The study was conducted with 117 students from two three-year colleges and three four-year universities located in the jeonbuk region. Data collection was carried out over a period of 30 days, from September 1 to September 30, 2023. For this study, a modified version of a questionnaire used in previous research was employed. The questionnaire consisted of a total of 34 items, including 6 items on general characteristics, 6 items related to five domains of clinical practice content, and 22 items related to satisfaction. The average difference in clinical practice satisfaction according to the characteristics of the universities was verified using the independent t-test. All statistical significance levels were set at α=0.05. The results indicated that the overall satisfaction with clinical practice was moderate, with students in three-year programs showing slightly higher satisfaction levels compared to those in four-year programs. University hospitals were the most frequent clinical practice institutions, accounting for a higher proportion than all other institutions combined. Factors influencing satisfaction included clinical practice guidance, clinical practice environment, clinical practice hours, and post-clinical practice satisfaction. These findings are significant in providing foundational data to improve the quality of clinical practice education for physical therapy students. By analyzing the differences between three-year and four-year programs, this study offers insights into the strengths and weaknesses of each and provides a basis for improving the educational curriculum accordingly.

Stroke patients have negative consequences for balance and gait ability due to symptoms such as muscle weakness and stiffness, muscle tene abnormalities, sensory abnormalities, and decreased body perception. This problem makes it difficult to control and maintain posture and interferes with the performance of basic daily life movements such as bathing, dressing, and moving. And it shows a decrease in gait speed and inefficient gait patterns, and this unstable gait is a decisive factor leading to falls. The first physical therapy goal for stroke patients should be to improve balance and gait ability. This study is a scoping review to investigate the effects of various interventions to improve balance and gait ability in stroke patients. We compared and analyzed ten related studies published from 2022 to 2024 on domestic academic search sites. The results showed that stability training of the intervention types investigated, obstacle walking training, balance training, Ankle stretching with intrinsic muscles, cognitive dual-task training, and trunk stabilization exercise had beneficial effect on balance ability in patients with stroke. In addition, obstacle walking training and balanced training using gym balls have been found to be effective in improving gait ability.