Earticle

Purpose: This study demonstrated a postural alignment exercise as conservative management strategy for a woman with excessive thoracic kyphosis presenting decreased chest function, and reports its results. Methods: A 21-year-old woman with thoracic kyphosis presenting limited chest function. The exercise program underwent for 30 min in the intervention phase, which consisted of exercises to improve the strength of back extensor and to stretch anterior chest region. Outcome measures comprised the severity of thoracic kyphosis and chest function (vital capacity [VC], forced expiratory volume in a second [FEV1], and chest expansion length). Results: The thoracic kyphotic angle decreased by 23.6% ($9.38^{\circ}$) and 25.4% ($10.58^{\circ}$) in the intervention and follow-up phases respectively. Also, chest function was improved in the intervention (VC: 3.7% [$0.10{\ell}$], FEV1: 17.1% [$0.39{\ell}$], and chest expansion length: 17.1% [0.96 cm]), and the improvement was maintained during the follow-up phase (VC: 4.8% [$0.13{\ell}$], FEV1: 17.1% [$0.39{\ell}$], and chest expansion length: 64.3% [1.81 cm]). Conclusion: These findings suggest that the postural alignment exercise was favorable for improving chest function of a woman with thoracic kyphosis.

Background Sleep significantly affects physical and mental health, and influences factors such as posture, muscle strength, and psychological well-being. Despite its importance, modern lifestyle factors contribute to widespread sleep disturbances, highlighting the necessity for deeper insight into how sleep interacts with health indicators. Purpose This study aimed to investigate the complex relationships among sleep duration and quality, physical health indicators, and mental health status in healthy adults. Study design Cross-sectional study Methods A total of 66 healthy adults aged between 20 and 60 years were assessed for sleep quality, depressive symptoms, sleep duration, spinal curvature, and thoracic muscle strength. Pearson’s correlation coefficient was used to analyze the relationships among these variables. Results Sleep duration was negatively correlated with the PSQI score (r = ?0.344, p = 0.005) and kyphosis angle (r = ?0.407, p = 0.001). Poor sleep quality positively correlated with depressive symptoms (r = 0.311, p = 0.011). The kyphosis angle was positively correlated with the thoracic extensor muscle strength (r = 0.675, p < 0.001). Conclusions This study demonstrates significant associations among sleep quality, spinal alignment, and mental health. This emphasizes the need for integrated clinical approaches that address sleep, posture, and psychological well-being to enhance overall health outcomes.

Purpose: Smartphone use is prevalent among adolescents and is associated with postural and neuromuscular problems. This study examined the effects of short-term seated smartphone use on postural alignment, cervical muscle activation, and the mechanical properties of muscles in adolescent males. Methods: Sixty male adolescents aged 13-18 years were assigned randomly to a smartphone group (n=30) or an interview group (n=30). The smartphone group watched videos for 30 minutes, while the interview group completed a verbal interview in the same posture. All participants were assessed at four time points: pre-task, one minute after task initiation, after 30 minutes, and 10 minutes post-task. The sagittal postural alignment was analyzed using reflective markers. Cervical muscle activation was recorded by surface electromyography. The muscle tone and stiffness were assessed using a handheld myotonometer. Repeated-measures ANOVA was used for analysis. Results: The smartphone group showed significant increases in the head and neck flexion angles and thoracic kyphosis over time, with some variables remaining elevated after the task (p<0.05). Muscle activation increased during and after the task in all measured cervical muscles only in the smartphone group, while no significant changes were observed in the interview group (p<0.05). The muscle tone and stiffness also increased over time, only in the smartphone group (p<0.05). Conclusion: Short-term smartphone use in a seated posture induced forward head posture, increased thoracic flexion, and elevated cervical muscle activation and mechanical load in adolescent males. These findings suggest that even brief exposure may adversely affect postural and neuromuscular function in adolescents.

Purpose: This study examined the effects of applying the Pilates reformer exercise to 17 adult women on the alignment of the standing posture. Methods: The subjects performed a Pilates reformer exercise for 60 minutes a day, three times a week, for a total of eight weeks. The Pilates reformer exercise consisted of five types: 1) lower and lift, 2) hundred, 3) plow, 4) airplane, and 5) twist. The standing posture alignment in the sagittal and frontal planes was measured using exbody 9100MOMI musculoskeletal analysis equipment. Results: A comparison of before and after the exercise using paired t-test revealed a significant decrease in the difference between the horizontal inclination and the vertical height that approached zero after the intervention in the frontal plane of anterior and posterior standing postures (p<0.05), and the lateral standing posture in the sagittal plane. In addition, the difference between the horizontal inclination and the vertical height decreased and approached zero after the intervention (p<0.05). Conclusion: The Pilates reformer exercise had a positive effect on the alignment of the standing posture.

Objective: We evaluatedthe effects of radial extracorporeal shockwave therapy (rESWT) on muscle tone, stiffness, decrement, postural alignment, neck function, and pain in adults with forward head posture Design: A single-blind randomized controlled trial. Methods: Thirty-one adults with FHP were randomly assigned to a group that received rESWT with corrective exercises (n = 15) or a group that performed corrective exercises only (n = 16) for 4 weeks. rESWT was applied once weekly (2,000 impulses, 1.0 bar), while corrective exercises were performed three times per week. Outcome measures included upper trapezius muscle tone, stiffness, and decrement (MyotonPRO), craniovertebral angle (CVA), Neck Disability Index (NDI), and pain (visual analog scale [VAS]). Pre- and postintervention data were compared using paired and independent t-tests. Results: The rESWT group showed significantly greaterreductions in muscle tone and stiffness than the control group (p < 0.05). Both groups demonstrated significant post-intervention improvements in CVA, NDI, and VAS scores (p < 0.05), butno significant between-group differences were observed in these measures Conclusions: rESWT combined with corrective exercises effectively reduced localized muscle stiffness in patients with FHP. Corrective exercise alone wassufficient to improve postural alignment and neck function and alleviate pain. These findings suggest that rESWT offers additional benefits in targeting mechanical muscle properties

Objective: In this study, we aimed to investigatethe effects of a lower trapezius strengthening exercise program combined with a complex exercise program on postural alignment, muscle strength, and muscle tone in female university students with forward head posture (FHP). Design: A randomized controlled trial Methods: Thirty-eight female university students with FHP who met ourinclusion criteria were recruited and randomly assigned to an experimental group (n=19) or a control group (n=19). Both groups completed a complex exercise program. The experimental group participants additionally performed a lower trapezius strengthening exercise program. Interventions were performed twice weekly for 4 weeks. Changes in cranial rotation angle, craniovertebral angle, muscle strength, and muscle tone were assessed pre- and post-intervention. Results: Both groups showed significant postintervention change in craniovertebral angle (p<0.05), with no significant differences between groups. In addition, the muscle strength of the left and right lower trapezius significantly increased only in the experimental group (p<0.05), indicating a greater improvement than that in the control group (p<0.05). Conclusions: The lower-trapezius strengthening exercise program significantly improved muscle strength in female university students with FHP. These results highlight the importance of lower trapezius muscle strengthening as an essential intervention for postural correction in female students with FHP.

Objective: The purpose of this study was to investigate the effects of an exercise program using a gym ball and sling on postural alignment, shoulder level, pulmonary and respiratory muscle pressure in adults aged 20 years and older. Design: Randomized controlled trial Methods: A total of 32 adults aged 20 years and older participated in the study. Participants were selected through a randomization program and assigned to a gym ball exercise group (n=16) and a sling exercise group(n=18). Each group performed an exercise program using either a gym ball or a sling. All interventions were performed 3 times a week, for a total of 3 weeks. To compare effects, we measured craniovertebral angle(CVA), cranial rotation angle(CRA), shoulder level, forced vital capacity(FVC), maximum voluntary ventilation(MVV), maximum inspiratory pressure(MIP), and maximum expiratory pressure(MEP) before and after the intervention. Results: Both groups had no significant differences in CVA, CRA, and shoulder level at pre-test, and both groups showed significant changes from pre- to post-intervention(p<0.05). In the gym ball exercise group, there was a significant change in FVC, MVV, MIP, and MEP, except for MIP, between pre- and post-intervention(p<0.05). In the sling exercise group, there were significant changes in MVV, MIP, and MEP, except FVC, between pre- and post-intervention(p<0.05). Conclusions: An exercise program using a sling and a gym ball is an effective intervention with clinically significant effects in improving postural alignment and pulmonary

Purpose: The aim of this study was to determine the effectiveness of pelvic tilt training using an inclinometer on joint position sense and postural alignment in individuals with stroke. Methods: Thirty-one subjects with chronic stroke were divided into two groups: the experimental group (16 subjects) and the control group (15 subjects). Subjects in both groups received neuro-developmental therapy five times per week. In addition, the patients in the experimental group also received pelvic tilt training using an inclinometer for 30 minutes, 3 times a week for 4 weeks. Maximal range of anterior, posterior pelvic tilt and joint position sense were used to evaluate pelvic tilt motion. Image analysis was performed for evaluation of postural alignment on in standing position. Results: Significant difference in Iimprovement of pre- and post-intervention of joint position sense was observed showed significant difference (p<0.05) in all groups. Experimental groups showed sSignificant differences in maximal range of posterior pelvic tilt in on the paretic side were observed in the experimental groups compared to with the control group (p<0.05). Conclusion: These findings suggest that pelvic tilt training using an inclinometer may help to improve range of pelvic tilt and joint position sense of stroke patients.

PURPOSE: This study examined the effects of high-intensity (HI) muscle strength training and stretching exercises on muscle strength, spasticity, postural alignment, and participation in the activities of daily living (ADL) in an adolescent with cerebral palsy (CP). METHODS: The study used a single-subject design with a 16-week follow-up. After a three-week intervention-free period, a participant underwent five data collection sessions for the baseline measurements. Subsequently, stretching and HI strength training occurred three times weekly for 48 sessions, with the outcome measures collected weekly post-treatment. Final measurements were taken the day after the last session, and a follow-up assessment occurred six weeks post-study to assess the learning effects. RESULTS: After 16 weeks of treatment, the participant exhibited improved targeted muscle strength and postural alignment without increased spasticity. On the other hand, no significant change in participation in the ADL was observed. CONCLUSION: The research findings suggest that HI strength training and stretching exercises may contribute to improvements in muscle strength and body alignment without increased spasticity in an adolescent with CP, but it may not have a significant impact on participation in ADL.

Purpose: This study covered the effect of shoulder stabilization exercise on muscle activity, postural alignment and self-efficacy of the elderly people with round shoulders by visiting village hall in rural area. Methods: 40 elderly people with round shoulders were recruited for this study (experimental group: 20 subjects and control group: 20 subjects). The experimental group was asked to perform shoulder stabilization exercise 60 minutes per one time for 8 weeks and three times in a week and the control group was asked to receive education related to pain management for the initial one time. Before and after the experiment, we measured the subjects' muscle activity of upper trapezius, serratus anterior, infraspinatus, pectoralis major and the lower trapezius, then postural alignment of craniovertebral angle and round shoulder posture. In addition, self-efficacy is measured through the questionnaire. Results: Compared to the control group, the experimental group showed significant differences in the muscle activity of all muscles, posture alignment of the craniovertebral angle. round shoulder posture, and improvement of self-efficacy. Conclusion: We found that shoulder stabilization exercise is effective in muscle activity, postural alignment and self-efficacy of the elderly people through visit-rehabilitation service. This study can be used for improving the physical and mental abilities through active visit-rehabilitation service for areas where have poor medical benefits. It is considered that systematic visit rehabilitation service should have institutional framework ultimately.

PURPOSE: This study compared the effects of sit-to-stand training with various foot positions combined with visual feedback on the postural alignment and balance. METHODS: Thirty stroke patients were assigned randomly into three groups of standing with a symmetrical foot position (SSF) (n = 10), asymmetrical foot position with the affected foot at the rear (SAF) (n = 10), and visual feedback and asymmetrical foot position (SVAF) (n = 10). Sit-to-stand training with different foot positions was performed for 30 minutes a day, five times a week, for a total of four weeks, and the effects on postural alignment and balance were assessed. RESULTS: The angle between the midline and scapula peak of the affected side was decreased significantly at sitting and thigh-off in the SAF group and at sitting, thigh-off, and standing in the SVAF group (p < .05). The angle between the midline and scapula peak of the non-affected side was increased significantly at sitting and thigh-off in the SAF group and at sitting, thigh-off, and standing in the SVAF group, the difference in the angle between the scapular peaks of the left and right sides was decreased significantly at sitting and thigh-off in SSF group, and at sitting in SAF group (p < .05). In the SVAF group, the angle at sitting, thigh-off, and standing was decreased significantly (p < .05). A comparison of the balance ability showed that BSS in the SVAF group was improved significantly (p < .05). CONCLUSION: Based on these results, the postural alignment and balance ability were improved in stroke patients who participated in sit-to-stand with visual feedback and asymmetrical foot position training.

월경곤란증에 대한 원인을 규명하는데 있어서 인체 대칭성과 균형에 중점을 두어 진단할 필요가 있다. 본 연구 목적은 월경곤란증 정도에 따라 자세 정렬과 족저압 균형에 차이가 있는지를 비교·분석하고자 한다. 월경곤란증을 가진 20대 여대생을 대상으로 월경곤란증 정도에 따라 경증그룹과 중증그룹으로 구분하여 자세 정렬과 족저압 균형에 대해 측정하였으며, 월경곤란증과 자세 정렬에 대한 상관관계를 분석하였다. 그 결과, 월경곤란증 정도에 따라 어깨높이 비대칭성 각도에만 유의한 차이가 나타났으며(p<0.05), 골반 및 무릎 정렬에서는 유의한 차이가 없었다. 상관관계 분석에서는 월경곤란증 점수(MDQ)와 어깨높이 비대칭성 각도 간의 유의한 양의 상관관계(r=0.621, p<0.005)가 나타났다. 이러한 결과는 월경곤란증과 어깨관절의 부정렬이 연관성이 있음을 나타내며, 이러한 요인을 분석하기 위해 후속 연구에서는 월경곤란증을 가진 여성에 대한 척추 정렬에 대해서도 알아볼 필요가 있을 것으로 생각된다.

In determining the cause of dysmenorrhea, it is necessary to investigate postural alignment and balance. The purpose of this study is to compare and analyze whether there is a difference in posture alignment and foot pressure balance according to the dysmenorrhea degree. The subjects were twenty female students in their 20s, who had pain caused by dysmenorrhea. According to the degree of dysmenorrhea, the subjects were divided into mild and severe groups. In the results, there was a significant difference only in shoulder height asymmetry angle between the mild and severe groups (p<0.05), and there was no significant difference in pelvic and knee joint alignment. In the correlation analysis, there was a significant positive correlation between the dysmenorrhea score (MDQ) and shoulder height asymmetry angle was found. These results indicate that dysmenorrhea symptom and asymmetric alignment of shoulder are related. To analyze these factors, further research will need to investigate the correlation between dysmenorrhea and spinal alignment.

Purpose: This study was conducted in order to investigate the exercise limit that may occur depending on changes in postural alignment by examining the significance of postural alignment changes, foot pressure, and balance of patients with stroke. Methods: In this study, 50 patients diagnosed with a stroke were selected as subjects. Imbalance of postural alignment of the trunk, pelvic tilt of trunk rotation of the body, angle of kyphotic curving of the thoracic, and angle of lordotic curving of the lumbar vertebra were measured. Foot pressure was examined by measuring average pressure and weight bearing. Balance was examined by measuring the center of pressure and limit of stability. Results: The significance of postural alignment, foot pressure, and weight bearing of the non-paretic side was examined. In addition, the significance between postural alignment and balance was examined. Conclusion: It is thought that limits of foot pressure and balance in the standing position can be caused by postural alignment. Thus, both a therapeutic intervention program and postural alignment training should be provided together in order to improve the function of patients with stroke.

PURPOSE: This study examined the clinical effects of sling-based shoulder stabilization exercise on pain, postural alignment, cervical range of motion, and functional disability in patients with neck pain accompanied by forward head posture (FHP) and rounded shoulder posture (RSP). METHODS: In this randomized controlled trial, forty patients with neck pain and concomitant FHP and RSP completed the study. All participants received standardized conventional physical therapy, followed by either sling-based or conventional shoulder stabilization exercise, three times per week for four weeks. The outcomes included the pain intensity assessed using the visual analogue scale at rest and during cervical movements, postural alignment, cervical range of motion, and functional disability assessed by the Neck Disability Index. The group-by-time effects were analyzed using repeated-measures analysis of variance. RESULTS: Both groups showed significant improvements in pain intensity, postural alignment, cervical range of motion, and functional disability over time. Compared with the control group, the sling group showed greater reductions in movement-related pain at follow-up, along with greater improvements in the Neck Disability Index scores and right lateral flexion range of motion. CONCLUSION: Both interventions improved the pain, posture, cervical mobility, and disability in patients with neck pain accompanied by FHP and RSP. On the other hand, sling-based exercise provided additional benefits in reducing movement-evoked pain and improving specific cervical movements, indicating its potential value in clinical management.

Purpose: The purpose of this study was to investigate the effects of proprioceptive exercise on the body alignment of elderly women. Method: The experimental group consisted of twenty elderly women who participated in proprioceptive exercise for 8 weeks. The subjects were measured using Global Posture System equipment for assessing their body alignment. Body alignment was measured at the ear, shoulder joint, knee joint and calcaneocuboid joint on the sagittal plane, and the left and right acromion process positions, the ASIS and the medial malleoulus on the coronal plane. The body alignment data was used to assess the changes before and after proprioceptive exercise. The data of the experimental group was compared and analyzed using the Wilcoxon singed-rank test between before and after proprioceptive exercise. The Mann-Whithney test was used to compare the experimental group and the control group. Result: The result of this study was that the body alignment of the experimental group at the ear and knee joint on the sagittal plane was significantly in alignment with the line of gravity (p<0.05) before and after proprioceptive exercise. The body alignment was statistically different (p<0.05) between the experimental group and the control group on the frontal plane and sagittal plane. Conclusion: This study showed that proprioceptive exercise does affect the body alignment in elderly women. This indicates that there is interaction that plays a crucial role for proprioceptive stimuli and the body alignment.

PURPOSE: The purpose of this study was to investigate the effects of flexible derotator of femur orthosis (FDO) during treadmill gait training on the quadriceps-angle (Q-angle), lateral pelvic tilt, gait speed, and number of steps in children with cerebral palsy. METHODS: Seven children with cerebral palsy who had rotational deformity of the lower extremities participated in this study. We used single group repeated measure design. The procedure consisted of baseline phase, intervention phase, and post-intervention phase. The baseline phase consisted of stretching and strengthening exercise and treadmill gait training without FDO. The treatment phase not only included the same procedures as those for baseline, but also included FDO during treadmill gait training. Postural alignment of the lower extremities was assessed with the Q-angle, and lateral pelvic tilt using the Dartfish software program. A 10-m walk test was used to evaluate gait speed and number of steps. RESULTS: For postural alignment, there was significant differences after the application of FDO (p<.05). For gait ability, there was significant differences in all phases (p<.01). CONCLUSION: These finding suggest that the application of FDO during treadmill gait training had a positive effect on the improvement of postural alignment and gait ability in children with cerebral palsy having rotational deformity.

Background: Primary dysmenorrhea, a common menstrual pain condition, is influenced by hormonal changes, including excessive prostaglandin production, that may alter sensory processing and musculoskeletal function. These physiological changes may also affect functions including postural alignment, balance control, and body awareness. Although dysmenorrhea-related symptoms have been extensively studied, research evaluating posture, balance, and body awareness for correlations with menstrual phases or dysmenorrhea severity remains insufficient. We assessed postural alignment, balance, pain intensity, and body awareness according to the severity of primary dysmenorrhea in women with mild and severe primary dysmenorrhea. Methods: Twenty-nine women in their 20s were classified as having mild (n=14) or severe (n=15) dysmenorrhea using the modified Menstrual Distress Questionnaire. Postural alignment, static and dynamic balance, pain intensity, and body awareness were then assessed during pre-menstrual and menstrual phases. Comparisons were made within and between groups. Results: Both groups showed significant changes in postural alignment, staticㆍdynamic balance, and body awareness during menstruation compared to their pre-menstrual phase (p<.05). No significant differences were observed between groups in static/dynamic balance, pain intensity, or body awareness (p>.05). Change in pelvic tilt was significantly greater in the mild dysmenorrhea group (p<.05). Conclusion: Functional changes in posture, balance, and body awareness were observed during menstruation regardless of dysmenorrhea severity. These findings suggest clinical assessments and interventions should emphasize menstrual phase-related physiological changes rather than dysmenorrhea severity alone.

Background: This study was conducted to prove the effects of the Schroth exercise on sagittal postural alignment to the visually impaired students. Methods: The subjects were 8 students who attend the special school in Daegu and performed the Schroth exercise 3 times per week for 3 weeks. Craniovertebral angle and pelvic alignment were measured to compare the effects of the exercise. Results: Craniovertebral angle and pelvic alignment on sagittal plane showed significant differences (p<.05). Conclusions: Schroth exercise was effective to improve postural alignment of sagittal plane to the visually impaired students and these results will have a positive impact on future study of improvement of postural alignment on sagittal plane to the visually impaired students.

Background: The purpose of this study is to investigate the effect of neck and shoulder self-stretching exercise using audiovisual media on neck pain, postural alignment, and joint position error in women with chronic neck pain. Methods: The subjects included 20 women that gave consent to participate in the study voluntarily. They performed the self-stretching exercises using audiovisual media was carried out 20 minutes 5 times a week during 3 weeks. Neck disability index (NDI) and visual analogue scale (VAS) were used to measure the functional disability and pain, A pressure pain threshold was measured using an algometer, and a cervical range of motion (CROM) measurement tool was used to measure the range of motion and error of proprioceptive position sense of the cervical spine. To assess posture alignment, forward head angle (FHA), forward shoulder angle (FSA) were measured using image J software. Results: The neck pain intensity was statistically significantly within group (p<.05). Neck and shoulder functional disability were a statistically significant difference within group (p<.05). Splenius capitis and upper trapezius pressure pain threshold were statistically significant difference in within group (p<.05). The postural alignment was statistically significantly within group (p<.05). The cervical range of motion in neck extension, right and left lateral flexion were statistically significantly within group (p<.05). The joint position error in neck flexion, extension, right and left lateral flexion decreased statistically significantly within group (p<.05). Conclusion: Self-stretching exercise using audiovisual media increased the mobility of the neck, decreased neck pain and joint position error, and improved posture alignment. As a result, there was a positive effect by applying the self-stretching exercise using audiovisual media to people with neck pain. Based on this, it is thought that it can be used as the basis for research related to home training programs for healthy self-management.

This study was conducted to identify how a flexi-bar exercise influences body alignment and balance in adults who have asymmetry in their right or left body. In total, 20 participants were separated into the experimental group and the comparison group. Those in the experimental group participated in a flexi-bar exercise for 6 weeks and based on the coronal plane before and after exercise, their body alignment and balance were measured behind the body. The result was those who had participated in a flexi-bar exercise significantly improved their angle of acromion on both sides, the difference in the angle and height of the posterior superior iliac spine on both sides(p<.05), and the balance of the center sagittal plane(p<.05). Through this study, it could be said that participating in a flexi-bar exercise would improve postural alignment and balance of the shoulder and pelvis in adults with asymmetric posture.