Background: Effective trunk stabilization has been a cornerstone in physiotherapy, particularly for individuals with lower back issues. While bridging exercises were traditionally employed for this purpose, there has been a growing interest in their modified versions to optimize therapeutic benefits. Objectives: To investigated the differential effects of traditional and modified bridging exercises, particularly when varying leg support and integrating abduction maneuvers during sling-assisted exercises, on trunk muscle responsiveness. Design: Cross-Sectional study. Methods: A group of twenty participants was subjected to three exercise protocols: Bilateral Limb Bridging (BLB), Single Limb Bridging (SLB), and Single Limb Bridging combined with Hip Abduction (SLBHA). Using Surface Electromyography (EMG), the study captured the activation patterns of the Internal Oblique (IO), Erector Spinae (ES), and Multifidus (MF) muscles. Statistical analysis was conducted using the Kruskal-Wallis test, with post-hoc examination for detailed insights. For data consistency, normalization was executed based on Maximum Voluntary Isometric Contractions, and EMG data interpretation was conducted using the RMS technique. Results: The most prominent variations in muscle activation were identified in the IO muscles on both sides. The left IO displayed marked activation disparities between BLB vs. SLB and SLB vs. SLBHA. Analogous observations were made for the right IO when comparing BLB to SLBHA and BLB to SLB. Conversely, ES and MF muscle activations remained consistent across the different exercises. Conclusion: Modified bridge exercises with sling-assisted leg supports with abduction can selectively activate IO muscles, with a noticeable asymmetrical effect favoring the left side.

Background: Research has been conducted on pain neuroscience education (PNE) for the relief of pain and symptoms associated with chronic neck pain (CNP). Focusing on the neurophysiology and neurobiology of chronic pain, pain processing, and particularly the function of the central nervous system for chronic pain, PNE helps patients to understand the causes of pain. Objectives: To investigate and systematically review interventional studies on the effectiveness of PNE for patients with CNP and to analyze the effect size by performing a meta-analysis. Design: A systematic review and meta-analysis protocol. Methods: The following databases and electronic collections will be searched for primary studies without time limits: PubMed, MEDLINE, OVID Embase, and CENTRAL in the Cochrane Library. Reference lists from identified studies will be manually hand-searched for additional relevant works. Patients 18 years of age and older with nonspecific neck pain lasting 3 months or longer will be included in the study, with exclusion criteria as follows: cancer pain, fractures of the spine or surgical intervention, cognitive impairment that does not allow the patient to follow the PNE program, pregnancy, chronic fatigue syndrome, fibromyalgia, and other related pathologies that may prevent full participation in the PNE program. There are no geographic restrictions; however, non- English studies will be excluded. Discussion: This study aims to evaluate the effects of PNE on pain and disability in chronic neck pain. Its results will help clarify whether the use of PNE alone can improve chronic pain. The advantages of systematic reviews include clear definitions and inclusion and exclusion criteria, standardized search formats, and objective independent reviews.

Background: There is a research report that lumbar mobilization for healthy people improves the knee extension angles and Q-angle related muscle activity (Q: quadriceps muscle). However, there is a lack of research on the effect of lumbar mobilization on gait variables such as cadence and gait speed, especially when mobilizing the central part of the lumbar spine from posterior to anterior. Objectives: To examine the effect of lumbar central PA mobilization in healthy people on cadence and gait speed. Design: Pilot study. Methods: There were 34 participants in this study. In the experimental group, lumbar posterior-anterior joint mobilization was performed once in Grade III-IV for 5 minutes, focusing on the segment with reduced movement. In the control group, lumbar posteroanterior mobilization was performed once in a total of Grade I-II for 5 minutes. To measure cadence and gait speed, STT-IWS and iSen System (San Sebastian, Spain) were used. Results: The comparison of cadence between groups, CG (Control group) increased cadence was about 6 more than EG (Experimental group) cadence, but it was not statistically significant. The gait speed of EG and CG was .30- .31, which was similar between the two groups, and the before and after values were also similar. There is no statistically significant difference Conclusion: The cadence and gait speed of the experimental group were not statistically significantly different than those of the placebo group.

Background: The effect of mobilization on lumbar back pain has been fully described in several clinical aspects, but evidence for muscle strength would be still less clear. Objective: To assess the effect of lumbar mobilization on lower limb strength in healthy individuals. Methods and Analysis: Healthy people aged 18-65 will be included regardless of race or sex. Original peer-reviewed primary reporting randomized controlled trials (RCTs) will be included. Electronic databases, such as MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, Web of Science, Pedro, CINAHL, ClinicalTrials.gov will be searched from inception until July 30. Only studies published in English will be included in this review. Two reviewers will complete the screening for eligibility independently, and the other two reviewers will also complete the risks of data extraction and bias assessment independently. Lower Limb strength will be assessed as primary outcome, and particular intervention or participant characteristics will be assessed as the secondary outcomes. Meta-analysis will be conducted using Review Manager 5.3.3, and evidence level will be assessed using the method for Grading of Recommendations Assessment, Development and Evaluation. Outcomes will be presented as the weighted mean difference or standardized mean difference with 95% CI. If I2 ≤ 50%, P>.1, the fixed effect model will be used, otherwise, random-effects model will be used. Ethics and dissemination: This review might not be necessary ethical approval because it does not require individual patient’s data; these findings will be published in conference presentations or peer-reviewed journal articles. PROSPERO registration number: CRD42020150144.

Background: Spinal Mobilization is one of the manual therapy technique that clinicians have used to treat pain, however, there is still a lack of research on changes in strength in healthy people. Objectives: To investigate the effect of posterior-anterior lumbar mobilization on lower limb strength in healthy individuals. Design: Two-group pretest-posttest design. Methods: In this study, 23 healthy subjects aged 20 years were assigned to 12 lumbar mobilization group (LMG) and 12 sham group (SG) to perform intervention and measurement through pre- and post-design. Intervention was performed in LMG with grade III~IV on L3-5 of the lumbar spine, and lumbar mobilization was performed for each segment. After intervention, knee flexion and extension strength were measured. To measure the main effect on muscle strength, a comparative analysis was conducted using paired t-test and independent t-test. Results: In LMG, knee flexor and extensor strength were increased significantly at 60°/s (P<.05). In addition, the extensors of LMG and SG were significantly different only at 60°/s, and the flexors were significantly different between groups at both 60°/s and 180°/s (P<.05). Conclusion: In healthy individuals, lumbar mobilization results in improvement of strength of knee flexor and extensor, and additional experiments on the effect of mobilization on the lumbar spine on functional changes in the lower limbs will be needed.

Background: Mobilization and cranio-cervical flexion exercise has been reported in reducing pain from cervical part and improving its motor function; also, has been represented that alleviate of neck pain and recover of neck muscles improve the normal gait performance. However, few studies have identified the effects of mobilization and exercise on pain and gait parameters with preceding issues. Objective: To examine the effects or changes of pressure pain threshold (PPT) and gait parameters in patients with chronic neck pain. Design: Cross-Sectional Clinical Trials Methods: Twenty patients with the history of neck pain (>3 months) performed the cervical mobilization and cranio-cervical flexion exercise. Gait parameters were assessed with wireless device and collected data were transmitted to the personal computer via Bluetooth. The PPT was measured posteroanterior direction at the prone position and the mean of subsequent three PPT measurements was used for the final analysis. Results: Both cervical central posteroanterior mobilization (CCPAM) (p<.000) and sling-based cranio-cervical flexion exercise (SBCCFE) (p<.000) group showed a significant increase in the PPT and the gait parameters, cadence (p<.023), was significantly increased in the CCPAM group, however slightly increased in the SBCCFE group. The comparison between the CCPAM and the SBCCFE groups after treatment did not show significant differences for the score on the PPT and gait parameters. Conclusions: This study suggests that CCPAM and SBCCFE increase PPT, cadence, and gait speed.

Background: Because of the lack of accurate values for applied forces in manual therapy, manual therapists relies on the magnitude of the individual’s perception during applying the force. However, excessive loading maneuvers carry risks for patients. Objective: To establish the relationship between the maximal force applied to swine skin with the specific region, sex, and baseline parameters of the subject. Design: Ex-vivo Study and laboratory Experimental research Methods: 3.5 kg of Korean pork sirloin that is a piece of swine was handled and it was set 3 dimensions; #A; #B; #C. Forty-seven participants who has no experience in physical therapy randomly carried out the experiment, indicated to push each place of the pressure spots with same posture and process under supervision from the instructor who has over 15 years of manual therapy, and we measured the pressure force in each time. Results: The biggest pressure force was recorded in spot #A, and #B was represented after #C. Pressure on #A showed certain statistic relation with height (r=.317, p<.05) and weight (r=.434, p<.01); pressure on #B showed certain relation which has statistical meaning with only height (r=.401, p<.01); pressure on #C emerged to have statistic relationship with height (r=.308, p< .05)and weight (r=.428, p<.01). The age aspect revealed relation with pressure on #A, #B and #C, but that was not statistically significant. Conclusions: It can be inferred that there is the most loss of pressure in the area where cartilage is like an island in the middle.

목적: 본 연구는 축구 공격전술상황 시 숙련자와 초보자간에 어떠한 시각탐색전략의 차이가 있는지를 밝히는데 그 목적이 있다. 대상: 축구 선수 경력 10년 이상의 숙련자와 축구경력 1년 이내의 초보자가 본 실험에 참여하였으 며, 모든 피험자는 다양한 공격전술상황에서 결정적인 골 찬스를 만들 수 있다고 생각되는 순간에 패스를 하는 과제를 총 20회씩 수행하였다. 이 과정에서 피험자의 안구움직임을 기록하였으며, 피험자의 시각탐색률(시선고정 빈도, 시선고정시간 비율), 전체영역별 시선고정 위치, 시선행동패턴을 분석하여 축구 기술 숙련성에 따른 시각탐 색의 차이를 살펴보았다. 결과: 본 연구의 결과는 다음과 같다. 첫째, 시선고정 빈도는 숙련자가 초보자에 비해 적은 시선고정 빈도가 나타났으며, 전체수행 시간 중 시선고정 시간을 백분율로 환산한 시선고정 시간 비율은 숙련자가 초보자보다 더 높게 나타남으로써 초보자보다 오랫동안 시선을 고정하는 것으로 나타났다. 둘째, 전체 영역별 시선 고정 위치는 숙련자가 초보자에 비해 중앙 영역에 주로 시선을 고정한 것으로 나타났으며, 초보자는 중앙을 포함한 전체 영역에 다양하게 시선을 고정하는 것으로 나타났다. 셋째, 시선행동패턴은 숙련자가 주로 중앙 패턴 을 포함한 시선행동패턴 유형을 활용하였고, 초보자는 일정한 시선행동패턴을 찾아볼 수 없는 것으로 나타났다.