Background: Thoracic spine self-mobilization exercise is commonly used to manage patients with neck pain. However, no previous studies have investigated the effects of thoracic spine self-mobilization exercise alone in patients with chronic neck pain.
Objects: The purpose of this study was to investigate the effects of thoracic self-mobilization using a tool on cervical range of motion (ROM), disability level, upper body posture, pain and fear-avoidance beliefs questionnaire (FABQ) in patients with chronic neck pain.
Methods: The subjects were 49 patients (21 males, 28 females) with chronic neck pain. The subjects were randomly divided into an experimental group (EG, n = 23) and control group (CG, n = 26). For the EG, thoracic self-mobilization was applied. We placed a tool (made with 2 tennis balls) under 3 different vertebral levels (T1-4, T5-8, T9-12) of the thoracic spine and the subjects performed crunches, which included thoracic flexion and extension in supine position. Five times × 3 sets for each levels, twice a week, for 4 weeks. Cervical pain, disability, upper body posture, FABQ results, and ROM were evaluated at baseline, after 4 weeks of intervention, and at 8 weeks of follow-up. Assessments included the quadruple visual analogue scale (QVAS); Northwick Park neck pain questionnaire (NPQ); craniovertebral angles (CVA), forward shoulder angle (FSA) and kyphosis angle (KA) measurements for upper body posture; FABQ and cervical ROM testing.
Results: The EG showed a statistically significant improvement after intervention in the QVAS (–51.16%); NPQ (–53.46%); flexion (20.95%), extension (25.32%), left rotation (14.04%), and right rotation (25.32%) in the ROM of the cervical joint; KA (–7.14%); CVA (9.82%); and FSA (–4.12%).
Conclusion: These results suggest that, for patients with chronic neck pain, thoracic selfmobilization exercise using a tool (tennis balls) is effective to improve neck pain, disability level, the ROM, and upper body posture.

INTRODUCTION
MATERIALS AND METHODS
RESULTS
DISCUSSION
CONCLUSIONS
CONFLICTS OF INTEREST
AUTHOR CONTRIBUTIONS
REFERENCES

• 김수진(대전대학교 일반대학원 물리치료학과) | Su-jin Kim (Department of Physical Therapy, The Graduate School, Daejeon University)
• 김선엽(대전대학교 보건의료과학대학 물리치료학과) | Suhn-yeop Kim (Department of Physical Therapy, College of Health and Medical Science, Daejeon University) Corresponding Author
• 이민지(대전대학교 둔산한방병원 물리치료실) | Min-ji Lee (Department of Physical Therapy, Dunsan Oriental Hospital, Daejeon University, Daejeon, Korea)