Background: Lower trapezius muscle function is important for the prevention and treatment of shoulder injuries. However, scapular posterior tilt movement has been overlooked in lower trapezius strengthening exercise programs. Objective: To examine the effects of prone arm lifting with scapular posterior tilt (PALSPT) on trapezius muscles. Design: Crossover study Methods: 17 healthy males were recruited for participation in this study. Participants performed backward rocking diagonal arm lifting (BRDAL) and PALSPT. To train participants in scapular posterior tilt movements for PALSPT, visual biofeedback of scapular movements was provided using a motion sensor. Electromyography (EMG) activities of the middle and lower trapezius were recorded using a surface EMG system. Differences in middle and lower trapezius muscle activity between BRDAL and PALSPT exercises were analyzed. Results: Lower trapezius muscle activity was significantly greater during PALSPT than during BRDAL (p=.006). Although greater EMG activity was observed in the middle trapezius during PALSPT than during BRDAL, this difference was not significant (p=.055). Conclusions: The results of the present study indicate that scapular posterior tilt movements must be considered in lower trapezius muscle strengthening programs.

Background: Walking is a complex activity. The main components of walking include balance, coordination, and symmetrical posture. The characteristics of walking patterns of stroke patients include slow walking, measured by gait cycle and walking speed. This is an important factor that reflects post-stroke quality of life and walking ability. Objective: This study aimed to examine the effect of deep lumbar muscle stabilization exercise on the spatiotemporal walking ability of stroke patients. Design: Quasi-experial study Methods: The experiment was conducted 5 times per week for 4 weeks, with 30 minutes per session, on 10 subjects in the experimental group who performed the deep lumbar muscle stabilization exercise and 10 subjects in the control group who performed a regular exercise. Variables that represent the spatiotemporal walking ability (step length, stride length, step rate, and walking speed) were measured using GAITRrite before and after the experiment and were analyzed. Results: There was a significant difference in the pre- and post-exercise spatiotemporal walking ability between the two groups (p<.05). Furthermore, there was a significant difference in the step rate and walking speed between the two groups (p<.05). Conclusions: Deep lumbar muscle stabilization exercise is effective in improving the walking ability of stroke patients. Therefore, its application will help improve the spatiotemporal walking ability of stroke patients.

Background: The treatment of pain in the iliotibial band friction syndrome has been difficult to determine, according to studies to date. However, recent studies have suggested that flexibility in the subacute stage of pain in the iliotibial band friction syndrome may help reduce pain. Objective: To investigate the immediate effect on pressure pain threshold and flexibility of the tensor fascia latae and iliotibial band by applying static and dynamic myofascial release foam rolling and self-stretching to adults with shortening iliotibial band. Design: Randomized controlled trial Methods: In this study, 50 subjects who were selected in advance as a randomized controlled trial were randomly allocated using a R Studio program. The included subjects were randomly allocated to three intervention groups. The static self-myofascial release 18 people, dynamic self-myofascial release group 16 people separated the self-stretching group 16 people and conducted a homogeneity check in advance. Before the start of the experiment, after of the experiment, 5 minutes after the end of the experiment, the pressure pain threshold and flexibility change for each part were measured. Results: The results of this study showed that the static self-myofascial release showed a significant difference in the pressure pain threshold in the tensor fascia latae and middle, lower part of the iliotibial band, compared with the other intervention groups (p<.05). In change of flexibility, the static selfmyofascial release was significantly different than the other intervention groups (p<.05). Conclusion: The result of this study suggest that static self-myofascial release using foam roller may help to improve the pain and flexibility of the iliotibial band and to apply it as a more discerning intervention.

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.

Background: Tension-type headaches, which make up the highest proportion of headaches, are prone to develop into chronic tension-type headaches (CTTH). The characteristic of CTTH in patients is that the active myofascial trigger point (ATrP) which causes pain in the muscles of the back of the head is increased, compared to the normal headache and moves the head position forward. Objective: The aim of this study was to investigate the effects of myofascial release (MFR) and posture correction in effectively improving neck function and sleep quality in the symptoms of CTTH patients. Design: Observer-blind study Methods: To reduce ATrP, MFR was applied and exercise was also applied to correct posture. The subjects of this study were 48 individuals randomly divided into three groups; The MFR group using the MFR technique; The MFR with exercise group subject to both the MFR technique and forward head position correction exercises (MFREx), and the control group. MFR and MFREx groups were given the relevant interventions twice a week for four consecutive weeks, and went through the number ATrPs, range of motion (ROM) of neck, Neck Disability Index (NDI) and the Pittsburgh Sleep Quality Index (PSQI) before and after the intervention. A physical therapist, who was fully familiar with the measuring methods of the equipment, was the measurer and not aware of the target's condition was blinded to take measurements only before and after intervention. Results: There was a significant improvement in the ATrP, Neck ROM, NDI and PSQI in the group of patients to whom the MFR technique and MFREx were applied. MFREx was more effective in increasing neck mobility. Conclusions: According to this study, the application of MFR is effective in improving neck movement and sleep quality in chronic tension headache patients.

Background: Foot drop is a common symptom after stroke and causes walking disorders. Therefore, its proper treatment is important for improving the walking ability of patients with foot drop. Objective: This study aimed to investigate the effects of electrostimulation during walking on the walking ability of patients with foot drop after stroke. Design: Quasi-experial study. Methods: The study enrolled 18 patients with foot drop after stroke. All subjects were assigned to the experimental or control group. The experimental group underwent electric stimulation during walking, while the control group used ankle foot orthoses. Both groups received treatment 20 minutes a day 5 times a week for 4 weeks. Outcome measures were assessed for walking and balance ability using the 10-m walking test (10MWT), 6-min walking test (6MWT), and Timed Up and Go test (TUG) Results: After the intervention, both groups showed significant improvements in 6MWT and TUG results. However, the experimental group showed significantly better improvement on all tests than the control group. Conclusion: The foot drop stimulator effectively improved the walking and balance ability of patients with foot drop after stroke.

Background: The prevalence of neck pain and neck dysfunction is high in general population. However, there is little literature on the relationship and factors affecting neck pain and neck dysfunction. Objective: To investigate the correlation between neck and shoulder pain, headaches, neck and shoulder dysfunction, and sleep quality in adults with chronic neck pain, and factors affecting neck pain and neck dysfunction. Design: Cross-sectional study Methods : The sample included 114 subjects, who had complained of chronic neck pain for more 12 weeks. We conducted a Pearson’s correlation between neck and shoulder pain, headaches, neck and shoulder dysfunction and sleep quality and a regression analysis of the related variables, thereby analyzing factors affecting neck pain and neck dysfunction. Results : In the present study, in adults with chronic neck pain, neck pain was positively correlated with the Neck Disability Index (NDI), Shoulder Pain and Disability Index (SPADI)-Pain score, and SPADI-Total score (p<.05). The NDI was positively correlated with neck pain, SPADI-Pain score, and SPADI-Total score, as well as with Pittsburgh Sleep Qulity Index(PSQI-K) (p<.05). Among the factors affecting neck pain, shoulder disability as assessed by the SPADI was a significantly associated with neck pain, while shoulder pain and shoulder disability determined by the SPADI were identified as significant variables among the factors affecting neck disability. Conclusion : These results indicated that as neck pain worsened , shoulder pain and neck and shoulder dysfunction also increased, which suggested that shoulder disability affected neck pain. In addition, as the neck dysfunction increased, neck pain and shoulder pain and shoulder dysfunction increased, and sleep quality deteriorated, which suggested that shoulder pain and shoulder disability affected neck disability.

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: Neurodynamic mobilization is divided into slider mobilization and tensioner mobilization. However, movement direction in neurodynamic mobilization has been overlooked in neurodynamic exercise program. Objective: To examine the effect of movement direction in neurodynamic mobilization on upper limb mobility and pain. Design: Quasi-experimental study Methods: Twenty-two adults positive for neurodynamic test for the median nerve were recruited for participation in this study. Twenty-two subjects were allocated to the applied neurodynamic mobilization at limited side group (ANTLS, n=7), the applied neurodynamic mobilization at contralateral limited side group (ANTCLS, n=7), and the applied neurodynamic mobilization at bilateral side group (ANTBS, n=8). Before the intervention upper limb limited was measured neurodynamic test for the median nerve, pain was measured using visual analogue scale (VAS), movement direction in neurodynamic mobilization was applied to each group, and then re-measured using neurodynamic test for the median nerve and VAS. Differences the Intra-groups before and between the intergroups after intervention were analyzed. Results: In the ANTLS and ANTBS groups, a statistically significant increase in ROM and decrease in VAS score in the population before and after intervention were indicated. Statistically significant differences in VAS and ROM from before to after intervention were found among the ANTLS, ANTCLS, and ANTBS groups. Conclusions: The results of the present study indicate that movement direction in neurodynamic mobilization must be considered within the limits of its selected range of the neurodynamic exercise program.

Background: Physical therapy has been widely studied in various fields, however, the academic trends and characteristics has not been systematically analyzed. Semantic network analysis is used as an approach for this study. Objective: To explore academic trends and knowledge system in the physiotherapy research in the Journal of International Academy Physical Therapy (J of IAPTR) Study design : Literature review Method: Semantic network analysis was conducted using the titles of 272 articles published in the Journal of IAPTR from 2010 to 2019. Results: Frequency analysis revealed following most frequently used key words; Stroke (27 times), Balance (21 times), Elder (13 times), Forward head posture (FHP, 11 times), Muscle activity (9 times). The relationship between the presented keywords is divided into six subgroups (FHP and pain, walk and quality, elder and balance, stroke and apoptosis, muscle strength and function) according to their correlation and frequency to be used together. Conclusion: The study is considered to be of help to researchers who want to identify research trends in physiotherapy.

Background: Flexible flat foot is that the medial longitudinal arch collapses in weight bearing and returns normal arch when weight is removed and the weight bearing shifts toward medial part of the foot, which can cause pathological problems in the alignment of the lower extremities and the entire body. Objective: To compare the foot pressure for adults with flexible flat foot. Design: Quasi-Experimental Study Methods: 24 participants with flexible flat foot were recruited and were randomly divided into Visual feedback Short Foot Exercise (VSFE) group and Short Foot Exercise (SFE) group. To compare changes of foot pressure about pre and post intervention, the contact pressure measurement was conducted. Results: In the VSFE, significant differences were observed for the foot pressure of the 1st toe, 1st, 3rd and 4-5th metatarsal, midfoot, medial and lateral heel (p<.05). The foot pressure of the 3rd and 4-5th metatarsal, midfoot showed significant differences in the SFE (p<.05). The contact pressure of the 1st toe, 3rd metatarsal showed significant differences between the groups. Conclusions: Visual feedback short foot exercise can be useful for moving the pressure from medial to lateral part, and can prevent possible pathological problems.