Background: Loss of sagittal balance can lead to excessive thoracolumbar (TL) kyphosis, which is a postural impairment characterized by an increase in kyphotic curvature in these two regions of the spine. Excessive TL kyphosis has been shown to adversely affects quality of life and activities of daily living (ADL). Objectives: This study aimed to investigate immediate spinal motion and resultant postural changes after the application of single thoracic extension mobilization. This was compared to the application of two extension mobilizations, one of which was applied to the lumbar region in the second group of patients with excessive TL kyphosis. Design: Quasi-experimental study. Methods: A total of 53 participants (71.6 years, 20 male/33 female) were recruited. All participants had greater than 40° of TL kyphosis, as measured with a single gravity-dependent inclinometer positioned over the T1 spinous process. One group received thoracic extension mobilization only, whereas the other group received both thoracic and lumbar extension mobilization. Results: Both groups demonstrated an improvement (decrease) in the thoracolumbar kyphosis angle. The group that received thoracic mobilization alone demonstrated a 6.46° change (P<0.0001), while the group that received both mobilizations demonstrated a change of 11.96° (P<0.0001). Combined mobilization applied to both the thoracic and lumbar regions resulted in a significantly greater change (reduction) in TL kyphosis (5.50°, P<0.0001). Conclusion: The results demonstrate that the addition of a second mobilization to the lumbar region results in greater active TL extension and reduced TL kyphosis. Clinicians treating patients with excessive kyphotic curvature should be mindful of the contribution of the lumbar region to loss of sagittal balance. The addition of this simple manual mobilization to the lumbar region appears to yield better short-term improvements in patients with overly kyphotic spinal posture.

Background: The Functional Movement Screen (FMS) is widely used for movement assessment but suffers from subjective scoring that leads to inconsistent evaluations. While previous studies have focused on reliability, the validity of AI-supported assessment remains unexplored. Objectives: To evaluate the reliability and validity of an AI-based motion analysis system using MediaPipe for three FMS movements. Design: Prospective reliability and validity study with repeated measures. Methods: Thirty healthy adults (age 23.4±2.8 years) performed three FMS tests (Deep Squat, Hurdle Step, Inline Lunge) recorded on video. Three evaluators (two experienced physical therapists and one novice) assessed recordings in three phases: Phase 1 involved traditional assessment by experts only to establish criterion reference, Phase 2 had all evaluators using AI support, and Phase 3 consisted of repeated AI-supported assessment. The AI system provided real-time visual feedback of joint angles and alignment through MediaPipe skeletal tracking. Results: Criterion validity showed strong agreement between traditional expert assessment and AI-supported assessment (r=0.94, P<.05). Inter-rater reliability improved from good (ICC=0.89) to excellent (ICC=0.91) with AI support. The novice evaluator achieved immediate expert-level performance with only 0.05 points difference from experts. Intra-rater reliability was excellent for all evaluators (ICC=0.84-0.89). Conclusion: The AI-based system demonstrated strong validity and improved reliability for fundamental movement assessment. While AI support enabled novice evaluators to achieve expert-level performance immediately, it may increase sensitivity to subtle movement variations. This technology shows promise for standardizing movement screening, though current limitations restrict its application to standing movements.

Background: Stroke often results in hemiparesis, which leads to asymmetrical plantar pressure and impaired balance control. The gastrocnemius muscle plays a key role in plantar flexion and postural stability. Dysfuncion of this muscle is associated with decreased posterior foot pressure and increased fall risk in stroke patients. Objectives: To investigate the effects of gastrocnemius muscle stimulation using microcurrent stimulation therapy on plantar pressure distribution and functional balance in stroke patients. Design: Randomized controlled trial. Methods: Twenty chronic stroke patients were divided into an experimental group (microcurrent stimulation therapy+conventional rehabilitation therapy) and a control group (conventional rehabilitation therapy only). plantar pressure (posterior foot pressure), center of anteroposterior pressure displacement (CAP), and balance ability were measured using the berg balance scale (BBS) and functional reach test (FRT) before and after 8 weeks of intervention. Results: The experimental group showed statistically significant increases in posterior foot pressure and reductions in CAP after intervention. BBS and FRT scores also significantly improved. Although the control group showed some improvements, the changes were smaller and less consistent. Conclusion: Microcurrent stimulation targeting the gastrocnemius muscle improved plantar pressure symmetry and postural stability in stroke patients, suggesting its effectiveness as an adjunctive balance rehabilitation intervention.

Background: Core stabilization exercises are a key component of exercises for the conservative treatment of adolescent idiopathic scoliosis (AIS). Objectives: To evaluate the effectiveness of two different home-based exercise instruction methods (leaflets versus video materials) for children with AIS performing core stabilization exercises. Design: A retrospective study. Methods: Pediatric outpatients diagnosed with AIS were assigned to either a leaflet group or a YouTube video group. They were instructed to perform core stabilization exercises at home daily, completing three sets per day for six months. Pre- and post-exercise (6 months) evaluations included X-rays to measure the Cobb angle and the degree of vertebral rotation. Additionally, endurance in maintaining the Superman and Bird-dog positions was assessed. Results: After 6 months of intervention, the leaflet and YouTube groups showed no significant differences regarding Cobb angle, rotational degree, or endurance in the Bird-Dog and Superman positions. However, within-group comparisons before and after the 6-month exercise period showed a significant improvement in Cobb angle in the leaflet group. If exercise leaflets are effectively utilised, they could facilitate the implementation of core stabilization exercises in children with AIS, potentially improving their prognosis. Conclusion: Providing exercise instruction via a leaflet may be more effective than using a YouTube video in facilitating adherence to core stabilization exercises and improving spinal alignment in children with AIS.

Background: Foam roller exercise is widely used for myofascial release and improving joint range of motion. Objectives: This study aimed to identify the most effective session of thoracic foam roller exercise by examining changes in thoracic kyphosis angle (TKA) and trunk active range of motion (AROM) in healthy males in their 20s. Design: Single-group design. Methods: The study analyzed changes in TKA and trunk AROM across sessions following the application of a thoracic foam roller exercise for 45 seconds per session over three sessions in 16 healthy males in their 20s. Results: Compared to pre-test values, TKA significantly decreased and trunk AROM significantly increased after thoracic foam roller exercise (P<0.01). Post hoc analysis showed a significant decrease in TKA in session 3 compared to session 1 (P<0.01). Trunk AROM (flexion, left lateral flexion, right lateral flexion) showed significant changes in sessions 2 and 3 compared to session 1 (P<0.01). Right rotation significantly improved in session 3 compared to session 1 (P<0.01). Conclusions: For managing thoracic vertebral alignment in healthy males in their 20s, three sessions of thoracic foam roller exercise per day are recommended. For improving trunk AROM management, two sessions per day be sufficient.

Background: Chronic nonspecific low back pain (CNLBP) is a common musculoskeletal condition among middle-aged adults, often causing physical limitations and reduced quality of life. Transcutaneous electrical nerve stimulation (TENS) is a widely used non-pharmacological method for pain relief and muscle modulation. Objectives: To compare the effects of two high-frequency, high-intensity TENS protocols on pain, muscle tone, and stiffness in individuals with CNLBP. Design: Single-blinded, randomized controlled trial. Methods: Twenty-eight individuals with CNLBP were randomly assigned to an experimental group (EG) or control group (CG). Both received 60 Hz, highintensity TENS twice weekly for four weeks. Pain equivalent current (PEC), visual analogue scale (VAS), pain degree (PD), muscle tone (Hz), and stiffness (N/m) were measured pre- and post-intervention by a blinded assessor. Results: The EG showed significant improvements in all outcomes (P<.05), while the CG showed significant change only in VAS scores. Between-group analysis showed greater reductions in pain and muscle-related variables in the EG. Conclusion: The EG protocol, with individualized intensity adjustments and targeted stimulation sites, was more effective than the CG protocol in improving pain, muscle tone, and stiffness in adults with CNLBP.

Background: Flexible flatfoot impairs gait and posture by weakening arch support, potentially leading to musculoskeletal dysfunction. Strengthening exercises, such as the short foot exercise (SFE), have shown promise in correcting this condition. Objectives: This study aimed to investigate the effects of SFE with visual feedback on medial arch height and foot function in adults with flexible flatfoot. Design: Experimental research. Methods: Adults diagnosed with flexible flatfoot were randomly assigned to either an experimental or control group. The experimental group performed SFE with visual feedback, whereas the control group performed the same exercises without feedback. Both groups trained three times per week for five weeks. Outcome measures included the Navicular Drop Test (NDT), YBalance Test (YBT), and Tetrax postural analysis. Results: In the NDT, both groups showed significant improvements (P<.05), while in the YBT, only the experimental group showed a significant improvement (P<.05). In contrast, there were no significant changes in the Weight Distribution Index (WDI) and Stability Test (ST) areas of the Tetrax system in either group (P>.05). Conclusion: SFE effectively improved arch height regardless of visual feedback, though only the visual feedback group showed significant improvements in dynamic balance. However, between-group differences were not statistically significant, suggesting that visual feedback provides subtle rather than substantial additional benefits. Further research with larger samples is needed to establish the clinical value of adding visual feedback to SFE protocols.

Background: The progressive digitalization of contemporary life, coupled with prolonged sedentary behavior, has contributed to the widespread occurrence of forward head posture (FHP) in the general population. Among the various exercise interventions aimed at correcting FHP, stretching exercises and proprioceptive training have garnered significant attention. Objectives: To investigate the effects of stretching exercises and proprioceptive training on craniovertebral angle (CVA), an indicator of forward head posture (FHP), and on the muscle tone of the suboccipital muscles. Design: Randomized controlled trial. Methods: Thirty participants were randomly assigned to either the stretching exercise group (n=15) or the proprioceptive training group (n=15), and each group underwent intervention three times per week for six weeks. CVA and muscle tone of the suboccipital muscles were measured before and after the six-week intervention, and the results were statistically analyzed for comparison. Results: Both groups showed a significant increase in CVA after the intervention (P<.05), with no significant difference between the groups. The muscle tone of the suboccipital muscles did not show statistically significant changes either within or between the groups. Conclusion: Six weeks of stretching exercise and proprioceptive training both resulted in a significant increase in CVA, demonstrating that both interventions are effective in improving FHP. However, neither intervention produced significant changes in the muscle tone of the suboccipital muscles.

Background: Pulmonary fibrosis (PF) is a progressive lung disease marked by excessive fibrosis and declining respiratory function. While pharmacological treatments help manage symptoms, they offer limited reversal of fibrosis and often have side effects. As a result, interest in rehabilitation approaches such as breathing exercises combined with self-myofascial release (SMR) has increased. These techniques may enhance trunk stability and thoracic flexibility, contributing to improved respiratory function. Objectives: This study investigated the effects of thoracic expansion exercises using SMR techniques on pulmonary function and chest mobility in a patient with PF, and assessed their clinical applicability. Design: Single-subject A-B-A′ design. Methods: A 60s male with idiopathic PF underwent 20 days of intervention. Standard rehabilitation was applied during baseline (A) and follow-up (A′) phases. During the intervention (B), SMR-based breathing exercises were added. Outcomes included Functional Reach Test (FRT), chest expansion, and pulmonary function tests (FVC, FEV₁, PEF, FEV₁/FVC). Data were analyzed using the 2SD band method. Results: FRT improved from 23.4 cm (A) to 31.3 cm (B) and 34.2 cm (A′). Chest expansion increased from 1.7 cm to 2.8 cm, and FVC rose from 1.70 L to 2.08 L before dropping to 0.94 L. FEV₁/FVC improved from 80.8% to 86.7% during intervention but decreased at follow-up. Conclusion: SMR-based thoracic expansion exercises may enhance trunk stability, thoracic mobility, and certain pulmonary function indicators in PF patients. These findings suggest potential clinical benefits, warranting further studies to confirm long-term effectiveness.