Background: Shoulder impingement syndrome is a common musculoskeletal condition in which exercise therapy is widely used; however, its effectiveness depends largely on patient adherence. Tele-rehabilitation strategies have been proposed to improve adherence in home exercise programs. Objectives: To compare the effects of a home coaching–based home exercise program (HCHEP) with a standard home exercise program (HEP) on exercise adherence, pain intensity, and shoulder disability. Design: A randomized controlled trial. Methods: Thirty participants with shoulder impingement syndrome were randomly assigned to either the HCHEP group (n=15) or the HEP group (n=15). Both groups performed a standardized home exercise program for 6 weeks. The HCHEP group additionally received structured tele-recovery coaching sessions focusing on feedback, goal setting, and problem-solving strategies. Outcomes included exercise adherence (%), pain intensity (Numeric Rating Scale), and shoulder disability (SPADI), assessed at baseline, post-intervention (6 weeks), and follow-up (12 weeks). Linear mixed models and repeated measures ANOVA were used for statistical analysis. Results: The HCHEP group showed significantly higher adherence and greater improvements in pain and shoulder disability compared with the HEP group (P<0.01). Significant interactions (group, time) were observed for all outcomes. Conclusion: Tele-recovery coaching enhances adherence and improves clinical outcomes in individuals with shoulder impingement syndrome.

Background: Lumbar Joint Mobilization (LJM) applies rhythmic forces to lumbar joints to improve mechanics and pain. Recent evidence suggests potential benefits for somatosensory input and postural control, though direction-specific effects remain unclear. Objectives: To investigate short-term effects of LJM on standing stability and trunk control through pre-post intervention comparison. Design: Quasi-experimental study. Methods: Twenty-five participants were randomized to experimental (n=13) or control (n=12) groups. Single-leg balance was assessed using force platform measurement with eyes open/closed conditions. The experimental group received Maitland-technique LJM including spinal compression, lateral compression, transverse process mobilization, rotational oscillation, and traction. Balance parameters included medio-lateral standard deviation (ML-SD), anteroposterior standard deviation (AP-SD), sway area, and path length. Results: The experimental group demonstrated significant medio-lateral stability enhancement (64% ML-SD reduction, P =0.003) with significant group×time interaction (F=4.20, P=0.043, η²p=0.044). Sway area decreased by 67% and path length showed large effect size (d=1.19, P<0.001). Improvements occurred in both visual conditions without increased visual dependence (stable Romberg Quotient), indicating somatosensory-driven enhancement. Machine learning classification achieved near-perfect accuracy (AUC=1.000). Conclusion: LJM produces immediate, direction-specific improvements in lateral trunk control through enhanced somatosensory feedback. Larger trials with long-term follow-up are needed to confirm sustained benefits.

Background: The purpose of this study was to examine whether performing cervical stabilization exercises prior to smartphone use could positively influence postural alignment, pain, and cervical mobility in individuals with forward head posture (FHP). Objectives: To investigate the immediate effects of cervical stabilization exercises performed before smartphone use on craniovertebral angle (CVA), cranial rotation angle (CRA), pain, and cervical range of motion (CROM) in individuals with FHP. Design: A randomized controlled trial. Methods: Participants were randomly assigned into two groups: the control group (Con, n=15), which only vied smartphone videos, and the exercise group (Exp, n=15), which performed cervical stabilization exercises before smartphone viewing. All participants used a smartphone for 20 minutes and pre- and post-measurements included CVA, and CRA, CROM, and VAS for pain. Results: The results demonstrated that participants who performed cervical stabilization exercises showed increased CVA and decreased CRA, suggesting an improvement in forward head alignment following smartphone use. In contrast, the control group exhibited decreased CVA, increased CRA, and elevated neck pain scores after smartphone viewing. Additionally, the control group showed a reduction in right lateral flexion range of motion, whereas no significant CROM changes were observed in the Exp group. Between-group comparisons revealed significant differences in CVA, CRA, and VAS, supporting the immediate protective effects of exercise. Conclusion: These findings suggest that performing cervical stabilization exercises before smartphone use may help mitigate posture deterioration and pain induced by smartphone viewing. This indicates that pre-emptive cervical stabilization exercise could serve as an effective preventive strategy for individuals with FHP.

Background: Stroke-related trunk muscle weakness impairs balance and sitto- stand performance. Although trunk kinesio taping has shown potential to improve trunk control, evidence regarding the immediate effects of simple and clinically applicable taping methods on sit-to-stand function remains limited. Objectives: The purpose of this study was to investigate the immediate effects of spiral trunk taping on sit-to-stand in stroke patients with trunk control disorders. Design: Randomized controlled trials. Methods: Twenty-four stroke patients were divided into an experimental group (n=12) and a control group (n=12). The experimental group received spiral trunk taping, whereas the control group received sham taping. Dynamic balance performance (sit-to-stand and Timed Up and Go) was assessed immediately after the intervention. Results: The experimental group demonstrated significant improvements in dynamic balance, with reduced completion times in both the sit-to-stand and Timed Up and Go following the intervention, whereas no significant changes were observed in the control group. Moreover, the magnitude of pre–post change in all dynamic balance variables was significantly greater in the experimental group compared to the control group. Conclusion: Spiral trunk taping significantly improved sit-to-stand and Timed Up and Go in stroke patients, suggesting that a trunk-centered taping approach may be an effective and clinically feasible intervention to enhance functional movement and dynamic balance after stroke.

Background: Stroke impairs postural control and hip abductor function. Closed Kinetic Chain (CKC) exercise emphasizes weight-bearing control, whereas Open Kinetic Chain (OKC) exercise emphasizes isolated strengthening. Objectives: To compare CKC, OKC, and combined hip abductor strengthening exercises on static balance and gait ability in chronic stroke. Design: Randomized controlled trial. Methods: Thirty participants were randomly assigned to CKC (n=10), OKC (n=10), or combined exercise (n=10) groups. Trained three times weekly for eight weeks. Static balance was assessed using Center of Pressure (COP) variables from the HUR BT4 system, including C90 area (90% confidence circle area) and standard deviation (STD) velocity, and gait ability was evaluated using the 10-Meter Walk Test (10MWT). Results: With eyes open, C90 area and trace length decreased in the CKC and combined groups (P<.05), and trace length improved more in the combined than the OKC group (P<.05). With eyes closed, all groups showed reductions in C90 area, trace length, and STD velocity (P<.05), with greater improvement in selected parameters in the combined group. Gait speed improved significantly in the CKC and combined groups (P<.05). Conclusion: CKC-based and combined exercises improved static balance and gait ability. CKC-based training may be an option for improving weightbearing control and gait in stroke rehabilitation.

Background: Sarcopenia is associated with functional decline in older adults; however, its independent role in acute stroke recovery remains unclear. Objectives: To examine the association between sarcopenia, baseline functional status, and 12-week rehabilitation outcomes in patients with acute stroke. Design: Single-center retrospective cohort study. Methods: A total of 251 patients with acute stroke were analyzed. Sarcopenia was defined according to the 2019 Asian Working Group for Sarcopenia criteria. Functional outcomes, including activities of daily living (K-MBI), cognitive function (K-MMSE), and balance (BBS), were assessed at admission and at 12 weeks. Multiple linear regression analyses were performed adjusting for age, sex, stroke etiology, lesion side, and baseline functional scores. Results: Sarcopenia was present in 44.6% of patients and was significantly associated with lower K-MBI, K-MMSE, and BBS scores at baseline (all P<.001). At 12 weeks, sarcopenia remained independently associated with poorer K-MBI and BBS scores (P<.001), while no significant association was observed with K-MMSE. Conclusion: Sarcopenia is independently associated with poorer baseline function and reduced recovery in activities of daily living and balance. Early identification and targeted management of sarcopenia may improve rehabilitation outcomes in patients with acute stroke.

Background: Shoulder pain, a common reason for seeking physical therapy (PT), may arise from the cervical spine or shoulder. Symptom localization (SL), is a systematic process to determine the source of symptoms through provocation/ alleviation testing. Objectives: To illustrate the clinical application of the SL sequence in a patient with shoulder pain. Design: A retrospective case report. Methods: A 29-year-old, female presented to PT with a 6-month history of right anterolateral shoulder pain that began after leaning on her arm while driving. Symptoms were aggravated with overhead movement and alleviated by external support. A thorough history/medical screening was performed. The SL examination sequence included: regional localization, structural localization, and confirmation testing. Results: The shoulder was identified as the source of symptoms (supraspinatus muscle-tendon unit). Prognosis was good secondary to the absence of underlying comorbidities and the ability to manually and positionally alleviate symptoms. Intervention included a combination of manual therapy (functional massage and joint mobilization) and neuromuscular re-education (gravity reduced training progressed to resisted exercises). Conclusion: This case provides an in-context example of SL to determine the source of symptoms, allowing for the implementation of a phased treatment approach, and return to prior level of function.

Background: Contemporary higher education requires interdisciplinary problem- solving competencies in addition to discipline-specific expertise. Integrating physical therapy, early childhood education, and digital urban construction may offer a novel approach to designing inclusive, safe, and developmentally appropriate spaces. Objectives: To evaluate the effects of a one-day Cross-Problem-Based Learning (Cross-PBL) workshop on teacher-student relationships, learning outcomes, and physical function in university students. Design: Pilot study. Methods: Six healthy male university students (19-23 years; two from each discipline) participated in a 3-hour intensive workshop. Plantar pressure analysis, questionnaires on teacher-student relationships and learning motivation, and reflective reports were collected before and after the workshop. Quantitative data were analyzed using the Wilcoxon signed-rank test (P<.05), and qualitative responses were analyzed descriptively. Results: No statistically significant changes were found in plantar pressure distribution (P>.05). However, tendencies toward change were observed in right foot anterior-posterior load distribution (P=.140) and primary sway axis during eyes-closed standing (P=.157). Questionnaire scores showed ceiling effects (5.0/5.0 pre- and post-workshop), whereas qualitative responses indicated improved teacher-student relationships, enhanced learning motivation, increased body awareness, and greater interdisciplinary understanding. Conclusion: Cross-PBL workshops may strengthen educational relationships, motivation, and interdisciplinary understanding, although short-term physical changes were limited.

Background: Although exercise and rehabilitation interventions are considered key strategies for managing sarcopenia, the characteristics and distribution of existing research focusing on stroke patients with sarcopenia have not been comprehensively mapped. Objectives: This scoping review aimed to systematically map the characteristics of sarcopenia assessment and exercise- and rehabilitation-based interventions in stroke patients with concomitant sarcopenia, and to identify current research trends and evidence gaps. Design: Scoping review. Methods: A systematic search was conducted in PubMed, Embase, and Web of Science from database inception to October 1, 2025. Studies involving adult stroke patients with sarcopenia and examining exercise, rehabilitation, or combined interventions were included. Study selection followed predefined eligibility criteria based on the PCC framework and was conducted according to the PRISMA-ScR guidelines. Findings were synthesized using descriptive numerical summaries and narrative synthesis. Results: Four studies were included, all conducted in Japan and designed as retrospective cohort or cross-sectional observational studies. Three studies evaluated chair-stand–based whole-body resistance exercise added to standard rehabilitation in convalescent rehabilitation settings, while one study examined the combined effects of energy intake and rehabilitation time in acute-care stroke patients. All studies diagnosed sarcopenia using the Asian Working Group for Sarcopenia 2019 criteria with bioelectrical impedance analysis and handgrip strength assessment. Higher frequencies of chairstand exercise were associated with improvements in sarcopenia status, muscle strength, and functional recovery. Conclusion: Current evidence on interventions for stroke patients with sarcopenia is limited and largely concentrated on chair-stand–based resistance exercise and combined nutrition–rehabilitation strategies in hospital settings. Future research should include multicenter randomized controlled trials, broader outcome assessments, and studies conducted across diverse healthcare and community rehabilitation settings to establish integrated rehabilitation strategies for stroke patients with concomitant sarcopenia.

Background: Stroke often leads to persistent gait impairments that significantly reduce mobility and quality of life. Conventional rehabilitation has demonstrated therapeutic value but is limited by insufficient personalization and low patient engagement. Objectives: This study aimed to evaluate the clinical effectiveness of a realtime Kinect-based motion analysis and AI-driven virtual reality (VR) gait training system for stroke rehabilitation. Design: Randomized controlled trial with parallel-group assignment. Methods: Thirty stroke patients were randomly assigned to a VR-based gait training group (n=15) or a conventional physical therapy group (n=15) for 8 weeks. The VR system integrated Kinect-based markerless motion capture, a 14-layer artificial neural network for gait parameter prediction, and immersive VR feedback to provide personalized gait retraining. Spatiotemporal gait parameters—including gait velocity, step length, cadence, and step width— were assessed before and after the intervention. Results: The VR group demonstrated significantly greater improvements in gait velocity (0.52 to 0.73 m/s, +40.4%), step length (78.3 to 95.7 cm, +22.2%), and cadence (100.2 to 110.4 steps/min, +10.2%) than the control group, while step width decreased (12.3 to 9.8 cm, −20.3%), indicating enhanced balance and stability. The artificial neural network accurately predicted movement patterns and supported adaptive training with real-time feedback. Conclusion: The real-time VR gait rehabilitation system effectively enhanced gait performance and motor coordination among stroke patients, outperforming conventional physical therapy. The integration of Kinect-based motion capture and AI-driven personalization provides a promising platform for scalable and clinically meaningful stroke rehabilitation.