The purpose of this study is to explore the effects of mobilization of C0-C1 and C7-T1 applied to asymptomatic individuals with reduced upper cervical rotation during the FRT. Design: parallel randomized controlled trial. 48 subjects(38.52 years±15.13) with C1-C2 rotation hypomobility in TFR joined the study and were randomized into three groups(C0, C7, control group). FRT in both directions was measured before and after the intervention. C0 intervention consisted of a dorsal translatoric mobilization of C0-C1 in the cervical neutral position. C7 intervention consisted of a ventral cranial translatoric mobilization of C7- T1 in neutral position and the control group maintained a supine position. C0 group experienced a FRT ROM to the restricted side increase of 17.64。(SD=4.55), that was significantly greater (P<0.001) than 5.95。 (SD=4.81) of the C7 group and 2.45。(SD=5.05) of the control group. The results showed that a dorsal translatoric mobilization of C0-C1 in neutral position restored the physiological FRT mobility in subjects with C1-C2 hypomobility and experienced statistical significant improvement in FRT as compared to a C7-T1 translatoric mobilization and a control group. (Level of evidence: 1b).

Few studies address the use of manual muscle stretching to improve spinal active range of motion(AROM). There is evidence that‘ Hold-Relax’(HR) is effective for increasing ROM in the extremities, which leads the researchers to anticipate similar benefits in the spine. The purpose of this study is to investigate the effects of HR(trunk flexors) and active thoracic flexion and extension on thoracic mobility, specifically flexion and extension in healthy individuals. A convenience sample of 30 physical therapy students(22-38 years) were randomly assigned to intervention sequence ‘A-B’ or ‘B-A’, with at least 7 days between interventions. Intervention‘ A’ consisted of HR of the ventral trunk musculature while ‘B’ consisted of thoracic flexionextension AROM. Thoracic flexion and extension AROM were measured before and after each intervention using the double inclinometer method. Paired t-tests were used to compare AROM pre and post-intervention for both groups, and to test for carry-over and learning effects. There was a statistically significant increase(mean=3° ; p=0.006) in thoracic extension following HR of the trunk flexors. There were no significant changes in thoracic flexion following HR, or in flexion or extension following the AROM intervention. No carryover or learning effects were identified. HR may be an effective tool for improving AROM in the thoracic spine in pain free individuals. Further investigation is warranted with symptomatic populations and to define the minimal clinical difference(MCD) for thoracic spine mobility.