Background: Women patients who have undergone high tibial osteotomy need management to control walking and balance and to enable functional daily life. In that way, land-based physical therapy and aquatic physical therapy were performed. Objectives: To investigated the effect of land-based and aquatic physical therapy on the balance and walking of women who had undergone high tibial osteotomy. Design: Randomized control trial. Methods: In all, this randomized controlled trial enrolled 21 patients with high tibial osteotomy who received land-based physical therapy (LP, n=7), aquatic physical therapy (AP, n=7), and land-based and aquatic physical therapy (LAP, n=7). Single-leg standing balance, 10-m walk test, and Knee injury and Osteoarthritis Outcome (KOOS-12) scores were. The intervention period was 3 days per week for 6 weeks. Results: One-leg standing balance and 10-m walk test increased statistically, and KOOS-12 score also increased statistically. All three groups have improved. As a result, the variable changes were compared in three groups, and although there was no significant difference between the land-based and aquatic physical therapy groups, the land-based and aquatic physical therapy combined programs improved further than the previous two groups. Conclusion: The balance and walking of female patients with high tibial osteotomy were found to have been very effective in land physical therapy and aquatic physical therapy. In addition, the land-based and aquatic physical therapy combination program can improve balance and walking more effectively.

Background: Forward head posture leads to resulting in posture instability and changes in spine alignment. To treat this condition, numerous studies have shown the effectiveness of joint mobilization. However, only a few studies have reported on the intervention location of joint mobilization or its effects on heart rate variability. Objectives: To investigated the effects of joint mobilization intervention at the lower cervical spine on pain, head posture, and heart rate variability (HRV) in patients with a forward head posture. Design: A randomized controlled trial. Methods: Twenty patients with forward head postures who met the study inclusion criteria were recruited. A randomization program was used to divide the subjects into experimental and control groups. Each group consisted of ten subjects. The intervention was performed for four weeks, three sessions per week, 15 min per day, and non-simultaneously throughout the 12-week study period. Results: A significant decrease in neck pain was shown in both the experimental and control groups. In contrast, significant changes in craniovertebral angle (CVA), cranial rotation angle (CRA), and HRV were found only in the experimental group. Conclusion: The mobilization of the cervical spine is an effective intervention for improving pain, head posture, and HRV.

Background: Short foot exercise, which is an intrinsic foot muscle exercise proposed by the foot core system, is used to improve the strength of intrinsic foot muscles and sensory input and function of the foot. However, there is a lack of studies that assessed the improvement in foot function after short foot exercise in patients undergoing rehabilitation after a modified Broström operation of the ankle joint. Objectives: To investigate the effects of short foot exercise on intrinsic foot muscle cross-sectional area and balance ability in patients who had undergone a modified Broström operation of the ankle joint. Design: A single blind, randomized controlled trial. Methods: Sixteen patients who were undergoing ankle rehabilitation exercises following the modified Broström operation were randomized into two groups. General physical therapy, short foot exercises, and ankle rehabilitation programs were performed in the experimental group (n=8), whereas general physical therapy and ankle rehabilitation programs were performed in the control group (n=8). For outcome measures, the intrinsic muscles of the foot were imaged using the Sonimage HS1 musculoskeletal ultrasound system. The Y-balance test and RS-foot scan system were used to confirm dynamic balance ability and static balance ability. Results: The cross-sectional area of the abductor hallucis and dynamic balance ability significantly improved in the experimental group that underwent short foot exercise compared to the control group (P<.05). In contrast, static balance ability was not significantly different between the two groups (P>.05). Conclusion: Short foot exercise successfully increased the cross-sectional area of the abductor muscle and improved dynamic balance after a modified Broström operation

Background: Patients who underwent rotator cuff repair (RCR) require management to control pain and prevent re tear and stiffness. Thoracic mobilization has been applied for the improvement of vertebra and shoulder movements and pain reduction. Also, core stability exercise is an intervention necessary for rehabilitation after shoulder surgery. Objectives: To examine the short term benefits of thoracic mobilization and core stability exercise for patients after RCR. Design: Randomized controlled trial with multi arm parallel group and single blind assessor. Methods: 30 participants after RCR were recruited. Participants were categorized into conventional physical therapy (CPT) group, thoracic mobilization (TM) group, and core stability exercise (CSE) group according to the randomization program. Each treatment, transcutaneous electrical nerve stimuli (TENS), TM, and CSE was applied to each group. 3 physical therapists only conducted evaluations; VAS (visual analogue scale), ROM (range of motion), and Korean version of Shoulder Pain and Disability Index (SPADI). Results: VAS and SPADI were statistically reduced, and ROM was statistically improved in all 3 groups. In between three group comparisons of changes in outcome variables, there was not a significant difference in VAS, but there was a significant difference in ROM and SPADI. In the post hoc test, ROM and SPADI showed a significant difference in TM and CSE compared to CPT. Conclusion: TM according to Maitland concept and CSE had beneficial effects compared to CPT in patients after RCR.

Background: Stroke patients have dosiflexor weakness. Functional electrical stimulation (FES) for motor and sensory threshold stimulation has been applied to patients with stroke. Objectives: To investigate effects of FES intervention for motor and sensory threshold on balance and gait in subacute patients with stroke. Design: A randomized controlled trial. Methods: In all, 34 patients with subacute stroke were recruited and randomly assigned to the motor threshold (MTG, n=17) and sensory threshold group (STG, n=17). The measured variables were static balance (BioRescue), dynamic balance (BBS), and gait (TUG test). The study period was 5 weeks, twice a day, 5 days a week. Results: There was a significant difference in all variables except the speed variable (open eye Romberg test) after the intervention; MTG improved more significantly except for the speed variable of the Romberg test (open eye). BBS score increased significantly only in the MTG group after the intervention, and the increase was more significant in the MTG group than in the STG group. The TUG test significantly decreased in both groups after the intervention, and the decrease was more significant in the MTG group than in the STG group. Conclusion: FES for motor threshold applied to patients with subacute stroke appears to be more effective in improving balance and gait ability than FES for sensory threshold.

Background: More women than men experience genu recurvatum, which can lead to knee pain and arthritis if left unattended. Pilates combined with taping is a suitable rehabilitation method for women with genu recurvatum. Objectives: To aimed the effect of taping and Pilates stabilization exercise on physical alignment and improvement of genu recurvatum in women with genu recurvatum. Design: A Randomized controlled trial. Methods: Twenty-one women were divided into three groups: taping group (back of knee taping and quadriceps femoris taping, n=7), Pilates exercise group (hip, knee and abdominal muscles exercise, n=7), and combined group (taping with pilates exercise, n=7). The measured variables were sagittal plane alignment and back and abdominal muscle, knee flexor and extensor strength. Results: After the intervention, all sagittal plane alignments were significantly improved in both the Pilates and combined groups. Sagittal plane alignment was significantly improved in the combined group compared with the taping group. Back and abdominal muscle strength were significantly improved in the Pilates and combined groups compared with the taping group. Knee flexor and extensor were significantly improved in the combined group compared with the Pilates group and in the Pilates group compared with the taping group. Conclusion: Pilates exercise with taping or Pilates exercise alone was effective intervention methods to improve physical alignment and strength in women with genu recurvatum.

Background: Incorrect postures of adolescents caused by the use of smart devices have been noted as a factor causing spinal diseases. Objectives: To examine the effect of joint mobilization and stretching on Cobb’s angle and respiratory function in adolescent idiopathic scoliosis (AIS). Design: Cluster-randomized controlled trial. Methods: A total of 22 subjects with AIS were enrolled. They were allocated to two groups: the joint mobilization (n=11) and the stretching (n=11). All interventions were conducted for 30 minutes, three times a week for six weeks. Outcome measures were the Cobb’s angle and respiratory function. The Cobb’s angle and respiratory function measured using the X-ray and Micro- Quark. Results: Joint mobilization group showed significant differences in Cobb’s angle and respiratory function, but stretching group showed significant differences Cobb’s angle. The differences in peak expiratory flow (PEF) between the two groups were significant. Conclusion: This study proved that joint mobilization is a more effective intervention for AIS to improve Cobb’s angle and respiratory function, when compared to stretching.

Background: Adults with forward head posture (FHP) often suffer from thoracic hyperkyphosis and thoracic dysfunction, and including reduction of the craniovertebral angle (CV angle) and tightening of the superficial neck muscles. In order to treat thoracic dysfunction, interventions aimed at improving thoracic mobility are necessary. Objectives: To examine the effects of maitland manual mobilization therapy on the thoracic spine in adults with FHP. Design: Single-blind randomized controlled trial. Methods: Thirty adults with FHP who met the selection criteria were randomized to the thoracic multiple joint mobilization (TMJM; n=15) group and the thoracic general joint mobilization (TGJM; n=15) group. Joint mobilizations were performed for 23 minutes a day for 4 weeks continuously, two times per week. Outcome measures were ImageJ, BTS FREE EMG 1000, neck disability Index (NDI). Results: Although changes in the left sternocleidomastoid muscle activity and NDI scores over time between the two groups differed, other variables were noted only changes observed over time. Muscle activity in the right sternocleidomastoid increased again in the TGJM group post-intervention and 2 weeks after the end of the experiment, but changes in other variables were retained or improved, confirming the lasting effects of thoracic joint mobilization. Conclusion: Thoracic multiple joint mobilization may be recommended as a more effective intervention for adults with FHP.

Background: Patients with stroke have core muscle weakness and limited rib cage movement, resulting in restrictive lung disease. Objectives: To examine the comparison of effects of rib cage joint mobilization combined with diaphragmatic breathing exercise and diaphragmatic breathing exercise on the pulmonary function and chest circumference in patients with stroke. Design: A cluster randomized controlled trial. Methods: Twenty-four patients were randomly assigned to an experimental group (rib cage joint mobilization combined with diaphragmatic breathing exercise group) and control group (diaphragmatic breathing exercise group). Patients in the experimental group underwent rib cage joint mobilization for 15 min and diaphragmatic breathing exercise for 15 min. The control group underwent diaphragmatic breathing exercise for 30 min. Both groups underwent exercise thrice a week for 4 weeks. The pulmonary function and chest circumference were measured using the MicroLab spirometer and a tape measure, respectively. Results: After the intervention, the pulmonary function and chest circumference significantly improved in both groups. These improvements were significantly higher in the experimental group than those in the control group. Conclusion: Rib cage joint mobilization combined with diaphragmatic breathing exercise improves pulmonary function and chest circumference in patients with stroke.

Background: Weakness of the trunk muscles decreases the trunk control ability of stroke patients, which is significantly related to balance and gait. Objectives: To compare the impact of diagonal pattern self-exercise on an unstable surface and a stable surface for trunk rehabilitation on trunk control, balance, and gait ability in stroke patients. Design: Nonequivalent control group design. Methods: Twenty four participants were randomized into the experimental group (diagonal pattern self-exercise while sitting on an unstable surface, n=12) and the control group (diagonal pattern self-exercise while sitting on a stable surface, n=12). All interventions were conducted for 30 minutes, three times a week for four weeks, and the trunk impairment scale (TIS), berg balance scale (BBS), functional gait assessment (FGA), and G-walk were measured. Results: All groups indicated significant increases in all variables (TIS, BBS, FGA, cadence, speed, stride length) after four weeks. The TIS, BBS, FGA, cadence, gait speed, and stride length group-by-time were significantly different between the two groups. Conclusion: We found that, in stroke patients, diagonal pattern self-exercise on an unstable surface is a more effective method for improving trunk control, balance, and gait ability than diagonal pattern self-exercise on a stable surface.

Background: A number of researchers have attempted to improve the balance of stroke patients, however there is still a question as to whether taping is effective in increasing balance. Objective: To determine the effect of paretic and non-paretic side taping on the balance ability in patients with stroke. Design: A single-blind randomized controlled trial Methods: This randomized single-blind controlled clinical trial with a repeated measures study included 45 subjects who were randomly assigned to paretic side taping groups (n=15), non-paretic side taping groups (n=15), and trunk exercise groups (n=15). Trunk exercise and paretic side taping groups had taping on the paralyzed erector spinae, while the non-paretic side taping group had taping on the non-paralyzed erector spinae. Trunk exercises were performed for 30 minutes to promote core muscles. The balance ability measured the center of pressure movement (paretic side, non-paretic side,forward, backward, limit of stability) in the sitting position. All measurements were evaluated using BioRescue. Results: All three groups showed significant increase in all variables after 4 weeks. The paretic and non-paretic side taping groups had a significant increase in all variables after 30 min of attachment. However, there was no significant difference among the three groups. Conclusions: Paralysis and non-paralysis taping improved the balance ability of patients with stroke in an immediate effect of 30 min. However, after 4 weeks of intervention, taping with trunk exercise did not differ from single trunk exercise. In future studies, various analyses need to be conducted through more diverse evaluations.