Background: Neck discomfort and movement limitations are common musculoskeletal problems among modern people. While cervical and thoracic joint mobilization are widely used interventions for cervical dysfunction, research comparing their immediate effectiveness in adults with asymmetrical cervical rotation is limited. Objectives: To compare the immediate effects of cervical versus thoracic joint mobilization in adults with adults with asymmetrical cervical rotation and discomfort. Design: Randomized controlled trial. Methods: Thirty adults with left-right differences in cervical rotation of more than 5 degrees were randomly assigned to a cervical mobilization group (CMG, n=15) or thoracic mobilization group (TMG, n=15). Both groups received Grade III mobilization for 15 minutes. Range of motion (ROM), pain (VAS), and neck disability index (NDI) were measured before and after intervention. Results: Both groups showed significant increases in ROM after intervention (P<.001). Within-group analysis revealed that the TMG showed significant pain reduction (P<.01) and significant reduction in left-right rotation asymmetry (P<.001), while the CMG showed improvement in ROM but no significant changes in asymmetry or pain (P>.05). Neither group showed significant changes in NDI. Between-group comparisons showed no significant differences in any outcome measures. Conclusion: Both cervical and thoracic joint mobilization increased cervical range of motion in adults with asymmetrical cervical rotation discomfort. The TMG demonstrated significant within-group improvements in left-right rotation asymmetry and pain reduction, suggesting potential clinical benefits of thoracic mobilization for certain aspects of cervical dysfunction.

Background: Pain neuroscience education (PNE) with other therapeutic approaches can reduce pain intensity in patients with Chronic musculoskeletal pain and chronic spine pain by improving quality of life and disability. However, in various clinical trials and reviews, the optimal dose of an intervention combined with PNE is still an area to be studied. Objectives: To investigated the effect of forward head posture (FHP) with chronic neck pain on the PNE combined with cervical and thoracic mobilization. Design: A non-randomized, controlled intervention study. Methods: Thirty-two subjects were allocated to pain neuroscience education combined with cervical and thoracic mobilization group (PCTMG, n=17) and cervical and thoracic mobilization with TENS group (CTMG, n=15). For 6 weeks, the PCTM group applied PNE and cervical and thoracic mobilization and the CTM group applied cervical and thoracic mobilization and TENS. Changes in intervention pre-post pain and kinesiophobia were observed. Results: Results from the study indicated that statistically significant decrease in VAS and TSK-11 in PCTMG. In CTMG, there was a statistically significant decrease in VAS. And in PCTMG, there was a statistically significant decrease in VAS and TSK-11 than in CTMG. Conclusion: Therefore, this study confirmed that PNE combined with cervical thoracic mobilization is an effective intervention compared to ervical thoracic mobilization alone in reducing pain and kinesiophobia in FHP with chronic neck pain.

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.