Background: Limitations of shoulder range of motion (ROM), particularly shoulder internal rotation (SIR), are commonly associated with musculoskeletal disorders in both the general population and athletes. The limitation can result in connective tissue lesions such as superior labrum tears and symptoms such as rotator cuff tears and shoulder impingement syndrome. Maintaining the center of rotation of the glenohumeral joint during SIR can be challenging due to the compensatory scapulothoracic movement and anterior displacement of the humeral head. Therefore, observing the path of the instantaneous center of rotation (PICR) using the olecranon as a marker during SIR may provide valuable insights into understanding the dynamics of the shoulder joint. Objects: The aim of the study was to compare the displacement of the olecranon to measure the rotation control of the humeral head during SIR in individuals with and without restricted SIR ROM. Methods: Twenty-four participants with and without restricted SIR ROM participated in this study. The displacement of olecranon was measured during the shoulder internal rotation control test (SIRCT) using a Kinovea (ver. 0.8.15, Kinovea), the 2-dimensional marker tracking analysis system. An independent t-test was used to compare the horizontal and vertical displacement of the olecranon marker between individuals with and without restricted SIR ROM. The statistical significance was set at p < 0.05. Results: Vertical displacement of the olecranon was significantly greater in the restricted SIR group than in the control group (p < 0.05). However, no significant difference was observed in the horizontal displacement of the olecranon (p > 0.05). Conclusion: The findings of this study indicated that individuals with restricted SIR ROM had significantly greater vertical displacement of the olecranon. The results suggest that the limitation of SIR ROM may lead to difficulty in rotation control of the humeral head.

Background: Mobilization with movement (MWM) is an effective intervention for increasing range of motion (ROM) and function without pain. Objectives: The purpose of this study is to comprehensively characterize the functional effects of MWM applied to the ankle joint in patients with stroke. Design: Systematic Review and Meta-analysis. Methods: International electronic databases, CINAHL, Embase, MEDLINE, PubMed, and Google scholar were included and identified after review by two investigators in July 2023 according to PRISMA guidelines. Data were synthesized using software provided by Cochran and analyzed using a random effects model with reweighting to account for heterogeneity between participants. Results: After excluding duplicate studies, 14 of the 19 articles screened through the abstracts were excluded, resulting in a total of five studies involving 109 participants with stroke. MWM showed significant differences in ankle ROM [overall effect (Z=3.27, P=0.00)], gait speed [overall effect (Z=3.33, P=0.00)], and cadence [overall effect (Z=2.49, P=0.01)]. Conclusion: The results of the meta-analysis confirmed that MWM is effective in improving ankle ROM and gait parameters in patients with stroke.

Background: The Trunk Stabilization Exercise and Respiratory Muscle Exercise may help address the complex biomechanical and neuromuscular issues that contribute to shoulder joint disorders and can help improve patient outcomes in terms of pain relief, range of motion, and functional ability. Objectives: To investigated the effects of conventional physical therapy, trunk stabilization exercise, and respiratory muscle exercise, on the Range of Motion (ROM), ULF and balance in patients with shoulder joint disorder. Design: A randomized controlled trial. Methods: This study randomly allocated 18 subjects to the control group, 19 to the trunk stabilization exercise group, and 19 to the respiratory muscle exercise group, while all interventions were performed five times a week for four weeks. The result measurement involved the ROM, the upper limb function test (ULT), and balance tests. Results: The respiratory muscles exercise group indicated significant improvement in ROM and balance tests than the trunk stabilization exercise group and control group. Conclusion: The respiratory muscle exercise is a more effective way to improve ROM and balance ability than trunk stabilization exercise for patients with shoulder joint disorder.

Background: The range of motion (ROM) and balance ability of the ankle joint affect the stability of the ankle and prevent injuries or hurts from falling. In the clinical tests conducted recently, the floss band is widely used to enhance the range of joint motion and exercise performance, and there are many studies that have applied it to ankle joint increasing dorsi flexion (DF) angle. Objects: This study compared the effects on the range of ankle motion and static/dynamic balance ability of the ankle through three conditions (before floss band intervention, after floss band intervention, and after active exercise intervention) for adults. Methods: One intervention between floss band and active exercise was applied randomly and another intervention was applied the next day. After each intervention, the ROM of the ankle joints and the static balance was checked by measuring conducting one leg test. And the dynamic balance was checked by conducting a Y-balance test. Results: In the case of DF, the range of joint motion showed a significant increase after floss band intervention compared to before floss band intervention (p < 0.05). Static balance ability showed a significant increase after the intervention of floss band and active exercise compared to before the intervention of floss band (p < 0.05). The dynamic balance ability showed a significant increase after the intervention of the floss band compared to before intervention of the floss band and after active exercise intervention (p < 0.05). Conclusion: Based on these results, it was confirmed that the application of floss band to the ankle joint increases DF and improves the static and dynamic balance ability. Based on this fact, we propose the application of a floss band as an intervention method to improve the ROM of the ankle joint and improve the stability of the ankle in clinical field.

Background: Low back pain is a very common musculoskeletal disorder. Since low back pain can indicate physical and psychological problems, reducing the pain level of low back pain can be the primary goal of rehabilitation. Objectives: This study was performed to explain the personalized treatment protocol of Maitland orthopedic physiotherapy based on the brick wall concept for low back pain patients with hypomobility. Design: Randomized controlled study. Methods: A total of 14 chronic low back pain patients were divided into two groups. The experimental group received orthopedic manual physical therapy intervention. The control group received traditional physical therapy intervention. After the 3 days intervention, the joint range of motion and pain of the low back were measured. Results: The low back flexion, extension, lateral flexion, and rotation joint range of motion was significantly increased in the experimental group than in the control group (P<.05). Low back pain was significantly reduced in the experimental group than in the control group (P<.05). Conclusion: It was confirmed that Maitland orthopedic physical therapy was an effective method as an intervention method to improve the joint range of motion and pain of chronic low back pain patients.

Background: Measurement of passive ankle dorsiflexion range of motion (ADROM) is often part of a physical therapy assessment. Objects: The objective of this study was to identify the effects of subtalar joint neutral position (SJNP) on passive ADROM according to knee position in young adults. Methods: We recruited 14 young adult participants for this study. Two examiners used a universal goniometer to measure passive ADROM with and without SJNP. Dorsiflexion force was applied to the forefoot until maximum resistance was reached in two knee positions (extension and 90˚ flexion) in the prone position. Subtalar joint position was also recorded at maximum ADROM. Passive ADROM was measured three times at different knee and subtalar joint positions, in random order. Two-way repeated-measures analysis of variance was used to compare the effects of subtalar joint and knee position on passive ADROM. Results: Passive ADROM was significantly lower with than without SJNP during both knee extension (mean difference: 7.4˚) and 90˚ flexion (mean difference: 16.9˚) (p<.01). Passive ADROM was significantly higher during 90˚ knee flexion than during knee extension both with (mean difference: 5.8˚) and without SJNP (mean difference: 15.2˚) (p<.01). The valgus position of the subtalar joint was significantly lower with than without SJNP during both knee extension (mean difference: 3.3˚) and 90˚ flexion (mean difference: 4.3˚) (p<.01). Conclusion: Our results indicate that the gastrocnemius may limit ankle dorsiflexion more than the soleus does. Greater dorsiflexion at the subtalar and midtarsal joints was observed during passive ADROM measurement without than that with SJNP; therefore, SJNP should be maintained for accurate measurement of ADROM.

The purpose of this study was to identify the effect of proprioceptive neuromuscular facilitation (PNF) stretching exercise and joint mobilization on ankle joint range of motion (ROM), plantar pressure, and balance in subjects with stroke. Thirty patients (n=30) were organized into three groups, each of which received different treatments: PNF stretching (n=10), joint mobilization (n=10), and joint mobilization and PNF stretching combined (n=10). Each group received three exercise sessions per week for four weeks. The ankle ROM was measured using a goniometer, and plantar pressure and balance ability were measured using BioResque static posturography. In comparison within each group, the joint mobilization group and the joint mobilization with PNF stretching group showed significant improvements in ankle ROM, plantar pressure, and balance ability (p<.05). In comparison between the groups, a statistically significant difference was found in SECS change between the PNF stretching group, joint mobilization group and the joint mobilization with PNF stretching group. This study found demonstrates that the joint mobilization and joint mobilization with the PNF stretching methods were effective in improving ankle ROM, plantar pressure, and balance ability in stroke patients.

Background:Rounded shoulder posture (RSP), a postural abnormality, might cause shoulder pain and pathologic conditions. Although most previous research has investigated RSP focusing on the proximal structures of the shoulder, such as the scapula and pectoralis muscles, the relationship between RSP and anterior distal structures of the upper extremity, such as the biceps brachii muscle and elbow joint, is not clearly understood.Objects:This study aimed to investigate the correlations between RSP and the biceps brachii length, elbow joint angle (EJA), pectoralis minor length, general pectoralis major length, humeral head anterior translation (HHAT), glenohumeral internal rotation (IR), external rotation (ER), and horizontal adduction (HAD).Methods:Twelve subjects with RSP (6 male, 6 female) were recruited. All subjects fulfilled the RSP criteria indicated by a distance ≥2.5 cm from the posterior aspect of the acromion to the table in the supine position. The examiner measured each of the following parameters twice: RSP, biceps brachii length, EJA, pectoralis minor length, pectoralis major length, HHAT, glenohumeral IR, ER, and HAD. Pearson’s correlation coefficient(r) was used to assess the correlation between RSP and all the variables.Results:There was a significant moderate positive correlation between RSP and biceps brachii length (r=.55, p=.032), moderate negative correlation between RSP and pectoralis minor length (r=-.62, p=.015), and moderate positive correlation between RSP and HHAT (r=.53, p=.038).Conclusion:The biceps brachii length, pectoralis minor length, and HHAT could be used to evaluate patients with RSP. Better understanding of the correlation between these factors and RSP could help in the development of effective methods to treat patients with this condition in clinical management.

This study used both kinesiotaping and extracorporeal shock wave therapy on patients diagnosed with frozen shoulder - a common musculoskeletal disorder in adults - in order to observe the effects on the joint range of motion. 21 adult(male 12, female 9) were selected and distributed into randomized groups. One group received kinesiotaping (n=10) and the other group received kinesiotaping together with extracorporeal shockwave therapy (n=11). After a 6 week duration of receiving kinesiotaping and extracorporeal shockwave therapy, changes in the joint range of motion in the patients were observed. Post-treatment of frozen shoulder, the changes in abduction within the shoulder joint were as follows: in both groups there was a noticeable increase in the joint range of motion (p<.05). Post-treatment of frozen shoulder, the changes in external rotation within the shoulder joint were as follows: both groups showed a significant increase in the joint range of motion (p<.05). The result of suggest that, it can be inferred that both the extracorporeal shockwave therapy and kinesiotaping are effective in increasing the joint range of motion in patients with frozen shoulder.

The aims of the current study were to assess reliability of range of motion (ROM) measurement of glenohumeral internal rotation (GIR) with a pressure biofeedback stabilization (PBS) method and to compare the reliability between manual stabilization (MS) and the PBS method. In measurement of pure glenohumeral joint motion, scapular stabilization is necessary. The MS method in GIR ROM measurement was used to restrict scapular motion by pressing the palm of the tester’s hand over the subject’s clavicle, coracoid process, and humeral head. The PBS method was devised to maintain consistent pressure for scapular stabilization during GIR ROM measurement by using a pressure biofeedback unit. GIR ROM was measured by 2 different stabilization methods in 32 subjects with GIR deficit using a smartphone clinometer application. Repeated measurements were performed in two test sessions by two testers to confirm inter- and intra-rater reliability. After tester A performed measurements in test session 1, tester B’s measurements were conducted one hour later on the same day to assess the inter-rater reliability and then tester A performed again measurements in test session 2 for confirming the intra-rater reliability. Intra-class correlation coefficient (ICC) (2,1) was applied to assess the inter-rater reliability and ICC (3,1) was applied to determine the intra-rater reliability of the two methods. In the PBS method, the intra-rater reliability was excellent (ICC=.91) and the inter-rater reliability was good (ICC=.84). The inter-rater and intra-rater reliability of the PBS method was higher than in the MS method. The PBS method could regulate manual scapular stabilization pressure in inter- and intra-rater measuring GIR ROM. Results of the current study recommend that the PBS method can provide reliable measurement data on GIR ROM.

The purpose of this study was to apply the joint mobilization technique to the level of segments with pain and to the level of segments with hypomobility respectively and compare the immediate effects of the joint mobilization technique on the pain, the active cervical range of motion (ROM), and treatment satisfaction of patients with acute mechanical neck pain. After the baseline assessment, forty-two patients were randomized into two groups: a painful group (n1=21) that received joint mobilization at the most painful cervical spine level and a hypomobile group (n2=21) that received joint mobilization at the most hypomobile cervical level. The patients received an intervention that applied unilateral posterior-anterior gliding for 5 minutes and two repetitions of 10 times of active extension motion with distraction. In the Wilcoxon signed-rank test, the painful group and the hypomobile group were improved significantly in all pain variables (p<.001), while the painful group was improved significantly in the active cervical flexion (p<.001), extension (p<.001), left side-bending (p<.01), right side-bending (p=.001), left rotation (p<.001), and right rotation (p<.001). The hypomobile group was significantly improved in active cervical flexion (p=.001), extension (p<.001), left side-bending (p<.05), right side-bending (p=.001), left rotation (p=.001), and right rotation (p<.01) after intervention. In the Mann-Whitney U test, there was no significant difference in any of the dependent variables after the intervention between the two groups, but the painful group was slightly superior to the hypomobile group in all variables except for the right lateral flexion ROM and treatment satisfaction. These outcomes suggest that the cervical joint mobilization may be applied to either the level of painful segments or the hypomobile segments for the treatment of patients with acute mechanical neck pain.

This study investigated the effects of axillary crutch length on trunk muscle activity and lumbo-pelvic-hip complex movements during crutch gait. Eleven healthy men participated in this study. The participants performed a three-point gait with optimal, shorter, and longer crutch lengths. Weight-bearing (WB) side was determined as the dominant leg side. The electromyography (EMG) activity of the bilateral rectus abdominis (RA) and erector spinae (ES) muscles and lumbo-pelvic-hip complex movements were monitored using a three-dimensional motion system with wireless surface EMG. Differences in the EMG activity of RA and ES muscles and range of motion (ROM) of lumbar spine, pelvis, and hip among conditions were analyzed using one-way repeated-measures analysis of variance, and a Bonferroni correction was conducted. There was less RA muscle activity on the WB side under the optimal crutch length condition compared with shorter and longer crutch length conditions (p<.05). The EMG activity of the RA muscle on the non-WB side and ES muscle on the WB side were significantly decreased under the optimal crutch length condition compared with shorter crutch length condition (p<.05). No significant differences in the EMG activity of the ES muscle on the non-WB side and ROM of lumbo-pelvic-hip complex were found among conditions (p>.05). These findings indicate that the optimal crutch length improves the trunk muscle efficiency during crutch gait.

The purpose of this study was to investigate the effects of Evjenth-Hamberg stretching on the active range of motion (ROM) of the hip joint and the pennation angle of the semitendinosus muscle. Eighty healthy adults participated in this study. The active ROM of the hip joint was measured by a goniometer and the pennation angle of the semitendinosus muscle was measured by ultrasonographic imaging (USI). Both ROM and pennation angle were recorded before and after the static stretching and the Evjenth-Hamberg stretching, respectively. Data were analyzed using paired t-lest and independent t-test at p<.05. The results were as follows: 1) The active ROM of the hip joint increased significantly after both stretching interventions compared with the baseline (p<.001). However, the active ROM of the hip joint increased significantly in Evjenth-Hamberg stretching compared with static stretching. 2) The pennation angle decreased significantly after both stretching interventions compared with the baseline (p<.001). However, the pennation angle decreased significantly in Evjenth-Hamberg stretching compared with static stretching. 3) Reliability data showed that there was a high consistency in USl measurements (ICC=.978). Our findings suggest that the Evjenth-Hamberg stretching was more effective than static stretching in increasing the active ROM of the hip joint and decreasing the pennation angle of the semitendinosus muscle.

The purpose of this study was to examine the effects of static stretching and Evjenth-Hamberg stretching the on range of motion (ROM) of the knee joint. The subjects were composed of twenty healthy males without weight-training experience. The ROM of the knee joint was measured by using an En-Knee. Three tests (performed on the 1st week, 4th week, and 8th week) were conducted to examine the change of each variable. Data were analyzed with a analysis of variance (grouptest) for repeated measures on last factor through SPSS 10.0. The data analysis revealed the change in the ROM was dependent on the stretching method. The results were as follows: The ROM was improved in both methods by each time, but the E-HS was more improved than the SS. In conclusion, this study indicated that the E-HS is more efficient than the SS on the ROM of the knee joint.

This study was designed to determine the effect of ankle taping and short period of walking on the treadmill on the range of motion (ROM) and proprioception at the ankle joint. Twenty healthy male subjects (mean age=24.2 yr) participated in this study. Goniometry and videotape replaying method were used to measure the ankle ROM. Passive sagittal and frontal plane motions were measured. The difference in degree between the stimulus point and the reproduced point was defined as an angular error. The measurements were performed at four different phases: pre-taping (PRT), post-taping immediately (POT), post-5 minute walking with taping (P5M), and post-10 minute walking with taping (P10M). The ankle of dominant limb was taped by a certified athletic trainer using a closed basket weave technique. Participants walked on the treadmill at 2.5 mph. The results showed that the mean of the sagittal plane motion at PRT, POT, P5M, and P10M was 53.0, 30.5, 36.2, and 40.2 degrees, respectively. The frontal plane motion at PRT, POT, P5M, and P10M was 33.6, 13.9, 15.7, and 18.6 degrees, respectively. The angular error at PRT, POT, P5M, and P10M was 5.5, 1.6, 1.8, and 1.9 degrees, respectively. After 10 minutes of walking, the sagittal plane motion and frontal plane motion was increased by 9.7 and 4.7 degrees compared with POT, respectively. The proprioception was significantly improved after the application of ankle taping. Both the restriction of frontal plane motion and proprioception improvement at the ankle joint may contribute to ankle stability during walking.

이 연구는 동결견 진단을 받은 환자에 대한 한국전통 정골요법(이하 KTO)을 적용하여 통증완화에 대한 유의성 연구가 진행하였던 환자를 대상으로 통증의 감소가 견관절의 가동범위도 증가하는지를 추가적으로 확인하기 위하여 진행하였다. 대상자는 총 14명으로 구성되어 있으며, 두 개 그룹으로 나누어 7명의 실험군과 7명의 대조군으로 하여 2그룹으로 나누어 연구를 진행하였다. 7명은 KTO를 총 10회 시술하고, 7명은 시술하지 않았다. 견관절의 가동범위의경우 항목별로 살펴보면 KTO를 적용한 그룹은 가동치의 변화를 살펴보았을 때 굴곡(7.33) 신전(10.00) 외전(8.76)내전(9.05) 외회전(8.10) 내회전(10.00)의 변화가 나타났다. KTO를 적용하지 않은 그룹의 가동치의 변화를 살펴보았을 때 굴곡(4.67), 신전(7.50), 외전(7.14), 내전(9.14), 외회전(6.59), 내회전(9.31)의 변화가 나타났다. 동결견 환자에게 한국전통정골요법을 적용하면 견관절의 가동범위 증가를 가져올 수 있음을 확인하였다.