Background: Most patients with chronic stroke have difficulty walking, and various exercise methods are used clinically to improve the disability. Among them, various methods are being applied to improve walking through torso movement. Objectives: This study was conducted to determine the effect of Maitland vertebra joint mobilization exercise and Evjenth trunk muscle stretching exercise on the walking ability of patients with hemiparesis due to chronic stroke. Design: A randomized controlled trial. Methods: In this study, 30 chronic stroke patients with hemiplegia were divided into 15 patients in the Maitland vertebra joint mobilization group (MVJMG) and 15 in the Evjenth trunk muscle stretching exercise group (ETMSEG), and the intervention was conducted for 3 weeks, 5 times a week, 30 minutes a day. After the intervention, walking ability was measured using a gait analyzer. Results: In terms of walking ability, there was a significant increase in walking rate, walking speed, and stride length following the intervention in both the MVJMG and ETMSEG groups (P<.05). When comparing the difference in walking ability between the two groups, there was no significant difference in walking rate. Conclusion: The study found that both Maitland vertebra joint mobilization and Evjenth trunk muscle stretching exercises were effective for improving walking function in chronic stroke patients. However, there was no significant difference in effectiveness between the two interventions.

Background: Mobilization movements was applied with different forces and frequencies for different clinicians. Force transmission varies with frequency. Objectives: The purpose of this study was to examine the effects of frequency- specific application of grade III PA movement on muscle tone and muscle activity around the lumbar vertebrae. Design: A one group pretest-posttest design. Methods: Twenty study subjects applied grades III of PA movement exercise of 0.5 Hz and 1 Hz with a force of 13 N around the 1st and 3rd lumbar vertebrae, and muscle tone and muscle activity were measured and compared before and after. Results: This study showed that 0.5 Hz grade III PA activity exerted an effect on the decrease in muscle tone of the 1st and 3rd right and left lumbar muscles. It was found that 0.5 Hz affected the right side of L1 and 1.0 Hz affected the left side of L1 in near-activity when applying the grade III PA movement by frequency. Conclusion: In the future, it will be necessary to investigate the effect of applying frequency according to various grades of PA movement.

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: 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: After a stroke, the patient may have abnormal muscle tone due to abnormal alignment. Physical therapists have used stretching, neural mobilization other methods to treat patients after stroke. In addition, joint mobilization is also used to stimulation in pathway of cervical segmental region and to normal cervical spine alignment. Objects: The purpose of this study was to determine whether Maitland cervical spine mobilization has an immediate effect on muscle tone and stiffness of upper extremity. Methods: Thirty subjects were divided into a experimental group (n1=10), a placebo group (n2=10), and a control group (n3=10). The Maitland cervical spine mobilization was applied in the supine position. Immediately after the intervention, muscle tone and stiffness of biceps brachii, brachioradialis, deltoid, and pectoralis major were measured using Myoton®PRO. In the placebo group, sham mobilization was applied to the fifth and sixth cervical vertebra, and the control group was instructed to control breathing. Results: In the experimental group, significant differences were found in muscle tone and stiffness of biceps brachii and brachioradialis in comparison with the affected side and the non-affected side before the intervention (p<.05), whereas there was no significant difference after the intervention (p>.05). Muscle tone of biceps brachii on the non-affected side and pectoralis major on the affected side was significantly decreased before and after the intervention (p<.05). The placebo and control group showed no changes on the non-affected and affected side, and no significant differences were detected before and after the intervention. All the groups revealed no significant differences in muscle tone and stiffness of upper extremity before and after the intervention. Conclusion: This study suggests that the application of Maitland cervical spine mobilization enhanced muscle tone of upper extremity on the involved side symmetrically, and influenced a decrease in muscle tone

The purpose of this study was to identify the immediate effects of Maitland joint mobilization with kinematic taping in subacromial impingement syndrome patients. The Maitland joint mobilization was applied glenohumeral joint. The mobilization was performed at the end of rage to Grade IV. After that, kinematic tape was attached to shoulder joint (supraspinatis, infraspinatis, and trapezius muscles). The intervention period was four days. The measurement was done five times. The shoulder pain, range of motion (flexion, abduction, and rotation of the shoulder joint), muscle tone and stiffness (upper trapezius and deltoid muscle) were measured. The shoulder pain decreased. The range of motion (ROM) was increased all flexion, abduction, and rotation of the shoulder joint. Muscle tone and stiffness were decreased, especially upper trapezius of those was greatly decreased. The findings of present study suggest that Maitland joint mobilization with kinematic taping is effective in decreasing pain, muscle tone and stiffness, and in increasing shoulder ROM in patients with subacromial impingement syndrome.

The purpose of this article was to investigate the effects of Maitland’s transverse movement on change of pain, trunk flexion movement and Cobb’s angle in patient with upper thoracic scoliosis. The subject are 37 years old with chronic low back pain participated in this study and has no experience surgery within the last six months due to back pain. 10 set was applied 10 times on the T3-T5 applied the transverse movement with grade Ⅳ to each segment by skilled physical therapist. Transverse movement was applied convex toward the concave side. Pressure pain threshold was reduced from 4/10 to 2/10. Trunk flexion range that is the distance between the middle finger and floor was increase from 7.3cm to 2cm. Cobb’s angle was decreased from degree 18 to 16. This result demonstrated that the Maitland’s transverse movement was benefit to reduce the pain and Cobb’s angle, and to increase the trunk flexion movement.

The aim of this study was to investigate the effect of Maitland mobilization and Kaltenborn-Evjenth mobilization on the SLR angle. Subjects randomly divided into Kaltenborn-Evjenth group(n=8) and Maitland group(n=7). The mean height, age, body weight was 176.00±5.10 cm, 22.75±1.83 years, 72.63±10.65 kg respectively in Kaltenborn-Evjenth group. The mean height, age, body weight was 175.00±5.60 cm, 22.29 ±3.68 years, 78.00±12.36 kg respectively in Maitland group. Hip joint accessary movements with Grade Ⅲ or IV were applied depend on the patient’s condition to the restricted direction for 1 minute each set, and performed 5 set in a Maitland group. Hip joint anteroposterior gliding with Grade Ⅲ were applied 60 for 1 minutes each set, and performed 5 set in a Kaltenborn-Evjenth group. The angle of first pain was referred to as P1 and subjects were pointed out that they could not bend the knee anymore, then examiner measure SLR angle. The SLR was significantly increased in the Maitland group compared to the Kaltenborn- Evjenth group after intervention(p<.05). In a within group difference, SLR significantly increased in the both groups(p<.05). These results indicated that Maitland mobilization could be recommended the excellent technique to increase the hip flexion in patient with hip hypo-mobility.

The purpose of this study is to investigate effects of Maitland orthopedic manipulative physiotherapy and stretching on pain, cervical range of motion, and muscle tone of adults with forward neck posture. A total 40 subjects were divided into a Maitland OMPT group(n=20) and a stretching group(n=20), performing joint mobilization exercise and stretching three times per week for six weeks. As for changes in pain, statistically significant decrease were found before and after the exercise within group comparison( p<.01), while no statistically significant difference was observed between-group comparison. In changes in cervical range of motion before and after the exercise, the Maitland OMPT group showed statistically significant increase(p<.01) in flexion, (left lateral flexion(p<.05), extension, left rotation, right rotation, and right lateral flexion, while the stretching group showed statistically significant increase(p<.05) in extension(p<.01), left rotation, left lateral flexion, right rotation, and right lateral flexion. However, no significant differences in between group comparison in flexion, extension, right rotation, left rotation, right lateral flexion and left lateral flexion. The results of measuring muscle tone changes showed that the Maitland OMPT group and the stretching group did not show significance in within and between group comparison(p<.05). In conclusion, the Maitland OMPT and stretching were effective on improving pain and range of motion.

The purpose of the present study is to apply Maitland orthopedic manual physical therapy to patients to examine the effects of the therapy on the digestive system through serum gastrin tests that can identify the motility of the digestive system and dyspepsia symptoms and can provide basic data for internal medicinal physical therapy. Maitland orthopedic manual physical therapy was implemented on 20 subjects in total, with 10 in a dyspepsia group and 10 in a control group, for 20 minutes per day, three days per week for three weeks, and the following results were obtained. In the control group, serum gastrin values significantly decreased between before and after treatment(p<.01), and among questionnaire items regarding dyspepsia, those regarding epigastric pain and belching showed significant decreases in these symptoms(p<.05). In the dyspepsia group, serum gastrin values significantly decreased between before and after treatment(p<.01) and all questions regarding dyspepsia showed significant decreases in all symptoms(p<.01). According to the analysis, the dyspepsia group decreased significantly more than the control group in serum gastrin values and all dyspepsia symptoms, except for belching(p<.001). Through the present study, it was identified that Maitland orthopedic manual physical therapy can improve dyspepsia symptoms and is an effective treatment method for internal diseases, such as dyspepsia, by improving gastric motility to become close to the normal state.