본 논문의 주요 목적은 총체전력 정책(TFP, Total Forces Policy) 차원에 서 국방동원 환경 변화에 부합하는 우리 군의 예비전력의 역할 변화와 방안 방향에 대해 제시하는 봄에 있다. 이를 위해서 주요 분석 요소는 미래 국방 동원 환경 변화에 따른 예비전력의 운용과 역할 변화, 국방동원에 대한 인식 전환, 4차 산업기술을 활용한 과학화 예비군훈련장의 구축 현황과 활용 방안이다. 장기화되고 있는 러-우 전쟁에서 볼 수 있듯이, 미래전의 양상과 인구급감에 따른 첨단 과학기술 중심의 군 구조 개편 등을 고려해 볼 때, 상 비군 중심의 전투에 예비군이 보완하는 형태의 전쟁 수행은 어려울 것이다. 국가 총체전력 차원에서 유사시 전장에서 상비전력과의 동반전력으로 전쟁 을 억제하고 전쟁의 지속능력을 보장할 수 있는 예비전력에 대한 인식 전환 을 통해 예산 확보와 주요 핵심 필요한 역할 등을 점진적으로 확대해야 한 다. 따라서 다양한 분쟁 상황에 대비하여 예비군을 필요한 시기와 장소에 적시적으로 보충하기 위해서 과학화 예비군훈련장을 중심으로 장비와 물 자를 편성해서 실전적 훈련이 꾸준히 전개돼야 한다.

Background: Balance is the foundation of performing daily activities, and has been proven to be improved by various compression materials. As a new and never-before-seen means, the floss band improves joint range of motion, increases muscle flexibility, and affects balance. Several studies using the short-term application of a floss band to the ankle have been conducted. However, long-term effects of the floss band on the knee warrant further research. Objectives: This study aims to examine the long-term benefits of strength exercises with a floss band applied to the knee for static and dynamic balance. Design: Quasi-experimental design. Methods: A total of 28 participants (four men and 24 women, aged 20–60 years) with no orthopedic knee conditions were recruited and randomized into two groups, with 14 in the group using the strength exercises with floss bands applied to the knee (the floss band group), and 14 in the group using internal rotation of the tibia during mobilization with movements (MWM; the MWM group). A physical therapist with 10 years of clinical experience applied the intervention 10 times, measuring static and dynamic balance before and after the intervention using the Balance Trainer 4. Independent t-tests and paired t-tests were used for statistical analysis, with a significance level of ⍺=.05. Results: Statistically significant effects for static balance and dynamic balance were observed in the comparison from pre- to post-intervention between the floss band and MWM groups (P<.05). Additionally, a statistically significant effect for dynamic balance was noted in the pre- to post-intervention comparison in the floss band group (P<.05). Conclusion: The strength exercises with floss bands applied to the knee are expected to have a long-term effect on improving dynamic balance.

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: Various treatments are being tried for lumbar neuropathy. Among them, neural mobilization aims to reduce peripheral nerve sensitivity by stimulating them directly. Similarly, applying kinesiotape stimulates skin and joint receptors around the nerves, thereby affecting nerve function and movement. Objectives: To investigated the effect of low back pain on the neural mobilization and kinesiotaping. Design: Randomized controlled trial. Methods: Thirty patients with chronic low back pain were randomly allocated to three groups: the neural mobilization exercise with kinesiotaping group (NEKTG, n=10), the neural mobilization exercise group (NEG, n=10), and the kinesiotaping group (KTG, n=10). Each group performed six intervention sessions over two weeks. The results were analyzed by measuring the numeric pain rating scale (NPRS) and straight leg raise (SLR) before and after the intervention in each group. Results: NEKTG, NEG, and KTG all indicated a significant decrease in the back pain index before and after the intervention. However, there were no differences observed between the three groups. The SLR angles before the experiment were identical across the three groups. The SLR angles before and after the intervention were as follows: the SLR angle significantly increased in NEKTG. Furthermore, there was a significant increase in the SLR angle in NEKTG compared to both NEG and KTG. Conclusion: Neural mobilization combined with kinesiotaping provided better therapeutic effects regarding pain reduction and neurodynamic improvement compared to alone kinesiotaping and mobilization with chronic low back pain.

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: Proprioception in the ankle joint is important for maintaining balance. There is a correlation between joint position sense (JPS), balance and ankle dorsiflexion range of motion (DF-ROM). Objectives: The purpose of this study was to compare the effects of talocrural joint mobilization (TJM) and muscle energy technique (MET) of plantar flexor muscle (PF) on improving joint position sense (JPS) and static balance. Design: Cross-over randomized trial research. Methods: Sixteen participants (male 10, female 6; 20’s of their age) without ankle instability were recruited. In a randomized, three conditions, no intervention, talocalcaneal mobilization, and PF-MET were all applied to 16 participants. For TJM, the Kaltenborn grade 3 joint gliding method, in which the talus moves posteriorly perpendicular to the tacrocrural joint plane, were used. In the PF-MET, MET method were applied gastrocnemius muscle and soleus muscle with 25% of 1 Repeat Maximum of each muscle. The all participants performed PF-MET and TJM for 18 minutes. DF-ROM measured the weightbearing lunge test. JPS measured using the active joint angle reproduction test. Static balance was measured displacement of center of pressure parameter. Results: PF-MET and TJM had significant differences in DF-ROM and AP displacements. PF-MET significantly increased at 5° and 15° of plantar flexion and 5° of dorsiflexion, and COP velocity significantly decreased in JPS compared to TJM. Conclusion: PF-MET and TJM are effective in increasing DF-ROM. However, PF-MET has a more positive effect on improving JPS and static balance than on talocrural joint mobilization.

Background: As sedentary life increases, people's thoracic vertebra joint movement decreases, and the resulting associated pain is complaining of a lot of discomfort. This is also affecting the autonomic nervous system. Objectives: The purpose of this study was therefore to find out the effect of thoracic vertebra joint mobilization on heart rate variability in upper back pain patients. Design: Randomized controlled trial. Method: Thirty subjects in this study were randomly assigned to two groups of 15 persons each using a randomization tool. Maitland's grade III joint mobilization, hot pack, and interferential current therapy (ICT) were applied to T1-L2 and hot pack and ICT were applied to the control group. The intervention was performed 3 times a week for 4 weeks. Results: There were statistically significant changes in Visual Analog Scale (VAS), Standard Deviation of all Normal R-R Intervals (SDNN), Low Frequency (LF), High Frequency (HF) and LF/HF ratio in the study group, and statistically significant changes in VAS, SDNN, and LF/HF ratio in the control group. In comparison of differences, there were statistically significant changes in VAS. Conclusion: Positive effects were found on SDNN and LF/HF ratio in both the joint mobilization group and the control group compared to before the study. In particular, even LF and HF were positive in the joint mobilization group showed influence.

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: Despite its high prevalence, interventions in plantar fasciitis remain inconclusive. To improve the daily life of plantar fasciitis patients, it is necessary to identify appropriate interventions to improve pain and foot pressure and balance. Improving the interventions for plantar fasciitis is one of the main goals for rehabilitation. Objectives: To investigate the changes in pain and static-dynamic foot pressure and balance through the evaluation of 42 plantar fasciitis patient before and after the foot stretching and joint mobilization interventions. Design: Randomized controlled trial. Methods: The 42 subjects of the study were divided into a stretching group and a joint mobilization group with 21 subjects being assigned to each group. The results before and after the experiment were analyzed by applying stretching and joint movement interventions for a total of 6 weeks. Results: Before and after the intervention, there were significant improvements in the pain index and static-dynamic foot pressure and static balance in both stretching and joint mobilization groups. However, the between-group comparison indicated no significant differences. Conclusion: The stretching and the joint mobilization can improve the pain and static-dynamic foot pressure and static balance in plantar fasciitis patients.

이 연구는 평시는 물론 전시에도 국방 분야에 계약직 민간근로자를 운 용함으로써 민간인력의 전문성을 활용하고 국방업무의 연속성을 높이는 방안을 제시한다. 미래 동원환경은 인구절벽에 따른 평시 병역자원과 전 시 동원예비군이 감소할 것으로 전망된다. 따라서 국방에서의 민간인력 확대가 불가피해 보인다. 전‧평시 민간인력 활용의 연속성이 국방혁신의 핵심이 될 수 있다. 그러나 현재의 국방민간인력 운용체계는 평시와 전 시가 전혀 다르다. 전시는 기술인력동원에 의해 이들을 대체하기 때문이 다. 그러나 전시에 동원된 기술인력들이 적절한 역할 수행을 하기까지는 시행착오와 지체로 인해 국방운영의 불연속성이 우려된다. 이것은 전시 작전지속지원과 작전의 성공을 어렵게 하는 요인이 될 것이다. 이에 대 안으로 평시 민간근로자의 계약관계를 전시 동원과 연계하는 방안이 필 요하다. 이를 위해 전시 기술인력 범위에 평시 활용 중인 민간인력‧업체 를 포함하는 방안이 있다. 제도를 개선하여 기술인력 동원지정‧관리에 대 한 군의 요구를 반영하는 것이다. 또는 가칭 ｢전‧평시 민간인력 활용에 관한 시행령｣을 제정하여 전‧평시 임무 위주로 민간인력 활용체계를 새 롭게 정립하는 것이다. 이 방안들은 예산에 입각한 새로운 국방인력구조 를 설계하고 운영의 연속성과 함께 효율성, 투명성을 높이게 될 것이다.

Background: If the weakness of the knee muscles persists and there is pain at the same time, lumbar mobilization can be used. Objectives: This study investigated the immediate effect of lumbar joint mobilization on postural sway and knee pain in elite volleyball players. Design: Randomized controlled trial. Methods: Twelve male elite volleyball players were recruited for this study. Lumbar joint mobilization was performed in all study subjects. Evaluation items were static and dynamic balance and knee pain change. All evaluations were made immediately after the intervention. Results: C90 area, trace length, and STD Y deviation in the open static balance were significantly decreased after intervention (P<.05). C90 area, trace length, Velocity, STD X deviation, and STD Y deviation in static balance with closed eyes decreased significantly after intervention (P<.05). In dynamic balance, the left and right side. COPs were significantly increased. Pain significantly decreased after intervention (P<.05). Conclusion: This study found that lumbar joint mobilization is an effective method for improving postural sway and knee pain in elite volleyball players.

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: A recent study found that pain neuroscience education (PNE) alters pain intensity, knowledge of pain, disability, psychological function, and pain behavior in patients with musculoskeletal pain. However, they noted that PNE alone was not sufficient to affect chronic low back pain (CLBP) reduction. Objectives: To investigated the effect of CLBP on the PNE combined with lumbar mobilization. Design: Quasi-experiment study. Methods: A total of 33 patients aged 25 to less than 65, recruited from L-hospital for low back pain in Chungcheongnam-do. Out of 33 subjects, 17 were pain neuroscience education combined with lumbar mobilization group (PLMG) and 16 were lumbar mobilization group (LMG). The outcome was visual analogue scale (VAS), oswestry disability index (ODI) and the fear avoidance beliefs questionnaire (FABQ). The collected data was analyzed using the SPSS ver. 21.0 program by paired t-test and independent t-test. Results: PLMG was indicated statistically significant decrease in VAS, ODI and FABQ before and after intervention. However, there were statistically significant changes in VAS and ODI before and after intervention in LMG. PLMG and LMG before and after intervention indicated statistically significant differences in VAS, ODI and FABQ. Conclusion: The inclusion of PNE combined with lumbar mobilization in patients with CLBP is a promising and feasible approach to the management of CLBP.

Background: There is a research report that lumbar mobilization for healthy people improves the knee extension angles and Q-angle related muscle activity (Q: quadriceps muscle). However, there is a lack of research on the effect of lumbar mobilization on gait variables such as cadence and gait speed, especially when mobilizing the central part of the lumbar spine from posterior to anterior. Objectives: To examine the effect of lumbar central PA mobilization in healthy people on cadence and gait speed. Design: Pilot study. Methods: There were 34 participants in this study. In the experimental group, lumbar posterior-anterior joint mobilization was performed once in Grade III-IV for 5 minutes, focusing on the segment with reduced movement. In the control group, lumbar posteroanterior mobilization was performed once in a total of Grade I-II for 5 minutes. To measure cadence and gait speed, STT-IWS and iSen System (San Sebastian, Spain) were used. Results: The comparison of cadence between groups, CG (Control group) increased cadence was about 6 more than EG (Experimental group) cadence, but it was not statistically significant. The gait speed of EG and CG was .30- .31, which was similar between the two groups, and the before and after values were also similar. There is no statistically significant difference Conclusion: The cadence and gait speed of the experimental group were not statistically significantly different than those of the placebo group.

Background: Generally, rounded shoulders may occur when an individual habitually takes a relaxed, slouched posture. Although various studies on the round shoulder exist, studies on the effect of improvement of thoracic mobilization on the round shoulder are insufficient. Objectives: To investigate the effect of thoracic mobilization on round shoulders and pulmonary capacities. Design: Randomized controlled trials. Methods: Twenty subjects were randomly allocated into an exercise group (n=10) and a mobilization group (n=10). To quantify the round shoulder before and after the intervention, the distance between the acromion and the table surface was measured, and the pulmonary capacities were also measured. The intervention program was conducted twice a week for 6 weeks. The exercise group performed corrective exercise, and the mobilization group performed both corrective exercise and thoracic mobilization. Results: The round shoulder in both groups was significantly decreased (P<.05), and the pulmonary capacities were significantly improved (P<.05). However, there was no significant difference between the two groups (P>.05). Conclusion: The combination of corrective exercise with stretching and strengthening exercises led to the improvement of round shoulders and pulmonary capacities, no additional benefits were detected with thoracic mobilization.

이 연구는 동원전력을 구성하는 동원자원의 군사적 효용성을 분석하 고 강화 방안을 제시하기 위한 것이다. 동원전력의 군사능력과 잠재역 량, 그리고 평판은 군사적 효용성의 척도이다. 동원전력이 평시 전쟁 억제 기능을 한다면 군사적 효용 가치가 있는 것이다. 그러나 전쟁 초 기 방어작전에 참여하는 동원사단은 군사력으로서 평판이 낮은 수준이 다. 이를 개선하려면 한국군의 ‘동원’ 개념부터 재설계해야 한다. 현대 화된 자원으로 잘 준비되고 훈련된 잠재전력을 유사시 작전에 활용하 는 개념이 동원이어야 한다. 둘째, 선발예비군 제도를 도입하여 비상근 전투예비군으로 동원사단을 집중 육성해야 한다. 이들은 상비전력 저하 를 상쇄하고 병역제도 전환기적 과도기에 국방운영의 융통성을 제공하 게 될 것이다. 셋째, 전시 군수소요의 충당은 국민의 재산을 먼저 활용 한다는 편의적 관례에서 벗어나 비축을 통해 평시 동원전력의 완전성 을 높여야 한다. 동원사단의 무기체계‧장비‧물자는 상비군과 동일하게 현대화하고, 긴요 품목 대부분은 비축하여 유사시 즉각 전투력이 발휘 되도록 해야 한다. 군과 정부는 미래 안보의 비관적 상황을 전제로 대 비하되 불가피한 선택의 시간이 오기 전에 동원자원의 군사력 효용성 을 높이는 정책을 과감하게 추진해야 할 것이다.

Background: Individuals with calf muscle shortening may have decreased dynamic balance. Objects: This study aimed to investigate the effect of mobilization with movement (MWM) and myofascial release (MFR) on kinematic changes in dynamic balance in individuals with calf muscle shortening. Methods: Thirteen participants were randomly assigned to the MWM or the mobilization with movement added myofascial release (MWM-MFR) group. The MWM group received treatment with only MWM, whereas the MWM-MFR group was treated with MWM and MFR. Pre- and post-intervention passive range of motion (PROM), maximum reaching lengths, and modified star excursion balance test (MSEBT) results were compared for all participants. Wilcoxon signed-rank test and Mann-Whitney U test were used for statistical analysis. Results: The results showed significant within-group differences in ankle PROM, but no significant between-group differences. The maximum reaching length in the MWM-MFR group in the posterolateral direction was significantly different before and after the intervention (p = 0.005). This group also showed significantly reduced ankle abduction in MSEBT during the posteromedial direction section 3 (p = 0.007) and posterolateral direction section 5 (p = 0.049) compared with the MWM group. Conclusion: Combined MWM and MFR intervention improves ankle stability in the coronal plane during the posteromedial and posterolateral forward mo

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: 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.

Oral squamous cell carcinoma (OSCC) metastasis is characterized by distant metastasis and local recurrence. Combined chemotherapy with cisplatin and 5-fluorouracil is routinely used to treat patients with OSCC, and the combined use of gefitinib with cytotoxic drugs has been reported to enhance the sensitivity of cancer cells in vitro . However, the development of drug resistance because of prolonged chemotherapy is inevitable, leading to a poor prognosis. Therefore, understanding alterations in signaling pathways and gene expression is crucial for overcoming the development of drug resistance. However, the altered characterization of Ca2+ signaling in drug-resistant OSCC cells remains unclear. In this study, we investigated alterations in intracellular Ca2+ ([Ca2+]i) mobilization upon the development of gefitinib resistance in human tongue squamous carcinoma cell line (HSC)-3 and HSC-4 using ratiometric analysis. This study demonstrated the presence of altered epidermal growth factor- and purinergic agonist-mediated [Ca2+]i mobilization in gefitinib-resistant OSCC cells. Moreover, Ca2+ content in the endoplasmic reticulum, store-operated calcium entry, and lysosomal Ca2+ release through the transient receptor potential mucolipin 1, were confirmed to be significantly reduced upon the development of apoptosis resistance. Consistent with [Ca2+]i mobilization, we identified modified expression levels of Ca2+ signaling-related genes in gefitinib-resistant cells. Taken together, we propose that the regulation of [Ca2+]i mobilization and related gene expression can be a new strategy to overcome drug resistance in patients with cancer.