Background: Chronic back pain not only causes physical discomfort and decreased functionality but also affects emotional well-being, resulting in feelings of anxiety, depression, and other psychological issues. Studies have indicated that cognitive functional therapy and motor control exercises can alleviate chronic low back pain and associated psychological issues. Objectives: To investigated the effect of chronic low back pain on the cognitive functional therapy (CFT) and motor control exercises (MCE). Design: Quaxi-experimental study. Methods: Forty patients with chronic low back pain were randomly assigned and divided into 20 cognitive functional therapy group with motor control exercises group (CFTMG) and 20 patients in motor control exercises group (MCEG). After applying CFT with motor control exercises and motor control exercises for 8 weeks, changes in numeric pain rating scale (NPRS), Oswestry disability index (ODI) and Fear-avoidance beliefs questionnaire (FABQ) were observed. Results: In the CFTMG, statistically significant changes were observed in NPRS, ODI, and FABQ before and after the intervention. In the MCEG, statistically significant changes were observed in VAS and ODI before and after the intervention. Conclusion: The application of CFTM and MCE in patients suffering from chronic low back pain has demonstrated effectiveness in alleviating pain, enhancing back function, and reducing kinesiophobia associated with the condition.

Forward head posture (FHP) is a musculoskeletal disorder that causes neck pain. Several exercise interventions have been used in South Korea to improve craniovertebral angle (CVA) and relieve neck pain. There has been no domestic literature review study over the past 5 years that has investigated trends and effects of exercise intervention methods for CVA with neck pain. This domestic literature review aimed to evaluate the trends and effects of exercise interventions on CVA and neck pain in persons with FHP. A review of domestic literature published in Korean or English language between 2018 and 2022 was performed. Literature search was conducted on Google Scholar and Korea Citation Index by using the following keywords: “exercise,” “exercise therapy,” “exercise program,” “forward head posture,” and “neck pain.” Ten studies were included in this review. All of the studies showed positive improvements after intervention programs that included exercises. Notably, four of these studies demonstrated significant differences in results between the experimental and control groups. Among the 10 studies, nine measured visual analogue scale or numerical rating scale scores and reported significant reductions in pain following interventions, including exercise programs. Five of these studies showed significant differences in results between the experimental and control groups. Furthermore, six studies that used neck disability index exhibited a significant decrease in symptoms after implementing intervention programs that included exercise, and significant differences in results were found between the experimental and control groups. This domestic literature review provides consistent evidence to support the application of various exercise intervention programs to improve CVA and relieve neck pain from FHP. Further studies are warranted to review the effects of various exercise interventions on FHP reported not only in domestic but also in international literature.

본 연구는 일회성 발목가동성 운동프로그램이 만성적인 발목불안정성(CAI)에 나타나는 발목가 동범위와 통증 수준에 미치는 영향을 확인하는데 목적이 있다. 연구 대상자는 발목불안정성 설문지 검사에 서 좌, 우측 평균 점수가 24점 이하인 성인여성 20명을 선정 하였으며 집단은 일회성 발목 가동성 운동프 로그램 집단(Ankle mobility exercise program, AE, n=10)과 대조군(CON, n=10)으로 구분하였다. AE 처 치는 일회성 운동에 대한 반응을 확인하기 위해 좌·우측 발목을 각각 1회(20분) 실시하였으며 처치 전후 발목불안정성 검사, 통증 및 발목가동범위를 확인하였다. 먼저 AE 프로그램을 실시한 AE 집단의 통증 수 준은 사전과 비교하여 사후 유의하게 감소하는 것으로 나타났다(p<.01). 또한 AE 프로그램 처치한 AE 집 단에서 배측굴곡이 사전과 비교하여 증가하는 것으로 나타났다(p<.05). 이러한 결과를 종합해 보면 일회성 발목 가동성 운동 프로그램은 CAI에서 나타나는 발목 통증과 발목의 가동범위를 개선시켜 결과적으로 발 목 불안정성을 완화시킬 수 있는 효과적인 운동 중재 방법이라고 생각된다.

Background: Pain neuroscience education (PNE) combined with exercise and mobilisation with cognitive goals presented decreases in pain and disability and an increase in spinal function compared to physiotherapy intervention in patients with chronic low back pain (CLBP). 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 randomized controlled trial. Methods: The subjects were randomly allocated to the MDT with PNE group (MPNEG, n=15) and the PNE group (PNEG, n=15). Pain neuroscience education was provided to both groups, and MDT exercise was additionally performed in the experimental group. Training was conducted 3 times a week for 8 weeks, and the Oswestry Disability Index (ODI) and numeric rating scale (NRS) were used to measure the level of back pain dysfunction, and each was evaluated before and after the experiment. Results: Results from the study indicated that statistically significant decrease in NRS and ODI in MPNEG. In PNEG, there was statistically significant decrease in NRS. And in MPMES, there was a statistically significant decrease in ODI than in PNEG. Conclusion: The MDT combined with PNE is more effective than PNE alone as a treatment method for improving lumbar dysfunction and reducing pain in chronic low back pain.

Background: Smartphone addiction has emerged as a significant social problem. Numerous studies have indicated the association between smartphone use and discomfort in the musculoskeletal system of the upper extremities. Objects: This cross-sectional survey aimed to compare the characteristics of musculoskeletal pain in the neck, trunk, and upper limbs between individuals with smartphone addiction and those without addiction. Methods: We collected a total of 326 healthy individuals’ data from China and Korea who had owned and used smartphones for more than 5 years between 20–50s through an online questionnaire consisting of 84 questions in four major sections. The first part contained basic information on the participant's personal characteristics and smartphones. The second part contained questions about smartphone use and posture. The third part was the smartphone addiction. The fourth part was to investigate musculoskeletal pain in various upper body parts. Results: Smartphone addiction has a weak negative correlation with age (r = –0.20, p < 0.01) and a weak positive correlation with the hours of smartphone use (r = 0.376, p < 0.01). Frequent musculoskeletal pain symptoms related to smartphone use were observed in the neck, shoulder, lower back, and wrists. The hours of smartphone use was slightly positively associated with the prevalence of musculoskeletal pain in the shoulder (r = 0.162, p < 0.05) and lower back (r = 0.125, p < 0.05). The prevalence of musculoskeletal pain in the neck (χ2 = 3.993, p < 0.05), shoulder (χ2 = 6.465, p < 0.05), and wrist (χ2 = 4.645, p < 0.05) was significantly higher among females than males. Conclusion: The results suggest that smartphone addiction should be recognized as a dual concern encompassing both physical health and psychosocial aspects. Furthermore, healthcare professionals, including physicians and physical therapists, should consider clients' smartphone usage patterns when assessing and treating with musculoskeletal pain.

본 연구는 요부 근막통증증후군이 있는 직장인 44명을 캐리어 오일 피부마사지 그룹과 대조군으로 나누어 캐리어 오일 피부마사지가 요부 통증 및 관절 가동성 에 미치는 영향을 알아보고자 실시하였다. 일주일에 3회, 6주 동안 캐리어 오일 피부마사지 그룹은 호호바 오일 약 3㎖를 도포하고 대조군은 오일 없이 요추부위 에 쓰다듬기 테크닉을 적용하였다. 실험 전후를 비교한 결과 캐리어 오일 피부마 사지 그룹에서 시각 통증 상사척도, 압통 역치, 요부 관절가동성에서 유의한 효과 가 있었다. 따라서 캐리어 오일 피부마사지는 요부 근막통증증후군에 적용하였을 때 물리치료 도수기법 프로그램 및 대체 요법으로 활용될 수 있다.

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: Back stabilization exercises have been applied to decrease low back pain. Pilates exercise can help stabilize the low back and pelvic alignment, and uses equipment such as cadillac, reformer, chair, and barrel. Objectives: This study was conducted to confirm the effects of pilates exercise using cadillac equipment and self-exercise using back pain educational materials on pain, pelvic inclination, and single leg stance ability in adult women with back pain. Design: Randomized controlled trial. Methods: Twenty-five participants (female 25) with unspecified low back pain with lumbar hyperextension and anterior pelvic tilt were recruited. 25 adult women with back pain were randomly divided into a pilates group and a selfexercise group. Pilates exercise intervention using a cadillac was administered to the pilates group, and posture and lifestyle education materials for back pain were provided to the self-exercise group. All of the interventions were conducted 3 times a week for 4 weeks, 50 minutes per session, and the results are as follows. Results: Data analysis in each group revealed statistical differences between self-exercise and divided into a Pilates intervention. A visual analog scale (VAS)/oswestry disability index (ODI) decreased pain in both groups, Independent t-test decreased pain in both groups, but there was no significant difference. Data analysis divided into a pilates group revealed statistical differences between a VAS/ODI and pelvic tilt angle and static balance. It has been shown to increase scores or relieve pain. Conclusion: Through this study, it was confirmed that the pilates exercise using cadillac can be effectively used to reduce back pain, improve pelvic alignment, and improve single leg stance ability in adult women with low back pain.

Background: The International Classification of Functioning, Disability and Health (ICF) model, created by the World Health Organization, provides a theoretical framework that can be applied in the diagnosis and treatment of various disorders. Objects: Our research purposed to ascertain the relationship between structure/function, activity, and participation domain variables of the ICF and pain, pain-associated disability, activities of daily living (ADL), and quality of life in patients with chronic low back pain (LBP). Methods: Two-hundred patients with chronic LBP (mean age: 35.5 ± 8.8 years, females, n = 40) were recruited from hospital and community settings. We evaluated the body structure/ function domain variable using the Numeric Pain Rating Scale (NPRS) and Roland–Morris disability (RMD) questionnaire. To evaluate the activity domain variable, we used the Oswestry Disability Index (ODI) and Quebec Back Pain Disability Scale (QBDS). For clinical outcome measures, we used Short-form 12 (SF-12). Pearson’s correlation coefficient was used to ascertain the relationships among the variables (p < 0.05). All the participants with LBP received 30 minutes of conventional physical therapy 3 days/week for 4 weeks. Results: There were significant correlations between the body structure/function domain (NPRS and RMD questionnaire), activity domain (ODI and QBDS), and participation domain variables (SF-12), rending from pre-intervention (r = –0.723 to 0.783) and postintervention (r = –0.742 to 0.757, p < 0.05). Conclusion: The identification of a significant difference between these domain variables point to important relationships between pain, disability, performance of ADL, and quality in participants with LBP.

Background: Technological developments have led to the creation of a mechanical device capable of providing a representative massage as a passive treatment. The use of mechanical massage offers the distinct advantage of being user-friendly and available for use at any given time. Objectives: To investigated present the outcomes of utilizing a massage bed on the range of motion (ROM) and pressure pain threshold (PPT) in patients diagnosed with chronic low back pain. Design: ABA design of a single case study. Methods: To measure the ROM of the subject's trunk flexion, extension, lateral flexion, and rotation, a tape measure and goniometer were utilized. Furthermore, PPT was measured using an electronic pressure pain meter. Baseline A and Baseline A’ periods were conducted for 5 consecutive days without intervention. Following the baseline periods, a massage bed intervention was administered for 1 hour daily for a total of 10 days during the Intervention B period. Daily assessments were performed, and the Intervention B period was conducted after the intervention. Results: The ROM effect was confirmed in trunk lateral flexion and rotation, while the PPT was effective in both L1, right L2, left L4, and left L5. Conclusion: The results of this study confirmed that the use of a massage bed improved the ROM and PPT in patients suffering from chronic back pain. Further randomized controlled trials involving a larger sample size are necessary to validate these findings.

Background: People these days use smartphone extensively as a means of diverse social activities, but excessive use of it has also created increasing forward head posture (FHP) with neck pain. To improve this FHP, neck stabilization exercise is necessary. Objectives: This study was to investigate the effects of stabilization exercise using biofeedback on FHP subjects with neck pain. Design: A non-randomized, controlled intervention study. Methods: This study chose 18 college students in their 20s whose neck disability index (NDI) was equal to or higher than 10 and cranio-vertebral angle indicated FHP as experimental group. The control group selected 18 persons with no neck pain and a normal range of cranio-vertebral angle. The stabilization movement was performed by applying three phases of pressure, with low of 20 mmHg, intermediate of 25 mmHg, and high of 30 mmHg, using the Stabilizer. To check the effects of stabilization exercise according to pressure, the circumference of deep neck muscles was measured with ultrasonic waves, and the activity of surface muscle of sternocleidomastoid (SCM) was measured using electromyography (EMG). Results: When the circumference of the deep neck flexor was analyzed according to the pressure change during stabilization exercise, the experimental group showed increase at all pressures. The activity of the SCM of the surface muscle increased in both groups as the pressure increased. Conclusion: The application of stabilization exercise was found to be more effective on forward head posture subjects with neck pain at lower pressures.

Background: Smart devices including smart phones have many benefits. However, prolonged used may aggravate cervical pain and postural deformity. Smart devices with appropriate applications (apps) may be useful cost-effective and easy-to-use instruments to relieve cervical pain and improve range of motion (ROM). Objectives: To review recent experimental studies on smart device-based apps on cervical pain and postural ROM improvement. Design: Systemic review study. Methods: Ten articles were selected through bibliographic searches and successive and exclusion procedure of the PubMed, ScienceDirect, and Google Scholar. Out of initial 1,046 articles, 98 articles were selected from abstract review. 33 articles were selected for full article review. Final 10 research articles were selected. Results: Three static ROM feasibility, two active ROM feasibility, four self-management promotion, and one pre/post research study articles were included. Smart device with artificial intelligent (AI) based app were utilized promote adherence to physical activity. Conclusion: Smart device apps steadily showed high feasibility even for research purpose. Studies on AL and machine learning apps showed mixed results for need for wider and precision application.

본 연구에서는 만성요통을 가진 여성노인의 체형 및 요부안정화를 위해 12주간 필라테스 운동 프로그램을 적용한 후 체형에 미치는 영향을 알아보고, 통증의 변화를 규명함으로써 노화를 늦추고 신체활 동 영역을 높일 수 있는 노인에게 적합한 운동 프로그램 개발에 필요한 자료를 제공하고자 하였다. 이에 3~5cm 중증도 통증범위의 만성요통을 가진 16명여성노인을 대상으로 주관적 통증척도지를 통해 실험집단 8명, 통제집단 8명을 단순무선표집(Simple Random Sampling)으로 선정하였다. 요부안정화 필라테스 운동 프로그램은 주 2회씩 총 12주간 50~60분간 실시하였으며, 1세트 종료 시 1분 휴식을 주는 방식으로 실시 하였다. 그 결과 첫째, 체형 및 통증에서는 경추 기울기에서 요부안정화 운동그룹의 경우 운동 전에 비해 감소하였으나 통제집단은 증가하였다. 둘째, 요부 통증의 결과 운동집단의 경우 운동에 비해 감소하였으나 통제집단은 증가하였다. 결론적으로 요부안정화 필라테스 운동은 만성요통을 가진 여성노인에게 있어서 통 증을 감소시킬 수 있는 프로그램으로 적용될 수 있으며, 체형을 개선시키는데 도움을 줄 수 있는 것으로 확인되었다.

목적: 본 논문의 목적은 연구 문헌 중 요통 환자에게 보행운동을 적용한 무작위 대조군 실험설계를 메타 분석을 하여 통증과 장애지수에 대한 효과를 알아보고자 하였다. 방법: 본 논문은 다음 데이터베이스에서 검색하였다: Google scholar, PubMed, Sciencedirect, KISS, RISS, NDSL. 지난 10년간 영어나 한국어로 된 논문 중, 요통이 있는 환자들이 보행운동을 하였을 때, 통증과 장애지 수를 연구한 논문들을 검색하였다. 이 논문에는 (1) 요통이 있는 환자, (2) 중재에는 보행운동이 포함되며, (3) 평가 지표에는 통증과 장애지수가 포함되었다. 최종 결과로 35개의 논문을 확인하였고, 그중 15개의 논문이 충족되었다. 결과: 본 논문은 요통 환자를 대상으로 보행운동을 중재로 주었을 경우의 논문 15편을 최종적으로 선정하 였고 분석하였다. 통증과 장애지수와 관련되어 각각 12개의 논문을 분석하였다. 통증과 관련된 12개의 논문의 효과 크기는 중간의 효과 크기나 나타났고, 장애지수와 관련된 12개의 논문의 작은 효과 크기가 있었다. 결론: 보행운동은 요통 환자들의 통증을 감소시키고 장애지수를 줄이는데 유의미한 효과가 있다. 따라서 보 행운동은 요통을 지닌 사람들에게 긍정적인 영향을 미칠 것으로 사료된다.

본 연구는 아로마 롤온 흡입법이 경로당 이용 노인의 스트레스, 통증, 우울 및 혈압에 미치는 효과를 확인하기 위한 원시실험연구이다. 대상자는 경기도 S시에 위치한 경로당 2곳에 등록된 노인 가운데 선정기준에 부합한 33명이 참여하였으며 자료수집 기간은 2022년 11월 14일부터 2022년 12월 19일까지 시행하였다. 아로마 롤온 흡입 전후에 경로당에 직접 방문하여 혈압 측정 후 자가설문으로 구성된 스트레 스, 통증, 우울을 조사하였다. 실험군에게 적용한 에센셜 오일은 마조람, 제라늄, 페페민트, 오렌지 스위트 를 캐리어 오일인 호호바오일에 희석한 것으로 하였다. 중재는 4주 동안 1일 3회 시행하였다. 연구결과, 아 로마 롤온 흡입법은 대상자의 스트레스(t=2.63, p=.013), 통증(t=2.46, p=.019), 수축기 혈압(t=3.01, p=.005)에서 통계적으로 유의한 차이가 있었다. 따라서 아로마 롤온 흡입법은 경로당 이용 노인의 스트레 스 감소 및 통증 완화, 혈압 관리에 유용한 간호중재로 활용가능할 것으로 기대된다.

Background: Clinical practice guidelines for patients with chronic low back pain (CLBP) recommend therapeutic exercise, and recently, interventions for pain neuroscience education (PNE) are also recommended. Objectives: To investigate the effects of aquatic exercise combined with PNE on pain, disability, and fear-avoidance beliefs in patients with CLBP. Design: Randomized control trial. Methods: The 27 participants recruited in this study were randomly allocated as pain neuroscience education combined with aquatic exercise group (PAEG, n=14) and aquatic exercise group (AEG, n=13). Both groups performed aquatic exercise for 50 minutes, 3 times a week for 6 weeks, and only PAEG received additional PNE. Numeric pain rating scale (NPRS), modified oswestry disability questionnaire (MODQ), and fear-avoidance beliefs questionnaire (FABQ) were used as evaluation methods before and after intervention. Results: Statistically significant decrease in NPRS, MODQ and FABQ (physical activity and work score) before and after intervention in PAEG. However, there were statistically significant changes in NPRS, MODQ and FABQ (physical activity score) before and after intervention in AEG. PAEG and AEG before and after intervention indicated statistically significant differences in MODQ and FABQ (work score). Conclusion: Aquatic exercise combined with PNE improved disability (MODQ) and fear-avoidance beliefs (FABQ) has been shown to have additional benefits. Therefore, combining PNE as a clinical intervention for CLBP patients will enhance the therapeutic effect.

Background: The application of exercise therapy and manual therapy to the thoracic spine is a widely used method of treating neck pain. Nevertheless, studies on the application of foam rollers and vibrating foam rollers to patients with neck pain are lacking. Objectives: To investigated the immediate effects of thoracic spine foam rolling and vibration foam rolling on pain and range of motion (ROM) in patients with chronic neck pain. Design: Randomized crossover trials. Methods: 24 patients with chronic neck pain participated in the study. The study subjects measured pain and ROM. Subjects were divided into vibration foam roller group, foam roller group, and control group. Results: Pain was not significantly different between and within groups (P<.05). There was a significant difference in flexion, extension, left rotation, and right rotation ROM in the vibration foam roller group after intervention (P<.05). There was a significant difference in flexion and extension ROM in the foam roller group after intervention (P<.05). There was a significantly greater increased extension ROM in vibration foam roller and foam roller groups compared with the control group (P<.0167). Conclusion: Thoracic spine foam rolling and vibration foam rolling improve ROM when treating patients with chronic neck pain. Therefore, it is recommended to use it in combination with other treatments

Background: Pain Neuroscience Education (PNE) is an educational approach that deals with the physiology of the nervous system as well as the pain system and refers to educating patients with chronic musculoskeletal disorders such as chronic back pain. Objectives: This study examined the effects of pain neuroscience education on patients with low back pain. Design: Systematic review. Methods: Electronic bibliographic databases of a regional information sharing system (RISS) and PubMed were searched to identify randomized controlled studies. In the final outcome, 43 publications were identified, and 13 studies met the inclusion criteria. Results: There were a total of 13 pain-related studies, including 11 studies using NPRS (VAS) and 2 studies using other pain measurement instruments. In NPRS, the effect size was 0.683, which had a medium effect size. In Roland morris disability questionnaire (RMDQ), the effect size was 0.544, which had a medium effect size. In Oswestry disability index (ODI), the effect size was 0.951, indicating a large effect size, but the confidence interval could not be obtained because there was only one study. Conclusion: Pain neuroscience education has positive effects on low back pain and disability index in related patients.

The ambiguity of complex regional pain syndrome (CRPS) posed a challenge to many medical researchers in the early days after its discovery and continues to do so till date. The establishment of the Budapest Criteria of the International Association for the Study of Pain resolved certain queries on CRPS. Many aspects of CRPS, such as pathophysiology and etiology, remain unknown. Therefore, of these aspects, we focused on the genetic basis of CRPS. In this qualitative review, we summarized the recent findings on the genetic association of CRPS and analyzed the roles of genes identified in each study and limitations of the studies. In particular, we confirmed the reliability of each study by comparing the following research, which used the following control groups or the same candidate genes. Notably, specific phenotypes of CRPS with dystonia indicate a significant association with human leukocyte antigen (HLA)-DQ8. Further, HLA-DQ8, which is associated with aberrant CD4+ T-cell reaction, could be associated with CRPS etiology since an increased CD4+ T-cell population was reported in CRPS patients. In addition, matrix metalloproteinase (MMP)-9 found in genome-wide expression profiling is noteworthy since MMP-9 is associated with neuro-inflammatory reactions. Despite these suggestions on the genetic aspects of CRPS, the pathophysiology and etiology of CRPS may be polygenic and multifactorial, influenced by multiple genes and other factors. Further, some studies have suggested that CRPS phenotypes have different etiologies. Thus, further studies with the precise classification of CRPS on a unified basis and with a significant number of case groups are required