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: A spinal extension and intensive rehabilitation program reduced the symptoms and pain of kyphosis, and improved function. Objects: This study aimed to demonstrate the effect of a spine extension device on the degree of thoracic kyphosis and extension angles, confirm reduction of the kyphosis angle and an increase in flexibility. Methods: Thirteen adults were enrolled in the experiment, using the spine extension device, which was set to passively extend the spine. The angle between the spinous process of the first thoracic vertebra and the spinous process of the twelfth thoracic vertebra was measured by dual inclinometer before and after using the spine extension device. Results: In the static posture, the thoracic kyphosis decreased after using the spine extension device in the thoracic extension posture, and there was a significant difference (p < 0.05); thoracic extension angle increased with statistical significance (p < 0.05). Conclusion: In this study, the thoracic kyphosis angle and thoracic extension angle of the subjects before and after using spine extension device was compared and analyzed, which proved that the spine extension device can effectively improve the mobility of spinal extension.

Background: Thoracic spine self-mobilization exercise is commonly used to manage patients with neck pain. However, no previous studies have investigated the effects of thoracic spine self-mobilization exercise alone in patients with chronic neck pain. Objects: The purpose of this study was to investigate the effects of thoracic self-mobilization using a tool on cervical range of motion (ROM), disability level, upper body posture, pain and fear-avoidance beliefs questionnaire (FABQ) in patients with chronic neck pain. Methods: The subjects were 49 patients (21 males, 28 females) with chronic neck pain. The subjects were randomly divided into an experimental group (EG, n = 23) and control group (CG, n = 26). For the EG, thoracic self-mobilization was applied. We placed a tool (made with 2 tennis balls) under 3 different vertebral levels (T1-4, T5-8, T9-12) of the thoracic spine and the subjects performed crunches, which included thoracic flexion and extension in supine position. Five times × 3 sets for each levels, twice a week, for 4 weeks. Cervical pain, disability, upper body posture, FABQ results, and ROM were evaluated at baseline, after 4 weeks of intervention, and at 8 weeks of follow-up. Assessments included the quadruple visual analogue scale (QVAS); Northwick Park neck pain questionnaire (NPQ); craniovertebral angles (CVA), forward shoulder angle (FSA) and kyphosis angle (KA) measurements for upper body posture; FABQ and cervical ROM testing. Results: The EG showed a statistically significant improvement after intervention in the QVAS (–51.16%); NPQ (–53.46%); flexion (20.95%), extension (25.32%), left rotation (14.04%), and right rotation (25.32%) in the ROM of the cervical joint; KA (–7.14%); CVA (9.82%); and FSA (–4.12%). Conclusion: These results suggest that, for patients with chronic neck pain, thoracic selfmobilization exercise using a tool (tennis balls) is effective to improve neck pain, disability level, the ROM, and upper body posture.

Background: Posterior-anterior (PA) vertebral mobilization, a manual therapy technique has been used for relieving pain or stiffness treating in spinal segment for in clinical practice, however evidence to gauge efficacy is yet to be synthesised. Objects: This study aimed to investigate the effect of PA mobilization of the thoracic spine on the respiratory function in patients with low back pain (LBP). Methods: The study participants included 30 patients with chronic LBP. They were randomly allocated to the experimental and control groups. The experimental and control groups received PA mobilization of the T1-T8 level of the thoracic spine and placebo mobilization, respectively. All patients received interventions for 35 minutes a day, five times a week, over 2-week period, respectively. Forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), peak expiratory flow (PEF), forced expiratory flow 25∼75% (FEF25∼75%), and chest wall expansion were measured before and after the intervention. Statistical analysis was performed using independent t-test and two-way analysis of variance, and Pearson’s correlation analysis was used to compare the correlation between respiratory function and chest measurement. Results: The experimental group showed significant improvements in FVC, FEV1, PEF, FEF25∼75% (p<.05), and chest wall expansion (p<.05) compared with the control group. Conclusion: PA mobilization of the upper thoracic spine may be beneficial for improving respiratory function parameters including FVC, FEV1, PEF, FEF25∼75%, and chest wall expansion in patients with chronic LBP.

목 적 : 확산강조영상은 뇌신경계에서 ischemia, infarction, inflammation, infection, tumor등 다양한 병변을 진단하는데 유용하다. 하지만 척추 확산강조영상은 심장의 운동, 호흡이나 연하에 의한 움직임과 척추체가 가깝게 있어 자기화율의 급격한 변화 등의 이유로 distortion과 artifact가 많이 발생하여 좋은 영상을 획득하기 어려웠다. 확산강조영상에서 영상의 distortion과 artifact를 변화시킬 수 있는 인자는 SENSE factor와 voxel size이다. 따라서 본 논문에서는 흉추 확산강조영상에서 SENSE factor와 voxel size를 변화시켜 영상을 획득 후 이를 비교평가 하고, 영상의 distortion, artifact 줄여 진단적 가치를 높이는 것이 본 논문의 목적이다. 대상 및 방법 : 척추질환이 없는 건강한 지원자 10명(남자: 7, 여자: 3, 평균연령: 29.6세)을 대상으로 하였다. 검사장비는 Ingenia 3.0T MRI (philips medical system, Netherlands)를 사용하였고, 신호수집 코일은 DS posterior coil을 사용하였다. FOV 240×184, B-factor 0, 1000 s/mm², slice thickness 4 mm, NEX: 10, TR과 TE는 장비에서 제공하는 가장 짧은 값을 사용하고 SENSE factor를 1, 2, 3으로 설정 후각 SENSE factor에서 voxel size를 1×1, 2×2, 3×3 mm로 변화시켜 영상을 획득하였다. 정량적 평가는 T2/SAG영상을 기준으로 Thoracic Spine 6th body에서 spinal cord까지의 거리를 각각 측정하여 distortion을 평가 하였고, 정성적 평가는 영상의학과 교수 1명, MRI 전문 방사선사 2명이 5점 척도로 영상의 artifact, distortion, 병변 검출 능력 등 전체적인 영상의 질을 비교평가 하였다. 통계적 유의성은 Wilcoxon signed rank test(SPSS 18.0K for windows)를 통해 검정하였고 p-value는 0.01미만인 경우에 통계적으로 유의하다고 판정하였다. 결 과 : 고정된 SENSE factor에서 voxel size 변화에 따른 distortion의 정량적 평가결과 SENSE factor 1에서 voxel size가 1×1, 2×2, 3×3으로 변화할 때 기준점에서 측정한 10명의 지원자의 평균길이는 6.54 mm, 5.33 mm, 4.79 mm, SENSE factor 2에서 평균 4.22 mm, 3.33 mm, 3.14 mm, SENSE factor 3에서 평균 3.04 mm, 2.63 mm, 2.29 mm로 측정 되었다. 동일한 SENSE factor에서 voxel size가 3×3일 때 영상의 distortion이 가장 많이 감소되었으며 동일한 voxel size에서는 SENSE factor가 3일 때 영상의 distortion이 가장 많이 감소되었다. 정성적 평가에서는 distortion, artifact의 발생정도와 척추체와 척수에서의 병변 검출 능력을 5점 척도(평가 불가: 1, 나쁨: 2, 보통: 3, 좋음: 4, 아주 좋음: 5)로 평가하였다. SENSE factor 1, voxel size 1×1, 2×2, 3×3으로 변화할 때 평균 2.23점, 2.30점, 2.33점으로 비교적 낮은 점수를 받았고 SENSE factor 2, voxel size 1×1, 2×2, 3×3으로 변화할 때 평균 2.86점, 4.20점, 4.13점, SENSE factor 3, voxel size 1×1에서 3.10점, 2×2, 3×3에서 평균 4.66점으로 가장 진단 가치가 높은 영상으로 평가되었다. 각각의 SENSE factor와 voxel size의 변화에 따른 영상의 distortion의 감소의 통계적 유의성을 알아보기 위해 Wilcoxon signed rank test로 검정한 결과 모두 p<0.01 로 나타났다. 결 론 : 확산강조영상은 뇌 질환에서 뿐만 아니라 척추와 spinal cord lesion을 감별하는데 매우 유용하다. 임상에서 Thoracic spine 확산강조영상 검사 시 본 논문에서 실험하여 얻은 결과처럼 SENSE factor: 3, voxel size: 2×2 또는 3×3을 선택하여 영상을 획득한다면 영상의 artifact, distortion이 감소되어 진단적 가치가 높은 영상을 만들 수 있을 것으로 사료된다.

The objective of this study is to provide basic information on coupled motions in thoracic spine during lateral bending from a neutral position for football and baseball players as well as for general university students. In the experiment, a total of 30 subjects participated(football players: 10, baseball players: 10, general students: 10). All subjects were in their 20’s. The subjects sat on a chair with lumbar support in a neutral position and bent to the right. As a result, for baseball players, coupled motions were observed in the opposite direction of the lateral bending in all parts of thoracic spine. For both football players and general students, coupled motions were observed in the same direction. These results confirmed that unilateral movements like baseball could affect coupled motions.

Few studies address the use of manual muscle stretching to improve spinal active range of motion(AROM). There is evidence that‘ Hold-Relax’(HR) is effective for increasing ROM in the extremities, which leads the researchers to anticipate similar benefits in the spine. The purpose of this study is to investigate the effects of HR(trunk flexors) and active thoracic flexion and extension on thoracic mobility, specifically flexion and extension in healthy individuals. A convenience sample of 30 physical therapy students(22-38 years) were randomly assigned to intervention sequence ‘A-B’ or ‘B-A’, with at least 7 days between interventions. Intervention‘ A’ consisted of HR of the ventral trunk musculature while ‘B’ consisted of thoracic flexionextension AROM. Thoracic flexion and extension AROM were measured before and after each intervention using the double inclinometer method. Paired t-tests were used to compare AROM pre and post-intervention for both groups, and to test for carry-over and learning effects. There was a statistically significant increase(mean=3° ; p=0.006) in thoracic extension following HR of the trunk flexors. There were no significant changes in thoracic flexion following HR, or in flexion or extension following the AROM intervention. No carryover or learning effects were identified. HR may be an effective tool for improving AROM in the thoracic spine in pain free individuals. Further investigation is warranted with symptomatic populations and to define the minimal clinical difference(MCD) for thoracic spine mobility.