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: 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.

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: 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.

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.

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: Research has been conducted on pain neuroscience education (PNE) for the relief of pain and symptoms associated with chronic neck pain (CNP). Focusing on the neurophysiology and neurobiology of chronic pain, pain processing, and particularly the function of the central nervous system for chronic pain, PNE helps patients to understand the causes of pain. Objectives: To investigate and systematically review interventional studies on the effectiveness of PNE for patients with CNP and to analyze the effect size by performing a meta-analysis. Design: A systematic review and meta-analysis protocol. Methods: The following databases and electronic collections will be searched for primary studies without time limits: PubMed, MEDLINE, OVID Embase, and CENTRAL in the Cochrane Library. Reference lists from identified studies will be manually hand-searched for additional relevant works. Patients 18 years of age and older with nonspecific neck pain lasting 3 months or longer will be included in the study, with exclusion criteria as follows: cancer pain, fractures of the spine or surgical intervention, cognitive impairment that does not allow the patient to follow the PNE program, pregnancy, chronic fatigue syndrome, fibromyalgia, and other related pathologies that may prevent full participation in the PNE program. There are no geographic restrictions; however, non- English studies will be excluded. Discussion: This study aims to evaluate the effects of PNE on pain and disability in chronic neck pain. Its results will help clarify whether the use of PNE alone can improve chronic pain. The advantages of systematic reviews include clear definitions and inclusion and exclusion criteria, standardized search formats, and objective independent reviews.

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: 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: 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: Bird dog exercise (BDE) is one of the lumbar stabilization exercises that rehabilitate low back pain by co-contraction of the local and global muscles. Previous studies have reported the effect of various type of BDEs (for example, practicing the exercises on various surfaces and changing the limb movement) for muscle co-contraction. Objects: This study aimed to investigate the effect of knee joint flexion position of the raised lower limb on abdominal and back muscle activity during BDE in patients with chronic low back pain (CLBP). Methods: Thirteen males participated in this study (age: 32.54 ± 4.48 years, height: 177.38 ± 7.17 cm). Surface electromyographic (SEMG) data of the internal abdominal oblique (IO), external abdominal oblique (EO), lumbar multifidus (MF), and thoracic part of the iliocostalis lumborum (ICLT) were collected in two knee joint flexion positions (90° flexion versus 0° flexion) during BDE. The SEMG data were expressed as a percentage of root mean square mean values obtained in the maximal voluntary isometric contraction. Results: Greater muscle activity of the IO (p = 0.001), MF (p = 0.009), and ICLT (p = 0.021) of the raised lower limb side and the EO (p = 0.001) and MF (p = 0.009) of the contralateral side were demonstrated in the knee joint flexion position compared to the knee joint extension position. Greater local/global activity ratios of the abdominal muscle (i.e., IO and EO) of the raised lower limb (p = 0.002) and the back muscle (i.e., MF and ICLT) of the contralateral side (p = 0.028) were also noted in the knee joint flexion position. Conclusion: BDE with a knee joint flexion position might be recommended as an alternative lumbar stabilization exercise to enhance muscle activity in both the raised lower limb and the contralateral sides of the trunk for individuals with CLBP

Background: Neck pain is a major health problem in developed countries and has a lifetime prevalence of 50%. Major problems include a reduced cervical range of motion, muscle stiffness, dysfunction, postural changes, and decrease in psychosocial level. Objects: This study aimed to investigate the effects of applying the upper trapezius inhibition dynamic taping to patients with chronic neck pain on their neck pain, functional level, cervical range of motion, psychosocial level, and neck posture. Methods: The study design was a randomized controlled trial. A total of 40 patients with neck pain participated in this study and were randomly assigned to a Dynamic Taping group (n = 20) or Sham Taping group (n = 20). In both groups, basic intervention cervical pain control therapy and shoulder stabilization exercise program were performed. In addition, dynamic taping and sham taping were applied to participants in the Dynamic Taping and Sham Taping groups to inhibit the trapezius muscle, respectively. All interventions were performed three times a week and a total of 12 times for 4 weeks, and the participants’ neck pain, functional impairment level, cervical range of motion, psychosocial level, and neck posture were measured and compared before and after the intervention. Results: Both groups showed significant differences in neck pain, functional level, cervical range of motion, psychosocial level, and neck postural before and after the intervention (p < 0.05). Moreover, there were significant differences between the two groups regarding the functional level and neck posture (p < 0.05). Conclusion: Inhibition dynamic taping of the upper trapezius muscle suppression is an effective method with clinical significance in reducing pain in individuals with chronic neck pain and improving the functional level, cervical range of motion, psychosocial level, and neck posture.

Treatment and management of chronic low back pain (CLBP) should be tailored to the patient’s individual context. However, there are limited resources available in which to find and manage the causes and mechanisms for each patient. In this study, we designed and developed a personalized context awareness system that uses machine learning techniques to understand the relationship between a patient’s lower back pain and the surrounding environment. A pilot study was conducted to verify the context awareness model. The performance of the lower back pain prediction model was successful enough to be practically usable. It was possible to use the information from the model to understand how the variables influence the occurrence of lower back pain.

Background: Back pain is associated with a high risk of recurrence. Various physical therapy techniques for back pain have been studied, including reprogramming the central nervous system by integrating sensation and motion with sensory exercise training. Objectives: To aimed verify the effectiveness of sensorimotor training in improving postural stability and pain levels. Design: A randomized controlled trial. Methods: The study population was randomized into a sensory exercise training group and trunk stabilization training group and treated three times a week for 4 weeks. Each group took part in sensorimotor training for 15 minutes or lumbar stabilization exercise for 15 minutes. Results: After the intervention both groups showed Improvements in the variables. There was a significant difference in the dynamic postural stability, limit of stability, and modified visual analog scale scores in the sensorimotor training group compared to the lumbar stabilization exercise group (P<.05). Conclusion: Sensorimotor training appears to be an effective physical therapy exercise program that can be applied in patients with low back pain to improve muscle control ability.

Background: The spinal nerves, which start at the lumbar level, are connected to the nerve innervation in the knees. Currently, there is a lack of research on the treatment of knee pain through lumbar mobilization. Objectives: To investigate the effects of lumbar joint mobilization (LJM) and transcutaneous electronic nerve stimulation (TENS) on proprioception and muscular strength in volleyball players with chronic knee pain. Design: Two group pre-posttest. Methods: A total of 26 professional volleyball players with chronic knee pain were allocated to the LJM (n=13) and TENS (n=13) groups. In the LJM group, grade III - IV amplitude was applied 3 times for 1 minute (80 times per minute) at the affected lumbar (L2-3) facet joint in the prone position. In the TENS group, the TENS treatment device was used to directly apply or 15 minutes to the area of chronic knee pain (100 Hz, 150 ㎲). Proprioception was measured by knee flexion and extension angles, and muscle strength was evaluated using an isokinetic test. Measurements were taken before and after interventions. Results: In the eye opened conditiond, proprioception significantly increased during both knee extension and flexion after LJM, while only knee extension was significantly increased in the TENS group. There was also a significant difference in knee extension between the two groups. In the eye close conditiond, proprioception was significantly improved only during knee extension in the LJM group, and the difference in knee extension between the groups was also significant (P<.05). The maximum torque of the affected knee joint was significantly improved at 60°/sec in both groups (P<.05); however, there was no difference between the two groups. There was no significant difference in the maximum flexion torque within or between the groups. Conclusion: This study suggests that LJM improved proprioception and muscular strength in volleyball players with chronic knee pain.

Background: It is reported that the proprioceptive sensation of patients with neck pain is reduced, and neck sensory-motor control training using visual feedback is reported to be effective. Objects: The purpose of this study is to investigate how sensorimotor control training for the cervical spine affects pain, function, and psychosocial status in patients with chronic cervical pain. Methods: The subjects consisted of 36 adults (male: 15, female: 21) who had experienced cervical spine pain for more than 6 weeks. An exercise program composed of cervical stabilization exercise (10 minutes), electrotherapy (10 minutes), manual therapy (10 minutes), and cervical sensorimotor control training (10 minutes) was implemented for both the experimental and the control groups. The cervical range of motion (CROM) and head repositioning accuracy were assessed using a CROM device. In the experimental group, the subjects wore a laser device on the head to provide visual feedback while following pictures in front of their eyes; whereas, in the control group, the subjects had the same training of following pictures without the laser device. Results: There were no statistically significant differences between the two groups in pain, dysfunction, range of motion, or psychosocial status; however, post-test results showed significant decreases after 2 weeks and 4 weeks compared to baseline (p < 0.01), and after 4 weeks compared to after 2 weeks (p < 0.01). The cervical joint position sense differed significantly between the two groups (p < 0.05). Conclusion: In this study, visual feedback enhanced proprioception in the cervical spine, resulting in improved cervical joint position sense. On the other hand, there were no significant effects on pain, dysfunction, range of motion, or psychosocial status.

Background: Various treatments have been proposed for chronic low back pain (CLBP), but recent guidelines and reviews recommend regular physical exercise. However, some other studies have reported opposite results that sling exercise (SE) and other exercises (OE) did not differ in improving CLBP. Objectives: To systematically review and meta-analyze the effects of SE on CLBP in studies published in Korea. Design: A Systemic Review and Meta-analysis. Methods: Randomized controlled trials comparing SE with OE and modality therapy (MT), published up to June 2020, were identified by electronic searches. Primary outcomes were pain and disability. The weighted mean difference (WMD), stand mean difference (SMD) and 95% confidence interval (CI) were calculated using a random-effects model. Results: Based on the results of the meta-analysis, SE was effective for pain in the comparison of SE and MT [short-term: WMD=-1.64, 95% CI (-3.06, - 0.22); long-term: WMD=-0.34, 95% CI (-0.42, -0.26)]. It was effective for pain in the comparison of SE and OE [short-term: WMD=-1.18, 95% CI (-2.15, - 0.20); long-term: WMD=-0.66, 95% CI (-0.89, -0.43)]. It was also effective for disability in the comparison of SE and MT [short-term: SMD=-15.82, 95% CI (- 23.10, -8.54)]. We found no clinically relevant differences in disability between SE and OE. Heterogeneity was high in the comparison of SE and overall variables. Conclusion: If SE is applied to physical therapy to improve the main symptoms of CLBP patients, it may contribute to their recovery. More high-quality randomized studies on the topic are warranted.

Background: Although various exercises have been performed for patients with chronic low back pain (CLBP), the effects of these exercises including joint mobilization, gym ball exercises, and breathing exercises on flexion relaxation ratio (FRR) have not been compared. Objective: To compare the effects of joint mobilization, gym ball exercises, and breathing exercises on the flexion relaxation phenomenon (FRP) and pain in patients with chronic low back pain. Design: Randomized pretest-posttest control group design. Methods: Thirty-six patients with chronic low back pain who were undergoing rehabilitation at a rehabilitation center were included. The patients were randomly divided into three groups: joint mobilization group (JMG; n=12), gym ball exercise group (GBG; n=12), and breathing exercise group (BEG; n=12). The exercises were performed for 40 minutes a day, twice a week, for a total of 12 weeks. Results: There were no significant differences in FRR between the three groups (P>.05). Significant decreases in the modified visual analog scale (MVAS) scores after intervention between the groups were found (P<.05). The GBG was significantly decreases from the JMG in the MVAS (P<.05). However, there were significant improvements between the pre- and post-interventional findings on FRR and MVAS in the three groups (P<.05). Conclusion: We demonstrated that intervention using joint mobilization, gym ball exercises, and breathing exercises improve FRP and pain in patients with CLBP.