The purpose of this study was to evaluate the effect of joint mobilization and manual stretching exercises in patients with hallux valgus. Twenty-three participants were divided into two groups; joint mobilization (n=11) and manual stretching exercises (n=12). The subjects participated in the experiment for 15minutes, three times a week, four weeks. The joint mobilization (Grade III, Maitland) was performed to experimental group for a minute and then rested for 10 seconds for each set. The manual stretching was performed to control group with three exercise session (preparatory and finishing exercises, agonist contraction exercises, agonist contraction and hold-relax exercises). In the results of the study, intragroup comparison of the deformity angles (DA) was shown to decrease from 15.18° to 13.09° in the joint mobilization group (p<.05) and from 19.00° to 16.83° in the stretching exercises group (p<.05). However, left static foot pressure (LSFP), right static foot pressure (RSFP), left dynamic foot pressure (LDFP) and right dynamic foot pressure (RDFP) did not significantly increase or decrease after the experiment. Intergroup differences also were not statistically significant in all variables (p>.05). The current study suggests that JM and MSE are effective in decreasing the DA in patients with hallux valgus.

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.

The International Headache Society (IHS) has validated cervicogenic headache (CGH) as a secondary headache type that is hypothesized to originate due to nociception in the cervical area. CGH is a common form of headache and accounts for 15% to 20% of all chronic and recurrent headaches. CGH is commonly treated with manual and exercise therapy. To date, no studies have isolated only one manual intervention in an attempt to determine its effectiveness. In this case study we present a 28-year-old patient with right upper cervical (UC) and occipital pain who responded well to a single manual intervention technique. This technique was applied in isolation for the first three visits and two therapeutic exercises prescribed on the fourth and fifth visit. In total, manual and exercise intervention occurred over 8 visits at which point in time the patient was discharged with no UC motion impairments, an NPRS rating of 0, a NDI and HDI demonstrating a 100% improvement and a 37% improvement in FOTO score. The traction based manual intervention and two therapeutic exercises prescribed for this patient were successful in relieving UC pain and CGH. At six months follow up, the patient was still symptom free.

The original focus of this study was to investigate the immediate effects of lumbar rotational mobilization on the one-legged standing ability. Fifteen subjects (6 men and 9 women, mean age = 22.77 (SD = 1.21), mean height = 165.46cm (SD = 11.65), mean weight = 61.46kg (SD = 8.29) volunteers from healthy individuals were recruited and randomized to a lumbar rotational mobilization (LRM) group and a trunk rotational exercise (TRE) group. Mobilization (grade 3 or 4) was applied to the LRM group on the lumbar spine (L1 to L5) in a side-lying, and trunk twist exercise (left and right side) was applied the to the TRE group with lunge position. Center of pressure (COP) and the velocity of the center of pressure (VCOP) of each participant were measured as a balance ability through one leg standing position. Results are as follows. In within-group difference, the COP of the LRM group reduced during standing with the right foot, but the VCOP change of the LRM was not statistically significant. In between-groups difference, COP of TRE group was decreased compared with LRM group only during left leg standing in the eyes (p <.05). The results of this study suggest that LRM is more effective than TRE in improving balance ability.

The purpose of this study was to identify the effect of upper thoracic mobilization on cervical alignment in stroke patients with forward head posture. The subject's of this study were two stroke patients with forward head posture and a cervical curve angle (four-line Cobb's method; FLCM) less than 40°. The intervention, central posterior-anterior (PA) mobilization, was applied to the T1-T4 vertebrae (upper thoracic spine) following the Maitland concept. This mobilization was applied three times per week for four weeks. In the results, the cervical curve angle (FLCM) increased for both subject 1 and 2. However, Jochumsen method score was decreased in subject 1, while it was increased in subject 2. These results demonstrate that upper thoracic mobilization had the positive effect on the cervical curve angle but not on Jochumsen method score. These findings suggest that PA mobilization on the upper thoracic spine could correct cervical curve angle measured by FLMC in stroke patients with FHP.

The objective of this study was to investigate the dynamic neural mobilization program on the changes in muscle activity and nerve conduction velocity (NVC) in stroke patients. The participants were sampled and randomly divided into experimental group I (n=12) who underwent arm neural mobilization and experimental group II (n=13) who underwent arm dynamic neural mobilization. As the pretest, peripheral NVC of the radial, median, and ulnar nerves were measured using the Viking Quest; the biceps brachii, brachioradialis, flexor carpi radialis, and extensor carpi radialis activities were measured with sEMG. Each intervention program consisted of 10 trials per set and three sets per session. The intervention programs were performed once daily for four weeks (four days/week). Posttest measurements were taken equally as the pretest measurements. Significant differences in peripheral NVC in all sections of the radial and median nerves and wristbelow elbow and below elbow-above elbow areas of the ulnar nerve, as well as in muscle activity of all muscles except the biceps brachii. These findings indicate that dynamic neural mobilization was effective in increasing peripheral NVC and altering the muscle activity.

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 main focus of this study was to investigate effects of lumbar central posteroanterior (PA) mobilization on isometric knee extension (IKE) ability and patellar tendon reflex amplitude (PTRA) in healthy university students. University students aged 19-26 (male; 10, female; 10) without any neurological disorders participated voluntarily and excluded the subjects with abnormal reflexes. The participation had an average body mass of 64.25±13.52 kg, an average height of 1.66±0.08m, and an average Body Mass Index (BMI) of 23.07±3.21. Every student was randomly assigned to be received squatting exercise and PA mobilization sequentially with 5 days of wash out period. IKE and PTRA were not significantly different between the two groups after the intervention. All the outcome measures were arranged into two data groups; PA mobilization and squatting exercise data group. In the PA mobilization data group, IKE and PTRA significantly increased after the intervention, however, these aspects were decreased in the squatting exercise group. These findings suggest that IKE and PTRA increase immediately after PA mobilization, therefore PA mobilization could be a valuable topic for controlled clinical trials.

The purpose of this study was to examine the effects of combined respiratory physical therapy on respiratory function, spinal curve and spinal mobility for community-dwelling elderlies with restrictive lung diseases. In total, 10 patients participated in an 8-week intervention program of thoracic cage mobilization and breathing exercise in combination. The results of the study are as follows: for respiratory function, the forced expiratory volume in 1 second (FEV1), forced vital capacity(FVC), and FEV1/FVC were significantly improved to .30±0.31ℓ, .46±.42ℓ, and 18.10±11.39%, respectively (p<.05). For spinal curve, the thoracic curve and the lumbar curve were improved significantly to -2.20±1.40° and -1.20±1.14°, respectively (p<.01). For spinal mobility, the thoracic flexion (3.40±2.99°), thoracic extension (3.50±1.43°), lumbar flexion (4.50±4.74°), and lumbar extension(- 1.50±1.84°) were all significantly improved (p<.05). These findings indicate that thoracic cage mobilization and breathing exercise in combination improve the respiratory function, spinal alignment, and spinal mobility in elderly people with restrictive lung diseases,

The purpose of this study was to measure the mean peak mobilization forces to the lumbar spine 1-3 with grade III and grade IV of posteroanterior (PA) mobilization. Twenty subjects with no history of Lumbar back pain (LBP) (10 female, 10 male) with a mean age of 24.1 years (SD = 6.0) were recruited for the study and PA mobilization were performed in each spine and the therapist took approximately 2.5s to complete mobilization. In the results, applied grade IV force showed no different according to each segment in LS1, LS2, LS3, however, there are distinct differences between LS1 and LS2, LS1 and LS3 during mobilization with grade III force. This study suggested that the mean peak force of the grade III and grade IV mobilization in the L1-L3 was almost similar each other.

The purpose of this study was to measure the mean peak mobilization forces to the cervical spine 3-5 with grade III and grade IV of posteroanterior (PA) mobilization. Asymptomatic 25 college subjects were participated in the trial and eligible physical therapists performed cervical mobilization. The mean peak mobilization force was measured during the PA mobilization with grade III and grade IV by attaching a flexible force transducer over the C3-C5 spinous process. Three cycles of PA mobilization were performed in each spine and the therapist took approximately 2.5s to complete mobilization. After applying the grade III mobilization to the C3-C5, 30 minutes later, the grade IV mobilization was applied to the same area again. There were no significant differences between C3, C4 and C5 during grade III as well as grade IV. Upon comparing the mean peak force of grade III with mean peak force of grade IV at the C3, C4 and C5 respectively, an insignificant difference was also observed. The mean peak mobilization force was 4.53±1.79 N at the C3, 5.10±1.91 N at the C4, and 5.17±2.63 N at the C5 during grade III force was applied. The mean peak mobilization force was 4.40±1.56 N at the C3, 5.53±2.01 N at the C4, and 5.38± 2.73 N at the C5 during grade IV force was applied. This study suggested that the mean peak force of the grade III and grade IV mobilization in the C3-C5 was similar each other, also there was no difference between mean peak force of grade III and grade IV on C3, C4 and C5.

The purpose of this study was to investigate the effects of central posteroanterior mobilization on the pain, muscle tone, flexibility of trunk flexion, lumbar lordosis in patient with chronic back pain has been studied. The target subject was a 23 year old man, who had chronic back pain without surgical history within six months. The pain has been indicated by the pressure pain threshold, when the subject was pressed his spinous process of L3-L1 by the pressure of grade Ⅳ. The muscle tone, elasticity, and stiffness were measured by the MYOTONEⓇ PRO, and the flexibility of trunk flexion was evaluated by the distance from the figure tips to the floor, when subjects flexed their body. The lumbar lordosis was measured from the X-ray picture. The lumbar central posteroanterior mobilization of Maitland orthopedic physical therapy has been applied to the spinous process of L3-L1 in grade Ⅳ by five sets and 10 times for each set. According to the measurement result right after the intervention, the pain decreased from 2/10 to 1/10 based on the visual analogue scale. The flexibility of trunk flexion (distance from the finger tips to the floor) increased The muscle tone decreased from 15.3 to 14.65 and the muscle stiffness also decreased 53.5 from 310 to 256.5. However, the muscle elasticity increased from 0.89 to 1.04 and there was no changed on the lumbar lordosis as 25°. The results of the present study suggest that the central posteroanterior mobilization decrease the pain, muscle tone, and muscle stiffness of the lumbar area, however increase the muscle elasticity and flexibility of the trunk flexion.

The purpose of the study was to determine the effect of joint mobilization with respiratory muscle taping on pulmonary function and chest expansion ability in patients with chronic stroke. Thirty subjects (n=30) were randomly divided into three groups: a joint mobilization group (n=10), a respiratory muscle-taping group (n=10), and a joint mobilization with respiratory muscle-taping group (n=10). Measurements for pulmonary function and chest expansion were performed to assess its effectiveness. A spirometer was used to measure the pulmonary function, and a tape measure was used to assess the chest expansion. In the joint mobilization group, peak expiratory flow (PEF) was increased. Forced expiratory volume in one second (FEV1), forced vital capacity (FVC), and upper and lower chest expansion were also increased. All of variables of respiratory muscle-taping group also were increased. FEV1 and FVC were significantly different between joint mobilization with respiratory muscle-taping and respiratory muscle-taping group. The results of the present study suggest that mobilization with respiratory muscle taping increase the pulmonary function and chest expansion.

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 case study was to investigate the effects of thoracic mobilization and manipulation on a patient with upper thoracic pain. The subject had been complaining of upper thoracic pain for the last 4 months. On the X-ray, T3 and T4 spinous process were located on the left side of the vertical axis. First, transverse mobilization was applied from left to right at the T3-T4 and then thoracic manipulation was performed. The intervention methods of mobilization and manipulation were based on the concept of Maitland manual therapy. The subject underwent a total of 20 sessions (five times per week for four weeks). The thoracic pain and vertebral rotation angle were measured to examine the effect of the intervention. The thoracic pain score decreased (from 4.0 to 1.5) and the angle of thoracic vertebral rotation decreased (from 7.0º to 4.0º). These results suggest that applied mobilization and manipulation in patients with a primary complaint of thoracic pain decreasing the thoracic pain and vertebral rotation angle.

The aim of this study was to observe the effects of kinesiotaping and joint mobilization on the metatarsophalangeal joint angle and pain in hallux valgus patients Twenty-one female hallux valgus patients in their 20s were divided into two groups, a Kinesiotaping group (KT, n=10) and another group with the addition of joint mobilization (KTJM, n=11). After undergoing 6 weeks of intervention, the change in the metatarsophalangeal joint and pain were measured. Metatarsophalangeal joint angle was significantly increased both the KT and the KTMJ group after intervention. In the change of pain, both the KT and KTJM groups on an individual basis also experienced a significant decrease in pain, though comparison between the two groups failed to represent a significant difference. These findings suggest that Kinesiotatping and joint mobilization increased the joint angle and reduced pain.

This study focused on evaluating the phytoextraction of heavy metals (Co, Pb, and Zn) induced by bioaugmentation of button mushroom compost (BMC) in Helianthus annuus (sunflower). When the potential ability of BMC to solubilize heavy metals was assessed in a batch experiment, the inoculation with BMC could increase more the concentrations of water-soluble Co, Pb, and Cd by 35, 25, and 45% respectively, compared to those of non-inoculated soils. BMC-assisted growth promotion and metal uptake in H. annuus was also evaluated in a pot experiment. In comparison with non-inoculated seedlings, the inoculation led to an increase in the growth of H. annuus by 27, 25, and 28% in Co-, Pb-, and Zn-contaminated soils, respectively. Moreover, enhanced accumulation of Co, Pb, and Zn in the shoot and root systems was observed in inoculated plants, where metal the translocation from root to the above-ground tissues was also found to be enhanced by the BMC. Evidently, these results suggest that the BMC could be effectively employed in enhancing the phytoextraction of Co, Pb, and Zn from contaminated soils.

Background:Limitation of hamstring extensibility is often associated with various musculoskeletal problems such as alterations in posture and walking patterns. Thus, certain appropriate strategies need to be established for its management.Objects:The aim of this study was to compare the effects of the neural mobilization technique and static stretching exercises on popliteal angle and hamstring compliance in young women with short hamstring syndrome (SHS).Methods:Thirty-three women with SHS were randomly assigned to either group-1 (n1=17) that underwent the neural mobilization technique or group-2 (n2=16) that underwent the static stretching exercises. Outcome measures included the active popliteal angle (APA) and a hamstring’s electromyographic (EMG) activity at a maximum popliteal angle of the baseline. Intervention for each group was performed for a total time of 3-min (6 sets of a 30-sec application).Results:There were significant interactions between time and group in the APA [group-1 (pre-test to post-test): 69.70±8.14° to 74.14±8.07° and group-2: 68.66±7.42° to 70.52±7.92°] (F1,31=6.678, p=.015) and the EMG activity of the hamstring (group-1: 1.12±.30μV to .69±.31μV and group-2: 1.19±.49μV to 1.13±.47 μV)(F1,31=6.678, p=.015). Between-group comparison revealed that the EMG activity of the hamstring was significantly different at post-test between the groups (p<.05). Furthermore, in within-group comparison, group-1 appeared to be significantly different for both variables between pre- and post-test (p<.05); however, group-2 showed significant difference in only the APA between pre- and post-test (p<.05).Conclusion:These findings suggest that the neural mobilization technique and static stretching exercises may be advantageous to improve hamstring compliance in young women with SHS, resulting in a more favorable outcome in the neural mobilization technique.

The purpose of this case study was to identify the effects of posteroanterior (PA) mobilization on the cervical spine in a patient with chronic whiplash-associated disorder (WAD). The subject of this study was a 58-year-old woman who sustained a chronic WAD as a result of a motor vehicle accident two years prior. The subject has progressively worsening neck pain and stiffness. The subject was determined to have a grade Ⅱb WAD the use of the Modified Quebec Classification. The intervention was central and unilateral PA mobilization on the spinous process of C4 and C5. The PA mobilizations were performed at the end of range to Maitland grade Ⅳ. The PA mobilization was conducted once daily for a total of eight days. Two sets of measurements were done one before and one after the intervention. Neck pain, cervical stiffness, range of motion and lordosis of the cervical spine were measured. Experimental intervention decreased the neck pain, and increased the neck stiffness and cervical ROM (range of motion) such as flexion, extension, lateral flexion and rotation. X-ray photographs also represented that cervical curvature increased from 35° to 40°. This study suggested that PA cervical mobilization applied to hronic WAD is effective in decreasing pain, increasing cervical ROM and cervical curvature.