Background: Chronic low back pain (CLBP) is associated with trunk and lower extremity muscle weakness. Kneeling squat (KS) is a hip-focused exercise commonly used in the activities of daily living. However, research on trunk and lower extremity muscle activity across movement phases (ascending, holding, and descending) during KS remains limited and warrants further investigation. Objects: To determine the muscle activity of transversus abdominis/internal oblique (TrA/IO), erector spinae, gluteus maximus (Gmax), gluteus medius (Gmed), rectus femoris (RF) in the contraction phases of KS in individuals with CLBP. Methods: Surface electromyography data were recorded during KS across the ascending, holding, and descending phases on the side with CLBP. A 60-bit metronome was used to control the exercise speed. Results: The muscle activity of the TrA/IO was significantly higher during the holding phase than during the ascending and descending phases. The Gmax and Gmed were significantly higher during the holding phase than during the descending phase, whereas, RF was significantly higher during the ascending phase than during the holding and descending phases. Conclusion: The holding phase of KS may be recommended as a trunk and lower extremity exercise to increase in TrA/IO, Gmax, and Gmed muscle activity. Additionally, the ascending phase activates RF muscle in individuals with CLBP.

Background: Chronic low back pain (CLBP) is a common health problem among female caregivers. In Korea, 70.4% of caregivers experience LBP after caregiving. The prevalence of LBP was higher in female caregivers of patients who required physical assistance with transfer than in those caring for patients who did not require physical assistance. Lifting movements, such as patient transfer and positioning, are associated with lumbopelvic stability (LPS) and knee muscle strength. However, no studies have investigated the differences in LPS and knee muscle strength between female caregivers with and without CLBP. Objects: This study was conducted to investigate the differences of the LPS, knee extension strength (KES) and knee flexion strength (KFS) between female caregivers with and without CLBP. Methods: Thirty-one female caregivers participated in this study. Participants were divided into two groups: (1) caregivers without CLBP (n = 13) and (2) caregivers with CLBP (n = 18). LPS, KES, and KFS levels were measured. An independent t-test was used to compare the LPS, KES, and KFS between caregivers with and without CLBP. The statistical significance was set at α of 0.05. Results: The LPS and KES scores were significantly lower in caregivers with CLBP than those without. In contrast, the KFS did not differ significantly between the groups. Conclusion: This study observed associations of both LPS and KES with CLBP among female caregivers.

Background: Aquatic exercise utilizing hot springs helps individuals with nonspecific knee pain by reducing joint stress and providing a safe environment for movement. It can improve muscle strength and balance, enhancing overall functional mobility. Objects: This study aims to examine the muscle strength of knee flexion, knee extension, dorsiflexion, and plantar flexion, as well as to investigate static and dynamic balance in middleaged females after performing hot spring aquatic exercise for 4 weeks. Methods: Twenty-two middle-aged females participated in the study. The participants performed hot spring aquatic exercise for 4 weeks. The hot spring aquatic exercise consisted of aquatic walking, aquatic stretching, aquatic side step, aquatic forward reach, aquatic squat, leg lift, and aquatic arm and leg rotation. Muscle strength was measured using microFET2, while static balance was assessed through the one-leg stance test, and dynamic balance was evaluated using the Y-balance test. This study utilized the paired t-test for statistical analysis, with a significance level set at 0.05. Results: The muscle strength of bilateral knee flexion showed a significant increase in the pre- and post-comparison (p < 0.05), and the muscle strength of bilateral knee extension also improved significantly (p < 0.05). In addition, a significant increase was observed in the muscle strength of bilateral dorsiflexion (p < 0.05). The one-leg stance test performed while supporting on the right leg showed a significant increase in the pre- and post-comparison (p < 0.05). Furthermore, the dynamic balance measurements performed while supporting on both the right and left legs demonstrated significant improvements in both legs when compared before and after the intervention (p < 0.05). Conclusion: In individuals with nonspecific knee pain, a 4-week hot spring aquatic exercise program can contribute to the improvement of lower extremity strength, as well as static and dynamic balance ability.

Background: Neck discomfort and movement limitations are common musculoskeletal problems among modern people. While cervical and thoracic joint mobilization are widely used interventions for cervical dysfunction, research comparing their immediate effectiveness in adults with asymmetrical cervical rotation is limited. Objectives: To compare the immediate effects of cervical versus thoracic joint mobilization in adults with adults with asymmetrical cervical rotation and discomfort. Design: Randomized controlled trial. Methods: Thirty adults with left-right differences in cervical rotation of more than 5 degrees were randomly assigned to a cervical mobilization group (CMG, n=15) or thoracic mobilization group (TMG, n=15). Both groups received Grade III mobilization for 15 minutes. Range of motion (ROM), pain (VAS), and neck disability index (NDI) were measured before and after intervention. Results: Both groups showed significant increases in ROM after intervention (P<.001). Within-group analysis revealed that the TMG showed significant pain reduction (P<.01) and significant reduction in left-right rotation asymmetry (P<.001), while the CMG showed improvement in ROM but no significant changes in asymmetry or pain (P>.05). Neither group showed significant changes in NDI. Between-group comparisons showed no significant differences in any outcome measures. Conclusion: Both cervical and thoracic joint mobilization increased cervical range of motion in adults with asymmetrical cervical rotation discomfort. The TMG demonstrated significant within-group improvements in left-right rotation asymmetry and pain reduction, suggesting potential clinical benefits of thoracic mobilization for certain aspects of cervical dysfunction.

이 논문은 목사 소설가 백도기의 1970년대 작품을 중심으로 기독교 소설이 그리는 고통과 기독교 언어의 분열이라는 주제를 살핀다. 백도기에게 기독교 신 앙과 소설 쓰기는 소설이 고통에 대해 다룰 때 양립 가능했다. 백도기 소설 속 고통 이야기는 두 갈래의 근원에 기반한다고 볼 수 있다. 하나는 그가 속했던 한신대학교의 신학적 경향과 가르침에서 온 것이고 다른 하나는 순교자 아버지 에 대한 기억이다. 한신의 신학은 백도기가 이웃 인간을 향한 관심, 그들의 고통 과 함께하는 고통, 혹은 함께하지 못하는 데에서 오는 고뇌의 서사를 쓰게 이끌 었다면, 부친 백남용 목사의 순교는 종교적 구원에 이르는 고통과 죽음을 그리 는 순교 서사를 반복해서 쓰게 했다. 한편 이 글은 그의 대표작 청동의 뱀 을 다시 읽으면서 이 소설이 한국경제의 성장과 교회의 양적 부흥 가운데 기독교 언어가 오히려 왜소해지는 상황을 지적하고 있다고 주장한다. 목사 주인공의 무 기력과 타락한 교인들을 적나라하게 보여주는 청동의 뱀 은 영적 타락에 대한 범박한 묘사에서 나아가 기독교인들에 의해 기독교 언어가 남용되고 무용해진 현실에 애통하는 소설로 읽을 수 있다.

Background: For patients with neck pain, a taping method has been used to promote thoracic spine extension. To induce thoracic spine extension without back pain, a neutral lumbo-pelvic position must be established. The spiral trunk taping method can induce a neutral lumbo-pelvic position and thoracic spine extension. Objectives: To determine the effectiveness of spiral trunk taping in inducing thoracic spine extension and neutral lumbo-pelvic position in patients with neck pain. Design: A randomized controlled trial. Methods: Thirty patients with neck pain were randomly assigned to groups. The experimental group received spiral trunk taping and the control group received sham taping. The resting position visual analogue scale (VAS) and VAS during painful movement were measured and compared pre and post treatment. Results: Significant within-subjects changes were resting position VAS (F=59.823, P=0.001) and VAS during painful movement (F=76.128, P=0.001). Significant between-subject changes were resting position VAS (F=10.402, P=0.003) and VAS during painful movement (F=7.657, P=0.01). Conclusion: Spiral trunk taping, which can induce thoracic spine extension and a neutral lumbo-pelvic position, was effective for neck pain. This study demonstrates the potential of a systemic taping approach in the management of neck pain, and provides important clues for future clinical applications.

Background: When shorter muscles are restored to normal, non-specific low back pain, which is the mechanism that causes pain along with muscle relaxation, disappears. Among the stretching methods, self-stretching is a good exercise method not only for treatment but also for preventive purposes. Objectives: To find out what is the most effective method of self-stretching, which is often used in treatment and preventive arbitration, which can reduce muscle activity and increase spinal flexibility in patients with non-specific back pain. Design: Randomized controlled trials. Methods: Three self-stretching exercise methods for erector spinae are randomly assigned to 13 people each, and three self-stretching exercise methods are performed for each study subject. Surface electromyography using, was performed to measure the erector spinae muscle activity. flexibility was measured through Trunk flexion test in a standing position. Muscle activity and flexibility were measured before and after stretching. Results: The difference in muscle activity and flexibility in the three groups, including cat stretching, seated stretching, and Reclining stretching, all showed statistically significant differences. There was no statistically significant difference in comparison between the three groups of stretch muscle activity. However, a statistically significant difference was shown in the comparison of the variability between the three groups of flexibility. In a post-mortem analysis comparing the amount of change in flexibility, the flexibility of the seated stretching in the chair increased significantly compared to the cat stretching group. Conclusion: It can be confirmed that the stretching method of the erector spinae, cat stretching, seated stretching, and Reclining stretching, all have positive effects on muscle activity and flexibility.

Background: In patients with low back pain (LBP), weakened core muscles and impaired proprioception contribute to decreased spinal stability and LBP recurrence. Objectives: To investigate the effects of abdominal bracing exercises (BE) and kinetic link training (BEKLT) on pain, balance, and proprioception in LBP patients. Design: Randomized controlled trial. Methods: Sixteen adults with LBP were randomly assigned to a BE group or a BEKLT group. Both groups completed a four-week intervention (three sessions per week). Pain was assessed using the visual analog scale (VAS), proprioception with the lumbar reposition sense test, and balance with the BT4 system. Results: Both groups showed significant reductions in VAS and proprioception error (P<.05), with no inter-group differences. In dynamic balance (limits of stability), the BE group improved in rearward, left, and right angles, while the BEKLT group improved in forward, rearward, and left angles (P<.05). A significant difference was observed in the forward leaning angle between groups (P<.05). For static balance, both groups showed significant reductions in trace length and C90 area (P<.05), with no inter-group differences. Conclusion: The findings suggest that both BE and BEKLT are effective interventions for reducing pain and improving proprioception and balance in LBP, with BEKLT providing additional benefits for dynamic balance.

Background: The increasing prevalence of smartphone use has been associated with musculoskeletal pain; however, the specific roles of demographic factors, smartphone usage time, posture, contents and state of addiction on pain in the upper-body regions remain unclear. Objects: This study investigated the influence of smartphone usage characteristics, including age, occupation, visual condition, duration, content, and posture, as well as smartphone addiction, on musculoskeletal pain in upper-body regions. This study aimed to comprehensively elucidate the factors contributing to the pain associated with smartphone use. Methods: A cross-sectional survey was conducted with 316 participants aged 20–59 years. Data on personal characteristics, smartphone use patterns, state of addiction (measured using the Smartphone Addiction Scale-Short Version), and musculoskeletal discomfort (Cornell Musculoskeletal Discomfort Questionnaire and Cornell Hand Discomfort Questionnaire) were collected. Binary logistic regression analysis identified significant predictors of pain in different body regions. Results: Younger age (20–30 years), being housewives or students, and vision impairment (shortsightedness) significantly increased the likelihood of neck, shoulder, and hand pain. Prolonged smartphone use (7–10 hours daily) and gaming were strongly associated with elevated pain risk, whereas moderate usage (1–4 hours daily) may be protect against lumbar pain. Non-neutral postures, especially side lying, have emerged as critical risk factors, with left-side lying linked to hand pain and right-side lying linked to upper back pain. Smartphone addiction consistently predicted pain across all regions by amplifying physical strain through prolonged engagement and poor posture. Conclusion: This study highlighted the multifactorial nature of smartphone-related musculoskeletal pain, emphasizing the roles of demographic characteristics, usage patterns, and addiction. These findings provide a foundation for developing tailored ergonomic and behavioral interventions to mitigate pain risks, particularly in high-use populations. Future research should validate these findings through longitudinal studies and objective measures.

Background: Various intervention methods are being used to treat subacromial impingement syndrome. However, there is a lack of research on intervention using manual therapy and kinesiotaping together. Objectives: To investigated the effect of subacromial impingement syndrome on the mobilization with kinesiotaping. Design: A quasi-experimental clinical trial. Methods: An experiment was conducted by allocated twenty-nine patients with shoulder impingement syndrome to the mobilization with kinesiotaping group (MKG, n=15) and the kinesiotaping group (KG, n=14). The intervention of MKG and KG was conducted 3 times a week for 6 weeks. The outcome was The Shoulder Pain and Disability Index (SPADI) and range of motion (ROM). The collected data was analyzed using the SPSS ver. 21.0 program by paired t-test and independent t-test. Results: After the intervention, MKG had significant improvements in SPADI pain, SPADI disability, external rotation and internal rotation in MKG. However In KG, there was no significant decrease in SPADI pain, SPADI disability, external rotation and internal rotation. And in MKG, there was a statistically significant decrease in SPADI pain, SPADI disability and increase in external rotation and internal rotation. Conclusion: The mobilization with kinesiotaping was effective in improving pain, disability, and ROM in patients with subacromial impingement syndrome.

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: The forward head posture acts as a factor that can cause various neurovascular and musculoskeletal dysfunctions. But searching for a study on quality of life for patient with forward head posture was challenging. Therefore, this study aims to find the factors that most affect the quality of life in patients with forward head posture. Objectives: The purpose of this study was to investigate the correlations between the cranio-vertebral angle (CVA), neck disability index (NDI), pain, and sternocleidomastoid (SCM) thickness of patients with forward head posture and the quality of life of the patients and to figure out important factors that affect the quality of life of the patients with forward head posture. Design: Cress-sectional study. Methods: To measure the CVA, the angle at which the visible protrusion of C7 and the ear bead were connected was measured, and the neck disorder index was evaluated using the Korean version of NDI. The degree of pain of the subject was measured using a visual-analog scale (VAS). The SCM thickness was measured using an ultrasound imaging device, and the quality of life was evaluated using the Korean version of the World Health Organization quality of life questionnaire (WHOQL-BREF). Results: A significant predictive model showing 88% explanatory power for the dependent variable was confirmed, with an appropriate regression equation being found. The factor that most affected patients' quality of life in the forward head posture was confirmed by the SCM thickness. Conclusion: When applying an intervention to improve a patient's quality of life for patient with forward head posture, an intervention method that improves the SCM thickness should be recommended.

Background: Interventions for acute low back pain include exercise therapy such as stretching, aerobic exercise, and sling exercise. Another treatment method for back pain is soft tissue release. Soft tissue release is a relaxation method that improves balance while allowing tension tissues to relax as much as possible. Objectives: To investigated the effect of acute low back pain on the massage ball exercise. Design: Randomized controlled trial. Methods: The twenty-eight subjects were randomly allocated to the Massage ball exercise with TENS group (MBETG, n=14) and the transcutaneous electrical nerve stimulation group (TG, n=14). For MBETG, massage ball exercise (BALLance Dr. Tanja Kühne method) was applied for 25 minutes followed by TENS for 15 minutes. The TG group applied TENS for 40 minutes. Each group conducted the intervention three sessions. The results were analyzed by measuring the numeric pain rating scale (NPRS), surface electromyography (%MVIC), and Oswestry disability index (ODI) before and after the intervention in each group. Results: Significant reduction was observed for NPRS and ODI in the MBETG (P<.05). And Significant higher was observed for %MVIC of the Erector spinae in the MBETG (P<.05). The NPRS and ODI in the MBETG were decreaed than the TG (P<.05). Conclusion: Massage ball exercise to patients with acute back pain will be effective in reducing pain, increasing muscle activity, and improving functional disability.

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.