Background: Vibration stimulation has emerged as a treatment tool to help reduce spasticity during physical therapy. Spasticity includes problems of reduced range of motion (ROM) and stiffness. However, the benefits of vibration rolling (VR) on interventions for stroke patients are unclear. Objectives: This study aimed to investigate the effect of VR intervention on the ankle ROM and ankle stiffness in stroke patients. Design: A randomized crossover study. Methods: Seven stroke patients completed two test sessions (one VR and one non-VR [NVR]) in a randomized order, with 48 hours of rest between each session. Participants completed intervention and its measurements on the same day. The measurements included ankle dorsiflexion and plantarflexion ROM and stiffness of ankle muscles, including the tibialis anterior, medial, and lateral gastrocnemius muscle. Results: After VR, ankle dorsiflexion ROM, lateral gastrocnemius stiffness, and medial gastrocnemius stiffness improved significantly (all P<.05). After NVR, only the lateral gastrocnemius stiffness improved significantly (P<.05). Furthermore, in the cases of changed values for ankle dorsiflexion ROM and lateral gastrocnemius stiffness were compared within groups, VR showed a more significant difference than NVR (P<.05) Conclusion: VR improved ankle ROM and muscle stiffness. Therefore, we suggest that practitioners need to consider VR as an intervention to improve dorsiflexion ROM and gastrocnemius stiffness in stroke patients.

Background: To evaluate whether extracorporeal shock wave therapy (ESWT) in the pain point is a more effective treatment than the trigger point for myofascial pain syndrome (MPS) of the upper trapezius. Objects: The purpose of this study was to compare the most effective areas when applying extracorporeal shock wave therapy. Methods: A total of 30 patients with MPS were randomly assigned to the trigger point in the ESWT (n = 15) and pain point ESWT (n = 15) groups. Interventions in both groups were performed in one session, i.e., 2,000 shocks with 1.5 bar intensity. Pain and function were assessed using the visual analog scale (VAS) and cervical range of motion (ROM) and based on mechanical muscle properties. Statistical analysis was performed using the repeated measures two-way analysis of variance to determine the significance probability between pre- and post-test. Results: Changes in mechanical muscle properties were not statistically significant between the two groups. However, VAS and cervical ROM showed statistically significant differences at pre- and post-intervention, regardless of the group (p < 0.05). Conclusion: Although no significant difference was observed in the intervention effect, applying an extracorporeal shock wave to the pain point rather than the pain trigger point should be considered in order to save time in effectively and accurately identifying the pain trigger point and site.

Background: Few comparative studies have been conducted on strengthening the anterior and posterior muscles of the trunk via lumbar stabilization exercises. Objectives: To compare the effects of forward leaning exercise and supine bridging exercise in stability exercise. Design: Randomized controlled clinical trial (single blind). Methods: Thirty subjects with spondylolisthesis were participated in this study. Fifteen subjects performed the bridging exercises and fifteen subjects performed the forward leaning exercises. Each exercise was held for ten seconds per repetition, and four repetitions were considered one sub-session. A total of four sub-sessions were performed in one full exercise session. The full exercise session required thirty minutes, including rest time. Trunk strength and range of motion and Oswestry disability index were measured. Results: Two weeks later, trunk flexion strength and trunk extension range of motion were significantly increased in the forward leaning exercise group than in the supine bridging group, trunk extension strength were significantly increased in the supine bridging exercise group than in the forward leaning group. After two weeks, the pain score was significantly lower in the forward leaning exercise group than in the supine bridging group. Conclusion: This study has shown that stabilization exercises are effective in increasing range of motion and strength in spondylolisthesis subjects. It was especially confirmed that the method of strengthening the anterior muscles of the trunk is more effective than the standard stabilization exercise method.

Background: Prolonged standing during work causes a lower extremity pain and disorders. Patellofemoral pain syndrome (PFPS) is one of the common diagnoses of the knee pain. Although the etiology of PFPS is not completely understood, it is considered to be multifactorial. Objects: The purpose of this study was to investigate difference in strength of knee muscles, quadriceps:hamstring muscles strength ratio (Q:H ratio), asymmetry ratio of knee muscles strength and dorsiflexion range of motion (ROM) between standing workers with and without PFPS. Methods: Twenty-eight standing workers with PFPS and 26 age-, height-, and weightmatched standing workers without PFPS participated in this study. A tension sensor measured knee muscle strength, and motion sensor measured dorsiflexion ROM. The asymmetry ratio of knee muscles was calculated by a specific formula using the knee muscles strength of the dominant side and the sound side. An independent t-test was used to identify significant differences in the strength, ROM, Q:H ratio, and asymmetry ratio between the PFPS and normal groups. Results: The standing worker with PFPS have significantly lower dorsiflexion ROM (p < 0.000) and higher asymmetry ratio of the hamstring muscles strength (p < 0.000) compare to the standing worker without PFPS. No significant differences were seen in the strength of quadriceps muscle and hamstring muscles, Q:H ratio, and asymmetry ratio of quadriceps muscle strength. Conclusion: There was a significant difference in the asymmetry ratio of the isometric hamstring muscle strength. This finding suggests that the asymmetry ratio of isometric hamstring muscle strength may be more important than measuring only the hamstring muscle strength of the PFPS side. Furthermore, the results of this study showed a significant difference in dorsiflexion ROM between the standing industrial workers with and without PFPS. Dorsiflexion ROM and isometric hamstring muscle strength should be considered when evaluating the subjects with PFPS.

Background: Many trials have been conducted the methods and types of intervention of form rollers, but no research has been done yet that mixes the methods and types of intervention. Objectives: To analyze the effects of myofascial release on the improvement of range of motion (ROM), flexibility, pain pressure threshold, and balance. Design: Randomized controlled trial. Methods: All subjects measured ROM, flexibility, pressure pain threshold, and dynamic balance by pre-test. After pre-test, subjects were randomized that static-vibration foam rolling group (n=12), dynamic-vibration foam rolling group (n=12), general foam rolling group (n=12). For the intervention, 3 sets of 90 seconds were applied to each group, and rest time was set to 60 seconds between sets. In the post-test and follow-up test after 10 minutes, all three groups were measured the ROM, flexibility, pressure pain threshold, and dynamic balance. Results: The results of comparing ROM, flexibility, pressure pain thresholds, dynamic balance ability appeared higher significant difference in the prepost- 10 minutes follow up test in comparison between time in the intragroup (P<.001). As a result of comparing the change of pre-post-10 minutes follow up, static vibration foam rolling showed higher significant difference compared to control groups (P<.001). Conclusion: Through this study, when foam rolling is applied within the same intervention time, static foam rolling can be expected to have a better effect than the existing dynamic foam rolling as well as vibration foam roller can expect better effect than general foam rolling.

Background: Ankle sprain in the Lead Leg Side (ALLS) is common in fencing athletes, and studies comparing the ankle range of motion (ROM) and strength of both legs are insufficient. Objectvies: To compare the ankle ROM and hip strength between two legs in fencing athletes who has ankle instability in the lead leg side. Design: Cross-sectional design. Methods: Seven fencing athletes with ankle instability participated in this study, and they randomly assigned into ankle in the Lead Leg Side (ALLS) and ankle in the Rear Leg Side (ARLS). Instability was determined by the Cumberland Ankle Instability Tool (CAIT), and then joint ROM and hip muscle strength were measured. Results: There were significant differences in dorsiflexion ROM, hip strength (extension and abduction) between the ALLS with ankle instability and ARLS (P<.05). Conclusion: This study suggests that the ankle ROM and hip muscle strength of ARLS are greater than ALLS in fencing athletes with ankle instability.

보행 시 하이힐 굽 높이에 따른 구간별 차이를 비교하고, 하지관절의 가동범위가 보행 시간에 미치는 영향을 알아보고자 하였다. 20대 여대생 10명이 연구에 참여하였고, 굽 높이에 따라 3차원 보행분석을 통하여 변인을 산출하였다. 통계방법으로 세가지 굽높이에 따른 차이는 일원변량분석을 실시하였고, 보행시간이 하지관절에 미치는 영향은 다중회귀분석을 실시하였다. 연구결과로 보행 시 구간 2는 굽이 높을수록 보행시간이 길게 나타났지만, 구간 3은 굽이 높을수록 보행시간이 짧게 나타났다. 보행시간이 하지 관절 가동범위에 미치는 영향을 분석한 결과 구간 2는 1 cm에서 발목관절, 무릎관절, 5 cm는 발목관절의 가동범위가 클수록 보행시간이 길어졌다. 구간 3은 1 cm에서 고관절 가동범위가 클수록 보행시간이 길어 졌고, 10 cm는 발목관절 가동범위가 작을수록 보행시간이 길어졌다. 따라서 굽 높이 신발의 경우 발목관절의 제어가 중요성이 변인으로 판단된다.

Background: Neck pain can be caused by any structure in the neck, such as intervertebral discs, ligaments, muscles, facet joints, dura mater, and nerve roots. The hyoid bone is a structure that is also related to head and neck posture, neck movement and pain, but there are no studies on hyoid deviation, neck pain, and range of motion (ROM). Objects: The purpose of this study was to investigate the effect of fascia relaxation and mobilization of the hyoid bone on the ROM, pain, and lateral deviation of the hyoid bone. Methods: Twenty-five patients with neck pain identified by the lateral motion test (10 males [35.13 ± 7.67 years, 172.69 ± 3.90 cm, 78.77 ± 6.96 kg] and 15 females [35.13 ± 10.05 years, 161.11 ± 4.09 cm, 52.59 ± 2.98 kg]) was chosen randomly. Baseline values for pain, neck ROM, and lateral deviation in the hyoid bone were recorded using a visual analogue scale (VAS), goniometer, and tape measure. Then, each patient was treated with hyoid fascia relaxation and mobilization, and all results were recorded after intervention. Comparison of the results before and after intervention was analyzed using paird t-test (p < 0.05). Results: Right rotation, extension, VAS, and rotational asymmetry statistically significant differences (p < 0.05). Right rotation and extension increased ROM, rotational asymmetry ratio and VAS decreased. However, there was no significant difference in flexion, left rotation, center point (p > 0.05). Conclusion: Fascia relaxation and hyoid mobilization could improve the ROM of cervical extension, asymmetry of the cervical rotation and neck pain.

Background: Stretch-oriented home exercise programs are often used as treatments for patients with adhesive capsulitis; however, there is lack of research on home exercise programs to strengthen rotator cuffs. Objects: The aim of this study is to investigate the effect of home exercise programs for rotator cuff strengthening on pain, range of motion (ROM), disability level, and quality of life in patients with adhesive capsulitis. Methods: Twenty-two patients with adhesive capsulitis volunteered to participate in this study. The subjects were randomly divided into an experimental group (n = 11) and control group (n = 11). For the experimental group, manual therapy and home exercise programs for rotator cuff strengthening were applied for 6 weeks; for the control group, only manual therapy was applied for 6 weeks. Shoulder pain (quadruple visual analogue scale, QVAS), ROM, disability (shoulder pain and disability index-Korean version, SPADI), and quality of life (world health organization quality of life scale-Korean version, WHOQOL-BREF) were evaluated at baseline, after 3 weeks, and after 6 weeks of intervention. The changes in the measurement variables were analyzed by using repeated measure analysis of variance. Results: Significant differences were observed between the experimental group and control group in the QVAS; SPADI-pain scores; SPADI-disability scores; SPADI-total scores; flexion, abduction, internal and external rotation ROM of the glenohumeral joint; and WHOQOLBREF total, overall, physical health, and psychological scores. All groups displayed statistically significant improvements as observed in the QVAS, SPADI, flexion, abduction, external and internal rotation ROM of the glenohumeral joint, and WHOQOL-BREF. Conclusion: Home exercise programs for rotator cuff strengthening had a positive impact on shoulder pain, shoulder ROM, disability level, and quality of life in patients with adhesive capsulitis. Therefore, we propose the use of home exercise programs for rotator cuff strengthening in the exercise rehabilitation of patients with adhesive capsulitis.

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: In patients with lumbar spinal stenosis (LSS), lumbar flexion exercise (LFE) is considered a standard therapeutic exercise that widens the space between the spinal canal and intervertebral foramen. However, some researchers have reported that lumbar extension exercise (LEE) may improve lumbar pain and functional ability in patients with LSS. Although exercise intervention methods for patients with LSS have been widely applied in clinical settings, few studies have conducted comparative analysis of these exercise methods. Objects: This study aimed to compare the effects of LFE, LEE, and lumbar flexion combined with lumbar flexion-extension exercise (LFEE) on pain, range of motion (ROM), pelvic tilt angle, and functional gait ability in patients with LSS. Methods: A total of 30 patients with LSS, LFE (n1=10), LEE (n2=10), and LFEE (n3=10) were assigned to each of the three exercise groups. The numerical pain rating scale (NPRS), modified-modified schober test (MMST)-flexion, MMST-extension, pelvic tilt inclinometer, and 6-minute walking test (6MWT) were measured. Results: After the intervention, statistically significant differences were observed in the NPRS (p=.043), MMST-flexion (p<.001), MMST-extension (p<.001), and 6MWT (p=.005) between groups. According to the post hoc test, the NPRS was statistically significant difference between the LFEE and LEE groups (p=.034). The MMST-flexion was statistically significantly different between the LFE and LEE (p=.000), LFE and LFEE (p=.001), and LEE and LFEE (p=.001) groups. The MMST-extension was statistically significantly different between the LFE and LEE (p<.001), LFE and LFEE (p=.002), and LEE and LFEE (p=.008) groups. The 6MWT was statistically significantly different between the LFE and LFEE (p=.042) and the LEE and LFEE (p=.004) groups. Conclusion: This study suggested that LFEE was the most effective exercise for pain and functional gait ability in patients with LSS, LFE was the most effective exercise for lumbar flexion ROM, and LEE was the most effective exercise for lumbar extension ROM.

Background: Measurement of passive ankle dorsiflexion range of motion (ADROM) is often part of a physical therapy assessment. Objects: The objective of this study was to identify the effects of subtalar joint neutral position (SJNP) on passive ADROM according to knee position in young adults. Methods: We recruited 14 young adult participants for this study. Two examiners used a universal goniometer to measure passive ADROM with and without SJNP. Dorsiflexion force was applied to the forefoot until maximum resistance was reached in two knee positions (extension and 90˚ flexion) in the prone position. Subtalar joint position was also recorded at maximum ADROM. Passive ADROM was measured three times at different knee and subtalar joint positions, in random order. Two-way repeated-measures analysis of variance was used to compare the effects of subtalar joint and knee position on passive ADROM. Results: Passive ADROM was significantly lower with than without SJNP during both knee extension (mean difference: 7.4˚) and 90˚ flexion (mean difference: 16.9˚) (p<.01). Passive ADROM was significantly higher during 90˚ knee flexion than during knee extension both with (mean difference: 5.8˚) and without SJNP (mean difference: 15.2˚) (p<.01). The valgus position of the subtalar joint was significantly lower with than without SJNP during both knee extension (mean difference: 3.3˚) and 90˚ flexion (mean difference: 4.3˚) (p<.01). Conclusion: Our results indicate that the gastrocnemius may limit ankle dorsiflexion more than the soleus does. Greater dorsiflexion at the subtalar and midtarsal joints was observed during passive ADROM measurement without than that with SJNP; therefore, SJNP should be maintained for accurate measurement of ADROM.

Background: Sling exercises are frequently used for the rehabilitation process of patients with shoulder joint injuries, but research on the significant frequency intensity and appropriate treatment duration for sling exercises with local vibration stimulation is lacking. Objects: The aim of this study was to investigate the effects of sling exercise with vibration on shoulder range of motion (ROM), muscle strength, pain, and dysfunction in patients with a medical diagnosis of shoulder joint injury. Methods: Twenty-two patients were randomly assigned to the experiment and control groups. Six sling exercises with and without 50 ㎐ vibrations were applied in the experiment and control groups, respectively. Each exercise consisted of 3 sets of 5 repetitions performed for 6 weeks. The assessment tools used included shoulder joint range of motion, muscle strength, pain level, and shoulder pain and disability index for functional disability. We conducted re-evaluations before and 3 and 6 weeks after intervention. The changes in the measurement variables were analyzed and compared between the two groups. Results: The ROM of the external rotation of the shoulder joint had a significant interaction between the group and the measurement point (F=3.652, p<.05). In both groups, we found a significant increase in external rotation angle between the measurement points (p<.05). The flexor strength of the shoulder joint significant interaction between the group and the measurement point (F=4.247, p<.05). Both the experiment (p<.01) and control groups (p<.05) showed a significant increase in shoulder flexor strength at the measurement points. After 6 weeks of the interventions, both the groups showed significantly improved VAS (p<.01), SPADI (p<.01), and orthopedic tests (p<.01). However, there was no significant difference between the group and the measurement point in terms of the clinical outcomes observed. Conclusion: The sling exercise with local vibration of 50 ㎐ affected the external rotation of the shoulder range of motion and improved shoulder flexor strength in the patients with shoulder injuries. Therefore, we propose the use of the sling exercise intervention with vibration in the exercise rehabilitation of patients with shoulder joint injuries.

Background: There have been many studies on self-myofascial release (SMR) stretching, but there are few comparative studies on the effects of massages using a release ball, which is a type of the SMR method. Objective: To investigate the immediate effects of release ball massage and self- stretching on proprioceptive sensory, hamstring’s temperature, range of motion (ROM) muscle strength,. Design: Crossover study. Methods: Thirty women in 20’s at S University in Busan voluntarily participated in the study. Participants were random to release ball group (n=15) or selfstretching group (n=15). Both groups performed 3 sets of exercises, stretching for 30 seconds and resting for 15 seconds in each position. The proprioceptive sensory, temperature of the hamstring muscle, ROM, and strength were measured before exercise, 5 minutes after exercise, and 30 minutes after exercise. Results: Release ball group showed significant differences in muscle length and temperature over time (p<.05). The comparison between two group over time showed significant differences in muscle length, temperature, and muscle strength (p<.05). Conclusions: These results demonstrate that release ball massage and selfstretching are beneficial for improving hamstring's temperature, ROM and muscle strength.

Background: Temporomandibular disorder (TMD) is characterized by pain and limited range of motion in the jaw. TMD patients generally prefer to chew on the unaffected or less-affected side, and this tendency often results in asymmetries in masseter muscle thickness and range of mandibular motion. Objects: The purpose of this study was to compare the asymmetries in masseter muscle thickness and range of mandibular motion in subjects with and without temporomandibular disorders. Methods: Thirty-nine subjects were divided into two groups: A TMD group (n1=19) and a control group (n2=20). The jaw opening range and laterotrusion were measured using a digital vernier caliper. The masseter muscle thickness was examined in both the resting state and the maximal clenching state using ultrasonography. The absolute asymmetry indices calculated based on the laterotrusion and masseter muscle thickness of the respective right and left sides. A two-way ANOVA and a Mann-Whitney U test were used for statistical analysis. Results: No significant different was found in the masseter muscle thickness between the TMD and control group. A significant difference was found in the absolute asymmetry indices of mandibular laterotrusion between the TMD and control groups (p<.05). Furthermore, the ranges of jaw opening were significantly different between males and females (p<.05). The absolute asymmetry index values of masseter muscle thickness at rest and during maximal clenching were also significantly different between males and females (p<.05). Conclusion: These results demonstrated that the subjects with TMD had a larger degree of asymmetry in laterotrusion than those without TMD. Therefore, a physiotherapy program needs to be designed to restore normal laterotrusion capacities for TMD subjects. These results also showed that female subjects had greater absolute asymmetry indices in masseter muscle thickness than male subjects. Therefore, more training is needed to promote bilaterally balanced chewing among women.

Background: Numerous studies have used smartphone applications to measure the range of motion in different joints. In addition, studies measuring the active range of motion (AROM) of the craniocervical joint have revealed high reliability. However, the subjects in these studies were all healthy subjects. No study has yet been conducted to measure the inter-rater reliability for the AROM of the craniocervical joint in stroke patients. Objects: The purpose of this study was to investigate the inter-rater reliability of the AROM of the craniocervical joint using a smartphone. Methods: The participants included 21 subjects who had strokes (17 males and 4 females). Two raters evaluated six types of craniocervical AROM, including flexion, extension, lateral flexion to the hemiplegic side, lateral flexion to the non-hemiplegic side, rotation to the hemiplegic side, and rotation to the non-hemiplegic side, using a goniometer and a smartphone to investigate inter-rater reliability. The inter-rater reliability was analyzed by intraclass correlation coefficients (ICC). Results: The inter-rater reliability of the smartphone was good for extension, lateral flexion to the hemiplegic side, lateral flexion to the non-hemiplegic side, and rotation to the hemiplegic side [ICC(2,k)=.86∼.88] and excellent for flexion [ICC(2,k)=.95]. The inter-rater reliability for rotation to the non-hemiplegic side was moderate [ICC(2,k)=.72]. Conclusion: These results suggest that the smartphone offers high inter-rater reliability for measurements of the craniocervical AROM in patients with stroke.

The purpose of this study was to identify the effect of proprioceptive neuromuscular facilitation (PNF) stretching exercise and joint mobilization on ankle joint range of motion (ROM), plantar pressure, and balance in subjects with stroke. Thirty patients (n=30) were organized into three groups, each of which received different treatments: PNF stretching (n=10), joint mobilization (n=10), and joint mobilization and PNF stretching combined (n=10). Each group received three exercise sessions per week for four weeks. The ankle ROM was measured using a goniometer, and plantar pressure and balance ability were measured using BioResque static posturography. In comparison within each group, the joint mobilization group and the joint mobilization with PNF stretching group showed significant improvements in ankle ROM, plantar pressure, and balance ability (p<.05). In comparison between the groups, a statistically significant difference was found in SECS change between the PNF stretching group, joint mobilization group and the joint mobilization with PNF stretching group. This study found demonstrates that the joint mobilization and joint mobilization with the PNF stretching methods were effective in improving ankle ROM, plantar pressure, and balance ability in stroke patients.

Background: Deficits of both ankle dorsiflexion range of motion (DFROM) and dynamic balance are shown in persons with chronic ankle instability and the elderly, with the risk of falls. Objects: This study aims to investigate the relationship between DFROM and dynamic balance in elderly subjects and young adults. Methods: Fifty-nine subjects were divided into three groups: ankle stability young group (SY), ankle instability young group (IY) and ankle stability older group (SO). We recruited three old subjects with ankle instability, but excluded them during a pilot testing due to the safety issue. DFROM was measured by weight bearing lunge test (WBLT) and dynamic balance was measured via star excursion balance test (SEBT) in anteromedial, medial, and posteromedial directions. The group differences in WBLT and SEBT and each group’s correlation between WBLT and SEBT were detected using the R statistical software package. Results: The dorsiflexion range of motion was significantly different between the SY, IY, and SO groups. The SO group showed the highest DFROM and IY group showed the lowest DFROM (SY: 45.88±.66˚, IY: 39.53±1.63˚, SO: 47.94±.50˚; p<.001). However, the SO group showed the lowest dynamic balance score for all SEBT directions (SY: 87.24±2.05 ㎝, IY: 83.20±1.30 ㎝, SO: 77.23±2.07 ㎝; p<.05) and there was no relationship between the dorsiflexion range of motion and dynamic balance in any group. Conclusion: Our findings suggest that ankle DFROM is not a crucial factor for dynamic stability regardless of aging and ankle instability. Other factors such as muscle strength or movement coordination should be considered for training dynamic balance. Therefore, we need to establish the rehabilitation process by measuring and treating ROM, balance, and muscle strength when treating young adults with and without ankle instability as well as elderly people.

Background: A limited hip rotational range of motion (ROM) has been considered to be one of characteristics of low back pain (LBP) in athletes. Although LBP frequently occurs in jiu-jitsu athletes, no previous has compared hip rotational ROM between jiu-jitsu athletes with and without LBP. Objects: The aim of the study was to compare ROM for hip internal rotation (IR) and external rotation (ER), and total hip rotation between jiu-jitsu athletes with and without LBP. Methods: Jiu-jitsu athletes were recruited for the LBP group (n1=15) and control group without LBP (n2=15). IR, ER, and total rotational range of hip joint were measured using a goniometer. Analysis of variance was used to compare the ROM between groups and sides. Results: The LBP group showed a significantly lower range of passive hip IR, passive total rotation, active IR, active ER, and active total rotation than the control group (p<.05). Dominant side of passive hip IR and active IR had a significantly lower ROM than non-dominant side (p<.05). In passive ER ROM, non-dominant side was significantly greater than dominant side (p<.05). Conclusion: Compared to jiu-jitsu athletes without LBP, athletes with LBP exhibit a loss of hip rotational ROM. Based on these results, clinicians and athletic trainers should measure hip rotational ROM when designing the management plan for jiu-jitsu athletes with LBP.

The purpose of this study was to examine the effects of the thoracic spine manipulation on spinal alignment (Cobb angle), pain, and trunk range of motion (ROM) in a patient with mild thoracic scoliosis. The Cobb angle was 11.0° and there was a right deviation of the thoracic spine. The subject had thoracic and lumbar pain, and had felt stiffness during turning of the trunk for about 3 years. Thoracic manipulation was applied at the upper thoracic spine as a therapeutic intervention three times per week for 5 weeks. After intervention, the Cobb angle decreased from 11.0° to 5.5° and the pain score decreased from 4.0 to 1.5, and the trunk left rotation ROM increased from 30.0° to 41.5°, and trunk right rotation ROM increased from 26.0° to 39.0°. These results suggest that the thrust thoracic manipulation technique had a positive effect on the spinal alignment, pain and trunk rotation ROM in patients with mild scoliosis.