Objectives : To evaluate the effectiveness of Chuna Manual Therapy for adhesive capsulitis by a systematic review manner. Methods : Five foreign electronic databases (Pubmed, Ovid-medline, Embase, Cochrane library, Chinese Academic Journals (CAJ)) and two Korean medical electronic databases (Oriental Medicine Advanced Searching Integrated System (OASIS) and Research Information Sharing Service (RISS)) were searched to find all randomized controlled trials (RCTs) using Chuna Manual Therapy as a treatment for adhesive capsulitis. The methodological quality of each RCT was assessed using the Cochrane risk of bias tool. Results : Twenty-one RCTs met our inclusion criteria. The meta-analysis showed positive results on the use of Chuna Manual Therapy combined with acupuncture or exercise therapy in terms of the efficacy rate and pain using the Visual Analogue Scale (VAS), compared to acupuncture or exercise alone [SMD-1.81 (95% CI & -2.54, -1.08), P<0.001, RR 1.19 (95% CI 1.14, 1.23), P<0.001)]. Positive results in terms of efficacy rate were also obtained comparing Chuna Manual Therapy to acupuncture alone [RR 1.10 (95% CI 1.02, 1.18), P=0.01]. Conclusions : Our systematic review found favorable results on the effectiveness of Chuna Manual Therapy for pain and efficacy rate of adhesive capsulitis. However, evidence was limited due to the lack of well-designed RCTs. More qualified clinical trials are needed to obtain stronger evidence.

Objectives : This study aimed to systematically and comprehensively review controlled clinical trials on the effectiveness and safety of Chuna Manual Therapy for stroke. Methods : By October 7, 2019, three core databases and three domestic databases were searched. Seven major academic journals on the related field were also hand-searched. Methodological quality of the included studies was evaluated using the Cochrane risk of bias tool. Meta-analysis was conducted and the quality of its evidence was assessed using the GRADE methodology. Results : Five articles met the eligibility criteria. The results of most of included studies were in favor of Chuna Manual Therapy. No study described any adverse events during or after the clinical trials. Meta-analysis of three eligible studies showed that the pre- and post-treatment scores on the Modified Barthel Index (mean difference 8.00, 95% confidence interval 0.26 to 15.74) and Berg Balance Scale (mean difference 3.57, 95% confidence interval 0.64 to 6.51) of the Chuna-treated group were significantly different, but only marginally higher than those of the non-treatment group. Thus, the level of evidence gathered from these studies was assessed to be low. Conclusions : Based on current available evidence, any confirmative conclusions cannot be made on the effectiveness and safety of Chuna Manual Therapy for stroke because of the small sample size, low methodological quality, presence of statistical heterogeneity, and missing safety information. More rigorously designed large-scale multi-center studies are needed to establish more specific and credible evidence to support or oppose the use of Chuna Manual Therapy for stroke.

Objectives : This study aimed to review the effects of Daoyin exercise on stroke patients in clinical studies. Methods : In this study, we reviewed 11 electronic databases (CAJ, EMBASE, Cochrane Library, Web of Science, Pubmed, RISS, Dbpia, NDSL, KISTI, KISS, KMBASE) on October 27, 2019. We included only randomized controlled trials (RCTs) which evaluated the effect of Daoyin exercise on stroke patients. The methodological quality of the included studies was checked using the Cochrane risk of bias tool. Results : After screening the papers, eleven RCTs fulfilled the inclusion criteria. The results of the meta-analysis showed that Daoyin exercise improves the measurement value on the Fugl-Meyer Assessment, Modified Barthel Index and National Institutes of Health Stroke Scale in stroke patients. Conclusions : We concluded that Daoyin exercise has therapeutic effects in functional recovery and in enhancing the independence of daily living activities for stroke patients. However, the quality of the original articles was low and the number of papers included were few. Thus, to confirm these results, further well-designed RCTs should be conducted.

Objectives : The purpose of this study was to assess the use of Korean medicine for treating radial nerve palsy. Methods : We searched for studies on the use of Korean medicine for the treatment of radial nerve palsy in 7 electronic databases and analyzed these studies. Results : We found 95 studies on radial nerve palsy from 7 electronic databases. We excluded 77 duplicate studies, 1 review article and 2 studies published before 2000. As a result, 15 case studies(36 patients) were included. Acupuncture(15 times), electroacupuncture(6 times), pharmacopuncture(9 times), herbal medicine(11 times), physical therapy(10 times), moxibustion(3 times), cupping therapy(1 time), chuna manual therapy(1 time) and yinyang balancing appliance(1 time) were used. LI11 for acupuncture, LI4, LI11 for electroacupuncture, bee venom as pharmacopuncture material and LI4, LI10, LI11 in pharmacopuncture point, Boik-tang gami as herbal medicine, hot pack for physical therapy, LI4, LI11 for moxibustion were the most frequently used. Conclusions : Korean medicine treatment for radial nerve palsy has been performed in various ways. However, we found limited evidence regarding Korean medicine for radial nerve palsy. Thus, we think various types of studies including more case reports, for radial nerve palsy should be performed in the future.

Objectives : The aim of this study was to report the improvements in pain that a woman experienced after receiving Korean medicine treatments for the pain associated with core decompression surgery due to avascular necrosis (AVN) of both femur heads. Methods : The patient was diagnosed as having AVN in both femur heads and underwent core decompression surgery. After operation, she had pain on her right inguinal region and her range of motion (ROM) was restricted. She was treated with Korean medicine including, herbal medicine, acupuncture, Chuna Manual Therapy and bee venom acupuncture (BV). This study was measured by using the Visual Analogue Scale (VAS) and the ROM scale. Results : After conservative treatment, the patient's pain was reduced and ROM was increased. Daily living quality had improved. Conclusions : In this case, Korean conservative medicine therapy with Chuna Manual Therapy had a positive effect on the symptoms after core decompression surgery due to avascular necrosis of the femur head.

Objectives : The purpose of this study was to explore the effectiveness of Korean medicine treatment and the Muscle Energy Technique on foot drop through a case study with a patient with common peroneal neuropathy. Methods : A patient with severe foot drop after an ankle sprain was hospitalized and treated with acupuncture and traditional medicine and the Muscle Energy Technique. The effect of the treatment was evaluated with the Numeric Rate Scale(NRS), dorsiflexion angle evaluation, and the Manual Muscle Test (MMT). Results : The results of the NRS, dorsiflexion angle evaluation and MMT showed greatly improvementwith results changing from 8 to 2, 0 to 15, and Grade 2 to Grade 4, respectively. Conclusions : This study suggests that Korean medicine treatment and the Muscle Energy Technique could be effective treatments for foot drop with common peroneal neuropathy. However further clinical studies are needed to establish a definite conclusion.

Objectives : The purpose of this study was to show the effectiveness of Chuna Manual Therapy applied to a osteoporosis patient with gait disturbance due to lower limb fracture surgery. Method : We focused on Chuna therapy accompanied with acupuncture, herbal medicine, moxibustion, cupping treatment and rehabilitation exercise. This case was assessed using the Visual Analogue Scale (VAS), Pain Free Walking Distance (PFWD), Berg Balance Scale (BBS), and Modified Barthel Index (MBI). Result : This patient showed improvement on the VAS from 6 to 3, PFWD from 0 m to 2000 m using a walker and 50 m by self-walking, BBS from 2 to 28, and MBI from 56 to 89. Moreover the walking state improved from gait disturbance to self-walking. Conclusion : This study suggests that Chuna therapy could be used to improve gait disturbance in patients with osteoporosis and lower limb fracture surgery.

Objectives : The purpose of this report was to introduce 3 cases of patients diagnosed with both medial collateral ligament tear and meniscal tear that showed clinical improvement after Korean medicine treatment. Methods : These patients received Korean herbal medicine, pharmacopuncture treatment, and acupuncture treatment. We assessed these cases by using the Numeric Rating Scale (NRS), Western Ontario and McMaster Universities'Arthritis Index (WOMAC), and the European Quality of Life-5 Dimension Index (EQ-5D). Results : After Korean medicine treatment, most of the NRS, WOMAC, and EQ-5D scores showed improvement on every discharge date of these 3 cases. The NRS and WOMAC scores of all cases showed a decrease. The EQ-5D of all cases showed an increase. Conclusions : Through this research, we concluded that Korean medicine treatment can be helpful in relieving pain and improving the quality of life and function of knee joint movement in patients with medial collateral ligament tear and meniscal tears.

Objectives : The purpose of this study was to report five patients with a sternum fracture after a traffic accident who improved with a combination of Korean medicine treatments. Methods : We collected data of traffic accident patients with a sternum fracture who were admitted to Dae-Jeon Jaseng Korean Medicine Hospital from March 2019 to September 2019. We observed five cases of patients treated with acupuncture, pharmacoacupuncture, herbal medicine, and Korean physical therapy. We measured the validity of the treatments using the Numeric Rating Scale (NRS) and European Quality of Life-5 Dimension (EQ-5D) at admission, at two weeks, and on the discharge date of hospitalization. Results : Following treatment using a combination of the above mentioned methods, the general overall condition of the patients had significantly improved. Furthermore, the NRS and EQ-5D scores were numerically better. Conclusions : After the combination of Korean medicine treatments, results from five patients with a sternum fracture after a traffic accident suggested that the treatments were effective. However, the number of subjects was insufficient and individual efficacy was not measured in this study. Therefore, further studies are needed on this topic.

Objectives : The purpose of this clinical study was to evaluate the effect of spinal decompression with Korean medicine treatment on the herniation of an intervertebral disc (HIVD) in a patient after fusion surgery of a cervical segment. Methods : A single patient was treated with spinal decompression, acupuncture, pharmacoacupuncture, and herbal medication. We measured the Numerical Rating Scale (NRS), Neck Disability Index (NDI), European Quality of Life-5 Dimension (EQ-5D), Cervical Range of Motion (cervical ROM) and the Beck Depression Inventory (BDI) score to evaluate the treatment effects. Results : The patient's post neck pain & pain in both arms improved significantly as suggested by the scores on the NRS, NDI, EQ5D, cervical ROM and BDI. Conclusions : Thus, spinal decompression, including Korean medicine treatment, could be taken into consideration for HIVD patients after fusion surgery.

Objectives : The purpose of this study was to analyze the clinical application status in papers related to Chuna Manual Therapy after musculoskeletal disorder surgery. Methods : We searched 6 electronic databases(RISS, DBpia, KISS, NDSL, OASIS, Pubmed) and 2 associated journals (Korea CHUNA Manual Medicine for Spine & Nerves, Korean Medicine Rehabilitation). We classified the papers by related musculoskeletal region and analyzed them in detail. Results : 1. Of the 24 papers included in the final analysis list, 13 were carried out for fascia and 18 for joints. 2. There were positive effects on the improvement of symptoms, including the relief of pain in patients, and there were no cases of severe side effects and adverse events. 3. Thus, CMT can be used as a safe and effective treatment if a skilled practitioner makes proper use of the follow-up procedure based on accurate judgment of the patient's postoperative condition. Conclusions : Through this paper, we expect that there will be active research on the clinical applications of Chuna Manual Therapy in Korean rehabilitation treatment after musculoskeletal disorder surgery.

Objectives : There are many theories about the anatomical relationships between the thoracic spinous and transverse processes. However, these studies were all conducted on cadavers. Thus, there might be differences when applied to living individuals. Therefore, the aim of this study was to determine whether the theories were similar when measured in living individuals. Methods : We conducted studies with 10 individuals aged 20-30 using 3D-CT. Four different measurements were taken between the thoracic spinous and transverse processes. To facilitate the relationship analysis, the spinous process positioned between the traverse process of the segment and the lower segment was set to 0.5. The spinous process located at the height of the traverse process of the lower segment was set to 1. The spinous process located between the traverse process of the lower segment and the two segments below was set to 1.5. Results : Therefore, based on the aforementioned settings, T1-T4 were 1, T5-T7 were 1.5, T8-T10 were 1, and T11 and T12 were 0.5. This indicated that the spinous processes of T1-T4 and T8-T10 were equal in height to the transverse processes of the lower segment, and that T5-T7 were at the midpoint of the height of the transverse processes between the lower segment and two segments below, and T11, T12 corresponded to the midpoint between the traverse process of the segment and the lower segment. Conclusions : Neither 'Geelhoed's rule'nor 'the rule of three'was accurate when applied to living individuals. However, this study had some limitations, so further research is needed.

Objectives : This study aimed to report the evidence of difficulty, safety, and frequency of the use of Chuna Manual Therapy. Methods : The survey questions were developed using the consensus from a professor who majored in Rehabilitation Medicine of Korean Medicine (RMKM). November 26th to December 31st 2018, the questionnaire was given to education training members of the Korean Society of Chuna Manual Medicine for Spine & Nerves by paper. Twenty-nine(23%) of the questionnaires were retrieved. Difficulty, safety, and frequency of the use of Chuna Manual Therapy were reported based on the questionnaire. Results : In this study, the more difficult techniques were observed to be less safe. In particular, the adjustment techniques applied to the cervical and lumbar spine was answered with high difficulty. Although these techniques are high difficulty and low safety, the reason for its versatility also suggests that the technique has a high therapeutic effect and necessity. Conclusions : This is the first consensus on experts'opinions on Chuna Manual Therapy for education. We hope that this report is helpful for Korean medicine doctors who operate technique and expected to make clinical evidence of Chuna Manual Therapy.