• 국제물리치료학회지
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• 제3권2호
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• pp.413-421
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• 2012

Few studies address the use of manual muscle stretching to improve spinal active range of motion(AROM). There is evidence that' Hold-Relax'(HR) is effective for increasing ROM in the extremities, which leads the researchers to anticipate similar benefits in the spine. The purpose of this study is to investigate the effects of HR(trunk flexors) and active thoracic flexion and extension on thoracic mobility, specifically flexion and extension in healthy individuals. A convenience sample of 30 physical therapy students(22-38 years) were randomly assigned to intervention sequence 'A-B' or 'B-A', with at least 7 days between interventions. Intervention' A' consisted of HR of the ventral trunk musculature while 'B' consisted of thoracic flexion-extension AROM. Thoracic flexion and extension AROM were measured before and after each intervention using the double inclinometer method. Paired t-tests were used to compare AROM pre and post-intervention for both groups, and to test for carry-over and learning effects. There was a statistically significant increase(mean=$3^{\circ}$ ; p=0.006) in thoracic extension following HR of the trunk flexors. There were no significant changes in thoracic flexion following HR, or in flexion or extension following the AROM intervention. No carryover or learning effects were identified. HR may be an effective tool for improving AROM in the thoracic spine in pain free individuals. Further investigation is warranted with symptomatic populations and to define the minimal clinical difference(MCD) for thoracic spine mobility.

• 한방재활의학과학회지
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• 제18권1호
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• pp.163-172
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• 2008

Objectives : This study was performed to evaluate the effects of thoracic vertebral region's Du mai(督脈) and Jia ji xue(夾脊穴) intervention on active range of motion(ROM) restricted shoulder pain. Methods : 1. Measurement : The unpleasantness of pain was measured by visual analogue scale(VAS), and ROM was measured by using Goniometer and scratch test. 2. Intervention : Use Acupuncture and bee venom injection in thoracic vertebral region's Du mai(督脈) and Jia ji xue(夾脊穴) that display main tender points. Results : The pain and ROM were improved after thoracic vertebral region intervention. Conclusion : Thoracic vertebral region intervention was effective to active ROM restricted shoulder pain, to reduce the pain and to improve ROM. And this study shows that active ROM restricted shoulder pain and thoracic vertebral region's tender points are connected to each other. Also, region that suggest main tender points previews region of thoracic vertebrae 5-8.

• 한국전문물리치료학회지
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• 제26권4호
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• pp.53-62
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• 2019

Background: Shoulder function is achieved by the coordinated movements of the scapula, humerus, and thoracic spine, and shoulder disorders can be associated with altered scapular kinematics. The trunk plays an important role as the kinematic chain during arm elevation. Objects: The purpose of this study was to determine the effects of thoracic hyperkyphosis on scapular orientation and trunk motion. Methods: Thirty-one subjects (15 in the ideal thorax group and 16 in the thoracic hyperkyphosis group) performed right-arm abduction and adduction movements in an unconstrained plane. The scapular orientation and trunk motion were recorded using a motion analysis system. Results: Those subjects with thoracic hyperkyphosis displayed greater scapular posterior tilting at a $120^{\circ}$ shoulder elevation, greater scapular internal rotation throughout the arm raising phase, and greater trunk axial rotation at the upper ranges of the shoulder elevation, compared to those subjects with an ideal thorax (p<.05). Conclusion: Thoracic hyperkyphosis can cause scapular instability, greater trunk rotation and greater scapular posterior tilting, and may contribute to preventing the achievement of a full range of humeral abductions in an unconstrained plane.

• The Journal of Korean Physical Therapy
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• 제29권4호
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• pp.158-163
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• 2017

Purpose: The purpose of this study was to investigate the relationship among pain, range of motion of the neck, neck disability index and grip strength after thoracic manipulation and cervical stabilization training in patients with chronic neck pain. Methods: In this study, twelve subjects with chronic neck pain were included. All participants had thoracic manipulation and cervical stabilization training. Intervention was conducted three times per a week, for 4 weeks. The visual analogue scale (VAS), range of motion of neck, neck disability index (NDI), as well as the grip strength before and after intervention were measured in all participants. Paired t-test was used to compare variables before and after intervention. Pearson correlation analysis was used to identify the correlations between the variables. Results: All variables after the intervention were significantly improved. There was a significant negative correlation between VAS and flexion angle of the neck (r=-0.669, p<0.05). Moreover, there was a significant positive correlation between NDI and VAS (r=0.636, p<0.05), and a significant negative correlation between NDI and flexion angle of the neck (r=-0.692, p<0.05). Conclusion: Patients with reduced pain following therapeutic intervention illustrated that there would be an improvement in the flexion angle rather than the extension angle of the neck, and that those with increased flexion angle would have less restriction of activities in daily living.

• 대한정형도수물리치료학회지
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• 제22권1호
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• pp.17-25
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• 2016

Purpose: This study was aimed to determine the effects of thoracic spine thrust manipulation on muscle activities of the scapular upward rotators and middle deltoid, active range of motion (AROM), shoulder pain, and rounded shoulder posture in young adults with rounded shoulder. Methods: The subjects were 30 young adults (14 males, 16 females) with rounded shoulder. Thirty subjects were randomly assigned to an experimental (manipulation) and control (placebo) groups of fifteen subjects respectively. The manipulation group received the manipulation (high velocity, low amplitude), which was performed by a physical therapist with the subject in the supine position and with the arms crossed over the chest and hands passed over the shoulders. For the sham group, the same procedure was performed, with the exception that the high-velocity thrust was not applied. Measurements were taken before and after the intervention. Muscle activity of upper and lower trapezius, serratus anterior, middle deltoid was measured using surface electromyography. Visual analog scale (VAS) was used for shoulder pain. Goniometry was used for shoulder abduction active range of motion (AROM). Straight edge was used for supine rounded shoulder posture (RSP) distance. Results: The muscle activity of the upper trapezius, lower trapezius and middle deltoid muscle increased significantly after the intervention (p<.05). However, no significant difference was observed in serratus anterior muscle (p>.05). The VAS was significantly decreased and AROM significantly increased after the intervention (p<.05). The distance of RSP were not significant (p>.05). The control group showed no differences before and after the intervention (p>.05). Conclusion: The results of this study suggest that thoracic spine thrust manipulation can be an effective component of treatment plan to improve pain and function.

• 대한물리치료과학회지
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• 제31권2호
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• pp.15-29
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• 2024

Background: This study investigated the effects on the range of motion, pain, disability index, and quality of life when applying thoracic mobility exercise in middle-aged women with chronic back pain. Design: pretest-posttest control group design Methods: The study subjects were 32 patients with chronic back pain of 3 months or more among middle-aged women divided 2 groups. All groups were tested thrice a week for 30 minutes per session for four weeks. Each subject was evaluated using the thoracic rotation Range of Motion, the numerical pain rating scale and pressure pain threshold, Disability Index(Oswestry Disability Index), the Quality of Life(SF-36) before and after treatment. Results: As a result of the study, the range of motion at T1 and T2 of the exercise group to which thoracic mobility exercise was applied was significantly increased in both left and right rotations(p<0.05). In the evaluation of pain, the number pain rating scale(NPRS) score decreased significantly(p<0.05), and the pressure pain threshold was significantly increased (p<0.05), but there was no significant difference from the control group. In the evaluation of the disorder index, the Oswestry disorder index decreased significantly after the experiment (p<0.05), and there was a significant difference in group comparison with the control group (p<0.05). In quality of life, there was a significant increase in PCS of SF-36(p<0.05), but there was no significant difference from the control group. Conclusion: Through this study, thoracic mobility exercise can be used as an effective exercise therapy intervention method to improve and promote physical factors of range of motion, pain and disability index, and physical components of quality of life when treating middle-aged women with chronic back pain in the future.

• 대한물리의학회지
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• 제5권3호
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• pp.363-373
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• 2010

Purpose : The purpose of this study was to compare differences in thoracolumbar ranges of motions by comparing ratios among 4 type diagnosis for patient with chronic low back pain. Methods : The subjects were 58 chronic low back pain patients. A motion analysis program (Global Postural System) was used after photography for posture measurement. To analyze differences in mobility percentages and ratios of thoracolumbar ranges of motion, one-way ANOVA was used. Results : Regional difference spinal posture and movement were found to diagnosis patients with chronic low back pain. Comparison of thoracolumbar ranges of motion revealed significant differences in the thoracic region during forward-bending of the trunk (p<.05). In the upper thoracic region, the herniated intervertebral lumbar disc (HILD) group was significantly larger than the spinal stenosis/herniated intervertebral lumbar disc (SS/HILD) group (p<.05). In the lower thoracic region, chronic sprains (CS) were significantly greater than in the spinal stenosis (SS) group and in the (SS/HJLD) group (p<.05). Comparative analysis of thoracic/lumbar mobility ratio showed the CS group's ratio during forward bending was largest: 1.66, while the HILD group's ratio was smallest: 84 a significant difference between the two groups (p<.01). Diagnosis was not associated with difference in thoracolumbar backward-bending range of motion (p>.05). Conclusion : Theses results indicate the clinical efficacy of diagnosing for chronic low back pain by evaluating spinal mobility.

• 한국산학기술학회논문지
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• 제21권2호
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• pp.396-403
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• 2020

본 연구는 자가등 가동운동(STME, Self Thoracic Mobilization Exercise)이 어깨 기능장애 환자에게 어깨통증과 장애정도, 어깨의 기능에 미치는 영향을 알아보고자 하였다. 어깨 기능장애 환자 32명을 대상으로 무작위로 STME와 대조군으로 할당하였으며, 시각 상사척도와 어깨기능장애, 어깨의 가동범위 평가를 중재 전-후 실시하였다. 16명의 STME 중재 그룹은 폼롤러를 활용하는 방법과 네발자세에서 이용하여 굽힘, 폄을 자가로 실시하였고, 16명의 대조군은 전기치료 패드를 이용한 플라세보 효과를 활용하였다. 두 집단은 20분 동안 주당 3회를 4주간 실시하였다. STME군이 대조군 보다 통증과 기능장애에서 모두 유의한 향상을 보였으며(p<0.05), 어깨의 가동범위는 STME을 이용한 그룹이 플라세보 그룹 보다 굽힘, 벌림, 가쪽 돌림에서 유의한 효과를 보였다(p<0.05), 하지만 폄과 안쪽돌림에는 유의한 효과를 보이지 못했다(p>0.05). 따라서 STME은 어깨통증과 기능장애 해결에 효과적이며, 향후 어깨 통증 환자에게 보다 쉬운 접근방법의 중재방법을 교육하고 효과적인 치료를 할 수 있을 것이다. 나아가 사회적 치료비용 또한 경감시킬 수 있을 것이다.

• 한국전문물리치료학회지
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• 제27권1호
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• pp.1-10
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• 2020

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 self-mobilization exercise using a tool (tennis balls) is effective to improve neck pain, disability level, the ROM, and upper body posture.

• 산업융합연구
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• 제18권2호
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• pp.27-35
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• 2020

본 연구는 목뼈와 등뼈에 적용한 관절가동술이 전방머리자세를 가진 성인의 목통증, 목관절가동범위 및 균형에 미치는 영향을 알아보고자 실시되었다. 전방머리자세로 판명된 대학생 26명을 목뼈 관절가동술 그룹과 등뼈 관절가동술 그룹으로 13명 씩 무작위 배정하여 모든 대상자에게 각각 하루 10회, 1회당 30초 적용, 30초 휴식으로, 주 3회, 4주간 관절가동술을 적용한 후 변화를 비교하였다. 연구 결과, 통증과 관절가동범위에서 두 그룹 모두 유의한 효과가 있었고(p<.01), 그룹 간 비교에서는 유의한 차이가 없었다. 정적 균형의 그룹 내 변화에서 목뼈 관절가동술 그룹이 오른발 및 눈을 감았을 때 유의한 개선을 보였고(p<.05), 등뼈 관절가동술 그룹에서는 유의한 변화가 없었다(p<.05). 왼발 정적 균형은 두 그룹 모두 유의한 개선이 없었고(p<.05). 그룹 간 정적 균형의 비교에서도 유의한 차이가 없었다(p<.05). 동적 균형의 그룹 내 변화에서 목뼈 관절가동술 그룹이 앞쪽, 왼쪽, 오른쪽에서 유의한 개선을 보였고(p<.05), 등뼈 관절가동술 그룹이 앞쪽과 오른쪽에서 유의한 개선을 보였다(p<.05). 그룹 간 동적 균형에서는 왼쪽에서 유의한 차이가 나타났다(p<.05). 본 연구를 통하여 목뼈 및 등뼈 관절가동술은 전방머리자세 성인의 통증, 관절가동범위, 균형 능력에 대하여 유의한 효과가 있었다.