• Journal of International Academy of Physical Therapy Research
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• v.9 no.2
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• pp.1513-1516
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• 2018

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 $40^{\circ}$. 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.

• Journal of International Academy of Physical Therapy Research
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• v.8 no.2
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• pp.1201-1205
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• 2017

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 $70{\underline{\circ}}$ to $4.0{\underline{\circ}}$). 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.

• Physical Therapy Korea
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• v.27 no.1
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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.

• Journal of the Korean Society of Physical Medicine
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• v.7 no.4
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• pp.509-514
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• 2012

PURPOSE: This study aims to compare the effects of upper backbone joint mobilization and self-stretching exercise in the patients with chronic neck pain. METHODS: Thirty seven patients with chronic neck pain were divides into self stretching group(SSG, n=18) and mobilization group(MG, n=19). To assess the degree of neck pain, the visual analog scale (VAS) was utilized, and to measure the joint range of motion at the flexion-extension, it was compared and analyzed by using the cervical range of motion (CROM) device. RESULTS: The joint range of motion and visual analog scale of SSG and MG showed significant effects on both groups. In the comparison of groups, there was no significant difference, but it indicated effects on improving the pain and the range of joint motion in MG. CONCLUSION: According to the analysis, not only self-stretching exercise intervening for direct treatment but also upper backbone joint mobilization intervening for indirect treatment are effective to improve the pain and the range of motion.

• PNF and Movement
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• v.20 no.3
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• pp.371-381
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• 2022

Purpose: Forward head posture (FHP) is known to cause pain, limit range of motion, and reduce quality of life. Joint mobilization is commonly used to correct FHP. However, no study has compared cervical, thoracic, and combined cervical and thoracic joint mobilization for FHP. The aim of this study was to investigate and compare the effects of each mobilization technique on range of motion in the sagittal plane and pain in patients with FHP. Methods: Forty-five patients were recruited and randomly divided into three groups: the mobilization group (CM; n = 15), the cervical and thoracic mobilization group (CTM; n = 15), and the thoracic mobilization group (TM; n = 15). Each intervention was performed in sets of three and repeated six times. Range of motion and pain were assessed pre- and post-intervention. The cervical range of motion was evaluated using a goniometer, and pain was evaluated using a visual analogue scale and pain thresholds of the suboccipital and upper trapezius muscles. Results: All groups showed an increase in range of motion post-intervention, but the increase in the CTM group was significantly greater than in the CM and TM groups (p < 0.05). Pain measured using the visual analogue scale decreased in all groups, but the decreases in the CM and CTM groups were significantly greater than in the TM group (p < 0.05). The pain thresholds of the suboccipital and upper trapezius muscles increased in all groups, but the increase in the CTM group was significantly greater than in the CM and TM groups (p < 0.05). Conclusion: Overall, our findings suggest that CTM may be more effective than CM or TM for improving cervical range of motion in the sagittal plane and pain in patients with FHP.

• Journal of Korea Entertainment Industry Association
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• v.13 no.6
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• pp.257-264
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• 2019

The purpose of this study was to investigate effective intervention(upper thoracic mobilization and upper cervical mobilization) methods for forward head posture. 32 subjects were divided into two groups: upper thoracic mobilization(UTM) and upper cervical mobilization(UCM) on three times a week for a total of four weeks. In both groups significant difference in forward head posture pre and post test(p <.01), significant difference between the two groups (p <.05, 95% CI: .157-.341). In both groups significant difference in neck disability index pre and post test(p <.01), significant difference between the two groups (p <.01, 95% CI: 1.273-8.728). In both groups significant difference in quality of life pre and post test(p<.05), significant difference between the two groups (p <.01, 95% CI: 4.234-18.391). The results of this study showed that the UTM was more effective than that of the forward head posture. It would be possible to provide more effective interventions for patients with forward head posture and also to prevent secondary musculoskeletal disorders due to forward head posture.

• Physical Therapy Korea
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• v.25 no.4
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• pp.37-45
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• 2018

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 ($FEV_1$), peak expiratory flow (PEF), forced expiratory flow 25~75% ($FEF_{25{\sim}75%}$), 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, $FEV_1$, PEF, $FEF_{25{\sim}75%}$ (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, $FEV_1$, PEF, $FEF_{25{\sim}75%}$, and chest wall expansion in patients with chronic LBP.

• Journal of the Korean Society of Radiology
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• v.9 no.7
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• pp.479-486
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• 2015

This study was conducted to investigate the effects of upper thoracic joint mobilization technique using Kaltenborn-Evjenth concept on the range of cervical and thoracic motion and pain in patients with chronic neck pain. The subjects were divided into a thoracic joint mobilization group(n=7) and a conservative physical therapy group(n=7). Each of the groups received thoracic joint mobilization or conservative physical therapy three times a week lasted for four weeks. The measurements were performed for the range of thoracic segmental motion(SpinalMouse), the pain(visual analogue scale) and the range of cervical joint motion(Inclinometer, Dualer IQ). They were made four times: before experiment, at 2weeks, 4weeks, and 4weeks after experiment.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.29 no.1
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• pp.11-23
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• 2023

Purpose: This study aimed to determine the effects of cervico-thoracic (C-T) mobilization technique and therapeutic exercise on muscle activity, craniovertebral angle (CVA), and neck disability index (NDI) in patients with neck pain. Methods: : A total of 30 patients with neck pain were included and divided into C-T mobilization combined with Pilates group (Experimental group; EG) and thoracic mobilization and self-exercise (Control group; CG) group; each group consisted of 15 patients. The exercises were performed by patients in both groups three times a week, for four weeks. NDI was used to measure functional disability and sEMG was used to measure muscle activity. Results: The EG participants showed significant improvement in the CVA and NDI after the intervention than the CG (p<.05). While both groups presented after intervention decreased muscle activity(upper trapezius), there were no statistically significant differences between the groups (p>.05). Conclusion: The findings of this study suggest that thoracic mobilization technique combined with Pilates exercise may have beneficial effects on CVA and NDI in patients with neck pain and forward head posture.

• Physical Therapy Rehabilitation Science
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• v.12 no.3
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• pp.310-319
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• 2023

Objective: The purpose of this study was to investigate the effects of a combination of progressive scapular stabilization exercises, neck and thoracic spine mobilization, and thermoelectric physical therapy on pain, range of motion, muscle strength, and function in patients with acute whiplash injury. Design: A randomized controlled trial design. Methods: A total of 24 subjects were included in this study. They were randomly assigned to an experimental group (n=12) that performed scapular stabilization exercises, neck and thoracic spine mobilization, and physiotherapy, and a control group (n=12) that only performed neck and thoracic spine mobilization and physiotherapy. The pre-test was conducted before the intervention and consisted of a total of 12 treatment sessions of 60 minutes each, three times a week. A posttest was conducted 4 weeks later. Pain, range of motion, muscle strength, and function were assessed before and after intervention. Results: The results of the study showed that there was a significant difference in pain reduction and range of motion and muscle strength improvement in the experimental group, and a significant difference was also found between the experimental group and the control group in terms of functional evaluation. Conclusions: The combination of exercise therapy and joint mobilization technique and physical therapy resulted in greater improvements in pain, range of motion, strength, and function assessment, contributing to improved overall function.