• Physical Therapy Korea
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• v.30 no.3
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• pp.184-193
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• 2023

Background: Studies investigating the immediate effects of a single intervention to correct forward head posture are rare. Objects: This study aimed to compare the changes in treatment effects in patients with forward head posture and neck pain after manual and self-exercise therapy over a 1-hour period. Methods: Twenty-eight participants were randomly divided into manual and self-exercise therapy groups. Following the initial evaluation, manual or self-exercise therapy was applied to each group for 30 minutes each in the prone, supine, and sitting positions. The variables measured were the craniovertebral angle (CVA), stress level, pain level, and sternocleidomastoid (SCM) stiffness. After the intervention, re-evaluation was conducted immediately, 30 minutes later, and 1 hour later. Two-way analysis of variance (ANOVA) was used to compare the maintenance of treatment effects between the two groups. Results: Based on the two-way mixed ANOVA variance, there was no interaction between the groups and time for all variables, and no main effects were found between the groups. However, a significant effect of time was observed (p < 0.05). Post hoc tests using Bonferroni's correction revealed that in both groups, the CVA, pain, and stress showed significant improvements immediately after the intervention compared with before the intervention, and these treatment effects were maintained for up to 1 hour after the treatment (p < 0.0083) in the manual therapy group. However, the stress level was maintained until 30 minutes later (p < 0.0083) in the self-exercise group. There was no significant decrease in right SCM stiffness before and after the intervention; however, left SCM stiffness significantly decreased after the self-exercise intervention (p < 0.0083). Conclusion: Both manual and self-exercise therapy for 30 minutes were effective in reducing forward head posture related to the CVA, pain, and stress levels. These effects persisted for at least 30 minutes.

• Journal of The Korean Society of Integrative Medicine
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• v.11 no.3
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• pp.195-204
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• 2023

Purpose : This study applied general training (control group) or cranio-cervical flexor training (experimental group) using a pressure biofeedback unit along with general training for 4 weeks to secondary school teachers with moderate to severe neck pain and forward head posture. After that, we tried to compare the effects through differences in neck pain intensity (using numberical rating scale), functional performance (using neck disability index), and cranio-vertebral angle change. Methods : All 50 subjects were randomly assigned to either the "experimental group (n= 25)" or the "control group (n= 25)", and the measurements were evaluated in the same way before the intervention (baseline) and after the intervention (4 weeks). During the intervention period, the subject visited the physiotherapy center and made a reservation three times a week at a fixed time as much as possible, and each training session was thoroughly conducted under the 1:1 guidance of the therapist in charge so that the correct movement and number of times could be performed without compensatory action. Results : As a result of the homogeneity analysis on the general characteristics of the subjects, there were no significant differences between the groups in all variables (p>.05). Compared to the "control group", the "experimental group" showed significant improvement after intervention in all measured variables of neck pain intensity, functional performance, and cranial-vertebral angle (p<.05). Conclusion : For secondary school teachers with forward head accompanied by neck pain, cranio-cervical flexor training using a compression biofeedback unit is an excellent method to show superior pain reduction and functional performance improvement compared to general training alone. In addition, it can be presented as a more effective intervention method that can promote recovery of forward head posture, which is an essential element of the solution.

• Physical Therapy Korea
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• v.19 no.3
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• pp.51-60
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• 2012

This study aimed to determine the usefulness of classifying patients with neck pain on the basis of the results of passive scapular elevation test. We classified 21 patients with neck pain into positive (n=12) and negative (n=9) groups on the basis of passive scapular elevation test; the 2 groups then equally performed scapular stabilization exercise program for 30 min, 3 times a week, for 4 weeks. Visual analogue scale (VAS), neck disability index (NDI), and range of motion (ROM) were recorded both before and after the intervention for both groups. Paired t-test was used to determine that there were significant changes between before and after the intervention, and independent t-test was used for analyzing changes between two groups of dependent variables. After 4 weeks of training, we observed significant decrease in pain and disability (p<.05) and a significant increase in rotation, flexion, extension, and side-bending ROM (p<.05) in both groups. Further, between pre- and post-intervention evaluations, we observed a significant decrease in pain and disability and a significant increase in rotation and flexion ROM in the positive group than in the negative group (p<.05). These results indicate that passive scapular elevation test may be used to identify mechanical disorders of the cervicoscapular muscle in patients with neck pain. Therefore, we recommend the use of passive scapular elevation test to determine appropriate treatment intervention when treating patients with neck pain.

• PNF and Movement
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• v.20 no.2
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• pp.203-214
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• 2022

Purpose: We investigated the effects of multimodal vs. stabilization exercises on chronic low back pain. Methods: Study participants were randomly assigned to a multimodal exercise (n = 20) or a stabilization exercise group (n = 20). Participants in the multimodal exercise group performed stabilization, stretching, and endurance exercises, whereas those in the stabilization exercise group performed only stabilization exercises. Participants in both groups performed the exercises for 1 hour thrice a week for 5 weeks. The following outcomes were evaluated: pain intensity (numeric rating scale), disability (the Oswestry Disability Index [ODI] and the Roland-Morris Disability Questionnaire [RMDQ]), pain-induced fear (the Fear of Daily Activities Questionnaire [FDAQ], the Fear-Avoidance Belief Questionnaire [FABQ], and the Tampa scale for kinesiophobia-11 [TSK-11]). Outcome measures were evaluated at baseline and after intervention. Results: Significant post-intervention improvement was observed in pain intensity and the RMDQ and FDAQ scores in both groups (p < 0.01). The post-intervention ODI, FABQ, and TSK-11 scores were improved in the multimodal exercise group (p < 0.01). Additionally, significant differences were observed in pain intensity, as well as in the ODI, FDAQ, and FABQ scores in the multimodal exercise group compared with these findings in the stabilization exercise group (p < 0.01). Conclusion: The multimodal and stabilization exercise programs reduced pain intensity, disability, and pain-induced fear. Compared with stabilization exercises, multimodal exercises more effectively reduced pain intensity, disability, and pain-induced fear. This study highlights that musculoskeletal rehabilitation for people with chronic low back pain should include a multimodal exercise program.

• Physical Therapy Rehabilitation Science
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• v.12 no.2
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• pp.177-184
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• 2023

Objective: Manual therapy is a commonly utilized approach in managing chronic pain, but its specific impact on pain catastrophizing remains uncertain. The objective of this systematic review and meta-analysis was to examine the effects of manual therapy on pain catastrophizing in individuals with chronic pain. Design: A systematic review and meta-analysis Methods: A comprehensive search was conducted in electronic databases to identify relevant studies published from 2014 onwards. Studies that evaluated the impact of manual therapy on pain catastrophizing in individuals with chronic pain were incorporated. The risk of bias in the selected studies was evaluated using the Cochrane tool for risk of bias in qualitative analysis. For the quantitative analysis, RevMan 5.4 software was utilized, employing a random-effects model as the analysis model. The effect measure used in the analysis was the standardized mean difference (SMD). Results: In total, 26 studies were collected, and following the screening process, three of them were incorporated into the final analysis. The included studies involved a total of 153 patients with chronic pain. The interventions comprised various manual therapy techniques targeting different areas of the body. Pain catastrophizing and pain intensity were the primary outcomes of interest. The meta-analysis revealed a significant reduction in pain catastrophizing scores following manual therapy intervention compared to control conditions (SMD = -0.91, 95% CI: -1.25 to -0.58). However, heterogeneity between the studies was observed. Conclusions: Despite the limited quantity and heterogeneity of studies, it has been demonstrated that manual therapy intervention is effective in reducing pain catastrophizing in individuals with chronic pain.

• Child Health Nursing Research
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• v.17 no.3
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• pp.190-197
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• 2011

Purpose: The purpose of this study was to identify factors influencing neonatal pain management by nurses in order to provide evidence-based data for the development of more efficient neonatal pain care programs. Methods: This study used a descriptive research design to survey 204 registered nurses working in neonatal intensive care units and nurseries in Busan. Data collection was done from July to September 2010. General knowledge of pain and pain scale, pain intervention, neonatal pain management, and barriers to pain management were measured. Data were analyzed using stepwise multiple regression with SPSS 17.0. Results: it was found that among the factors affecting neonatal pain management by nurses, the unit where the nurse worked was the most important influential factor, followed by knowledge of pain management, education level, and barriers from medical personnel in that order. The explanatory power of these four variables accounted for 42.0% of neonatal pain management. Conclusion: Study results indicate that it is necessary to develop education programs to increase knowledge of neonatal pain management for nurses caring for neonates. Also, plans for reduction of obstacle factors in medical personnel should be prepared.

• The Korean Journal of Pain
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• v.28 no.4
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• pp.254-264
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• 2015

Background: Pain medicine often requires medico-legal involvement, even though diagnosis and treatments have improved considerably. Multiple guidelines for pain physicians contain many recommendations regarding interventional treatment. Unfortunately, no definite treatment guidelines exist because there is no complete consensus among individual guidelines. Pain intervention procedures are widely practiced and highly associated with adverse events and complications. However, a comprehensive, systemic review of medical-dispute cases (MDCs) in Korea has not yet been reported. The purpose of this article is to analyze the frequency and type of medical dispute activity undertaken by pain specialists in Korea. Methods: Data on medical disputes cases were collected through the Korea Medical Association mutual aid and through a private medical malpractice liability insurance company. Data regarding the frequency and type of MDCs, along with brief case descriptions, were obtained. Results: Pain in the lumbar region made up a major proportion of MDCs and compensation costs. Infection, nerve injury, and diagnosis related cases were the most major contents of MDCs. Only a small proportion of cases involved patient death or unconsciousness, but compensation costs were the highest. Conclusions: More systemic guidelines and recommendations on interventional pain management are needed, especially those focused on medico-legal cases. Complications arising from pain management procedures and treatments may be avoided by physicians who have the required knowledge and expertise regarding anatomy and pain intervention procedures and know how to recognize procedural aberrations as soon as they occur.

• The Journal of Korean Physical Therapy
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• v.18 no.6
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• pp.59-65
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• 2006

Purpose: This study was to investigate the effects of rehabilitation exercise program on the muscle strength and pain in elderly with knee osetoarthritis. The progressive rehabilitation program included flexibility, strength, endurance, and active range of motion exercise and functional activities. Methods: Nineteen subjects with osteoarthritis of the knees randomized to exercise group(n=10) or control group(n=9), but fourteen subjects completed the trial with an adherence of 70% to the intervention and 77% to the control. The knee pain with VAS and quadriceps strength were evaluated at pre- and post-intervention. Results: The data were analysed with the two-way repeated ANOVA and paired t-test. The pain and quadriceps muscle strength had no difference among the groups and times. Within experimental group, pain was significantly decrease and quadriceps muscle strength significantly increased between pre and post intervention, while the control group showed no changes. Conclusion: Rehabilitation exercise program for knee osteoarthirits appear to be effective in knee pain and quadriceps muscle strength.

• Journal of the Korean Society of Physical Medicine
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• v.15 no.1
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• pp.25-32
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• 2020

PURPOSE: This study examined the efficacy of an interferential current (IFC) treatment on the improvement of pain, disability, and quality of life in stroke patients with lumbago. METHODS: A double-blind, randomized clinical trial was conducted on 40 stroke patients with lumbago. The patients were allocated randomly into two groups: the IFC treatment group (n= 20) and the placebo treatment group (n= 20). The IFC group received 30 minutes of IFC treatment on the lumbar region, while the placebo group received IFC treatment but without real electrical stimulation. The intervention was administered five days a week for four weeks. The primary outcomes of pain intensity were measured using a visual analogue scale. The secondary measurements included the Barthel Index, Oswestry Disability Index (ODI), and health-related quality of life (HRQoL). RESULTS: The measurements were conducted before and after the two-week intervention period. Compared to the placebo treatment group, the IFC treatment group showed significantly greater improvement in the pain intensity (p<.05), ODI (p<.05), and SF-36 (p<.05) at the end of the intervention. No significant differences in the Barthel Index were found between the two groups. CONCLUSION: These findings show that an IFC treatment can improve pain, functional ability, and quality of life, highlighting the benefits of somatosensory stimulation from IFC in stroke patients with lumbago.

• PNF and Movement
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• v.18 no.1
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• pp.117-126
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• 2020

Purpose: The purpose of this study was to investigate the effects of extracorporeal shock-wave therapy (ESWT) on pain, grip strength, and upper-extremity function in patients diagnosed with lateral epicondylitis and to provide an effective intervention method for lateral epicondylitis. Methods: Twenty patients with lateral epicondylitis were randomly assigned to the ESWT group (n = 10) and the stretching exercise group (n = 10). Interventions in both groups were performed six times twice a week for three weeks. The visible analog scale (VAS) was used to measure pain change. A dynamometer was used to measure grip strength (GS). Patient-rated tennis elbow evaluation (PRTEE) was used to measure the upper-extremity function. Results: There were significant differences in pain, grip strength, and upper-extremity function in both groups before and after intervention (p < 0.05). There were also significant differences in pain, grip strength, and upper-extremity function between the groups after intervention (p < 0.05). Conclusion: This study showed very positive improvement in pain, grip strength, and upper-extremity function after ESWT in patients with lateral epicondylitis. Therefore, ESWT can be recommended for patients with lateral epicondylitis.