[Purpose] To investigate effects of thoracic manipulation versus mobilization on chronic neck pain. [Methods] Thirty-nine chronic neck pain subjects were randomly assigned to single level thoracic manipulation, single level thoracic mobilization, or a control group. The cervical range of motion (CROM) and pain ratings (using a visual analog scale: VAS) were measured before, immediately after and at a 24-hour follow-up. [Results] Thoracic manipulation significantly decreased VAS pain ratings and increased CROM in all directions in immediate and 24-hour follow-ups. The thoracic mobilization group significantly increased in CROM in most directions at immediate follow-up and right and left rotational directions at the 24-hour follow-up. Comparisons between groups revealed the CROM for the manipulation group to increase significantly more than for control subjects in most directions at immediate follow-up and flexion, left lateral flexion and left rotation at the 24-hour follow-up. The CROM for the thoracic mobilization group significantly increased in comparison to the control group in flexion at immediate follow-up and in flexion and left rotation at the 24-hour follow-up. [Conclusion] The study demonstrated reductions in VAS pain ratings and increases in CROM at immediate and 24-hour follow-ups from both single level thoracic spine manipulation and thoracic mobilization in chronic neck pain.

BackgroundExercise is known to be an important component of treatment programs for individuals with neck pain. The study aimed to compare the effects of semispinalis cervicis (extensor) training, deep cervical flexor (flexor) training, and usual care (control) on functional disability, pain intensity, craniovertebral (CV) angle, and neck-muscle strength in chronic mechanical neck pain.MethodsA total of 54 individuals with chronic mechanical neck pain were randomly allocated to three groups: extensor training, flexor training, or control. A Thai version of the Neck Disability Index, numeric pain scale (NPS), CV angle, and neck-muscle strength were measured at baseline, immediately after 6 weeks of training, and at 1- and 3 -month follow-up.ResultsNeck Disability Index scores improved significantly more in the exercise groups than in the control group after 6 weeks training and at 1- and 3-month follow-up in both the exten-sor (P=0.001) and flexor groups (P=0.003, P=0.001, P=0.004, respectively). NPS scores also improved significantly more in the exercise groups than in the control group after 6 weeks’ training in both the extensor (P<0.0001) and flexor groups (P=0.029. In both exercise groups, the CV angle improved significantly compared with the control group at 6 weeks and 3 months (extensor group, P=0.008 and P=0.01, respectively; flexor group, P=0.002 and 0.009, respectively). At 1 month, the CV angle had improved significantly in the flexor group (P=0.006). Muscle strength in both exercise groups had improved significantly more than in the control group at 6 weeks and 1- and 3-month follow-up (extensor group, P=0.04, P=0.02, P=0.002, respectively; flexor group, P=0.002, P=0.001, and 0.001, respectively). The semispinalis group gained extensor strength and the deep cervical flexor group gained flexor strength.ConclusionThe results suggest that 6 weeks of training in both exercise groups can improve neck disability, pain intensity, CV angle, and neck-muscle strength in chronic mechanical neck pain.Trial registrationNCT02656030

BACKGROUND: In our digital society, the use of smartphones has increased rapidly. Parallel with the growing use of smartphones, musculoskeletal problems associated with intensive smartphone use have also increased. Neck flexion is the most commonly adopted posture by smartphone users while looking at the visual display terminals of smartphones for extended periods; this posture may lead to neck disorders. OBJECTIVE: The purpose of the current study was to investigate musculoskeletal disorders (MSDs) in smartphone users in Thailand in order to confirm high prevalence of neck pain. The study also aimed to determine all possible factors associated with neck disorders among smartphone users. METHODS: A cross-sectional survey study was conducted with 779 undergraduate smartphone users. A self-administered questionnaire was used to collect self-report measures of smartphone use and musculoskeletal disorders. Descriptive statistics were used to analyze participant characteristics and the prevalence of musculoskeletal disorders. Logistic regression analysis was used to identify associated factors. RESULTS: The most painful body region after the use of smartphones over a 12-month period was found to be the neck (32.50%). Factors associated with neck disorders were a flexed neck posture (Odds Ratio (OR): = 2.44, 95% Confidence Interval (CI) = 1.21-4.90) and smoking (OR 8.99, 95% CI 1.88-42.87). CONCLUSIONS: The results suggest that to address neck disorders in smartphone users preventive initiatives should focus on reducing flexed neck postures and smoking.

Abstract. [Purpose] To determine the therapeutic effects of core stabilization exercise in the treatment of patients with clinical lumbar instability.[Methods] Twenty subjects with clinical lumbar instability were randomly assigned to a treatment or control group. The treatment group received 10 weeks of core stabilization exercise (CSE), while the control group (CG) received 10 weeks of hydrocollator therapy and trunk stretching exercises. Pain intensity of the instability catch sign (ICS), functional disability, and trunk muscle activation patterns were measured before and at one day after 10 weeks of intervention.[Results] Both groups showed a significant reduction in pain intensity of ICS and reduced functional disability after 10 weeks of intervention; however, a significant improvement in the ratio activation of the transversus abdominis and internal oblique muscle relative to the rectus abdominis was only seen in CSE. In the comparison between groups, CSE showed significantly greater improvement in reduction of pain intensity during the ICS, significantly reduced functional disability, and significantly increased deep abdominal muscle activation after 10 weeks of intervention compared to CG.[Conclusion] The 10 weeks of CSE provided better therapeutic effects for pain intensity of ICS, reduced functional disability, and facilitated deep abdominal muscle activation of patients with clinical lumbar instability.

BackgroundThe aim of this study was to evaluate the efficiency of a simple prototype device for training respiratory muscles in lung function, respiratory muscle strength, walking capacity, quality of life (QOL), dyspnea, and oxidative stress in patients with COPD.MethodsThirty COPD patients with moderate severity of the disease were randomized into three groups: control (n=10, 6 males and 4 females), standard training (n=10, 4 males and 6 females), and prototype device (n=10, 5 males and 5 females). Respiratory muscle strength (maximal inspiratory pressure [PImax] and maximal expiratory pressure [PEmax]), lung function (forced vital capacity [FVC], percentage of FVC, forced expiratory volume in 1 second [FEV1], percentage of FEV1 [FEV1%], and FEV1/FVC), 6-minute walking distance (6MWD), QOL, and oxidative stress markers (total antioxidant capacity [TAC]), glutathione (GSH), malondialdehyde (MDA), and nitric oxide (NO) were evaluated before and after 6 weeks of training. Moreover, dyspnea scores were assessed before; during week 2, 4, and 6 of training; and at rest after training.ResultsAll parameters between the groups had no statistical difference before training, and no statistical change in the control group after week 6. FVC, FEV1/FVC, PImax, PEmax, QOL, MDA, and NO showed significant changes after 6 weeks of training with either the standard or prototype device, compared to pre-training. FEV1, FEV1%, 6MWD, TAC, and GSH data did not change statistically. Furthermore, the results of significant changes in all parameters were not statistically different between training groups using the standard and prototype device. The peak dyspnea scores increased significantly in week 4 and 6 when applying the standard or prototype device, and then lowered significantly at rest after 6 weeks of training, compared to pre-training.ConclusionThis study proposes that a simple prototype device can be used clinically in COPD patients as a standard device to train respiratory muscles, improving lung function and QOL, as well as involving MDA and NO levels.