Manipulative therapies and exercises are commonly used for the management of chronic ankle instability (CAI), but there is no evidence regarding the efficacy of high-velocity low-amplitude manipulation (HVLA) in addition to ankle therapeutic exercise to improve CAI in adolescent baseball players (ABP). To compare the effects of HVLA plus ankle therapeutic exercise and ankle therapeutic exercise alone on ankle status, pain intensity, pain pressure threshold (PPT), range of motion (ROM) of the ankle joint, and balance ability in ABP with CAI, a single-blinded randomized controlled trial was conducted. A total of 31 ABP with CAI were randomly allocated to the intervention (n = 16) or control (n = 15) groups. The intervention group received HVLA plus resistance exercise twice a week for 4 weeks, while the control group received resistance exercise alone. Ankle status, pain intensity, PPT, ROM, and balance ability were assessed before and after the intervention. The American Orthopedic Foot and Ankle Society scores showed significant group and time interactions (total, p = 0.002; pain, p < 0.001; alignment, p = 0.001). There were significant group and time interactions in pain intensity (resting pain, p = 0.008; movement pain, p < 0.001). For ROM, there were significant group and time interactions on dorsiflexion (p = 0.006) and eversion (p = 0.026). The unipedal stance of the balance ability showed significant group and time interactions in path length (p = 0.006) and velocity (p = 0.006). Adding HVLA to resistance exercises may be synergistically effective in improving the ankle status, pain intensity, ROM, and balance ability in ABP with CAI.

Female caregivers of people with disabilities are burdened physically and mentally. To improve these symptoms, an intervention that is easy to apply and has fewer side effects, such as natural healing, has been proposed, but the effect of healing using marine resources is unclear until now. The purpose of this study is to investigate the effect of meditation accompanied with stabilization exercise in the marine region on the improvement of pain, tactile sense, muscle characteristics, muscle strength, balance, quality of life, and depression in female caregivers of people with severe physical disabilities. Twenty-four female family caregivers were recruited and were randomly assigned to the marine therapy group (MTG, n = 12) and the control group (CG, n = 12). Both groups performed the same meditation (35 min) and stabilization exercise (25 min) twice a day for 3 nights and 4 days per session (total 8 sessions). The MTG performed these in the marine region, whereas the CG performed the interventions in the urban region. Pain (pain intensity and pain pressure threshold), tactile sense (tactile spatial acuity), muscle characteristics (stiffness, elasticity), muscle strength (hand and pinch grip strength), balance, quality of life, and depression were measured before and after the intervention and 4 weeks after the intervention. Both groups showed significant improvements in pain intensity (resting pain: f(2) = 72.719, p < 0.001; movement pain: f(2) = 24.952, p < 0.001), muscle strength (right pinch grip: f(2) = 15.265, p < 0.001), and depression (f(2) = 13.312, p < 0.001), while tactile spatial acuity (TSA) (upper part: f(2) = 14.460, p < 0.001; lower part: f(2) = 7.672, p = 0.002), dynamic balance (f(2) = 4.196, p = 0.024), and quality of life (overall quality of life & general health: f(2) = 5.443, p = 0.009; physical health: f(2) = 13.991, p < 0.001; psychological: f(2) = 9.946, p < 0.001; environmental: f(2) = 20.004, p < 0.001; total: f(2) = 11.958, p < 0.001) were significantly improved only in MTG. There was no significant change in pain pressure threshold (upper trapezius (UT): f(2) = 0.765, p = 0.473; levator scapula (LS): f(2) = 0.213, p = 0.809; splenius capitis (SC): f(2) = 0.186, p = 0.831) and muscle characteristics (UT stiffness: f(2) = 1.486, p = 0.241; UT elasticity: f(2) = 0.358, p = 0.702; LS stiffness: f(2) = 2.440, p = 0.102; LS elasticity: f(2) = 0.544, p = 0.585) in both groups. In comparison between groups, the MTG showed a significant difference in sensory function compared to the CG (resting pain: f(2) = 10.487, p = 0.005; lower part: f(2) = 5.341, p = 0.034 in TSA). Our findings suggest that meditation combined with stabilization exercise improved pain, muscle strength, and depression of female caregivers. In particular, greater benefits on tactile sense, balance, and quality of life were found in performing these in the marine region compared to the urban region.