Neck pain is a serious problem for public health. This study aimed to compare the effects of thermotherapy plus neck stabilization exercise versus neck stabilization exercise alone on pain, neck disability, muscle properties, and alignment of the neck and shoulder in the elderly with chronic nonspecific neck pain. This study is a single-blinded randomized controlled trial. Thirty-five individuals with chronic nonspecific neck pain were randomly allocated to intervention (n = 18) or control (n = 17) groups. The intervention group received thermotherapy with a salt-pack for 30 min and performed a neck stabilization exercise for 40 min twice a day for 5 days (10 sessions). The control group performed a neck stabilization exercise at the same time points. Pain intensity, pain pressure threshold (PPT), neck disability index, muscle properties, and alignment of the neck and shoulder were evaluated before and after the intervention. Significant time and group interactions were observed for pain at rest (p < 0.001) and during movement (p < 0.001), and for PPT at the upper-trapezius (p < 0.001), levator-scapula (p = 0.003), and splenius-capitis (p = 0.001). The disability caused by neck pain also significantly changed between groups over time (p = 0.005). In comparison with the control group, the intervention group showed significant improvements in muscle properties for the upper-trapezius (tone, p = 0.021; stiffness, p = 0.017), levator-scapula (stiffness, p = 0.025; elasticity, p = 0.035), and splenius-capitis (stiffness, p = 0.012), and alignment of the neck (p = 0.016) and shoulder (p < 0.001) over time. These results recommend the clinical use of salt pack thermotherapy in addition to neck stabilization exercise as a complementary intervention for chronic nonspecific neck pain control.

Background. Low back pain (LBP) is common in the elderly and an appropriate intervention for LBP management should be investigated. The aim of this study is to investigate the potential of mud‐heat intervention combined with core exercise as an alternative intervention for relieving pain and improving motor function in individuals with nonspecific chronic LBP. Methods. Thirty‐one individuals with chronic nonspecific LBP were randomly allocated to either the intervention group (n = 16) or the control group (n = 15). The intervention group used a mud pack for 30 min and performed a core‐exercise program for 50 min twice a day for 4 days (8 sessions). The control group performed the core‐exercise program only, at the same time point as the intervention group. Pain intensity was assessed using a 100 mm visual analog scale and a pain pressure threshold (PPT) as the primary outcomes. The secondary outcome measures included functional disability by LBP (Oswestry Disability Index), muscle properties, and static/dynamic balance. Results. There was a significant group difference in pain intensity at rest (p = 0.048) and in the PPT at the two sites assessed (2 cm lateral to L3 spinous process, p = 0.045; 2 cm lateral to L5 spinous process, p = 0.015). No group differences were found in terms of muscle properties. Compared to core exercise only, moor‐heat therapy and core exercise showed a significant improvement in static balance (p = 0.026) and dynamic balance (p = 0.019). Conclusion. Mud therapy combined with core exercise is effective in relieving pain and improving motor function in patients with chronic nonspecific LBP. Further research is needed to underpin these preliminary results.

This study aimed to investigate the effect of the load and bar position on trunk and lower extremity muscle activity during squat exercise. High bar back squats (HBBS) and low bar back squats (LBBS) were performed in random order at 50%, 60%, and 70% loads of one repetition maximum by 28 experienced healthy adult men who had been performing squats for at least one year. Before the experiment, the maximal voluntary contraction of the vastus medialis, vastus lateralis, rectus femoris, biceps femoris, rectus abdominis, transverse abdominis, external oblique, and erector spinae muscles was measured by means of surface electromyography. In addition, eccentric and concentric exercises were performed for 3 s each to measure the muscle activity. There was a significant difference in muscle activity according to the load for all muscles in the eccentric and concentric phases (p < 0.05), indicating that muscle activity increased as the load increased. In addition, in the comparison between HBBS and LBBS, significant differences were shown in all lower extremity muscles and all trunk muscles except for the external oblique in the concentric phase according to the bar position (p < 0.05). HBBS showed a higher muscle activity of the lower extremity in the eccentric and concentric phases than in LBBS, while LBBS showed a higher muscle activity of the trunk muscle in the eccentric and concentric phases than in HBBS (p < 0.05). HBBS requires more force in the lower extremity than LBBS and is particularly advantageous in strengthening the muscular strength of the quadriceps. In contrast, LBBS requires more muscle activity in the trunk than HBBS and is more effective in carrying heavier loads because of the advantage of body stability. This study suggests that rehabilitation experts apply the bar position and load as important variables affecting the intensity and method of training for target muscle strengthening of the lower extremities and trunk.

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.

Balance ability is a necessary exercise factor required for the activities of daily living. This study investigated the effects of short-term complex exercise (CE) and core stability exercise (CSE) on balance ability and trunk and lower-extremity muscle activation on healthy male adults. Twenty-nine healthy male adults were included. All performed CE and CSE for 1 min each; the exercise order was randomized. The primary and secondary outcomes were balance ability and muscle activation, respectively. In balance ability, CE showed a significant difference in all variables in both eye-opened and eye-closed conditions compared with the baseline (p < 0.05). In comparisons among exercises, the path length and average velocity variables showed a significant decrease in the eye-opened condition, and the path length variable showed a significant decrease in the eye-closed condition (p < 0.05). In muscle activation, CE showed a significant increase in the gluteus medius (Gmed) and decrease in the rectus femoris (RF), tibialis anterior (TA), and RF/biceps femoris (BF) ratio in the eye-opened condition compared to the baseline and a significant decrease in RF and RF/BF ratio in the eye-closed condition (p < 0.05). Both CE and CSE improved the static balance ability. Furthermore, muscle activation significantly increases in Gmed and decreases in the RF, TA, and RF/BF ratio. Therefore, we recommend including CE in an exercise program that has the purpose of improving static balance ability.

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.