Wei Wang, Jianping Huang, Jun Wang, Wanzhang Yang, Guanglin Li
{"title":"Effects of botulinum toxin on paraspinal muscle imbalance during spinal motions in adolescents with idiopathic scoliosis: Assessment using high-density electromyography.","authors":"Wei Wang, Jianping Huang, Jun Wang, Wanzhang Yang, Guanglin Li","doi":"10.1177/10538127241289351","DOIUrl":"https://doi.org/10.1177/10538127241289351","url":null,"abstract":"<p><strong>Background: </strong>The pathogenesis of adolescent idiopathic scoliosis (AIS) remains unclear, with muscle imbalance being a widely discussed hypothesis.</p><p><strong>Objective: </strong>This study examined the impact of muscle imbalance on AIS by injecting botulinum toxin A (BTX) into patients' unilateral muscles and investigating altered back muscle synergies.</p><p><strong>Methods: </strong>Three AIS patients received BTX injections in the concave-side paraspinal muscles. High-density electromyogram arrays placed from T8 to L4 recorded signals during five spinal motions at four timepoints (one pre-BTX and three post-BTX). Muscle synergies were extracted using non-negative matrix factorization and compared with data from ten healthy and ten AIS subjects from our previous studies.</p><p><strong>Results: </strong>Post-BTX, muscle activity maps during flexion/extension, sitting, and standing exhibited reduced symmetry, with concave/convex ratios decreasing and being statistically lower than those of healthy subjects at post-2 and post-3 follow-ups (<i>p </i>< 0.01). Muscles on the dominant side during lateral bending or axial rotation demonstrated decreased activation and differently distributed center of gravity positions on synergy maps compared to healthy subjects at all timepoints (<i>p </i>< 0.05). Post-BTX changes were particularly notable for the patient with mild deformity.</p><p><strong>Conclusions: </strong>BTX affected the activation of paraspinal muscles, providing insights into the role of muscle imbalance in AIS and informing future therapeutic strategies.</p>","PeriodicalId":15129,"journal":{"name":"Journal of Back and Musculoskeletal Rehabilitation","volume":"38 1","pages":"171-183"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143457559","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Andrea Bernetti, Francesco Agostini, Nikolaos Finamore, Marco Dal Borgo, Massimiliano Mangone, Antonio Ammendolia, Marco Paoloni, Alessandro de Sire
{"title":"Effectiveness of ultrasound-guided hip injections on pain and functioning in patients with hip osteoarthritis: A systematic review.","authors":"Andrea Bernetti, Francesco Agostini, Nikolaos Finamore, Marco Dal Borgo, Massimiliano Mangone, Antonio Ammendolia, Marco Paoloni, Alessandro de Sire","doi":"10.1177/10538127241296338","DOIUrl":"https://doi.org/10.1177/10538127241296338","url":null,"abstract":"<p><strong>Background: </strong>Osteoarthritis is the most common form of arthritis, causing pain, functional disability, and a reduction in terms of quality of life. Minimally invasive treatments like intra-articular hip injections are a therapeutic option and ultrasound guidance might improve the results of these injections.</p><p><strong>Objective: </strong>To summarize the evidence about the effectiveness of ultrasound-guided hip injections in terms of pain and functioning in patients affected by hip osteoarthritis.</p><p><strong>Methods: </strong>A systematic search of the literature was performed on three electronic databases: PubMed, Cochrane and PEDro, using a specific search strategy. We evaluated for inclusion all articles according to the following participants, intervention, comparison, and outcomes (PICO) model: P) Population: human patients affected by hip osteoarthritis; I) Intervention: intra-articular hip injections performed with a ultrasound-guidance; C) Comparator: sham therapy or every other conservative or oral, non-invasive, minimally invasive or surgical technique; O) Outcome measures: pain assessed by Visual Analogue Scale (VAS) or Numerical Rating Scale (NRS); functional outcomes.</p><p><strong>Results: </strong>At the end of the search, 43 articles were included in the review. Several drugs have been considered in the included studies: hyaluronic acid, platelet-rich plasma, corticosteroids, micro-fragmented adipose tissue, bone marrow concentrates, amniotic suspension allograft.</p><p><strong>Conclusion: </strong>Ultrasound-guided injections of hyaluronic acid might be effective on pain relief and functioning in patients affected by hip osteoarthritis. Also, other rehabilitative infiltrative techniques (i.e., corticosteroids and platelet-rich plasma) showed a positive effect in the short-term period.</p>","PeriodicalId":15129,"journal":{"name":"Journal of Back and Musculoskeletal Rehabilitation","volume":"38 1","pages":"19-47"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143458019","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Age-related differences on low back pain and lower extremity isokinetic muscle strength and balance.","authors":"Hazal Genç, Gamze Demircioğlu","doi":"10.1177/10538127241291310","DOIUrl":"https://doi.org/10.1177/10538127241291310","url":null,"abstract":"<p><strong>Background:: </strong>Given the growing population of the elderly, understanding how aging impacts pain, muscle strength, and balance, especially in individuals with chronic low back pain, is imperative.</p><p><strong>Objective:: </strong>This study aims to investigate age-related differences in lower extremity muscle strength and balance in patients with chronic low back pain.</p><p><strong>Methods:: </strong>In this cross-sectional study, 110 people with chronic low back pain were divided into two age groups (Group 1, age: 29.89 ± 6.82, Group 2, age: 51.42 ± 6.33). Both groups used Oswestry for low back pain and disability assessment, isokinetic device for muscle strength, and Biodex Balance System for balance assessment.</p><p><strong>Results:: </strong>There were no significant differences between groups in terms of pain (p = 0.426) or disability (p = 0.056). In contrast, significant differences were observed in isokinetic muscle strength: peak torque for the dominant side at 60°/s for quadriceps (p = 0.003) and hamstring (p = 0.007), and at 180°/s for hamstring (p = 0.012) and quadriceps (p = 0.011). The balance assessment revealed significant differences in fall risk (p = 0.004) and postural stability (p = 0.006) variables. The most significant regression association was found between dominant side 60°/s quadriceps and fall risk variables across age groups.</p><p><strong>Conclusion:: </strong>Understanding age-related differences in muscle strength and balance among patients with chronic low back pain is critical. Customizing rehabilitation interventions improves efficacy and quality of life. Further research is necessary to optimize clinical approaches and elucidate underlying mechanisms.</p>","PeriodicalId":15129,"journal":{"name":"Journal of Back and Musculoskeletal Rehabilitation","volume":"38 1","pages":"165-170"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143458070","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Joo-Young Jeon, Oh-Yun Kwon, Chung-Hwi Yi, Sung-Min Ha, Jun-Hee Kim, Seung-Yoon Han
{"title":"Evaluating pelvic rotator strength: Investigating asymmetry and its correlation with pelvic rotation angle during active straight leg raise.","authors":"Joo-Young Jeon, Oh-Yun Kwon, Chung-Hwi Yi, Sung-Min Ha, Jun-Hee Kim, Seung-Yoon Han","doi":"10.1177/10538127241295881","DOIUrl":"https://doi.org/10.1177/10538127241295881","url":null,"abstract":"<p><strong>Background: </strong>Although lumbopelvic rotation control muscle is important to maintain pelvic neutral alignment during active straight leg raise (ASLR), pelvic rotator strength has not been evaluated. Thus, a novel method is needed to measure pelvic rotator strength and to determine whether pelvic rotator muscle asymmetry is related to side difference in transverse plane pelvic rotation angle (TrPRA) during ASLR.</p><p><strong>Objective: </strong>To find average pelvic rotator strength, verify the reliability of pelvic rotator strength measurement method, and identify the correlation between pelvic rotator strength asymmetry and side difference in TrPRA during ASLR.</p><p><strong>Methods: </strong>Forty healthy participants were enrolled. Pelvic rotator strength was measured using a hand-held dynamometer. TrPRA was measured using a smart KEMA motion sensor. Reliability was analyzed using intraclass correlation coefficient (ICC). The correlation between pelvic rotator strength asymmetry and side difference in TrPRA during ASLR was analyzed using Pearson's correlation coefficient.</p><p><strong>Results: </strong>The average pelvic rotator strength was 120.3 N (72.9-202.2) for males and 94.4 N (58-125.8) for females. The reliability of pelvic rotator strength measurement demonstrated good to excellent intra- (ICC = 0.87-0.97) and inter-rater (ICC = 0.93-0.98) values. A significant moderate relationship existed between pelvic rotator strength asymmetry and side difference in TrPRA during ASLR (r = 0.39, <i>p</i> < 0.05).</p><p><strong>Conclusion: </strong>The pelvic rotator muscle strength measurement method can be clinically used with good to excellent intra- and inter-rater reliability. Pelvic rotator strength asymmetry should be considered to evaluate and manage the pelvic rotation control during ASLR.</p>","PeriodicalId":15129,"journal":{"name":"Journal of Back and Musculoskeletal Rehabilitation","volume":"38 1","pages":"93-100"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143457603","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Huijuan Tan, Steve Tumilty, Cathy Chapple, Guangyi Huang, G David Baxter
{"title":"Sensitized-points acupuncture versus routine integrative acupuncture for chronic low back pain: A randomized-controlled feasibility study.","authors":"Huijuan Tan, Steve Tumilty, Cathy Chapple, Guangyi Huang, G David Baxter","doi":"10.1177/10538127241289343","DOIUrl":"https://doi.org/10.1177/10538127241289343","url":null,"abstract":"<p><strong>Background: </strong>Chronic low back pain (cLBP) is a global health complaint. Acupuncture is an effective therapy for cLBP; however, evidence for an optimal acupuncture practice scheme is limited.</p><p><strong>Objective: </strong>This study aimed to determine the feasibility of conducting a randomized controlled trial (RCT) to assess the effectiveness of two acupuncture regimes (sensitized-points acupuncture and routine integrative acupuncture package) for cLBP.</p><p><strong>Methods: </strong>This was a two-arm, assessor-blind, randomized-controlled feasibility study. Thirty adult participants with cLBP were randomly assigned into two groups. Each group received 8 sessions of either sensitized-points acupuncture or routine integrative acupuncture package, respectively. Treatments were conducted twice per week. Outcomes were assessed at baseline (week 0), on a weekly basis for four weeks (week 1, 2, 3, 4), and follow-up (week 12). Student's t-tests, Mann-Whitney U tests, Fisher's exact tests, descriptive analyses, and power analyses were used for statistics.</p><p><strong>Results: </strong>Participants were recruited over 10 weeks with a recruitment rate of 12 participants per month. The treatment plan in both groups was well accepted and tolerated. Besides, the study was characterized by low adverse event rates (8.0% in Group A, 11.7% in Group B), high completion of the outcome measures (97.8% in Group A, 94.3% in Group B), and high participant retention rate (100% in Group A, 93.8% in Group B). Furthermore, preliminary analyses showed that both regimes of acupuncture were potentially efficacious and safe.</p><p><strong>Conclusions: </strong>Conducting a fully powered RCT to evaluate efficacy and safety of two acupuncture regimes in the management of cLBP is feasible.</p>","PeriodicalId":15129,"journal":{"name":"Journal of Back and Musculoskeletal Rehabilitation","volume":"38 1","pages":"101-112"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143457900","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Gokhan Alkan, Muhammet Sahin Elbasti, Gurkan Akgol, Arif Gulkesen, Hasan Ulusoy
{"title":"Ultrasonographic and pedobarographic evaluation of the effectiveness of extracorporeal shock wave therapy in patients with plantar fasciitis.","authors":"Gokhan Alkan, Muhammet Sahin Elbasti, Gurkan Akgol, Arif Gulkesen, Hasan Ulusoy","doi":"10.1177/10538127241291665","DOIUrl":"https://doi.org/10.1177/10538127241291665","url":null,"abstract":"<p><strong>Background: </strong>Prior studies showing the effectiveness of extracorporeal shock wave therapy (ESWT) in patients with plantar fasciitis are mostly based on patient-reported measurements.</p><p><strong>Objective: </strong>The aim of this study was to demonstrate the effectiveness of ESWT with ultrasonographic and pedobarographic measurements.</p><p><strong>Methods: </strong>A total of 50 patients were included in the study. All patients were evaluated before and six weeks after ESWT treatment. Pain was evaluated with the Visual Analogue Scale (VAS), functional status with Foot Function Index (FFI), and quality of life with Short Form-36 (SF-36). Plantar pressure measurements were made with a pedobarography device, and plantar fascia thickness was measured with ultrasonography.</p><p><strong>Results: </strong>After treatment, VAS-Pain decreased significantly. There was a statistically significant improvement in FFI scores after treatment. Similarly, a statistically significant improvement was seen in SF-36 scores. There was a significant decrease in ultrasonographic measurements of the plantar fascia thickness in the origo and midsection regions. There was a statistically significant decrease only in medial heel pressure measurements.</p><p><strong>Conclusion: </strong>The results of this study showed that ESWT provides symptomatic and functional improvements in patients with plantar fasciitis as well as ultrasonographic plantar fascia thickness and pedobarographic medial heel pressure measurements.</p>","PeriodicalId":15129,"journal":{"name":"Journal of Back and Musculoskeletal Rehabilitation","volume":"38 1","pages":"121-131"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143458058","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Pediatric supracondylar humerus fracture with fascicular median nerve injury: The role of neuromuscular ultrasound in diagnosis and management - a case report.","authors":"Esra Giray, Aslinur Keles","doi":"10.1177/10538127241290931","DOIUrl":"https://doi.org/10.1177/10538127241290931","url":null,"abstract":"<p><strong>Background: </strong>Supracondylar humerus fractures are the most common type of elbow fractures in children. Nerve injuries, primarily neuropraxia, are frequent complications and are often managed with a \"wait-and-see\" approach. Electroneuromyography (ENMG) is the standard method for evaluating peripheral nerve injuries, while ultrasound (US) is valuable for localizing lesions.</p><p><strong>Objective: </strong>This case report aims to highlight the beneficial role of US in the follow-up and rehabilitation of nerve injuries following pediatric supracondylar humerus fractures.</p><p><strong>Case presentation: </strong>A 4-year-old boy presented with a supracondylar humerus fracture that was treated with closed reduction and K-wire fixation. He exhibited weakness in the first two fingers of his left hand, difficulty grasping, and nail changes. Ultrasound revealed a median nerve lesion adjacent to the fracture site. ENMG indicated an acute severe axonal injury involving the branch innervating the flexor carpi radialis muscle. Following rehabilitation, there was improvement in hand grip strength, measured using a JAMAR hand dynamometer, and in health-related quality of life (QoL), assessed by the Pediatric Outcomes Data Collection Instrument (PODCI) score. Follow-up ENMG showed signs of mild reinnervation.</p><p><strong>Conclusion: </strong>Pre-ENMG ultrasound provides crucial information regarding which nerve should be examined with a nerve conduction study and identifies the initial muscle to be evaluated during needle EMG. This aids in accurately localizing nerve damage and guiding effective treatment.</p>","PeriodicalId":15129,"journal":{"name":"Journal of Back and Musculoskeletal Rehabilitation","volume":"38 1","pages":"192-199"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143457755","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Transformations in healthcare.","authors":"Remko Soer","doi":"10.1177/10538127241301247","DOIUrl":"https://doi.org/10.1177/10538127241301247","url":null,"abstract":"","PeriodicalId":15129,"journal":{"name":"Journal of Back and Musculoskeletal Rehabilitation","volume":"38 1","pages":"3"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143458051","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Umile Giuseppe Longo, Stefano Campi, Sergio De Salvatore, Ilaria Piergentili, Benedetta Bandini, Alberto Lalli, Valerio Ammendolia, Alessandro de Sire, Rocco Papalia
{"title":"Minimum clinically important difference of 36-item short form health survey (SF-36) to assess post-surgery quality of life in knee osteoarthritis.","authors":"Umile Giuseppe Longo, Stefano Campi, Sergio De Salvatore, Ilaria Piergentili, Benedetta Bandini, Alberto Lalli, Valerio Ammendolia, Alessandro de Sire, Rocco Papalia","doi":"10.1177/10538127241296344","DOIUrl":"https://doi.org/10.1177/10538127241296344","url":null,"abstract":"<p><strong>Background: </strong>Quality of life in patients receiving knee arthroplasty is crucial for rehabilitation. Even if the validity of the 36-Item Short Form (SF-36) was already confirmed, the Substantial Clinical Benefit (SCB) and Patient Acceptable Symptom Score (PASS) values of this score remain unknown for both Total Knee Arthroplasty (TKA) and Unicompartmental Knee Arthroplasty (UKA).</p><p><strong>Objective: </strong>The purpose of this research was to compute the Minimal Clinically Important Difference (MCID) of the SF-36 after UKA, and the SCB and PASS of SF-36 after TKA and UKA, in order to assess post-surgery quality of life in knee osteoarthritis.</p><p><strong>Methods: </strong>Overall, 59 patients (40 women and 19 men, mean age 60.3 ± 13.1 years) completed the questionnaire until six months follow-up. Of these patients, 22 underwent the TKA procedure, while 37 patients underwent the UKA procedure. The anchor question for computing the MCID and SCB thresholds was \"How would you describe your health condition in relation to your previous state?\". The PASS scores were determined using the ROC curve and the 75th percentile of the cumulative percentage curve of respondents who believe their symptoms are under control.</p><p><strong>Results: </strong>The MCID values of global SF-36, Physical Component Summary (PCS) and Mental Component Summary (MCS) after UKA were 11.3, 14.5 and 11.4, respectively. The SCB values of global SF-36, PCS and MCS after UKA were 23.5, 23.1 and 15, respectively. The PASS values of global SF-36, PCS and MCS after TKA were 71.2, 75 and 69.3, respectively. The PASS values of global SF-36, PCS and MCS after UKA were 70.4, 72.1 and 67.5, respectively.</p><p><strong>Conclusion: </strong>The SF-36 score represents a valid score for quality of life in patients with knee osteoarthritis. Taken together, the results showed a statistically significant improvement between inception and latest follow-up after TKA and UKA.</p>","PeriodicalId":15129,"journal":{"name":"Journal of Back and Musculoskeletal Rehabilitation","volume":"38 1","pages":"158-164"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143457730","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Impact of forward head posture correction on craniovertebral angle, neck disability, and spinal electromyography: A randomized controlled trial.","authors":"Walaa H Elsayed, Zaenab A Alowa","doi":"10.1177/10538127241296342","DOIUrl":"https://doi.org/10.1177/10538127241296342","url":null,"abstract":"<p><strong>Background: </strong>Forward head posture (FHP) is a common malalignment affecting the cervicothoracic spine. This deviation is associated with neck disability and muscle imbalance.</p><p><strong>Objective: </strong>This study aimed to investigate the efficacy of FHP correction using regional versus comprehensive spinal programs on the craniovertebral (CV) angle, neck disability, and spinal muscle activity.</p><p><strong>Methods: </strong>Sixty participants with FHP were randomly assigned to receive either a cervicothoracic correction program (control group) or a cervicothoracic plus lumbopelvic program (experimental group). The CV angle, neck disability index (NDI), and normalized electromyography as a percentage of maximum voluntary isometric contraction (%MVIC) from spinal muscles were measured before and after the intervention.</p><p><strong>Results: </strong>Post-intervention, both groups showed significant improvement across time in CV angle and NDI <i>(p < 0.001, p = 0.002)</i>. However, the between-group comparison was not statistically significant. The NDI showed significant improvement only in the experimental group (<i>p = 0.005</i>). The minimal clinical important difference (MCID) obtained was 6.44 for the NDI. A reduction in %MVIC over time was observed in both groups for cervical erector spinae (Right, <i>p = 0.006</i>, Left, <i>p = 0.001</i>). The between-group comparison of spinal muscle activation was not significantly different.</p><p><strong>Conclusion: </strong>The study suggested that FHP management using a cervicothoracic or cervicothoracic plus lumbopelvic protocol could improve cervical posture and lower cervical muscle demand. Incorporating a lumbopelvic into the cervicothoracic protocol was more effective in reducing short-term neck pain and disability than a cervicothoracic protocol alone. A comprehensive spine program may be a clinically beneficial rehabilitation protocol for FHP to improve neck pain and disability.</p>","PeriodicalId":15129,"journal":{"name":"Journal of Back and Musculoskeletal Rehabilitation","volume":"38 1","pages":"83-92"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143457712","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}