The 11th International Physical Therapy Research Symposium (IPTRS 2025)
The Faculty of Physical Therapy, Mahidol University acknowledges the importance of research collaborations among the institutes within our country and among those in Asia. For most people worldwide, health is a major concern, and the pursuit of better health is a top priority. Therefore, creating a network of institutions and professionals focused on physical therapy and health-related fields—such as Prince of Songkla University, Chulalongkorn University, Thammasat University, Saint Louis College, Khon Kaen University, University of Phayao, and the Consortium of Thai Physical Therapy Educational Institutions—as cohosts represents a significant and valuable vision. The conference will stimulate discussion and emphasize the sharing of knowledge and research. The Faculty has a strong intention to emphasize the research network and create innovation. This type of event is of great importance to Mahidol University, as it illustrates its commitment to quality and standard in its teaching and research programs, as well as the physical therapy profession. It demonstrates your ability to encounter the challenges facing our ever changing environment.
Faculty of Physical Therapy, Mahidol University
The immediate effects of terminal knee extension exercise synchronized with audible cues on motor unit behavior in athletes with anterior cruciate ligament reconstruction: a preliminary study
Background: After anterior cruciate ligament reconstruction (ACLR), the vastus medialis (VM) muscle commonly exhibits functional deficit. Incorporating a metronome during resistance exercises has been shown to improve cortical excitability. Terminal knee extension (TKE) exercise is designed to activate VM activity, especially safe for post-operative rehabilitation. Therefore, the aim of this study is to investigate the immediate effect of TKE exercise with and without audible cues on motor unit behavior in athletes with ACLR. Materials and Methods: Two participants who underwent ACLR within the first 2 weeks were allocated into 2 groups. An experimental group performed TKE exercise with audible cues. Adding audible cues in the current study was provided with the beat sound of metronome (1 Hz). The control group performed TKE exercise without audible cues. Decomposition electromyography (dEMG) was used to assess motor unit action potential (MUAP) and motor unit firing rate (MUFR) of VM muscle. The mean change of MUAP and MUFR were observed to compare pre- and post-exercise outcomes within and between groups. Results: Both groups exhibited an increase of peak MUAP. TKE with audible cues showed a greater change (40.16%) than without audible cues (10.03%). A decreased average MUFR after TKE exercise was observed in both with (41.62%) and without (8.10%) audible cues. Conclusion: After a single session of exercise, TKE with audible cues appears to enhance MUAP. This improvement may reflect changes in neural drive and adaptations in motor unit behavior. These findings might serve as a beneficial intervention to enhance rehabilitation outcomes in individuals with ACLR.
Copyright (c) 2025 The 11th International Physical Therapy Research Symposium 2025 (IPTRS 2025) https://creativecommons.org/licenses/by-nc-nd/4.0
Association of cognitive function with fall-related outcomes in Thai older adults with and without mild cognitive impairment
Objective: This study aimed to investigate the relationship between cognitive function and fall-related outcomes, including fear of falling and functional performance, in older adults with and without mild cognitive impairment (MCI). Materials and Methods: A cross-sectional study was conducted with 75 community-dwelling older adults (50 healthy older adults and 25 older adults with MCI). Cognitive function was assessed using the Montreal Cognitive Assessment (MoCA), while fear of falling (FoF) was measured using the Falls Efficacy Scale-International (FES-I). Functional performance was evaluated using the Timed Up and Go (TUG) test and Chair Stand Test (CST). Group differences were analyzed using Mann–Whitney U tests, and linear regression models examined associations between MoCA scores and fall-related outcomes. Results: Older adults with MCI exhibited significantly poorer functional performance than their cognitively healthy counterparts, with longer TUG durations (p = 0.009) and fewer CST repetitions (p = 0.002). Overall, regression analyses revealed a significant association between lower MoCA scores and longer TUG times (p = 0.025), as well as fewer CST repetitions (p = 0.001). However, no significant relationship was found between MoCA scores and FES-I scores (p = 0.737). Conclusion: Cognitive function is associated with functional performance, particularly mobility and lower extremity strength, in older adults. However, FoF may be influenced by factors beyond cognitive decline, such as psychological or emotional aspects. These findings highlight the importance of integrating cognitive and physical interventions to reduce fall risk in older adults with MCI.
Correlation between six minute walk test and shuttle walk test in people with long covid: a pilot study
Objective: The aftermath of acute SARS-CoV-2 infection, termed Long COVID, is characterized by persistent symptoms that detrimentally affect physical capacity and overall quality of life. The six-minute walk test (6MWT) and shuttle walk test (SWT) are established tools for assessing physical capacity, with SWT exhibiting a more favorable correlation with maximum oxygen consumption (VO₂ max) compared to 6MWT. This pilot study was designed to explore the correlation between 6MWT and SWT in individuals with Long COVID and to appraise the viability of 6MWT as a surrogate for SWT. Materials and Methods: A cohort of ten participants, inclusive of both male and female, aged between 40 and 80 years old, who were capable of independent ambulation and fulfilled the criteria for Long COVID, was recruited. Fatigue level was pre-screened using the DePaul Symptom Questionnaire-Post-Exertional Malaise subscale (DSQ-PEM subscale). Subsequently, both 6MWT and SWT were administered to evaluate their physical capacity. Results: The mean ± SD of the Shuttle walk test distance was 364.9 ± 13.518 meters, and the mean ± SD of the Six minute walk test distance was 416 ± 14.155 meters. A statistically significant correlation (r = 0.845) was detected between 6MWT and SWT. Conclusion: This pilot investigation furnishes preliminary evidence substantiating the efficacy of 6MWT to serve as an alternative assessment of cardiopulmonary endurance for people with Long COVID.
Correlation between craniocervical flexion test performance index and sternocleidomastoid activity in individuals with chronic non-specific neck pain
Objective: The aim of our study was to explore the relationship between the craniocervical flexion test performance index (CCFTPI) and sternocleidomastoid (SCM) muscle activation, in individuals with chronic non-specific neck pain (CNSNP). Materials and Methods: A cross-sectional study involving 20 individuals with CNSNP was conducted. Participants performed the craniocervical flexion test (CCFT) while the SCM activity was recorded using surface EMG. Spearman’s rank correlation coefficient was calculated to assess the relationships between CCFTPI and SCM activation at the highest pressure stage of the CCFT, using a statistical significance level of a = 0.05. Results: The CCFTPI score is this sample ranged from 120 to 300. The analysis revealed a statistically significant results of moderate negative correlation between CCFTPI and left SCM activation (ρ = –0.503, p = 0.024. This suggest that improved deep cervical flexion (DCF) function is linked to reduced superficial muscle activation. While the correlation for right SCM activation was negative, but not statistically significant (ρ = –0.344, p = 0.138). However, we observed a strong positive correlation between left and right SCM activation (ρ = 0.815, p < 0.001). Conclusion: These findings indicate that individuals with better deep cervical flexor function tend to exhibit lower SCM activation, suggesting that rehabilitation programs aiming to improve deep cervical flexor performance may help reduce compensatory superficial muscle activity. Future research could investigate the long-term effects of targeted interventions on neuromuscular patterns and clinical outcomes in this population.
Copyright (c) 2025 IPTRS 2025 https://creativecommons.org/licenses/by-nc-nd/4.0
Effects of high-frequency repetitive transcranial magnetic stimulation combined with action observation and execution on upper extremity motor function in subacute stroke: a preliminary study
Background: Objective: To investigate the effect of a combined high-frequency repetitive transcranial magnetic stimulation (HF-rTMS) with action observation execution (AOE) on upper extremity motor function in subacute stroke. Materials and Methods: Eight participants were randomly allocated to the experimental group (real HF-rTMS) or the control group (Sham-rTMS). All the participants also received 30 minutes of AOE training. The corticospinal excitability, which is represented by peak-to-peak motor evoked potential (MEP) amplitude of the lesioned hemisphere and the motor performance of the paretic hand from nine tasks of the Wolf Motor Function Test, was measured at baseline, immediately after 5 times HF-rTMS and AOE, and 1 week after the intervention. Results: The lesioned MEP of the experimental group increased after HF-rTMS, and the effect was maintained for one week. In addition, their time to complete hand-to-table and lift significantly decreased after AOE training and was maintained for one week. Conclusion: Five sessions of HF-rTMS followed by AOE training enhanced the paretic hand dexterity and persisted for at least one week.
The immediate effect of the combined FIFA11+ and change of direction training on knee valgus angle during cutting in male soccer players: A pilot study
Objective: This study aimed to evaluate the effectiveness of the FIFA11+ training program combined with change of direction (COD) training on reducing knee valgus angle and improving balance in soccer players. Materials and Methods: Six participants were randomly assigned 3 participants into the experimental group (FIFA11+ with COD training) and 3 participants into the control group (FIFA11+ only). Knee valgus angles were measured using 2D video analysis, which demonstrated reliability and validity in assessing knee kinematics. Results: The experimental group reduced the mean of knee valgus angle (KVA) from 25.2±7.0 to 21.0±2.3, and the control group reduced from 20.1±9.8 to 19.7±1.7 on the left leg. The results showed that the experimental group exhibited what seemed to be reductions in knee valgus angle compared to the control group. However, due to the small sample size, these changes were not statistically significant. Conclusion: Despite this limitation, the observed trends suggest that the combined FIFA11+ and COD training program may have potential benefits in enhancing knee biomechanics and preventing injuries. Further research with larger sample sizes is recommended to confirm these preliminary findings and to explore the long-term effects of such interventions. Overall, integrating reliable measurement techniques with targeted training programs offers a comprehensive approach to improving knee health and performance in soccer players.
Effect of transcranial alternating current stimulation (tACS) with physical therapy on motor recovery in individuals with subacute and chronic stroke
Objective: To investigate the effects of 20 Hz of transcranial alternating current stimulation (tACS) combined with physical therapy on motor recovery in stroke individuals. Beta band activity is associated with motor function, and its increase is observed alongside motor function recovery following a stroke. Materials and Methods: Ten stroke individuals (mean age 59.5 ± 3.8, 4 females) were participated in this study. Participants received beta-tACS (20Hz) at an intensity of 2 mA over the bilateral primary motor cortex (M1) for 30 minutes per session, followed by one hour of physical therapy. This combined intervention was conducted over 15 sessions, thrice a week for 5 weeks. Motor recovery of the upper and lower limbs was evaluated using Fugl-Meyer Assessment (FMA) both before and immediately after the intervention. Results: The pre-post comparison, performed using the paired t-test, revealed that after 15 sessions, FMA scores was significantly improved for both upper and lower extremities compared to baseline (P = 0.001). During the stimulation sessions, all participants (100%) reported perceiving white light flashes, while 90% experienced itching and tingling, 60% noted a burning sensation, and 40% reported sleepiness. Conclusion: 15 sessions of beta-tACS combined with physical therapy improved motor recovery of both upper and lower extremities in individuals with subacute and chronic stroke. Transient side effects were reported during tACS application, however it disappeared after tACS removal. These findings support the safety of tACS and highlights its potential benefit for stroke rehabilitation.
Exploration of non-contact anterior cruciate ligament injury risks in dominant and non-dominant limbs of basketball players
Background: The objective of this study was to investigate the risk of non-contact anterior cruciate ligament (ACL) injuries in dominant and non-dominant limbs of basketball players with the modified Landing Error Scoring System (mLESS). Objective: This study aimed to determine the prevalence of sarcopenia in Thai community-dwelling elderly according to the diagnostic criteria of AWGS2019. Materials and Methods: Ten basketball players participated in this preliminary study. They were instructed to complete lateral single-leg jump landing (LSJL) task for both dominant (DL) and non-dominant (NDL) limbs. The jumps were recorded using two cameras positioned in the sagittal and frontal planes. The videos were subsequently analyzed using the mLESS for scoring. Paired t-tests and Wilcoxon Signed Ranks Test were used to statistically compare of total and item mLESS scores between the DL and NDL, respectively. Spearman's rank correlation test was used to analyze the correlation between the score of each item and the total mLESS score. Results: There was no significant difference of total and item mLESS scores between the DL and NDL (p > 0.05). Significant correlations between individual items and the total mLESS score were observed for items 7 and 9 in the NDL. Conclusion: No significant differences of the mLESS scores were found between the DL and NDL. The DL and NDL seem to have a similar level of non-contact ACL injury risk during single-leg lateral jump landing.
Effects of Digital Pen with Tablet and Standard Mouse on Muscle Fatigue Rate and Discomfort in Prolonged Computer-based Tasks among Female Computer Users
Objective: The Digital Pen with Tablet (DPT) outperforms the Standard Mouse (SM) and other alternative mice in reducing both duration and intensity of muscle contractions in the neck, shoulders, and upper extremity. These reductions are crucial for lowering the risk of Work-related Musculoskeletal Disorders (WMSDs) caused by fatigue and overexertion mechanisms. Although evidence supporting the DPT’s effectiveness in preventing WMSDs is limited, this study aims to evaluate its role as a primary preventive strategy for WMSDs. Materials and Methods: A crossover experimental design with repeated measures was employed, involving 35 healthy female computer users. Participants completed two 2-hour rounds of computer-based tasks, alternating between the SM and the DPT. The Muscle Fatigue Rates (MFRs) of Upper Trapezius (UT), Pronator Teres (PT), Extensor Digitorum (ED), and Flexor Digitorum Superficialis (FDS) were assessed using electromyography. Statistical analyses were conducted to examine the effects of different devices and timepoints using unpaired and paired t-tests for normally distributed data. ​Results: The DPT significantly reduced the MFR of FDS compared with the SM, particularly during the second hour (p < 0.05), and maintained a stable MFR of FDS over the two hours. These findings demonstrate that the DPT effectively delayed the progression of fatigue in the FDS. However, no significant differences were observed in the MFR of UT, PT, and ED (p > 0.05). Conclusion: The DPT demonstrates superior effectiveness than the SM in delaying fatigue progression in the FDS, suggesting its role as the primary preventive strategy for WMSDs in the distal upper extremity.
Exercise intensity response and safety concerns of spot marching exercise in hypertensive older adults: a case report
Background: To evaluate the exercise intensity and safety concerns in older adults with controlled hypertension during Spot Marching Exercise (SME). Materials and Methods: Three older adults with controlled hypertension were instructed to perform SME at a constant individual step rate duration in 6 minutes. Exercise intensity was assessed using % maximum heart rate (%maxHR), % heart rate reserve (%HRR), and rate of perceived breathlessness (RPE) at the end of the exercise. Safety Monitoring: Heart rate (HR), electrocardiogram (ECG), oxygen saturation (SpO2), and respiratory rate (RR) were continuously monitored. Blood pressure (BP) was measured immediately before and after the exercise phase, as well as every two minutes during the resting and recovery phases. Results: Participants performed SME at individualized step rates (80% of maximum step rate): 70 steps/min for Participant 1, 40 steps/min for Participant 2, and 74 steps/min for Participant 3. Participant 1 achieved moderate to vigorous intensity (86.88% HRmax, 72.45% HRR, and an RPE of 3). Participant 2 achieved light to moderate intensity (66.74% HRmax, 38.00% HRR, and an RPE of 4). Participant 3 achieved light to moderate intensity (61.09% HRmax, 35.17% HRR, and an RPE of 2). For safety concerns, the responses of HR, ECG, BP, RR, and SpO2 remained within the safe exercise range during and after SME. No adverse events were reported during or following SME. Conclusion: 80 % of self-paced speed in 1 minute of SME maybe safe and alternative approach for cardiopulmonary endurance training in older adults with controlled hypertension.
Differences in lumbar joint position sense between individuals with movement control impairment and healthy individuals: A pilot study
Background: Proprioceptive input is crucial in postural control and movement coordination. Impaired lumbar proprioceptive sense may contribute to movement control impairment (MCI) in individuals with non-specific low back pain (NSLBP). While previous studies have demonstrated proprioceptive deficits in individuals with NSLBP, the lumbar proprioceptive sense in individuals with MCI remains underexplored. This study aimed to compare lumbar repositioning errors between individuals with and without MCI. Materials and Methods: A cross-sectional study was conducted with 18 male participants (9 with MCI, 9 without MCI), classified using a 6-item movement control test battery (MCTB). Lumbar proprioceptive sense was assessed using inertial measurement units (IMUs) placed at L1 and S2 during an active lumbar flexion task at 30° and 45°. Absolute errors (AEs) were calculated to quantify lumbar proprioceptive sense. Mann-Whitney U tests were used for between-group comparisons. Results: The MCI group exhibited significantly larger AEs at 30° lumbar flexion (3.72° vs. 1.83°, P=0.024) than the non-MCI group. Although AEs at 45° were higher in the MCI group (4.77° vs. 2.16°), the difference did not yield statistical significance (P=0.10). Conclusion: Individuals with MCI demonstrated greater lumbar repositioning errors, indicating deficits in proprioceptive function. These findings highlight the importance of assessing and addressing proprioceptive impairments in rehabilitation programs for those with MCI.
When fear takes over: how fear of falling affects functional ability in older adult fallers
Objective: This cross-sectional observational study aimed to investigate the association between fear of falling (FOF) and functional ability in low-concern fallers and high-concern fallers. Materials and Methods: Participants aged 65–80 years with a history of falls were classified into two groups based on their Falls Efficacy Scale-International (FES-I) scores: low-concern fallers (FES-I ≤ 27) and high-concern fallers (FES-I > 27). Functional ability was assessed using the Timed Up and Go (TUG) test and the Chair Stand Test (CST). The Mann-Whitney U test was used to compare FES-I, TUG, and CST scores between the two groups. Correlation analysis was performed to explore the relationship between FES-I and TUG, as well as between FES-I and CST. Results: High-concern fallers had significantly higher FES-I scores (z = -4.756, p < 0.001) and performed significantly fewer repetitions on the CST (z = -2.077, p = 0.038) compared to low-concern fallers. However, no significant difference in TUG scores was observed between the groups (z = -0.423, p = 0.673). Furthermore, there was a significant negative correlation between FES-I scores and CST performance (r(30) = -0.389, p = 0.028), but no significant correlation was found between FES-I and TUG (r(30) = 0.083, p = 0.650). Conclusion: A greater FOF is associated with reduced lower limb strength or sit-to-stand performance (as indicated by CST), rather than with general mobility (as indicated by TUG). These findings suggest that interventions targeting both FOF and sit-to-stand performance may be beneficial for older adult fallers.
A feasibility of home-based tele-rehabilitation on motor function and quality of life in spinal cord injury
Objectives: Individuals with spinal cord injury (SCI) require regular rehabilitation to improve motor function and quality of life. However, barrier factors i.e. transportation problems, financial constraints and caregivers’ availability to accompany them limit access to rehabilitation center. Tele-rehabilitation can overcome these barrier factors. This study aims to explore the feasibility of home-based tele-rehabilitation exercise in Thai SCI populations. Materials and Methods: Ten individuals with SCI underwent a tailored tele-rehabilitation program (1 hour/session, 3 sessions/week, 4 weeks) supervised by the physical therapist. The exercise programs include stretching, strengthening, balance and transfer training. Exercise intensity and Perceived Exertion (RPE) scale were recorded for each session. Upper and lower extremity motor function (ASIA-motor score) and quality of life (WHQOL-Thai) were assessed at baseline and post-intervention. Results: All participants demonstrated good adherence by completing 100% of the 12-session exercise program. The exercise program demonstrated high feasibility, with a high completion rate. However, no transfer training was provided to participants. The average RPE was 3.8, indicating light to moderate activity. ASIA-motor scores improved significantly (p = 0.003) after the intervention. However, no improvements were found in the total WHQOL-Thai score in any of its domains. Conclusion: Home-based tele-rehabilitation exercises have a potential to maintain adherence to rehabilitation programs for SCI populations, improve motor performance, though it may not improve quality of life. However, certain types of training were not possible via tele-rehabilitation because of unsafe home environments, limited space and the need for assistance.
Validity and test-retest reliability of the brief balance evaluation systems test in typically developing children aged 7 to 10 years
Background: This study evaluated the concurrent validity and test-retest reliability of the Brief Balance Evaluation Systems Test (Brief-BESTest) in typically developing children aged 7–10 years, a critical period for postural control development. We hypothesized that the Brief-BESTest would show excellent test-retest reliability and moderate to good concurrent validity compared to laboratory-based balance assessments. Materials and Methods: An observational study included 26 typically developing children aged 7 to 10 years and 11 months. Participants completed the Brief-BESTest, the Modified Clinical Test of Sensory Interaction on Balance (mCTSIB), and the unilateral stance test. Validity was analyzed using Pearson’s correlation coefficient to compare Brief-BESTest scores with sway velocity data from force plate assessments. Test-retest reliability was determined by administering the Brief-BESTest twice, eight days apart, using the intraclass correlation coefficient (ICC). Results: The Brief-BESTest showed excellent test-retest reliability (ICC (3,1) = 0.91; 95% CI = 0.80–0.96, p < 0.001). The SEM and MDC were 0.78 and 1.25, respectively. Concurrent validity showed moderate correlations with the Foam-eye open condition of the mCTSIB (r = 0.50, p = 0.01) and unilateral stance tests (Left- eye open: r = 0.48, p = 0.01; Right- eye open: r = 0.52, p = 0.01). Conclusion: The Brief-BESTest is a reliable and valid tool for assessing postural control in children. These findings highlight the potential of the Brief-BESTest as a practical balance assessment tool in pediatric clinical settings. However, further studies with diverse age groups are recommended to strengthen the generalizability of these results.
Reliability of the Thai version of the Trunk Assessment Scale for spinal cord injury: a preliminary study
Objective: Spinal Cord Injury (SCI) often results in impaired sitting balance and trunk control, which are critical for functional independence and quality of life. The Trunk Assessment Scale for Spinal Cord Injury (TASS) was developed to assess sitting balance and trunk control in individuals with SCI. Currently, there is a Thai translation available. However, no analysis of its reliability has been conducted. This study aimed to assess the inter-rater reliability and internal consistency of the Thai version of TASS to ensure its suitability for use in clinical and research settings. Materials and Methods: Ten individuals with SCI were assessed by three trained raters using the Thai version of TASS. Assessments were conducted independently to ensure unbiased scoring. Inter-rater reliability was analyzed using the intraclass correlation coefficient (ICC) with a 95% confidence interval (CI). Internal consistency was analyzed using Cronbach’s alpha. Result: The Thai version of TASS demonstrated excellent inter-rater reliability, with an ICC of 0.976 (95% CI: 0.929-0.993). Internal consistency was excellent, with a Cronbach’s alpha of 0.935, indicating strong agreement among the items within the scale. Conclusion: The Thai version of TASS is a reliable tool as evidenced by its excellent inter-rater reliability and high internal consistency. These findings support that it can be use in clinical and research settings to assess sitting balance in among individuals with SCI among evaluations in Thailand.
Inter- and intra-rater reliability of the Mini-BESTest in assessing individuals with peripheral vestibular disorders
Background: Vestibular disorders compromise balance and increase the risk of falls, yet reliable assessment tools remain limited. The Mini-Balance Evaluation Systems Test (Mini-BESTest), which evaluates multiple domains of postural control, may address this need. Previous research has been limited to bilateral vestibulopathy without reporting reliability metrics, leaving its measurement consistency in peripheral vestibular disorders unexamined. Objective: To evaluate the inter- and intra-rater reliability of the Mini-BESTest in patients with vestibular disorders. Materials and Methods: Ten patients with vestibular disorders participated. A licensed physical therapist conducted and recorded the initial Mini-BESTest assessments. Seven days later, two physical therapists independently scored the video recordings to determine inter- and intra-rater reliability. Intraclass correlation coefficients (ICC) were used (ICC(2,1) for inter-rater; ICC(3,1) for intra-rater), along with the standard error of measurement (SEM) and minimal detectable change (MDC). Results: The Mini-BESTest showed excellent inter-rater reliability for the total score (ICC = 0.96, SEM = 0.93, MDC = 2.58). Subscores demonstrated good to excellent reliability: sensory orientation, reactive postural control, and dynamic gait showed excellent reliability (ICC = 0.91-1.00), while anticipatory control (ICC = 0.90) demonstrated good reliability. Intra-rater reliability was excellent for the total score (ICC = 0.99, SEM = 0.46, MDC = 1.29), with sub scores also demonstrating excellent reliability (ICC = 0.93–1.00). Conclusion: The Mini-BESTest demonstrates strong reliability for the total score and most subscores in patients with vestibular disorders. These findings support the Mini-BESTest as a reliable tool for clinical and research use in assessing balance impairments
The effects of stepwise balance and mobility exercise on standing balance, physical activity, and quality of life in patients with idiopathic normal pressure hydrocephalus
Background: Postural control and balance disturbances in idiopathic normal pressure hydrocephalus (iNPH) are crucial as they worsen gait and impact daily activities. Although traditional exercises are recommended, limited research has compared the effectiveness of tailored programs for this group. This study aimed to evaluate the effectiveness of stepwise balance and mobility exercises on standing balance, physical activity, and quality of life (QoL) in patients with iNPH. Materials and Methods: A single group with pre- and post-test design for pilot testing was conducted on eight patients with iNPH who underwent CSF shunt surgery and participated in a stepwise exercise program with basic education. Standing balance was assessed using the center of mass and center of pressure from the Force Distribution Measurement platform and Inertial Measurement Units. The International Physical Activity Questionnaires (IPAQ)-short form and EuroQol 5-Dimension 5-Level (EQ-5D-5L) were used to measure physical activity and QoL. Assessments at baseline and 4 weeks post-intervention were compared with the Wilcoxon signed-rank test. Results: Significant improvements were observed in the angle between Y and major axis during standing with eyes open (p = 0.017), total metabolic equivalents (METs) on the IPAQ (p = 0.012), and EQ-5D-5L utility score (p = 0.018) after the intervention, while other variables remained unchanged. Conclusion: Stepwise balance and mobility exercise have a positive effect on standing balance, physical activity, and QoL in patients with iNPH following CSF shunt surgery.
Prevalence and risk factor of sarcopenia among Thai community-dwelling elderly
Background: Sarcopenia is defined as loss of muscle mass, muscle strength and/or performance with age-related. However, the prevalence of sarcopenia showed vary depending on population and definition used. Objective: This study aimed to determine the prevalence of sarcopenia in Thai community-dwelling elderly according to the diagnostic criteria of AWGS2019. Materials and Methods: This cross-sectional study was conducted in elderly aged ≥ 60 years living in four communities at Nakhon Pathom province. Participants were screened by the SARC-F questionnaire, muscle strength by dynamometer, walking performances by the 6-meter gait speed, and muscle mass by bioelectrical impedance analysis (BIA). The chi-square test was used for data analysis. Results: 160 community-dwelling elderly participated with mean age 68.9 ± 6.1 years and 75% female. The overall prevalence rate of sarcopenia was 63% (101/160). There were 29.4% (47/160) was defined as possible sarcopenia while 23.1% (37/160) was sarcopenia and 10.6% (17/160) severe sarcopenia. The results demonstrated that BMI and educational level were significantly associated with sarcopenia (p<0.05), while age, gender, and community living show no significant association with sarcopenia. Conclusion: High prevalence rate of sarcopenia in community-dwelling elderly. Low BMI and lower education levels are associated with an increased risk of sarcopenia. Therefore, early identify this condition can be beneficial for prevention adverse outcomes related sarcopenia.
Evaluating square stepping exercise and brain training for balance improvement and fall prevention in elderly: implications for Thai-reed mat: a randomized controlled trial
Objective: To evaluate the effect of square stepping exercise plus brain training program in elderly patients and provide information to assist clinicians in making evidence-based decisions on using Thai-reed mat to improve balance and prevent falling. Materials and Methods: We compared a Thai-reed mat exercise program plus brain training with general balance exercise in a single-blind, randomized controlled trial. In total, 60 elderly participants were randomly assigned to an intervention group (12-week mat exercise program) and a control group (12-week general balance exercise). The primary outcomes were the change in the physical performance test and the number of fallers. Results: The intervention group showed a mean increase of 7.81 repetitions in the 30-second chair stand test (95% confidence interval (CI) 5.82–9.19), while the control group showed a mean increase of 2.3 repetitions (95% CI 2.04–5.68). The mat exercise program provided significant benefits over general balance exercise in terms of a higher mean TUG difference of 6.51 sec (95% CI 4.14–8.01) in the intervention group compared with 9.31 sec; 95% CI 7.03-11.45) in the control group (p = 0.01) and the gait speed of 0.83 m/sec (95% CI 0.61–1.02) in the intervention group and of 0.32 m/sec (95% CI 0.21–0.45) in the control group (p = 0.04). The number of fallers was 3.33% and 6.66% in the intervention and control groups, respectively. Conclusion: Square stepping exercise with brain training using Thai-reed mat should be implemented as the key components in fall prevention programs for the elderly.
Short-term effects of an innovative rehabilitation program (InnoRehab) on physical parameters in recreational runners with medial tibial stress syndrome
Background: Medial tibial stress syndrome (MTSS), or shin splints, is a common running injury caused by overpronation leading to tibial periosteum traction. The InnoRehab training program was developed to target biomechanical factors of MTSS. This study evaluates the short-term effects of InnoRehab on pain (VAS), center of pressure (COP), pain distance at the medial tibia, and flexor hallucis longus (FHL) strength and cross-sectional area (CSA) in MTSS runners. Materials and Methods: Twenty runners with MTSS were randomly assigned to the InnoRehab group (n=10) or control group (n=10) for four weeks of exercises. Pre- and post-tests assessed VAS, pain distance at the medial tibia, COP, FHL strength, and CSA. Paired and independent t-tests analyzed within- and between-group differences, with statistical significance set at p<0.05 and a 95% confidence interval (95%CI). Results: The InnoRehab group showed significant improvements in VAS during running (p<0.00, 95%CI -3.50 to -1.80), VAS rest (p=0.036, 95%CI -1.63 to -0.07), VAS after running (p<0.001, 95%CI -2.71 to -1.09), pain distance at the medial tibia (p=0.001, 95%CI -5.02 to -1.78), FHL strength (p=0.029, 95%CI 0.16 to 2.24), and CSA (p=0.012, 95%CI 0.08 to 0.51). The control group showed a significant reduction in VAS during running (p=0.020, 95%CI-2.41 to -0.27). Post-intervention comparisons revealed significant differences between groups for VAS during running (p=0.047, 95%CI -2.26 to -0.02) and CSA (p=0.003, 95%CI 0.28 to 1.16). Conclusion: The 4-week InnoRehab program significantly improved pain and CSA of FHL in runners, suggesting its potential as the intervention for MTSS.
Effects of a step training program in community-dwelling older adults with dementia: an age, walking ability, and cognitive function subgroup analysis
Objective: To evaluate the effects of a step training program in community-dwelling older adults with dementia in different age, walking ability, and cognitive function subgroups. Materials and Methods: This study is a pilot quasi-experimental, wait-list controlled trial. Older adults who had a diagnosis of dementia and were able to walk 10 m were recruited. The step training program consisted of two 40-minute weekly exercise sessions and lasted for 12 weeks. Participants’ stepping performance and physical and cognitive function were assessed at the baseline and at 12 weeks. Participants were divided into different subgroups based on their age (<80 vs ≥80 years), walking ability (walking independently vs using a walking stick), and cognitive function (mild dementia vs moderate dementia), and the effects of the step training program were evaluated separately. Results: Participants below 80 years old significantly improved their choice stepping, step length, alternate stepping speed, and global cognition (p ≤ .026), while those aged 80 or above showed no significant improvement. Participants who walked independently significantly improved choice stepping, step length, and alternate stepping speed (p ≤ .049). In contrast, those who walked with a walking stick showed no significant improvement. Participants with mild dementia significantly improved their step length (p = .002), while those with moderate dementia had significant improvements in choice stepping, alternate stepping speed, and walking speed (p ≤ .024). Conclusion: Older adults with dementia who are younger, can walk independently, and are more cognitively impaired are more likely to benefit from the step training program.
Convergent validity of the multidimensional falls efficacy scale, activities-specific balance confidence, balance recovery confidence scale and the falls efficacy scale-international
Objective: Falls efficacy is a critical psychological construct in falls prevention and management. Various measurement instruments designed to measure falls efficacy, balance confidence, and fear of falling have often been used interchangeably. This study evaluates the convergent validity of the newly developed Multidimensional Falls Efficacy Scale (MDFES) in Singapore community-dwelling older adults against other falls efficacy-related patient-reported outcome measures (PROMs). Materials and Methods: This is a cross-sectional study design. One hundred and nineteen community-dwelling older adults aged 65 and older completed four PROMs, including the MDFES, the Activities-specific Balance Confidence Scale (ABC), the Balance Recovery Confidence Scale (BRC), and the Short Falls Efficacy Scale-International (FES-I). Convergent validity was evaluated using Spearman’s correlation coefficients and a priori hypotheses to assess the relationships between the multi-FES and other PROMs. Results: The multi-FES showed moderate positive correlations with the ABC (r = 0.51) and the BRC (r = 0.67). The multi-FES had a moderate negative correlation with the FES-I (r =-0.46). The strength and direction of the correlations were consistent with the priori hypotheses. Conclusion: Falls efficacy is closely related to balance confidence and fear of falling, but they are unique constructs. The MdFES demonstrates moderate convergent validity against balance confidence and fear of falling PROMs. It incorporates other self-efficacy domains to provide a more comprehensive assessment of falls efficacy. Further validation studies are recommended to support its clinical applicability and explore its relationship with additional performance metrics.
Associations between chronic low back pain and a 6-item movement control test battery: Analysis of total and direction-specific tests
Background: A 6-item movement control test (MCT) battery is a screening tool designed to identify movement control impairments in patients with chronic low back pain (CLBP) using a total score. In addition, the 6-item MCT battery can be further classified into flexion- and extension-specific tests. However, the associations between CLBP and direction-specific tests have not been investigated. Objectives: To determine the associations between CLBP and MCT battery based on a total score and direction-specific tests. Materials and Methods: 94 participants were recruited from physical therapy clinics and classified into two groups: 47 CLBP and 47 healthy controls. Each participant was assessed using 6-item MCT battery (3 flexion-specific and 3 extension-specific tests). A total MCT score of ≥2 out of 6 was considered a positive movement control impairment, while a score of ≥2 out of 3 in direction-specific tests was considered a positive direction-specific movement control impairment. The chi-square test was used to determine the associations between CLBP and MCT. Results: Statistical analyses revealed a significant association between the total score and CLBP (P=0.003). Significant associations between CLBP and direction-specific MCT battery were also observed (P=0.002 and P=0.038, respectively). Conclusion: The results suggest a potential link between movement control impairment and CLBP; however, causal relationships remain unclear. In addition, CLBP was also associated with both flexion- and extension-specific tests, suggesting that movement control impairment may not be specific to the directions. However, subclassifying movement control impairment using direction-specific tests may help clinicians design exercises specific to the direction of impairment.
Cross-cultural adaptation and validation of the Thai version of the updated perceived control of falling scale
Objective: Falls are a major health issue among older adults, often leading to injuries, reduced quality of life, and concern about falling. The Updated Perceived Control over Falling Scale (UP-COF) assesses perceived control over falling, a critical factor in fall prevention, but it has not been adapted for use in Thailand. This study aims to translate and cross-culturally adapt the UP-COF into Thai and examine its reliability and validity in older adults. Materials and Methods: The UP-COF was cross-culturally adapted following translation guidelines. Prefinal testing with 20 older adults resulted in minor adjustments. The test-retest reliability and concurrent validity of the Thai UP-COF were evaluated in 50 older adults. Reliability was assessed using the intraclass correlation coefficient (ICC 2,1), and validity was determined by the Pearson correlation coefficient with the Falls Efficacy Scale-International (FES-I). Statistical significance was set at p < 0.05. Results: The UP-COF demonstrated acceptable test-retest reliability with an ICC (2,1) of 0.75. Concurrent validity was confirmed, as total UP-COF scores were significantly negatively correlated with FES-I scores (r = -0.525, 95% CI [-0.701, -0.289], p < 0.001). Conclusion: The Thai version of the UP-COF is a reliable and valid tool for assessing perceived control over falling in older adults. It can support clinical and research efforts to enhance fall prevention strategies and improve the quality of life in this population.
Telerehabilitation versus clinic-based core stabilization exercise with abdominal drawing-in maneuver for chronic non-specific low back pain with lumbar instability: a randomized controlled trial
Background: Despite growing telerehabilitation use, few other studies have investigated the effectiveness of telerehabilitation-based core stabilization exercises for chronic non-specific low back pain (CNSLBP) with lumbar instability (LI). The aim of this study was to compare telerehabilitation versus clinic-based core stabilization exercise with abdominal drawing-in maneuver (CSE with ADIM) on pain, function, lumbar reposition error, quality of life, and satisfaction in CNSLBP with LI. Materials and Methods: In this single-blind randomized controlled trial, 30 participants CNSLBP with LI participants were randomly allocated to telerehabilitation (n=15) or clinic-based (n=15) groups. Both received a 7-week CSE with ADIM programs, delivered via video calls or in-clinic sessions respectively. Outcomes measured included numeric pain rating scale (NRS), Oswestry Disability Index (ODI), Roland-Morris Disability Questionnaire (RMDQ), 36-Item Short Form Survey (SF-36), and lumbar reposition error at baseline and post-intervention. Participant satisfaction was assessed upon completion. Results: Interim analysis (n=10 per group) showed significant within-group NRS, ODI, and RMDQ score reductions (p<0.05), with no significant between-group differences. Telerehabilitation improved 6/8 SF-36 domains (p<0.05), excluding emotional well-being and social function. Clinic-based improvements were limited to bodily pain and general health, with no significant between-group differences. Both groups achieved 96% adherence with high satisfaction: 99.4% (telerehabilitation-based) and 98% (clinic-based). Neither group exhibited significant differences in lumbar repositioning error within or between groups. No adverse events occurred. Conclusion: Telerehabilitation-delivered CSE with ADIM effectively reduces pain and improves function and quality of life in CNSLBP with LI, offering a viable alternative to clinic-based treatment.
Exploring the relationship between kinesiophobia, clinical outcomes, and lumbopelvic movement control impairments
Background: The Tampa Scale for Kinesiophobia (TSK) was developed to assess fear of movement in individuals with chronic low back pain (LBP). Previous studies demonstrated that kinesiophobia was associated with clinical outcomes (pain and disability). The 6-item movement control test battery (MCTB) has been proposed to identify lumbopelvic movement control impairment (MCI), which could be associated with kinesiophobia. Objectives: To determine the association between kinesiophobia clinical outcomes and MCI. Materials and Methods: A Total of 141 participants, including chronic LBP (n=47), no LBP (n=47) and a history of LBP (n=47) were recruited. TSK, numeric pain rating scale (NPRS), and Oswestry disability index (ODI) were collected. Then, participants underwent MCTB comprising 6 tests (3 flexion-specific and 3 extension-specific tests). The results of MCTB were recorded as the frequencies of positive MCI. The frequency for overall MCI ranges between 0 and 6, while the frequency for each direction-specific MCI ranges between 0 and 3. Spearman’s test was used to determine the associations. Results: Statistical analysis showed TSK was significantly associated (P<0.05) with NPRS (r=0.78), ODI (r=0.34), overall MCI (r=0.26), flexion-specific MCI (r=0.26), and extension-specific MCI (r=0.18). Conclusion: Our findings support the association between fear of movement and clinical outcomes consistent with those reported in literature. The association between fear of movement and MCI suggests the role of fear in movement control. Results further indicate that kinesiophobia compromises movement control in flexion-specific rather than extension-specific direction. However, the weak association (r<0.40) between kinesiophobia and MCI should be considered before applying to clinical practice.
Heart rate and blood pressure responses to different types of breathing techniques in young healthy adults
Background: Incentive spirometer (IS) is often used to prevent postoperative complications by improving lung volume, which may also influence cardiovascular autonomic function. Although various types of IS devices are available, there is no evidence regarding their acute effects on cardiovascular responses. Therefore, this study aims to compare heart rate (HR) and blood pressure (BP) responses among breathing techniques in young healthy adults. Materials and Methods: Thirty volunteers (aged 18-25 years) participated and were randomly assigned to a sequence involving diaphragmatic breathing exercise (DBE), Triflo® (TF), and BreatheMAX® (BM) devices as a crossover design. Each condition was tested on a different day over three consecutive days. Baseline parameters, HR, BP, and rate of perceived exertion (RPE) were evaluated before and after a 7-minute breathing exercise. Data were analyzed by repeated-measures ANOVA and paired t-tests, with significance set at P<0.05. Results: Within conditions, diastolic BP was significantly higher after TF (P<0.05), whereas no significant differences in HR and BP were found for DBE and BM (P>0.05). In addition, no significant differences in HR and BP were observed between conditions (P>0.05). RPE was significantly increased after all conditions (P<0.001), with RPE in TF and BM significantly higher compared to DBE (P<0.001). The increase in RPE was significantly greater in TF than in BM (P<0.001). Conclusion: While all breathing exercises led to increased exertion, TF produced a greater increase in BP and RPE. This suggests that patients with cardiovascular concerns may benefit from DBE or BM, whereas TF should be used with careful consideration.
Effects of rehabilitation program with specific structural exercise on physical strength and quality of life in liver transplantation patients: Small-n Experimental Research Design
The advantages of multimodal therapy on Achilles tendinopathy in para-athletes: a case report
Background: Approximately 52% of Indonesian athletes experience Achilles tendinopathy (AT) injuries, which are often accompanied by knee pain during running, walking, and jumping. This study sought to explore the most effective multimodal treatments for patients with AT. Materials and Methods: The patient was a 28-year-old male para-athletic athlete with a primary diagnosis of AT, classified as T45/46/57. He completed 10 physical therapy sessions, each lasting approximately 120 minutes, twice a week over three weeks. The patient participated in a multimodal exercise program (exercises, extracorporeal shockwave therapy, stretching, muscle release, electrical stimulation, and cryotherapy). Outcomes were measured every week. Results: Using the numeric rating scale (NRS) and manual muscle testing (MMT) outcomes, the patient reported the most significant improvement in pain (from 7 to 3). Additionally, the muscle strength of the ankle joint flexors and extensors increased from 4 to 5, respectively. Functional measurement using the victorian institute of sport assessment-achilles (VISA-A) Scale was initially 53% to 86%, with an interpretation below 60% of patients still experiencing problems in the Achilles tendon. Conclusion: This was the first study to explore a multimodal treatment strategy aim to at managing progression in a patient diagnosed with AT. The use of multimodal methods had a positive effect on repairing the soft tissue of the AT, leading to improvements in the patient's reported pain levels, increased lower muscle strength, and enhanced functional abilities in the patient diagnosed with AT.
Integrated medical approach and dual-task training: comprehensive strategy to reduce fall risk in older adults
Objective: An integrated medical approach combined with dual-task training (DTT) has emerged as a promising intervention for reducing fall risk in this population. This study investigated the effectiveness of an integrated exercise regimen that combines physical therapy, Thai hermit exercise, Tai Chi Chuan, and cognitive stimulation (DTT) to improve postural stability, gait performance, and cognitive-motor coordination in older adults. Materials and Methods: Forty-eight community-dwelling participants aged between 60–80 years were randomized to either integrated exercise training (IET) or stretching exercise (SE). Both groups were asked to exercise 45 minutes 3 times per week for 4 weeks. The balance performance was assessed by the Timed up and go test (TUG), for dual-task performance was assessed by TUG with cognitive, and TUG with motor test, for the cognitive assessment were conducted by the Montreal Cognitive Assessment (MOCA). All variables were analyzed to compare pre and post-exercise training after 4 weeks using the independent sample t-test. Results: After training, the IET group found a significant decrease in the timing of TUG with cognitive (p = 0.01) and significant difference between the IET group and SE group was found in TUG (p = 0.01), TUG with cognitive (p = 0.01), and TUG with motor (p = 0.01) test, whereas MOCA did not exhibit significant changes between groups after training. Conclusion: Integrated exercise with dual-task training, which simultaneously engages physical and cognitive tasks, has shown a potential to improve balance performance with dual-task factors in fall prevention in older adults.
Physical therapy combined with flip-flops versus physical therapy alone in plantar fasciitis: analysis of clinically meaningful improvements
Objective: To compare the effectiveness of physical therapy (PT) combined with flip-flops versus PT alone in plantar fasciitis, focusing on the number of participants achieving clinically significant improvements according to minimum clinically important difference (MCID) criteria. Materials and Methods: Sixty-six participants (aged 20–60 years) were randomly assigned to either the intervention group (PT with flip-flops, n=33) or the comparative group (PT alone, n=33) for 8 weeks. Both groups received PT (plantar fascia stretching, calf stretching, subtalar mobilization) and performed the same exercises at home as administered by therapists. The intervention group additionally wore Vari-Ving flip-flops, designed with arch support and cushioning features, for ≥4 hours daily. Outcome measures included first-step morning pain, first step post-inactivity pain, average pain, pressure pain threshold, Foot Function Index, Lower Extremity Functional Scale (LEFS), and Global Rating of Change (GRC). Results: All participants completed the study with 100% adherence. Both groups showed significant improvements across all measures (p<0.01). For first-step morning pain, 54 participants (27 per group) achieved MCID, while for post-inactivity pain, 53 participants (intervention: 27, control: 26) reached MCID, with the intervention group showing marginally greater improvement (p=0.05 with medium effect). Functionally, 34 participants (17 per group) met MCID on LEFS, and 40 participants (20 per group) showed meaningful recovery on GRC, with 11 intervention participants achieving substantial improvements (+5 GRC). Conclusion: Both interventions demonstrated clinically significant improvements. Home exercises, replicating therapist-administered techniques, effectively reduced pain and improved function, while supportive flip-flops showed potential as a valuable adjunct therapy enhancing overall effectiveness.
The effect of ice baths on creatine kinase (CK) levels following physical training in female footballers
Objective: Creatine kinase (CK) levels can increase, leading to cell and tissue damage after physical training. The ice bath is indicated as one of the methods that can be used to suppress the increase in CK. This study aimed to explore the impact of ice baths on creatine kinase levels after physical training in female football players. Materials and Methods: This research was an experimental study that included 20 women football athletes and was divided into two groups (an ice bath and a thermoneutral bath). Blood sampling was carried out before and 24 hours after physical exercise. The CK level was measured using an Enzyme-Linked Immunosorbent Assay (ELISA) test. An ice bath was given to both lower legs. The ice bath was done for 15 minutes at a temperature of 15 degrees Celsius. The non-parametric test was applied to identify the effect of each treatment on the CK level and the difference between both. Effect test using Wilcoxon test and Paired Samples test, and effect difference test using Mann-Whitney test. Results: Comparing within group, both groups showed a reduction of the CK level (p=0.000). Significant difference was observed (p=0.001). The ice bath was more effective in suppressing the increase in CK levels than the thermoneutral bath, with reductions of 26.8% and 52.6%, respectively. Conclusion: The increase in CK levels could be inhibited by an ice bath after exercise, thus could help to avoid cell and tissue damage.
The effects of inspiratory muscle training on lung function and respiratory muscle strength in adults with sedentary behavior: preliminary data
Background: Sedentary lifestyle have wide-ranging adverse impacts on health including increased risk of mortality, cardiovascular disease, cancer, and risks of metabolic disorders. These lifestyle directly negative influences on respiratory systems. Inspiratory muscle training is a simple and safe method that has been shown clinically improve respiratory function. Therefore, the method is benefit for reducing the risks of sedentary lifestyle. Objective: To compare effects of inspiratory muscle training on lung function and respiratory muscle strength among adults with sedentary behavior Materials and Methods: Current study was randomized controlled trial. Twenty sedentary adults were randomly assigned to inspiratory muscle training and control groups, ten adults in each group. Sedentary lifestyle was assessed by using Baecke Habitual Physical Activity Questionnaire (BHPAQ). Inspiratory muscle training was individually performed 15 times/set, complete 2 set each day, 5 day a week, for 4 weeks. Lung function and inspiratory and expiratory muscle strength were measured pre- and post-training. Unpaired-t test and paired-t test were used for analysis of outcomes. The significant different was set at 0.05. Results: The sedentary time of participants were 7.25±0.78 hours/day. Participants’ ages range between 18-25 years. The inspiratory muscle training was superior significant increase in lung function (FEV1, FVC, FEV1/FVC, and PEFR) and respiratory muscle strength between two groups (p<0.001). Lung function outcomes were significant difference between pre- and post-inspiratory muscle training (p<0.001). Conclusion: The 4-week inspiratory muscle training effectively enhanced lung function and respiratory muscle strength in adults with sedentary behavior.
Tablet posture matters: exploring tablet use, pain, and related factors in university students
Objectives: Tablets are commonly used in higher education, with increasing reports of neck pain linked to their use. However, limited research has specifically explored the tablet usage behaviors. This study aims to examine tablet posture, duration usage, and tilt angle, and their association with neck pain among college students. Materials and Methods: A cross-sectional study among college students using tablets for at least one year without neurological neck pain assessed demographics, tablet angles (0°–60°), postures, and neck pain using expert-validated questionnaires. Logistic regression and Spearman’s correlation analyzed factors associated with neck pain, with VAS scores and significance set at p < 0.05. Results: Of the 328 questionnaires from 17 universities, 91% were completed. Participants predominatly were female (72%) with age was 21 (20, 22) years old and BMI of 21.38 (19.10, 24.97) kg/m². Eighty-five percent, tablet use exceeding five hours daily. Tilt angles were 0° (20%), 10° (38%), and 20° (24%), with postures including leaning forward (36%) and legs crossed (26%). Moderate to severe neck pain (VAS≥3) was associated with posture (OR = 1.24, 95% CI: 1.07–1.44, p < 0.05) and female (OR = 2.22, 95% CI: 1.24–3.97, p < 0.05). Straight back and leaning forward postures showed negative associations with pain. No significant correlation was found between tilt angle and neck pain level (p = 0.30). Conclusion: Posture and gender may contribute to neck pain in tablet-using students due to musculoskeletal activation and structural differences, highlighting the need for ergonomic education and preventive strategies to reduce risk.
Effect of integrative exercise on cognitive function and the fear of falling in community-dwelling older adults
Objective: The aging population often faces challenges related to cognitive decline and an increased risk of falls, both of which can severely impact quality of life. Integrative exercises, combining physical, cognitive, and breathing elements, have been proposed as a potential intervention to mitigate these issues. This study explores the effect of integrative exercise on cognitive function and the fear of falling in community-dwelling older adults. Materials and Methods: A randomized controlled trial was conducted with participants aged 60 – 80 years old, who were randomly assigned to either an integrative exercise group (n=30) or a traditional exercise group (n=30) for 6 weeks three days a week. Cognitive function was assessed using Montreal Cognitive Assessment (MoCA), while the fear of falling was measured through the Falls Efficacy Scale-International (FES-I). Between-group differences were tested with an independent samples t-test. Results: Results indicated that participants in the integrative exercise group showed significant improvements in both cognitive performance (p < 0.01) and a reduction in fear of falling (p < 0.01) compared to those in the traditional exercise group. These findings suggest that integrative exercise, which includes components such as balance training, Thai - Chinese traditional exercise and cognitive tasks, may enhance both cognitive health and psychological well-being in older adults. Conclusion: The potential for integrative exercise programs to serve as effective, multidimensional interventions in promoting the reduction of fall-related injuries in older adults is evident. Further research is needed to explore the long-term effects and underlying mechanisms of this intervention.
The comparison of pulmonary function and exercise capacity between non-anemia and anemia chronic obstructive pulmonary disease (COPD)
Objective: The purpose of this study is to compare pulmonary function test (PFT) and exercise capacity between non-anemia and anemia COPD patients. Materials and Methods: A total of 80 participants with COPD were enrolled and divided into non-anemic and anemic COPD. Pulmonary function test was assessed using standard spirometry to measure forced vital capacity (FVC), forced expiratory volume in one second (FEV₁), and the FEV₁/FVC ratio. Exercise capacity was evaluated using the six-minute walk test (6MWT), with the six-minute walk distance (6MWD) recorded and adjusted for each participant. Results: The results shown FVC and the %predicted FVC were statistically significant differences between anemic and non-anemic COPD. The FEV1, % predicted FEV1, and FEV1/FVC were no statistically significant differences between anemic and non-anemic COPD. Additionally, 6MWD was significantly lower in anemic COPD compared to non-anemia COPD (p < 0.05), suggesting that anemia is associated with reduced exercise capacity in COPD patients. Conclusions: Anemic COPD patients had significantly lower FVC, %predicted FVC, and 6MWD (p < 0.05), indicating impaired pulmonary function and exercise capacity. Hemoglobin level may be a useful parameter for assessing rehabilitation readiness and guiding treatment decisions in this group.
Reliability of the four square step test in children with typical development age between seven to twelve years old
Background: Balance consists of both static and dynamic components. Dynamic balance involves motor planning and coordination which are essential for children’s daily activities and development. Although several measurement tools are available, the Four Square Step Test (FSST) is a practical and cost-effective tool for assessing dynamic balance, coordination, and agility. It has been examined of reliability in various population; however, the FSST in Thai children with typical development (TD) remains unexplored. This study aimed to assess the inter- and intra-rater reliability of the FSST in Thai children with TD aged 7–12 years. Materials and Methods: This study included 23 children with TD (mean age: 9.43 ± 1.75 years; 11 boys, 12 girls). Two raters conducted inter-rater reliability assessments, while intra-rater assessments were performed over a three-hour period. Reliability was examined using the intraclass correlation coefficient (ICC): inter-rater ICC (2,1) and intra-rater ICC (3,1). Values for ICC were classified as weak (<0.5), moderate (0.51–0.75), good (0.76–0.89), and excellent (>0.90). Results: Both groups exhibited an increase of peak MUAP. TKE with audible cues showed a greater change (40.16%) than without audible cues (10.03%). A decreased average MUFR after TKE exercise was observed in both with (41.62%) and without (8.10%) audible cues. Conclusion: The FSST demonstrated excellent inter- and intra-rater reliability in Thai children with TD, supporting its use in clinical and research settings to assess dynamic balance.