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Phys. Ther. Korea 2023; 30(1): 50-58

Published online February 20, 2023

https://doi.org/10.12674/ptk.2023.30.1.50

© Korean Research Society of Physical Therapy

A Study on the Effectiveness of Face-to-face Physical Therapy and Non-face-to-face Physical Therapy in Individuals With Rounded Shoulder

Young-ji Cho , Min-je Kim , Cho-won Park , Ye-bin Cho , In-A Heo , Su-jin Kim , PT, PhD

Department of Physical Therapy, College of Medical Science, Jeonju University, Jeonju, Korea

Correspondence to: Su-jin Kim
E-mail: sujink@jj.ac.kr
https://orcid.org/0000-0002-5222-4538

Received: January 16, 2023; Revised: January 31, 2023; Accepted: January 31, 2023

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

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Background: This study was carried out to determine whether non-face-to-face physical therapy would have similar exercise effects to face-to-face physical therapy. Hence, we developed an approach for patients, unable to visit hospitals due to circumstances such as the COVID-19 pandemic, to conduct physical therapy comfortably at home. Objects: This study aimed to compare the effects of a face-to-face and a non-face-to-face physical therapy treatment on improving a rounded shoulder posture.
Methods: The participants with rounded shoulders were randomly divided into a face-toface group (n = 15) and a non-face-to-face group (n = 15), and each group performed exercises for four weeks. The exercise program consisted of the bare hands exercise, Thera-Band exercise, and foam roller exercise. The participants in the face-to-face group came to a designated place to perform their exercises, and those in the non-face-to-face group performed the exercises at their own home using Google Meet (Google). Acromial height, total scapular distance (TSD), shoulder pain and dysfunction index (SPADI), and pectoralis minor thickness were measured. Data analysis was performed using the R Statistical Software (R Core Team), and a normality test was performed using the Shapiro-Wilk test.
Results: There were no significant differences between the face-to-face and the non-face-toface groups (p > 0.05). When comparing the differences before and after the exercises, both the face-to-face and the non-face-to-face groups showed significant differences in acromial height, SPADI, and pectoralis minor thickness (p < 0.05), and both groups showed no significant difference in TSD before and after the exercises (p > 0.05).
Conclusion: The results of this study support the results of previous studies reporting that shoulder stabilization exercise and pectoralis minor stretching training improves round shoulders. In addition, this study revealed that both the face-to-face and the non-face-to-face physical therapy treatments had therapeutic effects.

Keywords: Acromion, Muscle stretching exercises, Pectoralis muscle, Posture, Telerehabilitation

Article

Original Article

Phys. Ther. Korea 2023; 30(1): 50-58

Published online February 20, 2023 https://doi.org/10.12674/ptk.2023.30.1.50

Copyright © Korean Research Society of Physical Therapy.

A Study on the Effectiveness of Face-to-face Physical Therapy and Non-face-to-face Physical Therapy in Individuals With Rounded Shoulder

Young-ji Cho , Min-je Kim , Cho-won Park , Ye-bin Cho , In-A Heo , Su-jin Kim , PT, PhD

Department of Physical Therapy, College of Medical Science, Jeonju University, Jeonju, Korea

Correspondence to:Su-jin Kim
E-mail: sujink@jj.ac.kr
https://orcid.org/0000-0002-5222-4538

Received: January 16, 2023; Revised: January 31, 2023; Accepted: January 31, 2023

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background: This study was carried out to determine whether non-face-to-face physical therapy would have similar exercise effects to face-to-face physical therapy. Hence, we developed an approach for patients, unable to visit hospitals due to circumstances such as the COVID-19 pandemic, to conduct physical therapy comfortably at home. Objects: This study aimed to compare the effects of a face-to-face and a non-face-to-face physical therapy treatment on improving a rounded shoulder posture.
Methods: The participants with rounded shoulders were randomly divided into a face-toface group (n = 15) and a non-face-to-face group (n = 15), and each group performed exercises for four weeks. The exercise program consisted of the bare hands exercise, Thera-Band exercise, and foam roller exercise. The participants in the face-to-face group came to a designated place to perform their exercises, and those in the non-face-to-face group performed the exercises at their own home using Google Meet (Google). Acromial height, total scapular distance (TSD), shoulder pain and dysfunction index (SPADI), and pectoralis minor thickness were measured. Data analysis was performed using the R Statistical Software (R Core Team), and a normality test was performed using the Shapiro-Wilk test.
Results: There were no significant differences between the face-to-face and the non-face-toface groups (p > 0.05). When comparing the differences before and after the exercises, both the face-to-face and the non-face-to-face groups showed significant differences in acromial height, SPADI, and pectoralis minor thickness (p < 0.05), and both groups showed no significant difference in TSD before and after the exercises (p > 0.05).
Conclusion: The results of this study support the results of previous studies reporting that shoulder stabilization exercise and pectoralis minor stretching training improves round shoulders. In addition, this study revealed that both the face-to-face and the non-face-to-face physical therapy treatments had therapeutic effects.

Keywords: Acromion, Muscle stretching exercises, Pectoralis muscle, Posture, Telerehabilitation

Fig 1.

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Figure 1.Shoulder acromion height measurement.
Physical Therapy Korea 2023; 30: 50-58https://doi.org/10.12674/ptk.2023.30.1.50

Fig 2.

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Figure 2.Total scapular distance measurement.
Physical Therapy Korea 2023; 30: 50-58https://doi.org/10.12674/ptk.2023.30.1.50

Fig 3.

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Figure 3.Pectoralis minor thickness measurement.
Physical Therapy Korea 2023; 30: 50-58https://doi.org/10.12674/ptk.2023.30.1.50

Fig 4.

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Figure 4.Bare-hand exercises. (A) Levator scapulae stretching, (B) pectoralis major stretching, (C) scapular depression, and (D) Y to W. The picture on the left is the starting position, and on the right is the ending position.
Physical Therapy Korea 2023; 30: 50-58https://doi.org/10.12674/ptk.2023.30.1.50

Fig 5.

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Figure 5.Exercise with Thera-band. (A) Scapular retraction, (B) shoulder press, and (C) shoulder abduction. The picture on the left is the starting position, and on the right is the ending position.
Physical Therapy Korea 2023; 30: 50-58https://doi.org/10.12674/ptk.2023.30.1.50

Fig 6.

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Figure 6.Exercise with a foam roller. (A) Pulling elbow, (B) shoulder external rotation, (C) shoulder lifting, and (D) shoulder internal rotation. The picture on the left is the starting position, and on the right is the ending position.
Physical Therapy Korea 2023; 30: 50-58https://doi.org/10.12674/ptk.2023.30.1.50

Table 1 . Demographic characteristics of participants (N = 30).

VariableFace group
(n = 15)		Non-face group
(n = 15)		p-value
Age (y)21.0 ± 1.3721.27 ± 1.440.08
Height (cm)163.02 ± 5.69164.38 ± 7.160.10
Weight (kg)55.73 ± 9.2855.8 ± 11.880.11
Sex (male/female)2/133/120.92

Values are presented as mean ± standard deviation or number only..

Table 2 . Result of the difference before and after exercise for 4 weeks.

GroupFacep-valueNon-facep-valueGroup comparison in Δchange
Shoulder acromion height (cm)Before5.63 ± 0.93< 0.0015.36 ± 1.43< 0.0010.3
After4.46 ± 1.093.82 ± 1.17
ΔChange–1.17–1.54
Total scapular distance (cm)Before19.83 ± 2.51> 0.99919.83 ± 1.280.800.42
After19.97 ± 1.7319.50 ± 1.69
ΔChange0.14–0.33
SPADIa (%)Before19.74 ± 13.35*< 0.00112.67 ± 10.01*< 0.0010.4
After7.90 ± 7.423.65 ± 3.77
ΔChange–11.84–9.02
Pectoralis minor thickness (cm)Before0.67 ± 0.19< 0.0010.66 ± 0.310.0050.70
After0.59 ± 0.160.60 ± 0.26
ΔChange–0.08–0.06

Values are presented as mean ± standard deviation or number only. SPADI, shoulder pain and dysfunction index. aSPADI is a patient-completed questionnaire with 13 items assessing pain level and extent of difficulty with ADLs requiring the use of the upper extremities. *Significant difference in SPADI score before training between groups (p = 0.05)..