ASEAN Journal of Rehabilitation Medicine

Notes from the Editor-in-Chief

Kingkaew Pajareya — 2026-01-15

A Comparison of the Efficacy of Thai Traditional Massage and Focused Extracorporeal Shockwave Therapy for the Treatment of Chronic Plantar Fasciitis: A Randomized, Single-Blind Clinical Trial

Krongkaew Tochaiwat — 2026-01-15

Objectives: To compare the effectiveness of Thai traditional massage (TTM) and focused extracorporeal shockwave therapy (fESWT) in reducing pain and improving foot function in patients with chronic plantar fasciitis (PF)

Study design: A randomized, single-blinded, non-inferiority clinical trial

Setting: Department of Rehabilitation Medicine, Banglamung Hospital in Chonburi, Thailand. Conducted between September 2021 and August 2022

Subjects: Sixty-six patients (≥ 18 years) with chronic plantar fasciitis

Methods: Participants were randomly assigned to one of two groups (n = 33 each) using a block-of-four method. The interven-tion group received TTM once a week for four weeks, and the control group received fESWT using a BJC-80414 device for the same period. Both groups were instructed to perform daily muscle stretching exercises. Outcomes were assessed using the visual analog scale (VAS) and the foot function Index (FFI) at baseline and at 2, 4, and 8 weeks.

Results: The patients’ characteristics in the TTM and fESWT groups showed no significant differences. After treatment, however, The TTM and fESWT groups were significantly different, with the TTM group having lower pain scores than the fESWT group. Comparison of VAS and FFI at the two-week timepoint found they were not different in FFI (pain, disability, activity limitation) after TTM between the two groups. There was, however, a statistically significantly difference at weeks 4 and 8 at the p = 0.05 level. A comparison of VAS and FFI at baseline and after 2, 4 and 8 weeks of treatment showed the average VAS scores were statistically significant decreased, whereas FFI (pain, disability, activity limitation) scores were statistically significantly increased at those time points.

Conclusions: The treatment of chronic plantar fasciitis using either Thai traditional massage or focused extracorporeal shockwave therapy can statistically significantly reduce pain and improve foot functionality. However, there is no statistically significant difference in foot functionality between the two treatment methods.

Effects of Cervical Proprioception Training Versus Strengthening Exercise of the Deep Neck and Lower Trapezius Muscle Combined with Cranio-Cervical Flexion Training (CCFT) to Improve Postural Control of the Neck in Office Workers with Chronic Neck Pain: A Single-Blind, Parallel-Group Randomized Controlled Trial

Peerapong Wongsawan — 2026-01-15

Objectives: To compare the effects of cervical proprioception training versus strengthening exercises of the deep cervical flexor and lower trapezius muscles, each combined with cranio-cervical flexion training (CCFT) on postural control of the neck in office workers with chronic neck pain

Study design: A single-blind, parallel-group randomized controlled trial

Setting: Outpatient Department (OPD), Physical Therapy Clinic, Ramathibodi Chakri Naruebodindra Hospital, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Thailand

Subjects: Thirty-three office workers with neck pain lasting more than 3 months were included. After three participants were excluded prior to the first assessment, twenty-eight people remained in the study (average age 31.2 years; 11 men, 17 women).

Methods: All treatments lasted 45-60 minutes per session, twice a week for 6 weeks (total of 12 sessions). Group 1 did CCFT plus neck position training (n = 10). Group 2 did CCFT plus neck and shoulder muscle strength training (n = 9). The control group did only CCFT (n = 9).

Cervical joint position error (JPE), cervical range of motion (ROM), pain intensity (VAS), and the Neck Disability Index (NDI). Outcomes were assessed at baseline, at 4- and 6-weeks post-intervention, and at the 12-week follow-up.

Results: All groups showed significant within-group reductions in mean JPE error angles across all directions by T3 (p < 0.05). Group 2 exhibited the earliest improvement, with a significant reduction in JPE at T1 (week 4), whereas Group 1 reached signi-ficance at T2 (week 6). Between-group comparisons revealed that both intervention groups (groups 1 and 2) demonstrated significantly greater improvements in JPE than the control group. Cervical ROM increased over time in all groups. group 1 showed greater improvements in right/left lateral flexion than group 2, with no differences compared to the control group. Pain intensity (VAS) and NDI scores decreased significantly from baseline in every group (p < 0.05). However, the magnitude of reduction did not differ significantly between groups for VAS, while NDI reduction was greatest in Group 2.

Conclusions: Combining CCFT with deep cervical flexor and lower trapezius strengthening exercises yielded the most rapid and pronounced improvements in proprioceptive accuracy, postural control (ROM), and neck disability. All combinations of interventions were more effective than CCFT alone in reducing JPE, pain, and disability.

A study of Short-Term Effects of Using Shoulder-Posture-Corrector Belts Combined with Stretching Exercise in the Management of Chronic Neck Pain in Office Workers: A Single-Blind Randomized Controlled Trial

Jakrapat Sawatruang — 2026-01-15

Objectives: To investigate the short-term effects of combining shoulder-posture-corrector belts with stretching exercise in the management of chronic neck pain in office workers, compared with stretching exercise alone.

Study design: Single-blind randomized controlled trial

Setting: Outpatient Unit, Department of Rehabilitation Medicine, Siriraj Hospital, Thailand

Subjects: Sixty patients, aged 20 to 50, with a moderate degree of nonspecific neck pain lasting for at least three months

Methods: Sixty participants were randomly assigned to a control group or an intervention group. All participants were instructed to perform a neck stretching program at home for two weeks. The intervention group received the additional use of the shoulder-posture-corrector belts while sitting at work for two weeks. The primary outcome was the improvement in the management of chronic neck pain, measured using a visual analogue scale (VAS). Secondary outcomes were evaluated using the Neck Disability Index-Thai version (NDI-TH) score, cervical range of motion (CROM), and craniovertebral angle (CVA). Data collection also included compliance, satisfaction, and adverse effects. The outcome measurement was evaluated at baseline and after two weeks.

Results: The study outcomes revealed no statistically significant differences between groups in terms of VAS, NDI-TH (total) scores, CROM (all movement directions), or CVA (p = 0.244, 0.140, 0.119–0.836, and 0.207, respectively). The intervention group demon-strated greater improvements than the control group, with a statistically significant difference only in NDI-TH (pain domain) score (p = 0.010). However, both groups showed improvements in VAS, NDI-TH (pain domain), and NDI-TH (total) scores (p < 0.05). Regarding patients’ compliance and satisfaction, subjects from both groups showed comparable good compliance and satisfaction. There were no serious adverse effects reported by either group.

Conclusions: The use of shoulder-posture-corrector belts combined with stretching exercises demonstrated a significant improvement only in the pain domain of the Thai version of the Neck Disability Index (NDI-TH) compared with stretching exercises alone in the management of chronic neck pain in office workers after two weeks of treatment.

A Retrospective Study on the Association of Age and Sex with the Effectiveness of Canalith Repositioning and Home-Based Rehabilitation in Benign Paroxysmal Positional Vertigo Patients

Watcharin Tayati — 2026-01-15

Objectives: To investigate the association between sex, age, and the effectiveness of the canalith repositioning procedure (CRP) combined with home-based vestibular rehabilitation in patients with benign paroxysmal positional vertigo (BPPV), and to examine their influence on dizziness-related quality of life as measured by the Dizziness Handicap Inventory (DHI).

Study design: Retrospective observational study

Setting: The Outpatient Departments of Otolaryngology and Physical Therapy, Trang Hospital, Trang Province, Thailand

Subjects: Seventy‑eight adults with benign paroxysmal positional vertigo (BPPV) treated with canalith repositioning and home‑based vestibular rehabilitation.

Methods: In this retrospective observational study, 78 patients who underwent CRP and home-based vestibular exercises between October 2023 and February 2024 were analyzed. Patients were divided into two age groups (18-59 years and ≥ 60 years) and compared by sex. Treatment outcomes were measured based on symptom resolution and changes in DHI scores before and after treatment. Group comparisons were performed using chi-square tests, t-tests, and correlation analyses, with statistical significance set at p < 0.05.

Results: The overall resolution rate was 97.4%. There were no significant differences by age or sex. Age correlated positively with DHI pre‑ and post‑scores (r = 0.83 and 0.73, p < 0.01), and post‑treatment DHI was higher in females than males (p = 0.02).

Conclusions: This study highlights that while CRP combined with home-based vestibular rehabilitation is effective for BPPV treatment, older adults and females experience greater dizziness- related handicaps. These findings emphasize the need for age- and sex-specific considerations in rehabilitation programs, particularly regarding realistic outcome expectations for older adults and enhanced support for females who may experience greater residual handicap.

The Effectiveness of Addition of Melodic Intonation Therapy on Language Ability in Stroke Patients with Broca’s Aphasia: A Pilot Randomized Controlled Trial

Somjit Ruamsuk — 2026-01-15

Objectives: To evaluate the effectiveness of adding melodic intonation therapy (MIT) to conventional therapy in improving language abilities in Thai-speaking stroke patients with Broca’s aphasia

Study design: A pilot randomized controlled trial

Setting: Three government hospitals in Thailand

Subjects: Eleven stroke survivors diagnosed with Broca’s aphasia were enrolled in the study; eight completed the intervention and were analyzed.

Methods: Participants were randomly assigned to receive either conventional speech therapy or conven-tional therapy combined with MIT. Participants received three hours of therapy a week for eight weeks (two 30-minute sessions with a speech-language pathologist (SLP) and four 30-minute home-based sessions conducted by a caregiver). A blinded SLP assessed outcomes using the Thai adaptation of the Western Aphasia Battery (WAB) at baseline and three months post-baseline. Non-parametric tests (Wilcoxon Signed-Rank and Mann-Whitney U tests) were used due to the small sample size.

Results: The median age of participants was 56.5 years (IQR: 50.8-57.8) in the conventional group and 58.0 years (IQR: 33.5-67.5) in the conventional with MIT group. The median post-onset duration was longer in the conventional group (5.4 months, IQR: 2.4-9.8) compared to the MIT group (2.6 months, IQR: 1.0-4.6). Both groups showed improvements in fluency, comprehension, repetition, naming, and Aphasia Quotient (AQ). The MIT group demonstrated significantly greater gains in repetition and naming (p < 0.05).

Conclusions: The findings of this pilot study suggest that adding MIT to conventional therapy may enhance repetition and naming abilities in Thai-speaking individuals with Broca’s aphasia. This finding supports the adaptation of MIT for tonal language contexts and highlights its potential in aphasia rehabilitation programs in Thailand. However, due to the limited sample size and statistical power, further research with larger samples is needed to confirm these findings.

Assessment of Rehabilitation Medicine Education in Thai Undergraduate Medicine Curricula and its Relevance to General Practice: A Cross-Sectional Study

Kanokphol Supasirimontri — 2026-01-15

Objectives: To evaluate the content of rehabilitation medicine in undergraduate medicine curriculum and its relevance to general practice

Study design: Cross-sectional study

Setting: Department of Rehabilitation Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand

Subjects: Medical graduates from the Faculty of Medicine Siriraj Hospital who practiced as general practitioners and graduated between 2018 and 2020

Methods: A total of 842 medical graduates were surveyed using a structured questionnaire consisting of three sections: basic characteristics information, rehabilitation medicine content aligned with the Medical Competency Assessment Criteria for National License 2012, and recommendations for teaching and learning management. Participants rated the content using a four-point Likert scale based on frequency and criticality. Frequency was defined as the frequency with which each topic was applied in general practice, while criticality referred to the importance of each topic in its clinical practice. Data were analyzed using the Rasch rating scale model, a psychometric approach that applied the logistic regression technique to transform ordinal ratings into an interval scale. The level of the variable is on the logit scale, and the measurement unit is referred to as a logit.

Results: The response rate was 24.2%. According to the model, the frequency scores ranged from -3.31 to 3.05 logits, and the criticalities ranged from -2.12 to 2.44 logits. Integrating these two factors determined the “relevance,” representing the extent to which topics in the rehabilitation curriculum for medical graduates were relevant in their experience, with values ranging from -5.43 to 5.49 logits. The five most relevant topics covered were stroke (5.49 logits), pressure ulcers (4.68 logits), osteoarthritis (4.38 logits), diabetic foot ulcers (4.33 logits), and chronic obstructive sleep apnea (4.19 logits), respectively.

Conclusions: Stroke rehabilitation, pressure ulcers, and osteo-arthritis were identified as the most relevant topics in rehabilitation medicine for general practice. Therefore, teaching management should consider the appropriate teaching hours and assessments.