A Healthy Life with Self-Natural Posture Exercise

Abstract

This chapter explores the effectiveness of the Self-Natural Posture Exercise (SNPE) program for individuals with chronic pain and musculoskeletal conditions. SNPE emphasizes self-regulation and natural postural correction as a unique approach to rehabilitation. Within this chapter, several studies show positive effects on physical self-concept, pain reduction, and overall health across diverse populations. It has been particularly beneficial for women with chronic low back pain, adolescents, and individuals with various musculoskeletal disorders. Research also explores its impact on energy expenditure, exercise intensity, and pain-related factors, shedding light on its mechanisms and outcomes. The SNPE program demonstrates effectiveness for chronic pain and musculoskeletal conditions across diverse populations. In a 12-week study, significant improvements in muscle power, flexibility, and pain reduction were revealed. Previous research showed a positive impact on the correction of forward head posture, relief from various pains, and improvement in pelvic alignment. SNPE also prevented scoliosis in adolescents and adapted to different energy expenditure levels. This chapter highlights the innovative and impactful nature of SNPE in addressing chronic pain and facilitating rehabilitation across diverse populations. SNPE goes beyond pain management, actively enhancing overall physical well-being and offering promising solutions for various musculoskeletal challenges across a broad demographic spectrum.

1. Introduction

In recent years, there has been a growing emphasis within the fields of rehabilitation and exercise science on incorporating innovative and holistic approaches to promote health and well-being [1]. The concept of wellness encompasses various dimensions of an individual’s health, including physical, intellectual, emotional, social, spiritual, vocational, financial, and environmental aspects. It reflects a dynamic and evolving process influenced by the interplay of physical, mental, social, and environmental factors. The ultimate objective extends beyond the mere absence of illness to attain a state of overall health and happiness [2].

Within this evolving setting, the Self-Natural Posture Exercise, known as SNPE, program has emerged as a promising method for addressing various aspects of chronic pain and musculoskeletal conditions. This introductory chapter aims to explores the multifaceted effects of SNPE on physical self-concept, perceived pain reduction, and overall health outcomes in individuals facing chronic pain and musculoskeletal issues. The rationale for investigating SNPE in the context of chronic pain lies in its unique emphasis on self-regulation and natural postural correction [3].

Chronic pain, a complex phenomenon with psychological and emotional scope, significantly influence physical well-being [3, 4]. SNPE, as a self-directed exercise program, offers a distinctive approach to addressing challenges associated with chronic pain by encouraging active individual participation in their therapy [5]. Subsequent chapters examine a diverse range of studies analyzing the impact of SNPE on specific aspects of chronic pain and musculoskeletal conditions. These studies provide valuable insights into the potential of SNPE as an integrative therapeutic intervention, examining its influence on physical self-concept, perceived pain reduction, disability, range of motion (ROM), muscular strength, and pelvic pain [3].

The compilation includes studies with diverse populations including women with chronic low back pain, individuals with various musculoskeletal disorders, and adolescents. By incorporating studies investigating the effects of SNPE on energy expenditure, exercise intensity, and specific pain-related factors, our understanding of SNPE’s mechanisms and outcomes will be enriched [6].

The exploration extends to potential role of SNPE in conditions such as dysmenorrhea, premenstrual syndrome, and chronic knee pain, providing a holistic perspective on its versatility in enhancing overall well-being. This chapter aims to consolidate current research findings, shedding light on the intricate interplay between SNPE and various facets of musculoskeletal health. The diverse array of studies presented collectively contributes to the evolving narrative of SNPE as an innovative and effective approach to chronic pain management and therapy. This chapter would provide a comprehensive understanding of how SNPE may serve as a catalyst for change in physical function, posture, and pain perception.

2. Mechanism of SNPE

The SNPE is a specialized exercise method designed to independently correct misaligned spines and restore the natural posture of the human body through self-regulation. This targeted exercise focuses primarily on posture correction and draws inspiration from orthodontic principles.

2.1 Exercise components

SNPE utilizes specific belts, namely the posture correction belt and pelvic correction band, worn around the hips and legs, respectively.

The standard SNPE program consists of eight exercise units, including the 1st movement (Standing SNPE Signature Movements), 2nd movement (SNPE exercises performed while lying down), 3rd movement (SNPE exercises performed in the prone position), 4th movement (SNPE exercises performed while rolling), C-move (cervical movement), T-move (thoracic movement), L-move (lumbar movement), and SC-move (sacrum-coccygeal movement) (Figure 1) [3, 5]. Integral to the exercise routine are complementary tools, such as the wave pillow, a basic tool (Figure 2A), Danason (a neck massage tool) (Figure 2B), and other tools such as the wave stick, that can be used for specific movements. These tools aid in alleviating spinal muscle tension and gradually correcting spinal deformities.

Figure 1.

Eight movements of SNPE. Adopted from https://snpelife.com/baseexercise/

Figure 2.

(Left) Wave pillow and (Right) Danason (a neck massage tool). Adopted from http://snpeshop.com/

2.2 Orthodontic influence

SNPE incorporates sustained traction using prosthetics and elastic tools, akin to orthodontic practices. This approach, applied over time, allows for gradual dental correction. The potential application of such techniques to the SNPE belt in spinal correction exercises holds promise. The successful correction of rigid teeth, influenced by osteoblasts and osteocytes, suggests that this method may extend to correcting misaligned body postures. Consistent post-correction use of the SNPE belt, comparable to dental correction aids for preventing tooth misalignment, is considered crucial for avoiding relapse and maintaining preventive measures during body transformations. The distinctive features of SNPE spinal correction exercises can be summarized as the 3Us:

2.2.1 United

Dr. Jungki Choi invented a comprehensive exercise method, integrating the study and research of various disciplines such as chiropractic care, yoga, Pilates, fitness, and diverse exercise therapies. This approach aims to alleviate and treat musculoskeletal disorders and pain.

2.2.2 Unique

A unique exercise method that applies the principles of orthodontics to the human body, utilizing the SNPE belt and spinal exercise tools as a novel therapeutic approach.

2.2.3 Useful (practical)

An effective exercise method for self-pain relief and proper posture correction, suitable for individuals of all ages and genders. This practical exercise can be performed in limited spaces, and it yields positive results in a short period.

3. Eight movements of SNPE

3.1 1st movements

3.1.1 Execution

• Wear SNPE posture correction belt and pelvic correction band.

• Stand straight, imagining there is a chair behind you.

• Sit deeply, expand the chest, arch the back, and shape hands like scissors.

• Shift weight to heels, raise toes, and lower the hips continuously.

• Key points: scissor-shaped hands, shift weight to the back, expand the chest.

3.1.2 Expected benefits

• Prevents neck disc and wrinkles by correcting the spine’s shape.

• Prevents kyphosis, relieves shoulder pain by correcting posture.

• Prevents lower back pain and lumbar disc issues.

• Manage the postpartum body and correct pelvic alignment.

• Strengthens muscles, provides hip-lifting effects.

• Corrects bowlegs (O, X legs) (Figure 3).

Figure 3.

1st movement of SNPE. Adopted from https://snpelife.com/baseexercise/

3.2 2nd movements

3.2.1 Execution

• Wear SNPE posture correction belt and pelvic correction band.

• Stretch calves using hands on the floor.

• Lie down, breathe, and engage abdominal and thigh muscles.

• Lower knees to the ground with exhalation and maintaining alignment.

• Keep shoulders, toes, and knees aligned for 1–3 minutes.

• Rise by tilting sideways after SNPE 2nd movement.

3.2.2 Expected benefits

• Corrects posture.

• Increases body temperature, aids digestion, prevents constipation, and alleviates menstrual pain.

• Relaxes tension in the transverse colon and enhances blood circulation.

• Relieves lower back pain and corrects pelvic alignment (Figure 4).

Figure 4.

2nd movement of SNPE. Adopted from https://snpelife.com/baseexercise/

3.3 3rd movements

3.3.1 Execution

• Lie down, tie legs with posture correction belt and pelvic correction band, and place hands under forehead.

• Lift legs, squeezing thighs, and buttocks.

• Maintain C-shaped waist curve for 10–20 seconds (5–10 sets).

3.3.2 Expected benefits

• Strengthens the waist, forms a C-shaped curve, and corrects pelvic balance.

• Raises body temperature.

• Corrects bowlegs (O, X legs) and knee misalignment.

• Strengthens waist and glutes muscles, and alleviates lower back pain.

• Corrects hip joints and pelvic alignment (Figure 5).

Figure 5.

3rd movement of SNPE. Adopted from https://snpelife.com/baseexercise/

3.4 4th movements

3.4.1 Execution

• Roll backward from a seated position, raising toes over the head, then return to a bent position.

3.4.2 Expected benefits

• Prevents and relieves pain in the neck, shoulders, back, lower back, pelvic pain, and muscle pain.

• Aids digestion, relieves constipation.

• Improves blood circulation.

• Corrects shoulder height, balances the back.

• Strengthens abdominal muscles (Figure 6).

Figure 6.

4th movement of SNPE. Adopted from https://snpelife.com/baseexercise/

3.5 Cervical movement (C-move)

3.5.1 Execution

• Using wave pillow

  • Place the pillow under the neck or align with the hairline.

  • Move the head left and right, releasing tension.

  • Also, use the rounded part to massage the neck.

• Using Danason

  • Massage each vertebra by moving Danason along the hairline and neck boundary.

  • Use a towel under Danason for comfort.

  • Move Danason along each vertebra, applying pressure (1–3 minutes each).

  • Also, use a wooden hand tool.

3.5.2 Expected benefits

• Restore the straight neck (straightening C-curve) for prevention and relief.

• Prevent and alleviate neck disc, neck, and shoulder pain.

• Correct posture and prevent neck wrinkles (Figure 7).

Figure 7.

C-movement of SNPE. Adopted from https://snpelife.com/baseexercise/

3.6 Thoracic movement (T-move)

3.6.1 Execution

• Using wave pillow.

  • Lie on the pillow vertically, knees up.

  • Raise and lower the pelvis while lifting the torso.

  • Repeat 30 times for 3–5 sets in various positions.

• Using Danason

  • Apply Danason under the hip and massage.

  • Move the body left and right while using Danason.

3.6.2 Expected benefits

• Prevent and correct the posture for a hunched back and rounded shoulders.

• Prevent rounding of the back, hunched shoulders, and associated symptoms.

• Assist in conditions such as frozen shoulder and correct rotator cuff abnormalities.

• Prevent and relieve forward head posture, straight neck, neck disc symptoms, and scoliosis (Figure 8).

Figure 8.

T-movement of SNPE. Adopted from https://snpelife.com/baseexercise/

3.7 Lumbar movement (L-move)

3.7.1 Execution

• Using wave pillow

  • Place the pillow under the pelvis or waist.

  • Lift and lower legs to form a diamond shape.

  • Repeat 20–30 times for 3–5 sets.

  • Alternatively, use posture correction belt and pelvic correction band.

3.7.2 Expected benefits

• Correct the straightened lower back, forming a C-shaped curve.

• Alleviate lower back and pelvic pain, providing relief from lumbar disc issues.

• Relax stiff muscles in the lower back.

• Strengthen deep abdominal muscles, contributing to spinal stability.

• Reduce excess fat around the lower back and abdomen (Figure 9).

Figure 9.

L-movement of SNPE. Adopted from https://snpelife.com/baseexercise/

3.8 Sacrum-coccygeal movement (SC-move)

3.8.1 Execution

• Using wave pillow

  • Lie down with the pillow under the pelvis.

  • Move hips left and right to release muscles.

  • Tilt the pelvis for additional stretch.

• Using Danason

  • Press gently to release tension.

  • Consult a professional before starting a new exercise routine.

3.8.2 Expected benefits

• Correct pelvic alignment for improved posture.

• Alleviate pelvic pain and discomfort.

• Relax stiff muscles around the tailbone area.

• Relief lower back pain, tailbone pain, and hip joint pain (Figure 10).

Figure 10.

SC-movement of SNPE. Adopted from https://snpelife.com/baseexercise/

4. Effects of SNPE on chronic pain

4.1 Effectiveness of SNPE in chronic pain management

The effectiveness of the SNPE program in managing chronic pain has been explored through various studies, highlighting its multifaceted impact on both physical and psychological dimensions. In an initial 12 weeks study [4, 5], participants undergoing the SNPE program reported significant improvements in muscle power, subjective health, flexibility, and a reduction in perceived pain. Significantly, a positive shift in physical self-concept was observed, highlighting the potential of SNPE as an intervention for chronic pain conditions [3].

4.2 Physical fitness and pain perception

A subsequent investigation examined the effects of SNPE on physical fitness, ROM, and pain perception among women with chronic musculoskeletal pain [6]. Positive outcomes were observed in flexibility, neck and shoulder ROM, waist flexion, hip rotation, and functional movement screen (FMS) outcomes. This suggests that SNPE not only enhances flexibility and ROM but also reduces pain perception in women with chronic musculoskeletal pain. Studies focusing on young women with chronic low back pain indicated significant improvements in the lumbar disorder index, lateral flexion, back strength, and pelvic pain release in the SNPE group [7]. This further supports SNPE’s efficacy in various dimensions of health.

4.3 Moderating effects of SNPE self-efficacy

Another study explored the moderated mediating effect of SNPE self-efficacy on perceived pain through performance, revealing a significant correlation between higher self-efficacy and improved performance [8]. The perceived pain reduction effect was more pronounced in specific regions (waist, pelvis, hip, and knee) compared to shoulder pain, highlighting the specialized benefits of SNPE movements for different body areas. Examining affective complexity in female patients with chronic pain, a 12-week SNPE program led to pain and stress reduction, and increased life satisfaction [3].

5. Impact of SNPE on specific health issues

5.1 Correction of forward head posture (FHP) and neck pain

The study focused on young women with cervical discomfort and aimed to assess the impact of the 12 weeks SNPE program on FHP correction and neck pain relief [9]. The findings indicated a significant reduction in the distance between the centerline and ears, improvement in the craniovertebral angle (CVA), and decreased pain in trigger points, particularly in mastoid processes, vertebra prominens (C7), and upper trapezius (Table 1). These results suggest that SNPE is an effective exercise program for correcting FHP and alleviating neck pain [9].

Variables		Pre	Post	t	p
Posture	Ear_L (mm)	58.3 ± 22.1	41.5 ± 19.9	2.495	0.034
	Ear_R (mm)	52.0 ± 24.4	29.2 ± 21.5	2.861	0.019
	Acromion process_L (mm)	46.1 ± 26.3	35.6 ± 23.4	1.738	0.116
	Acromion process_R (mm)	52.7 ± 16.7	29.6 ± 28.3	3.067	0.013
	Glabella (mm)	9.9 ± 8.0	13.2 ± 7.6	−.991	0.348
	C7 (mm)	9.8 ± 7.8	5.9 ± 4.5	1.848	0.098
	Shoulder (mm)	6.6 ± 7.4	3.3 ± 6.3	1.383	0.200
	CVA (°)	46.1 ± 6.3	53.7 ± 8.1	−2.280	0.049
Pain	Mastoid process_L (score)	5.2 ± 1.7	1.0 ± 1.2	6.498	0.000
	Mastoid process_R (score)	5.1 ± 1.6	0.9 ± 0.9	10.088	0.000
	C7_L (score)	4.9 ± 2.0	1.5 ± 1.4	6.053	0.000
	C7_R (score)	4.6 ± 2.3	1.2 ± 1.1	4.841	0.001
	Upper trapezius_L (score)	5.1 ± 1.6	2.0 ± 1.2	5.670	0.000
	Upper trapezius_R (score)	5.3 ± 2.4	2.0 ± 0.9	4.337	0.002
	Supraspinatus_L (score)	5.3 ± 1.4	2.1 ± 1.4	6.000	0.000
	Supraspinatus_R (score)	5.5 ± 1.7	2.2 ± 2.0	5.706	0.000

Table 1.

Assessment of posture and cervical region pain.

Mean ± standard deviation.

CVA: craniovertebral angle.

5.2 Enhancing knee joint function and pain reduction

Examining women with chronic knee joint pain, a study revealed that the SNPE Lower Limb Conditioning Program effectively enhanced knee joint function, modified muscle tone, and reduced pain assessed by Western Ontario and McMaster Universities Osteoarthritis Index. The SNPE group demonstrated superiority over the control group, indicating its potential as an exercise for improving knee health by targeting joint function, pain reduction, and muscle tone modification [10].

5.3 Improvement in cervical and shoulder pain

A study focusing on women with chronic musculoskeletal pain investigated the impact of SNPE on cervical and shoulder pain as well as joint operating range. SNPE demonstrated significant improvements in cervical and shoulder pain, especially in cervical flexion and rotation (left) and shoulder mobility. This suggests that SNPE is beneficial for women with chronic musculoskeletal pain, indicating its effectiveness in improving specific regions [11].

5.4 Benefits for individuals with chronic spinal disorder

For individuals with chronic spinal diseases, SNPE showed notable benefits in pain reduction, muscle tone improvement, postural alignment, and skeletal structure changes. A customized SNPE program tailored to specific spinal diseases proved effective in enhancing muscle tone, correcting postural alignment, and contributing to pain relief in individuals with chronic spinal disorder [10, 11].

5.5 Posture correction and pain relief in young women with chronic neck pain

In women in their 20s and 30s experiencing chronic neck pain and forward head posture, SNPE demonstrated significant improvements in CVA, shoulder balance, overall body alignment, and pain relief. This suggests that the SNPE program is effective for correcting posture and alleviating neck pain in this specific demographic [9].

5.6 Pelvic misalignment and women’s health

In another investigation, the effectiveness of SNPE in pelvic correction and menstrual symptom relief was evaluated in individuals with primary dysmenorrhea. The SNPE pelvic program resulted in decreased menstrual cramps, improved pelvic alignment, and positive changes in breast discomfort. These outcomes propose SNPE as an intervention for individuals with primary dysmenorrhea, showing potential benefits in pelvic alignment and symptom relief [12]. After 12 weeks of the SNPE program, the lumbar disorder index significantly decreased in the SNPEG group (pre: 7.6 ± 2.7 vs. post: 3.1 ± 2.7, p < 0.001). Lumbar flexion increased from 22.4 ± 2.7 to 26.8 ± 2.9 cm (p < 0.05), while extension decreased from 12.2 ± 1.0 to 10.9 ± 1.0 cm (p < 0.05). Left lateral flexion decreased from 46.8 ± 3.9 to 42.5 ± 2.7 cm, and back strength in the SNPEG group increased from 57.5 ± 13.4 to 72.6 ± 12.5 kg (p < 0.001) [13]. Furthermore, SNPE program decrease the pelvic pain (Table 2).

Sites	Pre	Post	p
Sacrum left	4.6 ± 1.1	0.7 ± 0.9	≤0.05
Acrum right	3.0 ± 1.5	1.2 ± 1.3
Iliopsoas left	6.5 ± 1.4	2.3 ± 1.5
Iliopsoas right	5.8 ± 1.6	2.2 ± 1.6
Lateral iliac crest left	4.7 ± 2.2	1.6 ± 1.9
Lateral iliac crest right	5.7 ± 1.9	2.1 ± 1.6
Adductor left	5.2 ± 2.5	2.5 ± 2.2
Adductor right	6.3 ± 2.1	3.1 ± 2.4
Gluteus maximus left	6.3 ± 2.2	1.8 ± 0.8
Gluteus maximus right	6.4 ± 2.4	1.7 ± 0.8

Table 2.

Pelvic pain assessment.

Mean ± standard deviation.

Pelvic misalignment in women is often associated with infertility, menstrual pain, and lower back discomfort [14, 15]. After childbirth, many women experience pain and discomfort attributed to misalignments [16]. Proper pelvic management is crucial for women’s health. A warm body is conducive to women’s health and fertility. Correcting misaligned pelvises contributes to body warmth, preventing issues arising from a cold body [17]. Pelvic misalignment impedes healthy childbirth, causing pain and complications during delivery [18]. Maintaining a properly aligned pelvis is essential for a pain-free and healthy childbirth experience. Pelvic misalignment due to childbirth can lead to various women’s health issues. SNPE exercises have proven therapeutic effects for preventing and managing conditions such as lower back pain and menstrual pain [13, 14, 15].

6. Effects of SNPE on adolescents

6.1 The impact of poor posture on adolescents

Previous research indicates that poor posture in adolescents can lead to kyphosis and scoliosis, characterized by excessive backward bending of the thoracic and sacral vertebrae, and an exaggerated frontal curve in the lumbar region, respectively [19]. Good posture is closely linked to overall health, while poor posture is associated with various musculoskeletal conditions that develop gradually over time due to repeated strain [20, 21].

6.2 Factors contributing to musculoskeletal conditions

Factors such as the repeated use of specific body parts, uncomfortable postures, excessive strain, or overwork are known to cause minor damage to muscles, blood vessels, and nerves in joints, leading to chronic health issues in the musculoskeletal system accompanied by pain or dysesthesia [20, 21]. Musculoskeletal conditions evolve gradually due to prolonged exposure to adverse conditions, emphasizing the importance of implementing preventive measures.

6.3 Musculoskeletal health in adolescents

Adolescents, who often spend extended periods sitting at desks, may experience bodily imbalances due to insufficient physical activity, a lack of exercise, poor fitness, and postural instability, contributing to lumbar pain and even scoliosis [22]. In a study investigating the impact of rolling exercise with spinal stimulation on improving scoliosis in elementary school students, twelve 6th-grade students diagnosed with scoliosis were selected, with six in the experimental group and six in the control group. The rolling exercise, a component of the SNPE, was applied four times a week for 12 weeks. Cobb’s angle was measured before and after the intervention to assess the exercise’s effect [23]. The results revealed a positive impact of rolling exercise with spinal stimulation on thoracic Cobb’s angle, indicating a significant improvement in the experimental group. This study highlights the potential benefits of incorporating simple and accessible exercises like rolling into school settings for the early detection and prevention of scoliosis among students.

The Cobb’s angle is a crucial measurement in orthopedics to quantify the degree of curvature in the spine, particularly in the context of scoliosis. A larger Cobb’s angle typically indicates a more substantial curvature of the spine [24]. In the pre-post comparison of the study investigating the effect of spine-stimulating rolling exercise on improving elementary school students’ scoliosis, the experimental group showed a significant reduction in scoliosis. In contrast, the control group exhibited a worsening of scoliosis (Table 3). These findings emphasize the potential of simple exercises in school settings for early scoliosis detection and prevention.

Group	Pre	Post	t	P
Experiment	12.7 ± 6.9	7.2 ± 6.0	3.722	0.014
Control	11.5 ± 7.3	11.8 ± 8.1	−0.260	0.805

Table 3.

Changes in thoracic Cobb’s angle between pre and post SNPE program (°).

Mean ± standard deviation.

7. Effects of SNPE on fitness and functional movement

7.1 Pain perception and functional movement improvement

The investigation aimed to systematically evaluate the impact of a 12 weeks SNPE program on pain perception, functional movement, and fitness in women with chronic pain [3]. The exercise group demonstrated a significant reduction in pain perception, as assessed by the Short-Form McGill Pain Questionnaire (pre: 9.5 ± 7.2 vs. post: 3.5 ± 2.8, p < 0.01). FMS tests indicated improvements in various movements, with significant group differences observed. While both the exercise group and non-exercise group showed an increase in the FMS total score, the exercise group exhibited greater improvement in flexibility, measured by sit-and-reach and back extension, demonstrating that SNPE is a valuable exercise modality for reducing pain perception, enhancing functional movement, and improving flexibility in women with chronic pain [3].

7.2 Correlation between SNPE motion performance and musculoskeletal pain regions

Another study investigated the relationship between SNPE motion performance and musculoskeletal pain regions in adult women with chronic musculoskeletal pain. The evaluation focused on factors such as shoulder and pelvic balance, angles formed by specific body points, and shoulder position during 1st movement of SNPE. Significant relationships were found between motion performance and pressure pain thresholds in specific areas, providing insights into musculoskeletal pain regions associated with 1st movement of SNPE. This offers a basis for tailoring effective exercise programs to alleviate chronic musculoskeletal pain during SNPE exercise program [25].

7.3 Energy expenditure and exercise intensity evaluation

Furthermore, a study assessed the energy expenditure (EE) and exercise intensity (EI) of SNPE in women certified as skilled instructors, ranging from their 20s to 40s. Oxygen uptake (VO₂) and heart rates (HR) were measured during eight basic movements of SNPE. The 4th movement of SNPE demonstrated the highest EE and exhibited a statistically significant difference from the other 7 movements (p < 0.05), including the 1st, 2nd, 3rd, T, L, SC, and C-movement. The EI of SNPE movements was calculated based on the metabolic equivalent (MET) of task by employing the measured VO₂ (Table 4). The 4th movement of SNPE was categorized as vigorous intensity, while T, 1st, and L-movement were classified as moderate exercise intensity. The other movements were determined as low EI, with the 3rd, SC, 2nd, and C-movement in order. However, HR exhibited a different order of EI, with the 1st, 4th, T, 3rd, L, SC, 2nd, and C-movement, respectively (Table 4). A significant difference was observed among the 1st, 4th, and the other 6 movements (p < 0.05) [13].

	VO2 (ml/kg/min)	MET	HR (beats/min)
1st movement	13.7 ± 2.7	3.9 ± 0.8	123.5 ± 17.6
2nd movement	6.5 ± 1.5	1.9 ± 0.4	79.3 ± 13.6
3rd movement	10.3 ± 2.9	2.9 ± 0.8	107.2 ± 18.6
4th movement	21.5 ± 5.6	6.1 ± 1.6	121.8 ± 18.4
C-movement	5.3 ± 1.1	1.5 ± 0.3	75.6 ± 11.4
T-movement	15.7 ± 4.2	4.5 ± 1.2	107.7 ± 17.9
L-movement	11.6 ± 2.3	3.3 ± 0.7	98.9 ± 14.9
SC-movement	8.5 ± 2.5	2.4 ± 0.7	90.3 ± 12.2

Table 4.

Energy expenditure and exercise intensity of SNPE.

Mean ± standard deviation.

VO₂; oxygen uptake, MET; metabolic equivalents, HR; heart rate.

8. Limitations and future research

Numerous studies robustly affirm the versatility and effectiveness of SNPE in various dimensions of women’s health. However, research on its application in men remains limited. Consequently, future studies are needed to explore the effectiveness of SNPE in correcting posture and alleviating pain in men. This chapter, therefore, lacks an analysis of potential gender differences in the utility and effectiveness of SNPE for these purposes. Future research should delve into SNPE’s potential as a tailored and holistic exercise program applicable across diverse age groups and specific health conditions for both men and women.

9. Conclusions

In conclusion, the synthesis of diverse studies strongly supports the versatility and effectiveness of SNPE in various dimensions of women’s health while it has not been extensively studied with men. SNPE’s holistic approach, ranging from posture correction to targeted enhancements in joint function and pelvic health, positions it as a promising component of comprehensive pain treatment strategies.

The integration of these studies underlines SNPE’s possibility as a tailored and holistic exercise program applicable across different age groups and specific health conditions. Notably, its positive impact on musculoskeletal health in adolescents highlights the importance of early detection and preventive measures through accessible exercises like rolling. This comprehensive research reinforces SNPE’s utility and effectiveness in correcting posture, and alleviating pain. The integrated findings offer valuable insights for healthcare professionals, instructors, and individuals seeking structured exercise programs to manage and alleviate chronic pain. In essence, SNPE emerges as a multifaceted and effective intervention with broad applications in women’s health and well-being, emphasizing its significant role in holistic health approaches.

Collectively, these findings substantiate SNPE as a multifaceted intervention that enhances physical aspects, including disability, ROM, and muscular strength. Moreover, SNPE has a positive impact on emotional well-being, affective complexity, and self-regulation. SNPE distinguishes itself as a personalized and effective approach to pain management, delivering specialized benefits for different body regions.

Conflict of interest

The authors declare no conflict of interest.