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http://dx.doi.org/10.12674/ptk.2016.23.2.057

Can Suboccipital Release Followed by Cranio-Cervical Flexion Exercise Improve Shoulder Range of Motion, Pain, and Muscle Activity of Scapular Upward Rotators in Subjects With Forward Head Posture?  

Kim, Bo-been (Dept. of Physical Therapy, The Graduate School, Yonsei University)
Lee, Ji-hyun (Dept. of Physical Therapy, The Graduate School, Yonsei University)
Jeong, Hyo-jung (Dept. of Physical Therapy, College of Health Science, Sangji University)
Cynn, Heon-seock (Dept. of Physical Therapy, College of Health Science, Yonsei University)
Publication Information
Physical Therapy Korea / v.23, no.2, 2016 , pp. 57-66 More about this Journal
Abstract
Background: For the treatment of forward head posture (FHP) and forward shoulder posture, methods for strengthening scapular retractors and deep cervical flexors and stretching pectoralis and upper cervical extensors are generally used. No study has yet assessed whether suboccipital release (SR) followed by cranio-cervical flexion exercise (CCFE) (SR-CCFE) will result in a positive change in the shoulders and neck, showing a "downstream" effect. Objects: The purpose of this study was to investigate the immediate effects of SR-CCFE on craniovertebral angle (CVA), shoulder abduction range of motion (ROM), shoulder pain, and muscle activities of upper trapezius (UT), lower trapezius (LT), and serratus anterior (SA) and LT/UT and SA/UT muscle activity ratios during maximal shoulder abduction in subjects with FHP. Methods: In total, 19 subjects (7 males, 12 females) with FHP were recruited. The subject performed the fifth phase of CCFE immediately after receiving SR. CVA, shoulder abduction ROM, shoulder pain, muscle activities of UT, LT, and SA, and LT/UT and SA/UT muscle activity ratios during maximal shoulder abduction were measured immediately after SR-CCFE. A paired t-test and Wilcoxon signed-rank test were used to determine the significance of differences in scores between pre- and post-intervention in the same group. Results: The CVA (p<.001) and shoulder abduction ROM (p<.001) were increased significantly post-versus pre-intervention. Shoulder pain was decreased significantly (p<.001), and LT (p<.05) and SA (p<.05) muscle activities were increased significantly post- versus pre-intervention. The LT/UT muscle activity ratio was increased significantly post- versus pre-intervention (p<.05). However, there was no significant change in UT muscle activity and SA/UT muscle activity ratio between pre- and post-intervention (p>.05). Conclusion: SR-CCFE was an effective intervention to improve FHP and induce downstream effect from the neck to the trunk and shoulders in subjects with FHP.
Keywords
Cranio-cervical flexion exercise; Forward head posture; Forward shoulder posture; Suboccipital release;
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