Browse > Article
http://dx.doi.org/10.20540/JIAPTR.2021.12.1.2345

Does the Addition of Upper Thoracic Manipulation to Proprioceptive Training Improve Cervicocephalic Joint Position Sense and Forward Head Posture in Asymptomatic College Students?  

Battal, Grace (Physical Therapy Department, Lebanese University)
Ali, Nibal (Physical Therapy Department, Lebanese University)
Chamoun, Rima (Physical Therapy Department, Lebanese University)
Hanna-Boutros, Berthe (Physical Therapy Department, Lebanese University)
Publication Information
Journal of International Academy of Physical Therapy Research / v.12, no.2, 2021 , pp. 2345-2353 More about this Journal
Abstract
Background: This study evaluated the effectiveness of upper thoracic manipulation (UTM) and proprioceptive training versus proprioceptive training alone on forward head posture (FHP) and cervicocephalic joint position sense (CJPS) in asymptomatic university students during a short interval of time. Objectives: To evaluate whether the suggested combination would provide greater benefit, and be superior to proprioceptive training alone in improving proprioceptive acuity and head posture. Design: A single-blind randomized controlled trial. Methods: Thirty-three university student volunteers with asymptomatic FHP were recruited. Subjects were randomly assigned to a manipulation group (n=16) receiving UTM combined with proprioceptive training or a proprioception group (n=17) receiving proprioceptive training only. The intervention period lasted 5 weeks in total, and consisted of one 15 to 20-minute session per week. FHP and CJPS were assessed before and after the intervention. Results: A significant pre- to post-intervention decrease in FHP and joint position error was identified in both groups (P<.05). Subjects in the manipulation group demonstrated greater improvements in CJPS and head posture compared to the proprioception group (P<.05). Conclusion: These findings support employing either intervention for treating asymptomatic students with FHP. However, the addition of UTM to proprioceptive training was more effective than proprioceptive training alone in reducing joint position errors and improving head posture.
Keywords
Forward head posture; Cervicocephalic joint position sense; Thoracic manipulation; Proprioceptive training;
Citations & Related Records
연도 인용수 순위
  • Reference
1 Jull G, Falla D, Treleaven J, Hodges P, Vicenzino B. Retraining cervical joint position sense: the effect of two exercise regimes. J Orthop Res Off Publ Orthop Res Soc. 2007;25(3):404-412.   DOI
2 Yang J, Lee B, Kim C. Changes in proprioception and pain in patients with neck pain after upper thoracic manipulation. J Phys Ther Sci. 2015;27(3):795-798.   DOI
3 Haavik H, Murphy B. The role of spinal manipulation in addressing disordered sensorimotor integration and altered motor control. J Electromyo. And Kinesio. 2012;22:768-776.   DOI
4 Bosquet L, Berryman N, Dupuy O, et al. Effect of training cessation on muscular performance: a meta-analysis. Scand J Med Sci Sports. 2013;23(3):e140-e149.   DOI
5 Pickar JG, Bolton PS. Spinal manipulative therapy and somatosensory activation. J Electromyogr Kinesiol. 2012;22(5):785-794.   DOI
6 Cagnie B, Dickx N, Peeters I, Tuytens J, Achten E. The use of functional MRI to evaluate cervical flexor activity during different cervical flexion execises. J Appl Physiol. 2008;104(1):230-235.   DOI
7 Alahmari K, Reddy RS, Silvian P, Ahmad I, Nagaraj V, Mahtab M. Intra- and inter-rater reliability of neutral head position and target head position tests in patients with and without neck pain. Braz J Phys Ther. 2017;21(4):259-267.   DOI
8 Fard BS, Ahmadi A, Maroufi N, Sarrafzadeh J. Evaluation of forward head posture in sitting and standing positions. Eur Spine J. 2016;25(11):3577-3582.   DOI
9 Ruivo RM, Pezarat-Correia P, Carita AI. Intrarater and interrater reliability of photographic measurement of upper-body standing posture of adolescents. J Manipulative Physiol Ther. 2015;38(1):74-80.   DOI
10 Roren A, Mayoux-Benhamou MA, Fayad F, Poiraudeau S, Lantz D, Revel M. Comparison of visual and ultrasound based techniques to measure head repositioning in healthy and neck-pain subjects. Man Ther. 2009;14(3):270-277.   DOI
11 Sremakaew M, Jull G, Treleaven J, Barbero M, Falla D, Uthaikhup S. Effects of local treatment with and without sensorimotor and balance exercise in individuals with neck pain: protocol for a randomized controlled trial. BMC Musculoskelet Disord. 2018;19(1):48.   DOI
12 Destefano LA. Greenman's principles of manual medicine. 4th ed. Philadelphia: Lippincott Williams & Wilkins; 2010.
13 Khayatzadeh S, Kalmanson OA, Schuit D, et al. Cervical spine muscle-tendon unit length differences between neutral and forward head postures: biomechanical study using human cadaveric specimens. Phys Ther. 2017;97(7):756-766.   DOI
14 Przybyla A, Mohite A, Blease S, Adams MA, Dolan P. How does posture affect lever arms of neck flexor and extensor muscles. J Biomech. 2006;39:S49.
15 Yong MS, Lee HY, Lee MY. Correlation between head posture and proprioceptive function in the cervical region. J Phys Ther Sci. 2016;28(3):857-860.   DOI
16 Lakie M, Campbell KS. Muscle thixotropy-where are we now? J Appl Physiol. 2019;126(6):1790-1799.   DOI
17 Falla D, O"Leary S, Fagan A, Jull G. Recruitment of the deep cervical flexor muscles during a postural-correction exercise performed in sitting. Man Ther. 2007;12(2):139-143.   DOI
18 Silva AG, Punt TD, Sharples P, Vilas-Boas JP, Johnson MI. Head posture and neck pain of chronic nontraumatic origin: a comparison between patients and pain-free persons. Arch Phys Med Rehabil. 2009;90(4):669-674.   DOI
19 Yip CHT, Chiu TTW, Poon ATK. The relationship between head posture and severity and disability of patients with neck pain. Man Ther. 2008; 13(2):148-154.   DOI
20 Yong MS, Lee HY, Lee MY. Correlation between head posture and proprioceptive function in the cervical region. J Phys Ther Sci. 2016;28(3):857-860.   DOI
21 Gu SY, Hwangbo G, Lee JH. Relationship between position sense and reposition errors according to the degree of upper crossed syndrome. J Phys Ther Sci. 2016;28(2):438-441.   DOI
22 Cross KM, Kuenze C, Grindstaff T, Hertel J. Thoracic spine thrust manipulation improves pain, range of motion, and self-reported function in patients with mechanical neck pain: a systematic review. J Orthop Sports Phys Ther. 2011;41(9):633-642.   DOI
23 Ernst E. Adverse effects of spinal manipulation: a systematic review. J R Soc Med. 2007;100(7):330-338.   DOI
24 Walser RF, Meserve BB, Boucher TR. The effectiveness of thoracic spine manipulation for the management of musculoskeletal conditions: a systematic review and meta-analysis of randomized clinical trials. J Man Manip Ther. 2009;17(4):237-246.   DOI
25 Sheikhhoseini R, Shahrbanian S, Sayyadi P, O'Sullivan K. Effectiveness of therapeutic exercise on forward head posture: a systematic review and meta-analysis. J Manip Physiol Ther. 2018;41(6):530-539.   DOI
26 Lee KJ, Han HY, Cheon SH, Park SH, Yong MS. The effect of forward head posture on muscle activity during neck protraction and retraction. J Phys Ther Sci. 2015;27(3):977-979.   DOI
27 Peterson CM, Zimmerman CL, Tang R. Proprioception interventions to improve cervical position sense in cervical pathology. Inter J of Ther and Rehab. 2013;20(3):154-163.   DOI
28 Nam SH, Son SM, Kwon JW, Lee NK. The Intra-and Inter-rater Reliabilities of the Forward Head Posture Assessment of Normal Healthy Subjects. J Phys Ther Sci. 2103;25(6):737-739.   DOI
29 Liu JX, Thornell LE, Pedrosa-Domellof F. Muscle spindles in the deep muscles of the human neck: a morphological and immunocytochemical study. J Histochem Cytochem. 2003;51(2):175-186.   DOI
30 Dunning JR, Cleland JA, Waldrop MA, et al. Upper cervical and upper thoracic thrust manipulation versus nonthrust mobilization in patients with mechanical neck pain: a multicenter randomized clinical trial. J Orthop Sports Phys Ther. 2012;42(1):5-18.   DOI
31 Weon JH, Oh JS, Cynn HS, Kim YW, Kwon OY, Yi CH. Influence of forward head posture on scapular upward rotators during isometric shoulder flexion. J Bodyw Mov Ther. 2010;14(4):367-374.   DOI
32 Treleaven J, Jull G, LowChoy N. The relationship of cervical joint position error to balance and eye movement disturbances in persistent whiplash. Man ther. 2006;11(2):99-106.   DOI
33 Cho CY. Survey of faulty postures and associated factors among Chinese adolescents. J Manipulative Physiol Ther. 2008;31(3):224-229.   DOI
34 Oliveira AC, Silva AG. Neck muscle endurance and head posture: a comparison between adolescents with and without neck pain. Man Ther. 2016;22:62-67.   DOI
35 Faulin EF, Guedes CG, Feltrin PP, Joffiley CMMSC. Association between temporomandibular disorders and abnormal head postures. Braz Oral Res. 2015;29:S1806-83242015000100260.
36 Moore MK. Upper crossed syndrome and its relationship to cervicogenic headache. J Manipulative Physiol Ther. 2004;27(6):414-420.   DOI
37 Cleland JA, Mintken PE, Carpenter K, et al. Examination of a clinical prediction rule to identify patients with neck pain likely to benefit from thoracic spine thrust manipulation and a general cervical range of motion exercise: multi-center randomized clinical trial. Phys Ther. 2010;90(9):1239-1250.   DOI
38 Studin M, Owens W. The mechanism of the chiropractic spinal adjustment/manipulation: the neurological effect part 3 of a 5 part series. J Amer Chiro. 2017;39(7):30-41.
39 Ferreira L, Ferreira PH, Hodges PW. Changes in postural activity of the trunk muscles following spinal manipulative therapy. Man Ther. 2007;12(3):240-248.   DOI
40 Miller J, Gross A, D'Sylva J, et al. Manual therapy and exercise for neck pain: a systematic review. Man Ther. 2010;15(4):334-354.   DOI
41 Gong W. Effects of Cervical Joint Manipulation on Joint Position Sense of Normal Adults. J Phys Ther Sci. 2013;25(6):721-723.   DOI
42 Mahmoud NF, Hassan KA, Abdelmajeed SF, Moustafa IM, Silva AG. The relationship between forward head posture and neck pain: a systematic review and meta-analysis. Curr Rev Musculoskelet Med. 2019;12(4):562-577.   DOI
43 Hansraj KK. Assessment of stresses in the cervical spine caused by posture and position of the head. Surg Technol Int. 2014;25:277-279.
44 Lee MY, Lee HY, Yong MS. Characteristics of cervical position sense in subjects with forward head posture. J Phys Ther Sci. 2014;26(11):1741-1743.   DOI
45 Gong W. The effects of cervical joint manipulation, based on passive motion analysis, on cervical lordosis, forward head posture, and cervical ROM in university students with abnormal posture of the cervical spine. J Phys Ther Sci. 2015;27(5):1609-1611.   DOI
46 Kang JH, Park RY, Lee SJ, Kim JY, Yoon SR, Jung KI. The effect of the forward head posture on postural balance in long time computer based worker. Ann Rehabil Med. 2012;36(1):98-104.   DOI
47 Karas S, Olson Hunt MJ. A randomized clinical trial to compare the immediate effects of seated thoracic manipulation and targeted supine thoracic manipulation on cervical spine flexion range of motion and pain. J Man Manip Ther. 2014;22(2):108-114.   DOI
48 Salahzadeh Z, Maroufi N, Ahmadi A, et al. Assessment of forward head posture in females: observational and photogrammetry methods. J Back Musculoskelet Rehabil. 2014;27(2):131-139.   DOI
49 Lee HY, Teng CC, Chai HM, Wang SF. Test-retest reliability of cervicocephalic kinesthetic sensibility in three cardinal planes. Man Ther. 2006;11(1):61-68.   DOI
50 Kristjansson E, Dall Alba P, Jull G. A study of five cervicocephalic relocation tests in three different subject groups. Clin Rehabil. 2003;17(7):768-774.   DOI