• Physical Therapy Rehabilitation Science
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• v.13 no.3
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• pp.343-353
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• 2024

Objective: Long-term imbalances in the muscles around the neck could the functional resting length of the muscles, resulting in a chronic forward head posture. This study aimed to assess the effects of combining posture correction exercises with extracorporeal shockwave therapy on muscle activity, neck function and pain in adults with forward head posture. Design: Pretest-posttest two groups design. Methods: A total of 22 adults, diagnosed with forward head posture, participated in the study. Random assignment allocated 11 participants to the posture correction exercise (PCE) group, while the other 11 were assigned to the posture correction exercise group combined with extracorporeal shockwave therapy (ESWT). In the combined group, ESWT was administered twice a week for four weeks, delivering 1,000 impulses in a radial pattern to the levator scapulae and upper trapezius muscles. The PCE group performed a exercise program for approximately 30 minutes, three times a week, over the same four-week period. The PCE focused on strengthening weakened muscles and stretching of shortened muscles. Results: Both the PCE group and the combined group with ESWT exhibited a significant increase in lower trapezius muscle activity within groups (p<0.05). Moreover, the craniovertebral angle and neck disability index showed significant improvements in both groups (p<0.05). While the pressure pain thresholds tended to increase only in the combined group, the difference was not statistically significant (p>0.05). Conclusions: This suggests that both the PCE program and the combination with ESWT can be effective in enhancing posture and reducing pain in individuals with forward head posture.

• PNF and Movement
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• v.19 no.1
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• pp.31-42
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• 2021

Purpose: The purpose of this study was to investigate the effect of visual and auditory feedback combined with theraband exercise in rounded shoulder posture. Methods: There were 43 adults with rounded shoulder posture who had a distance of 2.5 cm or more from the posterolateral of the acromion to the table in the supine position that participated. The participants were randomly divided into four groups: those with visual feedback from the lateral view (visual feedback; VFB, n = 11) provided, those with auditory feedback of praise (auditory feedback; AFB, n = 10) provided, those with visual feedback and auditory feedback (visual auditory feedback; VAFB, n = 11) provided, and those without any feedback (control group; CON, n = 11). Theraband exercise with or without feedback was carried out three times per week for three weeks. To confirm the effect of theraband exercise with visual feedback and auditory feedback on pain, range of motion (ROM), posture, and psychological variables were measured before and after exercise in participants with rounded shoulder posture. Results: The VAFB group showed significant differences in pain, ROM, posture, and psychological variables when compared before and after treatment. However, the differences among the VAFB, VFB, AFB, and CON groups were significant in the ROM of abduction, the New York Posture Rating, and the scapular index. Conclusion: In conclusion, theraband exercise combined with visual feedback from the lateral view and auditory feedback by praise improved rounded shoulder posture. Moreover, auditory feedback was more significant statistically than visual feedback.

• Journal of the Korean Society of Physical Medicine
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• v.14 no.2
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• pp.53-61
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• 2019

PURPOSE: Forward head posture (FHP) is a head-on-trunk malalignment that results in musculoskeletal dysfunction and neck pain. To improve forward head posture, both the craniocervical flexion exercise (CCFE) and the visual guide (VG) technique have been used. This study compared the immediate effects of CCFE and VG combined with CCFE on craniovertebral angle (CVA), as well as on the activity of the sternocleidomastoid (SCM) and anterior scalene (AS) muscles during CCFE in subjects with FHP. METHODS: In total, 16 subjects (nine males, seven females) with FHP were recruited using the G-power software. Each subject conducted CCFE and CCFE combined with VG in random order. The CVA was recorded using a digital camera and the ImageJ image analysis software. The EMG data of SCM and AS were measured by surface electromyography. A paired T-test was used to assess differences between the effects of the CCFE and VG combined with CCFE interventions in the same group. RESULTS: The CVA was significantly greater for CCFE combined with the VG than for CCFE alone (p<.05). The activity of the SCM and AS muscles was also significantly greater when the VG was combined with CCFE than during CCFE alone across all craniocervical flexion exercise phases (p<.05). CONCLUSION: Use of the VG technique combined with CCFE improved FHP in subjects with FHP compared to CCFE alone.

• Journal of the Korean Society of Physical Medicine
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• v.15 no.2
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• pp.11-21
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• 2020

PURPOSE: This study examined the effects of posture improvement exercise using virtual reality programs on the posture and balance of patients with forward head postures. METHODS: Thirty men and women in their 20 s, who had a forward head posture, were divided randomly into a group with posture correction exercise and a group with posture correction exercise combined with virtual reality programs. The posture correction exercise was composed of squats, XCO training, and chin-tuck exercise. In contrast, exercise with virtual reality games involved the Hot Squat, Climbey, and Baskhead programs while wearing a headset. Both groups performed the exercises 15 min a day, three times per week, for four weeks. The balance ability, distance between the acromion and earlobe, and neck joint range of motion were assessed before and after the exercises. RESULTS: Both groups showed significant reductions in the distance between the acromion and the earlobe, along with significant improvements in the range of joint motion. The group that performed the virtual reality exercises showed a significant increase in the limit of stability. Both groups showed a significant decrease in the sway length. In contrast, the group given the virtual reality exercises showed a significant reduction in the sway speed while standing with their eyes closed. CONCLUSION: Exercise applying virtual reality programs can be used in clinical and home programs to correct the postures of individuals with a forward head posture because they can trigger interest in inducing active participation.

• Journal of The Korean Society of Integrative Medicine
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• v.10 no.3
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• pp.13-25
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• 2022

Purpose : The purpose of this study was to investigate the effects of combined cervical stabilization exercise (CSE) and stretching exercise (SE) on office workers with forward head posture (FHP). Methods : A total of 32 office workers with forward head posture were randomly assigned to experimental (n=16) and control (n=16) groups. The experimental group underwent combined CSE and SE, and the control group underwent cervical self-myofascial release and SE. Both groups performed exercises for 40 min per day, thrice per week for a total of 6 weeks. Craniovertebral angle (CVA), respiration, disability, and joint range of motion (ROM) before and 6 weeks after intervention were measured and compared. Results : There was no significant between-group difference in the general characteristics (p>.05). The intra-group comparison showed significant differences in the visual analog scale (VAS) and neck disability index (NDI) of both groups post-intervention (p<.05). CVA and forced expiratory volume in 1 seconds (FEV₁) were significantly improved post-intervention in the experimental group only (p<.05). In the experimental group, all ROM variables were significantly improved post-intervention. In contrast, in the control group, all ROM variables improved significantly post-intervention, except for extension (p<.05). The inter-group comparison showed significant differences in NDI, left lateral flexion, right lateral flexion, and left rotation between the two groups (p<.05). Conclusion : The combination of CSE and SE, which stabilizes the cervical spine, had positive effects on cranial rotation angle, respiration, disability, and joint ROM in office workers with forward head posture. Therefore, the combination of the two exercises may be an effective option to reduce symptoms and prevent postural problems in office workers with FHP.

• Journal of the Ergonomics Society of Korea
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• v.30 no.3
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• pp.419-426
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• 2011

Objective: The objective of this study was to evaluate a work of guards, using an ergonomic method(work analysis and posture analysis). Background: Most studies about guards were conducted in the field of medical, problems of shift, and the physical problems of old workers and social problems. But, guards consist of vulnerability group so it needs an ergonomic research in musculoskeletal disorders. Method: A head of an ergonomic estimation was work analysis(determination of combined task, work tool, work time and frequency of combined task) and posture analysis(upper body and lower body) of workers based on the video. Results: The result showed that combined task of guards was classification of patrolling, security, cleaning and waiting. The security indicated the highest ratio in the work time of combined tasks. The results of posture analysis for guards indicated high value in neutral. But, lower arm indicated high value in bending(left: 59%, right: 50%). Conclusion: The results of ergonomic methods indicated that guards' physical work load was not high during work, but comfortable work environment would be required for old guards. Application: If an ergonomic rule can be integrated into existing work environments, the risk of occupational injuries and stress will be reduced.

• Physical Therapy Korea
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• v.25 no.4
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• pp.1-8
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• 2018

Background: Round shoulder posture, results from excessive flexed posture of the thorax, is defined as a position of scapular protraction, anterior tipping, and downward rotation. However, previous studies have focused on only passive position of the thorax during scapular posterior tilting (SPT) and have not reported on SPT combined with correction of flexed posture. Objects: The aim of this study was to compare effects of SPT and SPT with prone trunk extension (SPT + PTE) on activities of the lower trapezius, serratus anterior, and thoracic erector spinae and degree of posture in subjects with round shoulder and flexed posture. Methods: Fifteen subjects with round shoulder and flexed posture were recruited. The caliper was used to measure the degree of round shoulder and flexed posture. Electromyography was performed to collect data of muscle activities. Paired t-test was used to compare two exercise (${\alpha}=.05$). Results: When SPT + PTE was applied, the degree of round shoulder posture (p=.001) and flexed posture (p=.039) significantly decreased compared with that when SPT was applied. The lower trapezius activity significantly increased in the SPT + PTE condition compared with that in the SPT condition (p=.026). There were no significant differences in serratus anterior activity between SPT + PTE and SPT. The thoracic erector spinae activity significantly increased in the SPT + PTE condition compared with that in the SPT condition (p=.014). Conclusion: SPT + PTE might be one of the effective methods to enhance activities of lower trapezius and thoracic erector spinae, and to reduce round shoulder posture and flexed posture in subjects with round shoulder and flexed posture.

• Journal of the Korean Society of Physical Medicine
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• v.12 no.2
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• pp.121-127
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• 2017

PURPOSE: Forward head posture and turtle neck are common musculoskeletal disorders of the cervical vertebrae. The purpose of this study was to investigate the effects of combined exercise training and chiropractic on the grip strength and cervical muscle strength of subjects with forward head posture and turtle neck. METHODS: The subjects were divided into two groups: forward head posture (n=9) and turtle neck (n=9). Both groups performed combined exercise training and chiropractic. The subjects were instructed about the exercise training once a week. This training was performed for 30 minutes every day for 8 weeks, and the chiropractic was performed for 15 minutes once a week. The cervical muscle strength and grip strength were measured. Two-way repeated measured ANOVA was performed for statistical analysis. RESULTS: In changes to the left grip strength, the main effect over time was significant, but the interaction effect and the main effect in the groups were not significant. In changes to the right grip strength, no difference was found to be statistically significant. In changes to the cervical muscle strength, no difference was found to be statistically significant. CONCLUSION: The increases of grips strengths and cervical muscle strength in forward head posture group were greater than turtle neck group but there were not found to be statistically significant.

• Journal of International Academy of Physical Therapy Research
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• v.11 no.1
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• pp.1960-1968
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• 2020

Background: The alignment of the neck and shoulder is important in people with forward head posture. However, previous studies have mainly conducted fragmentary studies on the neck and shoulders, and studies on the combined movement of the neck and shoulders are incomplete. Objective: To investigate the effects of 6 week dynamic exercise program using Thera-band on craniovertebral angle (CVA) in adults with forward head posture. Design: Quasi-experimental study. Methods: The study was conducted on 24 adults with forward head posture and experimented with neck and shoulder exercises and divided them into groups of neck exercises, shoulder exercises, and neck and shoulder exercises to measure CVA values before and after the experiment. The neck exercise program included flexion and extension muscles of the neck and shoulder exercises included dynamic exercise of the upper extremities such as the trapezius muscles and serratus anterior muscle. The CVA results were measured using PA200. Results: Following the interventions, neck exercise group showed significant improvement in CVA (P<.05), but shoulder exercise group and combined exercise group did not show any significant results (P>.05). However, both groups showed some positive results. Significant differences were seen in the comparisons between the three groups (P<.05), and the results of the post-hoc test showed significant differences in neck exercise group and shoulder exercise, neck exercise and combine exercise group. Conclusion: This study suggested that the Thera-band neck exercise is beneficial for foward head posture patients and is expected to be used in clinical trials.

• Journal of Korean Physical Therapy Science
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• v.26 no.3
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• pp.57-69
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• 2019

Background: The purpose of this study was to compare and analyze the effects of neck and trunk combined exercise program and single exercise on neck angle and neck and shoulder muscle activity. Design: Randomized controlled trial. Methods: In the single exercise group, the basic stretching, head bending and neck bending exercises were performed. The neck and trunk combined exercise group performed torso strength and trunk stability exercises to stabilize the trunk, and then performed the same neck exercise as the single exercise group. The exercise program was conducted 5 days per week for 2 weeks. One-way repeated ANOVA was used to investigate the statistical analysis of neck angle, neck and upper and middle trapezius muscle activity. Results: 1) There was no significant difference in neck angle degree after exercise in neck single exercise group. 2) In the neck and trunk combined exercise, the neck angle degree decreased continuously with the increase of the experimental period and showed a significant difference. 3) In the single exercise group, the muscles which showed significant difference compared to the post-exercise were the right upper, left and right middle trapezius. 4) In the neck and trunk combined exercise group, the right neck muscles showed significant difference after the exercise before the experiment. Conclusion: It was found that the neck and trunk combined exercise was more effective in reducing neck angle and the muscle activity of the subjects with forward head posture was decreased and increased. However, both exercises showed positive effects.