• The Journal of Korean Physical Therapy
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• v.35 no.3
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• pp.83-88
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• 2023

Purpose: This study was to investigate the effect of forward head posture (FHP) and round shoulder posture (RSP) on changes in muscle activities according to shoulder flexion and abduction tasks. Methods: Twenty-two male subjects with no history of neurological, musculoskeletal surgery or injuries, or pain in the spine region within the previous 3-month periods were recruited for this study. Craniovertebral angle (CVA) and Scapula Index were measured before performing 90° abduction and flexion tasks holding a 3kg dumbbell. Muscle activities were measured during the tasks. All measurements except height of the acromion were carried out in a sitting position at the height of the subject's knee angle of 90 degrees, and two tasks were randomly performed with the arm that the subject mainly use to throw the ball. The abduction and flexion angles were checked by the examiner using a goniometer beside the subject. Results: Correlation coefficient analysis between Scapular Index and upper trapezius muscle activity during shoulder abduction task showed significant positive correlation. No significant correlation was observed between CVA, Scapular Index, and other muscle activities. Conclusion: FHP showed increased muscle activation, making it difficult to change muscle activity under lower loads, and RSP was correlated with UT activation in shoulder abduction. Therefore, in the RSP, the loaded shoulder abduction is considered a potential risk factor for increasing shoulder muscle tension. This paper proposes an approach to treating RSP before FHP.

• Physical Therapy Korea
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• v.26 no.2
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• pp.61-68
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• 2019

Background: Forward head posture (FHP) is a postural alignment of the cervical vertebrae that leads to increased gravitational load on cervical segmental motions. The overhead arm lift test assesses the ability to actively dissociate and control low cervical flexion and move the shoulders through overhead flexion. Objects: The purpose of this study was to explore muscle activities in the upper trapezius (UT), serratus anterior (SA), sternocleidomastoid (SCM), and lower trapezius (LT) alongside changes in head position during the overhead arm lift test in individuals with FHP. Methods: Fifteen subjects with forward head posture and fifteen subjects with normal subjcects were enrolled in this study. The patients performed the overhead arm lift test, and muscle activities of the UT, SCM, SA, and LT were measured using surface electromyography and by evaluating changes in head position. Independent t-tests were used to detect significant differences between the two groups and Cohen's d was calculated to measure the size of the mean difference between the groups. Results: The FHP group demonstrated significantly increased muscle activity of the UT ($32.46{\pm}7.64$), SCM ($12.79{\pm}4.01$), and LT ($45.65{\pm}10.52$) and significantly decreased activity in the SA ($26.65{\pm}6.15$) than the normal group. The change in head position was significantly higher in the FHP group ($6.66{\pm}2.08$) than the normal group. Effect sizes for all parameters assessed were large between the two groups. Conclusion: The subjects with excessive FHP displayed were unable to fix their heads in position during the overhead arm lift test. The overhead arm lift test can thus be used in clinical settings to confirm control of the neck in these subjects.

• Journal of International Academy of Physical Therapy Research
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• v.6 no.2
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• pp.871-877
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• 2015

This research was conducted to investigate the effect of continuous antagonistic muscle strengthening exercise and Evjenth-Hamberg stretching on the pulmonary function of university students with abnormal transformation of forward head posture(FHP). The results of study subject to the continuous antagonistic muscle strengthening(CAS) group(n=10) and Evjenth- Hamberg stretching(EHS) group(n=10) that was conducted 3 times a week for 6 weeks are as follow. FVC, IVC, and MVV all were shown to be significant in the pre post comparison between the CAS group and EHS group(p<.05), and significant difference was shown for MW between the two groups(p<.05) in which the CAS group showed better effect. Based on the results above, it is considered that combining continuous antagonistic muscle strengthening exercise has better effect on pulmonary function compared to application of only Evjenth-Hamberg stretching.

• Journal of International Academy of Physical Therapy Research
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• v.4 no.2
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• pp.633-639
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• 2013

This study aims to reveal the impact of continuous antagonist strengthening(CAS) and Evjenth-Hamberg stretching(EHS) on the cervical mobility in the university students with abnormal transformation of forward head posture(FHP). Our experiment was conducted 3 times a week for 6 weeks in a total of 20 individuals : continuous antagonist strengthening(CAS) group(n=10) & Evjenth-Hamberg stretching(EHS) group(n=10). In a pre and post comparison, both CAS group and EHS group appeared significantly in mSBI and SBA(p<.05) and the two-group comparison showed a significant difference(p<.05) : CAS group showed better effects. Thus, it is considered that the combined use with continuous antagonist strengthening(CAS) had better effects for cervical mobility than Evjenth-Hamberg stretching(EHS) alone.

• The Journal of the Convergence on Culture Technology
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• v.4 no.4
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• pp.101-105
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• 2018

The purpose of this study was to evaluate the effect of Kinesio Taping on the forward head posture before application and immediately after application. We measured 18 students college students in Kangwon province by using Exbody's equipment before applying kinesio taping and immediately after application, we measured plumb line, CVA and PCMT. The results of this study were statistically significant (p <.05) as compared to before Kinesio Taping application for both Plumb Line, CVA, and PCMT immediately after application of Kinesio Taping. Therefore, it was confirmed that the effect of improving the head posture from the moment of Kinesio taping application.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.23 no.1
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• pp.43-51
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• 2017

Background: This study was carried out to compare the effects of shoulder stabilization exercise and thoracic extension exercise including deep neck flexor exercise on posture and pain targeting physical therapists and occupational therapists with forward head posture. Methods: A total of 30 physical therapists and occupational therapists (15 males, 15 females), who are working in the nursing hospital at Daejeon, were randomly divided into a shoulder stabilization group (n=10), a thoracic extension exercise (n=10), and a control group (n=10), and 3 times were carried out for 8 weeks. Results: In the results of all measurements, 2 groups except for the control group showed a significant change in the recovery of forward head posture, and the should stabilization exercise group showed a relatively superior effect compared to the thoracic extension exercise group. Conclusions: These results of a study will be a basic data for the development of the forward head posture exercise therapy program.

• Physical Therapy Korea
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• v.12 no.4
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• pp.41-47
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• 2005

The purpose of this study was to determine the intra-rater and inter-rater reliability of various forward head posture measurements. Ten healthy adults (age, $20.4{\pm}2.2$ yrs; height, $164.0{\pm}5.5$ cm; weight, $58.7{\pm}7.3$ kg) participated in the study. They were free of injury and neurologic deficits in the upper extremities and neck at the time of testing. The subjects were asked to perform head forward posture by under the guidance of physical therapists. Markers were placed on the C7 spinous process, mastoid process, tragus of the ear, outer canthus, and forehead. Measurement 1 for forward head posture assessment was measured as the angle between the horizontal line through C7 and the line connecting the C7 spinous process with the tragus of the ear. Measurement 2 was measured as the angle between the C7 spinous process, the mastoid process and the outer canthus. Measurement 3 was measured as two kinds of angles the HT (head tilt) angle is between the line from the midpoint of forehead to the tragus line and Y-axis at the tragus point. The NF (neck flexion) angle is between the line from the tragus to the C7 line and the Y-axis at the C7. Intra-rater, inter-rater reliability and coefficient of variation was assessed by comparing the measured values from three kinds of measurements of forward head posture. The intra-rater reliability was indicated by intraclass correlation coefficients [ICC(1,1)] and inter-rater reliability was shown by intraclass correlation coefficients [ICC(3,k)]. The results of study were as follows: ICC(1,1) values for intra-rater reliability of three measurements were in the 'excellent' category. ICC(3,k) values for inter-rater reliability of three measurements were also in the 'excellent' category. The coefficient of variation of method 2 had a lower value than method 1 and method 3. This data means that the measured value of method 2 was less scattered. Further research is needed to determine whether the validity of all measurements is revealed in the 'excellent' category.

• The Journal of Korean Physical Therapy
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• v.32 no.6
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• pp.378-382
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• 2020

Purpose: This study aimed to examine the effects of forward head posture on the flexion-relaxation ratio (FRR) and muscle activity during sustained neck flexion and to investigate the correlation between craniovertebral angle and FRR. Methods: Nineteen subjects participated in this study and were allocated to a forward head posture (FHP) group or a non-forward head posture (NFHP) group. Craniovertebral angle (CVA) and FRR were measured in all subjects, and all participants performed a standardized cervical flexion-extension movement in two phases: Phase I, sustained cervical full flexion for 5s; and Phase II, cervical extension with the return to the starting position for 5s. The value of CVA has calculated three times, and the value of FRR was measured three times in order to obtain the mean value. Results: FRR values in the FHP and NFHP group were significantly different (p<0.05). Phase I was significantly different, but the Phase II was not significantly different between the FHP and NFHP group (p>0.05). There was a significant correlation between the muscle activity of Phase I and CVA (p<0.05). However, FRR and the muscle activity of the Phase II were not a significant correlation with the CVA (p>0.05). Conclusion: FHP increases the muscle activity of the cervical erector spinae during sustained neck flexion and reduces FRR, which can cause fatigue in the cervical erector spinae. In addition, for those with a smaller CVA, muscle activity of the cervical erector spinae is increased during sustained neck flexion, which can increase neck muscle tension.

• Journal of The Korean Society of Integrative Medicine
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• v.11 no.3
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• pp.195-204
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• 2023

Purpose : This study applied general training (control group) or cranio-cervical flexor training (experimental group) using a pressure biofeedback unit along with general training for 4 weeks to secondary school teachers with moderate to severe neck pain and forward head posture. After that, we tried to compare the effects through differences in neck pain intensity (using numberical rating scale), functional performance (using neck disability index), and cranio-vertebral angle change. Methods : All 50 subjects were randomly assigned to either the "experimental group (n= 25)" or the "control group (n= 25)", and the measurements were evaluated in the same way before the intervention (baseline) and after the intervention (4 weeks). During the intervention period, the subject visited the physiotherapy center and made a reservation three times a week at a fixed time as much as possible, and each training session was thoroughly conducted under the 1:1 guidance of the therapist in charge so that the correct movement and number of times could be performed without compensatory action. Results : As a result of the homogeneity analysis on the general characteristics of the subjects, there were no significant differences between the groups in all variables (p>.05). Compared to the "control group", the "experimental group" showed significant improvement after intervention in all measured variables of neck pain intensity, functional performance, and cranial-vertebral angle (p<.05). Conclusion : For secondary school teachers with forward head accompanied by neck pain, cranio-cervical flexor training using a compression biofeedback unit is an excellent method to show superior pain reduction and functional performance improvement compared to general training alone. In addition, it can be presented as a more effective intervention method that can promote recovery of forward head posture, which is an essential element of the solution.

• Journal of the Korean Society of Physical Medicine
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• v.18 no.4
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• pp.145-154
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• 2023

PURPOSE: This study was conducted to investigate the effect of the sling exercise wearing a neck orthosis on the craniovertebral angle, muscle tension, and headaches in adults with a forward head posture and tension headache. METHODS: In this single-blinded, randomized, controlled, comparative study, a total of 22 adults with forward head postures and tension headaches were randomly assigned to the experimental group (sling exercise wearing a neck orthosis, n = 11) or the control group (sling exercise without a neck orthosis, n = 11). All participants undertook the sling exercise program (3×/week for 4 weeks). The craniovertebral angle, muscle tension, and headache were measured before and after the 4-week training. RESULTS: Significant improvements were observed in the craniovertebral angle, muscle tension, and headache in the experimental group (p < .05). This group also showed a larger decrease in the muscle tension and headache (upper trapezius, -4.97 Hz vs -1.70 Hz, p < .05; splenius capitis, -5.44 Hz vs -2.54 Hz, p < .05; headache, -19.73 score vs -14.64 score, p < .05, respectively). CONCLUSION: The sling exercise wearing a neck orthosis could be an effective way to relieve the symptoms caused by a forward head posture. It could also be a more effective way of decreasing muscle tension and headaches than the sling exercise without wearing a neck orthosis.