• 대한물리의학회지
• /
• 제13권3호
• /
• pp.121-132
• /
• 2018

PURPOSE: This study was conducted to investigate the effects of type of exercise on neck disability, pain, and postural changes in subjects with forward head posture. METHODS: Two independent researchers conducted a search using KISS, RISS, DBpia (domestic), PubMed, OVID, and Science Direct (overseas) databases. We selected randomized controlled clinical trials by searching using the terms "forward head posture", "exercise therapy", and "therapeutic exercise". Studies published from 2007 to December 2017 were included. PEDro Scale was used to evaluate the quality of the selected studies, and meta-analysis was conducted using the CMA program. This review was registered at PROSPERO (CRD42018068633). RESULTS: Of the total 13768 studies searched, 17 were selected. Positive effects on neck disability were achieved with the base and biomechanical elements (ES=1.63, 95% confidence interval [CI] .49 to 2.75) as well as base, modulator, and biomechanical elements (ES=1.50, 95% [CI] .69 to 2.30). Neck pain improved with the base, modulator, and biomechanical elements (ES=1.96, 95% [CI] 1.08 to 2.82), while postural changes improved with biomechanical elements (ES=1.45, 95% [CI] .64 to 2.25). Additionally, type of exercise had a positive effect. CONCLUSION: The most effective exercises for neck disability are of the base and biomechanical elements, while the most effective types for neck pain are of the base, modulator, and biomechanical elements and the most effective exercise for posture is of biomechanical elements. Combined exercises targeting biomechanical elements were effective at treating disability, pain, and postural changes.

• 대한정형도수물리치료학회지
• /
• 제24권1호
• /
• pp.15-21
• /
• 2018

Background: The purpose of this study was to determine the effects of cervical deep muscle flexion exercise (CCFE) on craniovertebral angle, pain, and neck disability for patients with chronic neck pain Methods: The subjects of this study were randomly divided into three groups of 30 patients with chronic neck pain: rectus abodominis functional massage (n=10), cervical deep muscle flexion exercises group (n=10), and the control group(n=10). To assess visual analog scale (VAS) was used to test the neck pain, To assess neck posture was used to craniovertebral angle, VAS was used to test the neck pain, neck disability index (NDI) was used to test the neck dysfunction. All measurements were performed before and after each intervention was applied 3 times a week for 4 weeks. Results: In the results of all measurements, 2 groups except for the control group showed a significant change in the recovery of posture, neck pain, neck disability index (p<.05). Conclusions: Our results of this study showed that applying cervical deep muscle flexion exercise and rectus abodominis functional massage to patients with chronic neck pain improved cervical posture, neck pain, neck disability.

• 한국전문물리치료학회지
• /
• 제23권3호
• /
• pp.11-20
• /
• 2016

Background: A forward head posture (FHP) is one of the most common types of poor head posture in patients with neck disorder. A prolonged FHP might increase pressure on the posterior cranio-cervical structure and exhibit reduced performance on a cranio-cervical flexion test (CCFT). CCFT is included to activate deep cervical flexor muscles and inhibit excessive activation of superficial cervical flexor muscles. Therefore, the selective activation of deep cervical flexors is needed for effective exercise for FHP. Objects: The purpose of this study was to compare muscle thickness between longus colli (Lco) and sternocleidomastoid (SCM) using ultrasonography in subjects with FHP depending on head support. Methods: This was a cross-sectional, case-control research design study. The ultrasonographic images of Lco and SCM were taken in 17 subjects with FHP during the 5 phases of the CCFT with and without a head support. Towel was used for supporting head to make the neutral head position in supine. Changes in muscle thickness during the test were calculated to infer muscle activation. Data were analyzed using repeated measures of two-way analysis of variance with the significance level of .05. Results: When subjects performed the CCFT with head support, there was a significant difference in muscle thickness of Lco and SCM (p<.05). According to a post hoc paired t-test, change of thickness of Lco was greater at all phases, and change of thickness of SCM muscle was less at phase 4 and 5 in condition with head support (p<.01) compared to condition without head support (p<.01). Conclusion: The result of this study suggest that applying head support for neutral head position during CCFT could be a useful method for activating Lco muscle without excessive activation of SCM muscle.

• 대한물리의학회지
• /
• 제16권2호
• /
• pp.1-8
• /
• 2021

PURPOSE: This study examined the effects of changes in the head direction (forward, upward 10° and downward 10°) on the quadriceps, center of pressure (COP), and foot pressure during squat exercises. The aim was to determine if the head direction could better activate the quadriceps muscle and provide a safer and stable squat posture during squat exercise. METHODS: Fifteen healthy college students were asked to stand on a Zebris, and three electrodes for sEMG were attached to their vastus medialis oblique (VMO), vastus lateralis (VL), and rectus femoris (RF) muscles. The participants then performed squatting exercises under three head directions (forward, upward 10°, and downward 10°). Surface electrodes were then used to record the EMG data during exercise. The Zebris FDM-SX was used to measure the foot pressure and COP of the participants. RESULTS: In squat exercise, the upward head direction group showed significantly higher VL activation than the downward head direction group (p < .05). The upward head direction group showed a significant backward change in the deviation of the COP than the downward and forward groups (p < .05). The upward head direction group showed a significant decrease in forefoot pressure than the downward and forward groups (p < .05) and an increase in the hindfoot pressure compared to the downward and forward groups (p < .05). CONCLUSION: The head direction upward in squat exercise has a positive effect on the quadriceps.

• 대한통합의학회지
• /
• 제5권2호
• /
• pp.11-17
• /
• 2017

Purpose : The aim of this study was to verify differences in cervicocephalic joint position sense error after different sustained sitting postures in healthy young adults. Methods : Twenty-five healthy adults(12 men, 13 women) participated in this study. Repositioning errors of neck movement were observed in participants during joint repositioning tasks. During 2 test days with a 1-week interval, the participants performed forward head posture and upright sitting posture in random order. Both head-to-neutral(HTN) and head-to-target(HTT) tasks were performed on each day. On the first day, the participants sat slouched or upright for 10 minutes. Then, they sat upright and moved their heads at a self-selected speed with their eyes-closed to pre-determined neutral and target positions as accurately as possible. The participants noticed that when they reached a pre-determined position, the errors between pre-determined neutral and target positions and current position was recorded. The tasks consisted of flexion, extension and lateral bending. On the second day, the same test was performed after another sitting posture for 10 minutes. Repositioning error values were collected by using a smart phone-based inclinometer. The mean value for three trials was used for data analysis. A paired t-test was used for statistical analysis. Results : Significant differences in joint repositioning errors were found between the repositioning error after different sitting postures on the sagittal plane for both the HTN and HTT tasks (P<.05). No significant differences in errors on the coronal plane were found (P>.05). Conclusion : Cervicocephalic joint position sense can be affected by sitting postures, especially on the sagittal plane.

• The Journal of Korean Physical Therapy
• /
• 제30권4호
• /
• pp.141-145
• /
• 2018

Purpose: Changes in the curvature of the vertebral columns of elderly women with increasing age causes various side effects and disorders. Therefore, this study was conducted to evaluate the effectiveness of the 8-figure scapular brace to improve pulmonary function and balance ability based on lung capacity and foot pressure by increasing the vertebral curvature. Methods: Seventeen elderly women with a forward head posture were selected. Women were asked to wear the 8-figure scapular brace and the forced expiratory volume in 1 second (FEV1) and forced vital capacity (FVC) were measured, as were changes in foot pressure. Measurements were conducted three times each and the mean values were used for subsequent analyses. For static evaluation, we used the paired t-test to identify differences between pre and post values. Results: There was no significant difference in FEV1 and FVC before and after use of the brace (p>0.05); however, there was a significant decrease in forefoot pressure and an increase in rearfoot pressure following application of the brace (p<0.05). Conclusion: Application of the 8-figure scapular brace to correct vertebral curvature in elderly women influenced pressure distribution change from immediate effect body arrange of cervical and thoracic. However, wearing the 8-figure scapular brace may interfere with expansion of the chest and therefore respiratory muscle activity. Accordingly, it is necessary to apply appropriate treatment when wearing a scapular brace and to allow a sufficient intervention period while also providing therapeutic interventions such as posture correction or respiration training.

• 대한물리치료과학회지
• /
• 제25권1호
• /
• pp.44-51
• /
• 2018

Background: In this paper, the relationship between the Cranio-Vertebral Angle (CVA) and the vital capacity in each position is reviewed, and the vital capacity in the position is studied. Methods: This study targeted 20 non-smoking female students of U university, which is located in Gyeongju-si. To review the Forward Head Posture (FHP) of each subject, CVA was measured, and FVC, FEV1, and FEF (25-75%) were measured and analyzed using a spirometer. Subjects were ordered to exhale three times with ease and then inhale up to their total lung capacity. After then, they were requested to exhale longer than six seconds. Then the inspiration and expiration were repeated. The measurement was executed in three positions, including supine, prone, and sitting. In each position the measurement was repeated twice, and a one-minute break was given between each cycle, so it was measured six times in total. SPSS 14.0 for Windows was used to analyze the data. The subjects' general properties were analyzed using descriptive statistics, and the correlation between the angle and the respiration variable result in each position was analyzed. The result of the respiration variable in each position was analyzed using the one-way ANOVA, and then a Scheffe post-hoc comparison was executed. Results: According to the analysis result of the correlation between the angle and respiration variable in each position, the sitting position and FEF (25-75%) showed a positive correlation (P<0.05). The respiration variable in each position showed a significant difference in FVC (p<0.05), and the Scheffe post-hoc comparison differed in prone and sitting positions. Conclusion: To increase the FVC of FHP patients, different exercises for each position can be applied, and the result of this study can be utilized as background data for further research.

• 대한통합의학회지
• /
• 제8권1호
• /
• pp.113-124
• /
• 2020

Purpose : The purpose of this study was to investigate the effects of exercise intervention combined with 3D visual feedback and motion observation on postural alignment and cerebral cortical activity in subjects with forward head posture (FHP). Methods : The study included 28 participants with FHP, randomly divided into a 3D visual feedback plus motion observation group (n=14) or control group (n=14). The experimental group received corrective exercise combined with 3D visual feedback and motion observation for FHP, three times a week for four weeks. We examined cervical spine radiographs in the lateral standing position with both arms crossed to measure the craniovertebral angle (CVA) and cervical lordosis (CL). Relative alpha (RA) and beta waves (RB) were measured by wireless dry EEG. Results : The CVA value was significantly different between the groups, and the CL value was significantly different only in the experimental group. RA and RB values were not significantly different before and after intervention in the control group. RB values were significantly decreased before and after intervention in the experimental group. Conclusion : Based on the results of this study, we suggest that interventions combined with motion observation and 3D visual feedback may be effective as exercise methods to improve postural alignment and cerebral activity in subjects with FHP. Further research is required to generalize our results on technical supplementation complemented with 3D visual feedback devices.

• 대한물리의학회지
• /
• 제10권1호
• /
• pp.83-89
• /
• 2015

PURPOSE: The purpose of this study was to investigate the vital capacity and maximal voluntary ventilationin subjects with forward head posture (FHP). METHODS: Twenty-eight subjects participated in this study (normal 14, FHP 14) and were resident in B city. The mean age, height and weight of subjects was 22.80yrs, 169.36cm and 62.79kg. Subjects were asked to breath maximally for FVC and repeatedly for MVV during 12 seconds. The variables of data were collected as follows: Forced Vital Capacity(FVC), Forced Expiratory Volume in One Second($FEV_1$), $FEV_1$/FVC, Maximal Voluntary Ventilation(MVV). Each trial was performed by 3 times and we used the means to analyze the data. The mann-whitney U test and independent t-test were used to compare the vital capacity between normal and FHP subjects. All statistical analyses were performed using SPSS 21.0 for window versionand p-values less than 0.05 were used to identify significant differences. RESULTS: The FVC, $FEV_1$, $FEV_1$/FVC and MVV of FHP subjects were decreased more than that of normal subjects and the difference was statistically significant between two groups. CONCLUSION: The vital capacity of subjects with FHP was generally lower than normal subjects. This study shows that the vital capacityof subjectswith FHP could be decreased due to the bad neck posture that weakens the respiratory accessory muscles of neck.

• 대한통합의학회지
• /
• 제3권4호
• /
• pp.61-67
• /
• 2015

Purpose : The purpose of this study was to find out the effect of exercise on the angle and distance between scapular stability and McKenzie stretch exercise. Method : 30 volunteers took part in this experiment and we divided into three groups(experimental group A, experimental group B, control group C). Experimental group A performed scapular stabilization exercise and experimental group B performed McKenzie neck stretching exercise and control group didn't perform any exercise. Experimental group(A, B) received a total of 12 exercise session over a 4 week period (three times per week). Posture and craniovertebral angle changes of the neck using GPS measurements reported. Result : The CVA and distance change after exercise were significantly reduced in the experimental group A and B. Conclusion : Therefore, we have confirmed through experiments reducing a CVA and distance between scapular stabilization and McKenzie neck stretching exercises, whereby we would also be helpful to ensure the treatment of forward head posture.