• Physical Therapy Rehabilitation Science
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• v.11 no.4
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• pp.446-453
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• 2022

Objective: The popularization of smartphones can lead to abnormal cervical alignment in university students. The aim of this study was to investigate the relationship among smartphone screen time, cervical alignment, and muscle function in university students. Design: Cross-sectional study. Methods: Seventy-five university students participated in the study. They completed the evaluation of cervical alignment and muscle function, such as handgrip strength, proprioception, and muscle quality (tone, stiffness, and relaxation time). All participants recorded their general characteristics and individual smartphone screen time before the evaluation. They were evaluated craniovertebral angle (CVA) using smartphone application (angle meter 360) for measuring cervical alignment. The muscle function was assessed using a digital hand-held dynamometer, dual inclinometer, and MyotonPRO device. Results: Of all participants, twenty-five university students had forward head posture (CVA<49°, 33.33%). Independent t-test revealed that there were significant differences on smartphone screen time, muscle stiffness, and muscle relaxation between the participants with and without forward head posture (p<0.05). There were significant correlations between the smartphone screen time and the CVA, muscle tone, and muscle relaxation (r=-0.493, 0.250, and -0.500, respectively). Conclusions: The results indicate that the university students with forward head posture had high smartphone screen time and muscle stiffness compared to the students without forward head posture, and smartphone screen time might be associated with cervical alignment and muscle quality.

• Journal of The Korean Society of Integrative Medicine
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• v.7 no.4
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• pp.265-272
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• 2019

Purpose : Excessive computer use frequently results in musculoskeletal disorders of the neck and shoulder such as forward head posture (FHP). The purpose of this study was to investigate effects of neck and shoulder exercise program on spino-pelvic alignment and the correlation between change in head and neck posture and spino-pelvic alignment in FHP. Methods : The study included 44 participants with FHP. The participants performed the exercise for correction of FHP 2-3 times a week for 4 weeks. We examined whole spine X-ray images in the lateral standing position with both arms crossed. We measured anterior head translation distance (AHT), craniovertebral angle (CVA), cervical lordosis (CL), thoracic kyphosis (TK), lumbosacral lordosis (LSL), sacral slope (SS), pelvic tilt (PT), and pelvic incidence (PI) of the subjects. The association between change in AHT and each spino-pelvic parameter was also subjected to Pearson's correlation coefficient analysis. Results : There were statistically significant differences before and after exercise in the parameters of AHT, CVA, and SS (p<.05). Significant negative correlation was observed between the change in AHT and CVA (r=-.768, p<.001), and CL (r=-.388, p<.05). There was significant positive correlation between the change in AHT and SS (r=.328, p<.05), and PI (r=.333, p<.05). However, no significant correlation was observed in change in AHT with that of TK, LSL, and PT. Conclusion : Based on the above results, we conclude that there is a relationship between change in AHT, which is a parameter associated with forward displacement of the head, and that of CVA, CL, SS, and PI after exercise in cases of FHP.

• Korean Journal of Applied Biomechanics
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• v.27 no.3
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• pp.211-217
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• 2017

Objective: The purpose of this study was to investigate the effect of a 12-week professional body massage program (PMP) on forward head posture, neck pain, and plantar foot pressure balance in men in their 20s. Method: A total of 20 men with musculoskeletal diseases were recruited for this study. The participants were asked to take part in a PMP twice a week for 12 weeks. The cranial vertical angle (CVA) for forward head posture and visual analogue scale (VSC) for neck pain and right/left foot plantar pressure balances were extracted to compare between pre- and post-program differences. Results: CVAs before ($56.86{\pm}4.55^{\circ}$) and after ($62.72{\pm}4.57^{\circ}$) and VSCs before ($6.95{\pm}1.70$) and after ($1.70{\pm}1.56$) PMP revealed statistically significant differences. The right foot, after PMP, showed a significant increase in the plantar pressure balance from $46.17{\pm}2.95$ to $49.44{\pm}1.29%$, while the left foot decreased significantly from $53.83{\pm}2.95%$ to $50.56{\pm}1.29%$. Therefore, based on these results, it may be said that the foot pressure balance abilities were improved after PMP because the ideal foot pressure ratio is 50%. Conclusion: Consequently, it was suggested that a 12-week PMP could be utilized for improvement of forward head posture, neck pain, and foot plantar pressure balance in men in the 20s with musculoskeletal diseases.

• Journal of International Academy of Physical Therapy Research
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• v.7 no.2
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• pp.989-993
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• 2016

The purpose of this study was to investigate the effects of occipital bone stimulation by cervical stabilizing exercise on the muscle tone, stiffness, ROM, and cervical lordosis in patient with forward head posture(FHP). This study was a case study of a single patient with forward head posture. This study used a ABA' design, A and A' were the baseline phases and B was the intervention phase. The intervention was occipital bone stimulation by cervical stabilization exercise. It was administered once daily for 7 days. The therapist kept hands together, and placed the two index fingers under the subject's occipital bone. The subject performed the chin-in exercise with a maximum isometric contraction for 20 sec.The exercise was implemented by performing the movements 10 times as a set and repeating the set three times. The muscle tone was not significantly changed after intervention. However, the stiffness was decreased and lasted the effect lasted without intervention. The cervical flexion angle was increased, but the cervical extension angle was not significantly changed after the intervention. The left and right lateral flexion angles were increased and the effect lasted without any intervention. However, the left and right rotation angles were significantly changed after the intervention. Cervical lordosis increased not from $37^{\circ}$ to $41^{\circ}$ after the intervention. These results suggest that occipital bone stimulation by cervical stabilizing exercise had a positive effect on cervical stiffness, flexion and lateral flexion ROM, and lordosis in a patient with forward head posture.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.24 no.2
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• pp.1-7
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• 2018

Background: This study was carried out to investigate the effect of mulligan taping group and repeated measurement group on muscle activity and grip strength of adult with forward head posture. Methods: Thirty adults with forward head posture were randomly assigned to each of 15 mulligan taping and repeat measurement groups. The mulligan taping group measured the pre-test and post-test muscle activity and the grip strength three times and compared the mean values. The repeat group was repeatedly measured and measured before and after the experiment, The collected data were analyzed using SPSS statistical program. Results: There was no significant difference between mulligan taping group and repeated measurement group in changes of muscle activity. There was a significant difference between mulligan taping group and repeated measurement group in changes of grip strength. Conclusions: Mulligan taping was applied to an adult with forward head posture, there was no significant change in muscle activity of flexor carpi radialis and palmaris longus, but it seems to improve hand function by re-aligned of nearby muscles by maintaining scapular stability.

• Journal of Digital Convergence
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• v.16 no.11
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• pp.543-551
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• 2018

This study investigated the effects of corrective exercise and TECAR on cervical alignment, pain threshold, and pain in forward head posture patients. The subject includes 30 forward head posture patients. In the intervention methods, the experimental group combined corrective exercise and TECAR treatment. Only the corrective exercise was applied to the control group. Assessments were made on cervico vertebra angle (CV angle), pain pressure threshold (PPT) and neck disability index (NDI) visual analog scale (VAS). The intervention was conducted six times a week for two weeks. Both groups showed significant differences in CV angle, PPT, NDI, and VAS. Also, PPT, NDI, and VAS excluding CV angle were significantly improved in the study group compared to the control group. These results suggest that the intervention method that combines corrective exercise and TECAR treatment has a more positive effect on pain and ADL ability of forward head posture patient.

• 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 Oral Medicine and Pain
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• v.21 no.1
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• pp.55-65
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• 1996

This study was performed to investigate the effects of head posture and occlusal splint on the vertical dimension in mandibular rest position and swallowing. Thirty health dental students ware selected lot this study and BioEGNⓡ(Bioresearch Inc., USA) was used for measuring interocclusal distance during rest - swallowing - rest - tapping movement. This swallowing movements were observed in both normal head posture(NHP) and forward head posture (FHP). Thickness of occlusal splint was about 2mm at posterior molar area and even tooth contact were achieved on light biting. The four mandibular positions at which interocclusal distance measured were swallowing position, after swallowing position in which interocclusal distance was maximum, rest position follows swallowing, and tapping position after rest. Changes of distance in each position were measured for three mandibular planes, that is, sagittal, frontal, and horizontal plane, respectively. The results obtained were as follows : 1. In normal head posture, the mandible was raised 1.03mm without splint, and 0.77mm with splint on swallowing, and there was no significant difference between the two. In horizontal plane, however, mandible was displaced more anteriorly in both swallowing position and tapping position with splint. 2. In forward head posture, the mandible was less raised with splint on swallowing, but features in horizontal plane were almost same as those in normal head posture. 3. In natural dentition, significant difference between NHP and FHP were observed in horizontal plane trajectory for swallowing and tapping position. But the difference for same positions were observed in frontal trajectory with splint. 4. Total amount of mandibular movement of two groups classified with sagittal interocclusal distance of swallowing position generally showed significant difference between the higher and the lower height group in head posture without splint. 5. Correlationship among total amount of mandibular movement for three mandibular planes were observed between sagittal plane and horizontal plane, and between sagittal plane and frontal plane in head posture without splint.

• The Journal of Korean Physical Therapy
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• v.26 no.3
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• pp.140-146
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• 2014

Purpose: Differences in scapular kinematics and muscle activity appear in the forward head and rounded shoulder posture (FHRSP). Thus, the aim of this study was to investigate the following effects according to different postures on scapular kinematics and muscle activity around scapular region in individuals with and without FHRSP during overhead reaching task. Methods: Thirty pain-free subjects with/without FHRSP participated in this study. All subjects were positioned into three positions: habitual head posture (HHP), self-perceived ideal head posture (SIHP) and therapist-perceived neutral head posture (TNHP). Muscle activities of upper trapezius (UT), lower trapezius (LT) and serratus anterior (SA) were measured during overhead reaching task. Results: Muscle activity of trapezius muscle (UT and LT) during HHP was significantly higher than SIHP and TNHP in FHRSP group (p<0.05), but there was no difference between SIHP and TNHP. SA also significantly increased muscle activity in HHP more than SIHP and TNHP in FHRSP group (p<0.05), but there was no significant difference between SIHP and TNHP. In Non-FHRSP group, although there was a tendency of different muscle activities among three postures, it was not statistically significant. Conclusion: This result demonstrates that muscle activity associated with overhead reaching task is increased in HHP which affects the scapular kinematics and SIHP contributes changed scapular kinematics and proper recruitment of muscle activity in FHRSP similarly to TNHP.

• 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.