• The Journal of Korean Physical Therapy
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• v.30 no.6
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• pp.218-223
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• 2018

Purpose: The purpose of this study was to evaluate the impact of active vibration exercise on the neck pain, disability index, and muscle activity of patients with forward head posture. Methods: A total of 24 patients were randomly assigned to an experimental group or a control group (n=12 each). The experimental group performed active vibration exercise using a flexi-bar for 20 minutes a day, five times a week for four weeks. The study measured patient neck pain using a visual analog scale, neck pain related disability using the neck disability index, and muscle activity using electromyography. Results: The intragroup comparison showed significant differences in the visual analog scale score, neck disability index score and upper trapezius, lower trapezius and serratus anterior muscle activity values among patients in the experimental group. The intergroup comparison showed that differences in the visual analog scale score, neck disability index score and upper trapezius, lower trapezius and serratus anterior muscle activity values in the control group. Conclusion: This study showed that active vibration exercise was effective in improving the neck pain, disability index, and muscle activity of patients with forward head posture.

• 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.

• Physical Therapy Rehabilitation Science
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• v.6 no.1
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• pp.33-38
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• 2017

Objective: This study tried to examine the muscle activity of the neck and trunk according to head posture changes during use of laptops. Design: Cross-sectional study. Methods: This study included nineteen young men and women. All subjects maintained each posture while practice typing on laptops for ten minutes with a 5-minute break between each posture. For the neutral head posture, the subjects practiced typing while pulling their chins down towards the Adam's apple and were able to look at their knees while having their external auditory meatus, acromion, and greater trochanter vertical to the ground. For the natural head posture, they practiced typing while balancing their posture between extension and flexion of the cervical vertebrae by themselves without any guidelines. While a forward head posture was created by having their heads face the front horizontal to the rope hanging from the ceiling, they practiced typing with their external auditory meatus located in the place which was 5 cm in front of the vertical plane. The subjects used general word process but practiced typing with accuracy and high speed. Muscle activities were randomly measured using surface electromyography according to each postures. Results: The research result had found that muscle activity with the natural head posture was more significantly reduced than that of the forward head posture in the sternocleidomastoid muscle, upper trapezius, cervical vertebral spinae, and thoracic vertebrae spinae muscles (p<0.05) and that the neutral head posture was more significantly reduced than that of forward head posture in the upper trapezius, cervical vertebral spinae, and thoracic vertebrae spinae muscle activity (p<0.05) with significant increases in lumbar spinae muscle activity (p<0.05). Also, muscle activity with the neutral head posture significantly increased more in the sternocleidomastoid muscle and lumbar spinae than that of the natural posture (p<0.05). Conclusions: Our study results suggest that in order to prevent musculoskeletal pain, the neutral head posture with use of laptops is effective in reducing load to the shoulders and vitalizing the postural muscles.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.29 no.2
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• pp.59-67
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• 2023

Background: The purpose of this study is to analyze the effect of shoulder and neck stabilization exercise using a gym ball for healthy women in their 20s with round shoulder and forward head posture, it is intended to try and find improvement for posture. Methods: The subjects of the study were 25 women who understood the purpose of the research and voluntarily agreed to participate in the experiment. They carried out the shoulder and neck stabilization exercise program using a gym ball, which was conducted for 35 minutes, 3 times a week for 4 weeks. The position of the round shoulder and shoulder bones was measured using an tape measurement and were recorded in both at pre, 2 weeks, and post intervention. The craniovertebral angle (CVA) and craniorotational angle (CRA) was measured using an image J. Results: The round shoulder posture left was statistically significantly different within group (p<.05); however, the round shoulder posture right wasn't statistically significantly different (p>.05). As a result of this contrast, test were significant different in both at pre, 2 weeks and post. The scapular position on the left and right were statistically significantly different within the group (p<.05). As a result of the contrast, test were significant different in both at pre, 2 weeks and post (p<.05). The CVA and CRA on the left and right were statistically significantly different within the group (p<.05). As a result of the contrast, test were significant different in both at pre, 2 weeks and post (p<.05). Conclusion: The gym ball exercises improved the posture of women in their 20s. Therefore, gym ball exercises can help improve the quality of life of those with shoulder and neck pain.

• Journal of the Korean Society of Physical Medicine
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• v.4 no.2
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• pp.117-124
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• 2009

Purpose：The purpose of this study was to investigate of the change of the forward head posture(FHP) according to computer using time. Methods：Subjects were 30 male and 30 female. The factors of FHP were measured cranial vertical angle, cranial rotation angle, and head, upper back, neck flexion/extension angle according to computer using time. Change of FHP used to Digital Inclinometry(JTech, Dualer IQTM Dual Inclinometer). The data were collected by data logger(Logger Teknologi HB, Akarp, Sweden). Results：Cranial vertical angle, cranial rotation angle, and head, upper back, neck flexion/extension were increased according to computer using time(p<.05). But cranial vertical angle and cranial rotation angle, and head, upper back, neck flexion/extension were not significant differences between male and female group(p>.05). Conclusion：The effects of cranial vertical angle, cranial rotation angl and head, neck and upper back angle depend on the computer task time. Increased of FHP may result increased tension in posture muscles of cervical spine, resulting in a risk of musculoskeletal disorders.

• 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.

• Journal of the Korean Society of Physical Medicine
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• v.2 no.2
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• pp.219-228
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• 2007

Objective : The purpose of this study was conducted to find treatment of forward head posture and shoulder instability with proprioceptive neuromuscular facilitation concept. Methods : This is literature study with books, seminar note and international course. Results : Forward head posture and shoulder instability has related each other. Forward head posture will make muscle instability, weakness and stiffness on neck and shoulder girdle. It will make pain also. Important muscle are suboccipital muscle, omohyoid muscle, sternoclaidomastoid muscle, scaleni, pectoralis minor, levator scapular and digastric. Conclusion : Treatment of the forward head posture and shoulder instability is provided. It is that treatment of stiff muscle with eccentric muscle work, muscle elongation, muscle strengthening at the structure level and at the functional level for daily activities.

• PNF and Movement
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• v.5 no.2
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• pp.1-10
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• 2007

Purpose : The purpose of this study was conducted to find treatment of forward head posture and shoulder instability with proprioceptive neuromuscular facilitation concept. Methods : This is literature study with books, seminar note and international course. Results : Forward head posture and shoulder instability has related each other. Forward head posture will make muscle instability, weakness and stiffness on neck and shoulder girdle. It will make pain also. Important muscle are suboccipital muscles, omohyoid muscle, sternoclaidomastoid muscle, scaleni, pectoralis minor, levator scapular and digastric. Conclusion : Treatment of the forward head posture and shoulder instability is provided. It is that treatment of stiff muscle with eccentric muscle work, muscle elongation, muscle strengthening at the structure level and at the functional level for daily activities.

• Journal of Oral Medicine and Pain
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• v.20 no.2
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• pp.361-376
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• 1995

The purpose of this study was to investigate the relationship between the head and neck postre and the cervical curvature, especially in forward head postrue(FHP). Sixty patients with craniomandibular disorders and thirty dental students without any signs and symptoms of craniomandibular disordres participated in this study as patient groups and sa control group, respectively. The author evaluated the head and neck posture of all subjects by plumb line and CROM( Cervical Ragne of Motion), and had taken cephaograph in natural head position. On the cephalograph the angle of cervical inclination formed by true horizntal plane and 4th cervical vertebra(C4) and the radius of cervical curvature from C1 to C5 were measured. A specially designed ruler was used for measuring cervical curvature. Occlusal contac number and force with T-scan system, electromygraphic activity of cervical muscles with Bio-EMG, and distance of freeway space with Bio-ECN were recorded, respectively. The collected data were processed by SAS/STAT progrm. The obtained results were as follows : 1. In subjects with longer radius which was less cervical curvature, head positioned more anteriorly than subjects with smaller radius, and they showed slightly straight cervical vertebra. 2. Between the patients and the control group, there were no differences in cervical curvature, in forward head position by plumb line and in CROM. But the patient group had a greater cervical inclination than the control group had. 3. There were positive correlation between cervical curvature and forward head position by plumbline,between forward head position y plumb line and that by CROM in patient group. The cervical inclination, however, had negative correlation with cervical curvature, and with forward head postion by plumb line, respectively. 4. In case of showing more cervical curvature and more forward head position by plumb line the head position was defined as forward head posture. In patient group, subjects without forward head posture showed greater posterior teeth contact force than subjects with forward head posture, but in control group, there were no difference between the two subjects. 5. There were higher electromyographic activity in almost all muscles and smaller freeway space in induced forward head posture than those in natural head position in subjects without forward head posture. In conclusion, head position of patients with craniomandibular disorders were not more anterior than that of normal control person, but they had tendency to head extension. From the result of this study, forward head posture could be defined as posterior rotation of upper cervical segment with a straight lower cercial segment due to loss of normal lordosis.

• 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.