• 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.

• Journal of International Academy of Physical Therapy Research
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• v.10 no.3
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• pp.1862-1867
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• 2019

Background: The importance of postural stabilization and cervical mobilization in subjects with pain from the anterior head posture is drawing more attention. However, studies on head and neck stabilizing intervention after mobilization are lacking. Objective: To examine the effects of Kinesiotaping and posture setting exercise on forward head posture (FHP). Design: Crossover Study Design Methods: The subjects were 17 male and female college students in their 20s with FHP. They were randomized into the Kinesiology taping group (KTG) with 9 subjects and posture stabilizing exercise group (PSEG) with 8 subjects. The intervention was conducted for 4 weeks, and changes in pain, craniovertebral angle (CVA), and proprioception were observed before and after intervention. Results: Pain was significantly reduced in the KTG and PSEG both before and after intervention. CVA and proprioception were significantly increased only in the PSEG. The differences in CVA and proprioception between the two groups were significant. Conclusions: These findings suggest that the application of posture setting exercise could decrease pain, proprioceptive error and increase CVA on FHP.

• Journal of International Academy of Physical Therapy Research
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• v.10 no.2
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• pp.1763-1767
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• 2019

Background: Although previous researches have developed interventions for neck problems, headache, and temporomandibular disorder in patients with forward head posture (FHP), changes in masticatory muscle tone or stiffness as FHP worsening have not been investigated. Objective: To examine changes in masticatory muscle tone and stiffness through craniovertebral angle (CVA). Design: Cross sectional study Methods: The subjects were 21 healthy males with normal head posture. Three CVA were established for posture measurement in which the bilateral anterior temporal and masseter muscles were measured during the subjects maintained a series of postures. Results: The Right masseter muscle significantly increased in stiffness with advancing FHP (p < 0.05). No significant changes were observed in the muscle tone or stiffness of any other masticatory muscles, and no significant differences were found in bilateral masticatory muscle tone or stiffness in each measurement posture. Conclusions: This study suggests that the increased stiffness of the right masseter muscle as the FHP worsened requires consideration in physical therapy assessment and intervention.

• The Journal of Korean Physical Therapy
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• v.28 no.2
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• pp.149-154
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• 2016

Purpose: The aim of this study is to suggest an intervention method for clinical use in the future by analyzing the effect of breathing exercise on activity of sternocleidomastoid muscle and scalenus anterior muscle, which are respiratory synergist muscles, and pulmonary functions in patients with forward head posture. Methods: Prior to the experiment, 12 patients (experimental group) performed feedback exhalation exercise along with conventional deep neck exercise, and 11 subjects (control group) performed feedback deep neck exercise along with conventional deep neck exercise. The intervention programs were performed for 40 minutes once a day (three times a week for four weeks). Results: Before intervention, %RMS was measured for surface electromyography (sEMG), and FVC, FEV1, and FEV1/FVC were measured using a spirometer. After four weeks, these items were re-measured under the same condition and analyzed. In within-group comparison of the experimental group, activity of sternocleidomastoid muscle and scalenus anterior muscle showed a significant decrease (p<0.05)(p<0.001), and forced vital capacity (FVC) showed a significant increase (p<0.05). In within-group comparison of the control group, activity of sternocleidomastoid muscle and scalenus anterior muscle showed a significant decrease (p<0.05), and in between-group comparison, there were significant differences in activity of sternocleidomastoid muscle and FVC (p<0.05). Conclusion: Long-term forward head posture restrains exercise performance of the neck and leads to exercise avoidance of the neck during daily activities, thus restraint factors might be created even while breathing. To cut off this link, a constant effort is required and diversified research on the correlation between neck functions and breathing should be conducted.

• Journal of the Korean Society of Physical Medicine
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• v.11 no.3
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• pp.41-47
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• 2016

PURPOSE: Forward head posture (FHP) is one of the most common postural problems among white-collar workers who perform highly repetitive tasks in the same position. The aim of this study was to research the effects of thoracic and lumbar support fixtures on forward head posture (FHP) during visual display terminal (VDT) work. METHODS: The subjects were 36 healthy male students with no problems in their medical history or respiratory systems. The subjects were randomly assigned to three groups: control group (n=12), thoracic support fixtures (n=12), and lumbar support fixtures (n=12). We conducted a text typing task of the same content for 20 minutes, and evaluated the angles, including the craniovertebra angle (CVA), craniorotation angle (CRA) with photogrammetry. RESULTS: The thoracic and lumbar support fixture groups showed a statistically significant difference at the CVA and CRA to the control group (p<.05), and the post-hoc test showed an increase of the CVA and decrease of the CRA than the control group. However, when we compared the effects of thoracic and lumbar support fixtures on FHP, there was no significant difference in the difference in decrease of the CVA or increase of the CRA (p>.05). CONCLUSION: We determined that VDT work using thoracic and lumbar support fixtures has a positive effect on forward head posture in white-collar workers. Further studies are required to find the more effective location of support fixtures.

• 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.27 no.4
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• pp.278-285
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• 2020

Background: Individuals with forward head posture (FHP) have neck pain. To correct the FHP, a posture correction band is commonly used. However, we do not know the posture correction band influenced the pulmonary function in individuals with FHP. Objects: This study aimed to elucidate the effects of the posture correction band on the pulmonary function in young adults with neck pain and FHP and to monitor how the pulmonary function changed over time. Methods: Twenty subjects with chronic neck pain and forward head posture were recruited. Subjects performed pulmonary function test four times: before, immediately, and 2 hours after wearing the postural band, and immediately after undressing the postural band. Vital capacity (VC), forced vital capacity (FVC), peak expiratory flow (PEF), and forced expiratory volume at one second (FEV1) were measured. The modified Borg dyspnea scale was used to measure each subject's responses to the posture correction band. The mixed-effect linear regression was used to the effect of the posture correction band over time. Results: There were no significant differences in VC, FVC, PEF, FEV1 values over time (p > 0.05), although all values slightly decreased after applying posture correction band. However, the score of the modified Borg scale significantly changed after wearing the postural bands (p < 0.05), indicating the subject felt discomfort with posture correction band during breathing. Conclusion: Because the posture correction band did not change the pulmonary function over time, but it induces psychological discomforts during breathing in people with FHP. Therefore, this posture correction band can be used for FHP realignment after discussion with the subjects.

• Journal of the Korean Society of Physical Medicine
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• v.1 no.1
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• pp.93-108
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• 2006

Purpose : To evaluate effects of McKenzie exercise on the functional recovery and forward head posture of chronic neck pain patients. Methods : The subjects were consisted of fifteen patients who had abnormal neck posture, mild neck pain (28 males, 17 females; mean aged 21.9) from 19 to 33 years of age(mean age 21.9). All subjects were received McKenzie exercise for 35 minutes with clinical massage per day three times a week during 4 weeks period. Neck disability index was used to measure functional disability level. Visual analogue scale(VAS) was used to measure subjective pain level. craniovetebral angle(CVA), cranial rotation angle(CRA) was used to measure forward head posture with digital camera. All measurements of each patients were measured at pre-treatment and after 2 week, after 4 week, post-treatment on 2 week. Result : The VAS of McKenzie exercise was significantly reduced between pre-treatment and post-treatment (p<.05) and effects of pain reduce was continued follow 2 weeks. The Neck Disability Index of McKenzie exercise was significantly reduced between pre-treatment and post-treatment (p<.05) and effects of pain reduce was continued follow 2 weeks. The CVA of McKenzie exercise was significantly reduced between pre-treatment and post-treatment (p<.05) and effects of pain reduce was continued follow 2 weeks. The CRA of McKenzie exercise was not significantly reduced between pre-treatment and post-treatment (p<.05). Conclusion : McKenzie exercise improved pain and function of Chronic neck pain patients.

• Journal of the Korean Society of Physical Medicine
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• v.15 no.3
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• pp.51-59
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• 2020

PURPOSE: The purpose of this study was to provide clinical basic data to reduce pain and improve function by comparing neck muscle activity and neck alignment using self-stretching and passive stretching exercises for chronic neck pain caused by forward head posture. METHODS: The subjects were divided into 15 subjects assigned to perform self-stretching exercise and 15 subjects assigned to perform passive stretching exercise. The intervention was conducted for a total of 4 weeks. The muscle activity in the neck was measured by surface electromyography (EMG) before intervention, and craniovertebral and cranial rotation angles were measured by X-ray. The 4-week intervention was conducted and the above items re-measured in the same manner and analyzed. RESULTS: Muscle activity within both groups after intervention using self-stretching or passive stretching exercise was significantly different (p < .05)(p < .01). Neck alignment of both groups was significantly different (p < .001)(p < .01). Further, muscle activities of the upper trapezius and splenius capitis muscles showed significant differences (p<.05). Lastly, neck alignment showed statistically significant difference (p < .05). CONCLUSION: Self-stretching exercise activated motor nerves as a posture correction exercise, thereby improving inhibition of muscle activity, muscle contraction delay, and pathological conditions of the muscle. For future research, interventions of self-stretching exercise will be needed for patients with chronic back pain accompanied by forward head posture, and various clinical studies on postural improvement of forward head posture by maintaining a normal muscle tone state are needed.

• Journal of International Academy of Physical Therapy Research
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• v.7 no.2
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• pp.1018-1024
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• 2016

The purpose of this study was to identify the effects of cervical alignment, pain, and physique to apply proprioceptive neuromuscular facilitation(PNF) techniques in patients with forward head posture (FHP). The subjects of this study were 24 patients diagnosed with FHP. They were randomly divided into two groups: a PNF group(n=12) and a control group(n=12). The intervention was performed a total of 24 times, 30 min a day, six times a week for four weeks. Data on cervical alignment(forward head displacement, FHD), pain(visual analog scale, VAS), and physique(height, weight, and body mass index) were obtained pre- and post-intervention. Two-way repeated measures ANOVA was used to compare the groups and time. For FHD, the VAS, and physique(height and BMI), there was an interaction effect for the groups and time(p<.001, BMI: p<.05) and main effects for time(p<.001, BMI: p<.05). For weight, there were main effects of time(p<.01). For FHD(p<.01) and the VAS(p<.05), there were main effects for the groups. In the PNF group, there were significant improvements in FHD, VAS, and physique. In the control group, there was a significant increase in FHD. The results of this study indicated that PNF intervention using scapular and upper extremity patterns effective in FHP positively. The use of a therapeutic intervention on physique changes may also be effective in improving poor posture and help to better patients' quality of life.