• Journal of International Academy of Physical Therapy Research
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• v.7 no.1
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• pp.956-964
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• 2016

The purpose of this study was to identify the effects of continuous muscle strengthening applied to the antagonist of the sternocleidomatoid, upper trapezius, and pectoralis major, which are the shortened muscles of forward head posture(FHP) subjects, and Evjenth-Hamberg stretching(EHS) applied to the shortened muscles on changes in pressure pain threshold(PPT). Twenty subjects were divided into the continuous antagonist strengthening(CAS) group(n=10) and the EHS group(n=10), and each group performed its respective exercise three times a week for a six week period. The results were as follows: The comparison of changes in PPT within each group before and after the treatment showed a statistically significant difference(p<.05) according to the treatment period and a statistically significant difference according to the treatment period and method(p<.05). While the comparison of the tests of between subjects effects between the groups did not show a statistically significant difference, the CAS group exhibited better effects. The above results suggest that the combined application of CAS and EHS generates better effects on changes in PPT than the single application of EHS. Given that stretching and muscle strengthening exercises even for the short research period of six weeks could change the PPT, continuous exercises and a correct postural habit for a longer period of time are likely to help prevent chronic pain and correct FHP.

• The Journal of Korean Physical Therapy
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• v.21 no.4
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• pp.9-16
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• 2009

Purpose: This study was done to assess the effect of changes in forward head posture (FHP), neck mobility and headache clinical parameters on episodic tension-type headache (ETTH) and chronic tension-type headache (CTTH) who did craniocervial exercises. Methods: Twelve CTTH subjects and twelve ETTH subjects were studied. Side-view pictures of subjects were taken in both sitting and standing positions, in order to assess FHP by measuring the craniovertebral angle. Cervical range of motion (CROM) was employed to measure cervical mobility. A headache diary was kept to assess headache intensity, frequency, and duration. All subjects did three types of craniocervical exercise over 8 weeks. Measurements were done at pre-treatment, and at 4 and 8 weeks post-treatment. Results: Forward head posture and headache-related clinical parameters showed a significant improvement after craniocervical exercise (p<0.05). Flexion/extension and left/right rotation of CROM was significantly increased after the intervention (p<0.05), whereas changes in left/right bending did not reach statistical significance. Conclusion: This study indicates that craniocervical exercise may be effective in the management of tension-type headache.

• The Journal of Korean Physical Therapy
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• v.21 no.2
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• pp.71-77
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• 2009

Purpose: This study assessed the differences in the forward head posture (FHP), cervical range of motion, and headache clinical parameters in episodic tension-type headache (ETTH) subjects, chronic tension-type headache (CTTH) subjects, and healthy controls (university students). Methods: Fifteen CTTH subjects, 15 ETTH subjects and 15 controls without headache were examined. Side-view images of each group were taken in both the sitting and standing positions, in order to assess the FHP by measuring the craniovertebral angle. The CROM was used to measure the cervical range of motion. A headache diary was kept for 4 weeks to assess the headache intensity, frequency, and duration. Results: The craniovertebral angle was smaller, ie, there was a greater FHP, in the CTTH and ETTH subjects than in the healthy controls in both the sitting and standing positions (p<0.05). The CTTH and ETTH subjects showed a lower cervical range of motion than the healthy controls in the total range of motion as well as in the half-cycles (p<0.05). Conclusion: The increased FHP and decreased cervical range of motion might be a contributing factor in the initiation of tension-type headache.

• The Journal of Korean Physical Therapy
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• v.31 no.4
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• pp.248-253
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• 2019

Purpose: To improve pulmonary function and decrease in balance ability with increasing forward head position and vertebral curvature, we applied Figure-8 brace to confirm the immediate effect on vital capacity and balance and to see if it is applicable. Methods: A total of 34 elderly women aged 65 or older and young women in their 20s with FHP were screened to measure vital capacity, measuring the forced expiratory volume in 1 second (FEV1) and forced vital capacity (FVC), and measuring the foot pressure to see the change in balance. For statistical analysis, the difference between pre and post values was compared using pared t-test. Results: As a result of vital capacity measurements, there was no significant difference between FEV1 and FVC for women over 65 years old (p>0.05). Young women in their 20s had no significant difference in FEV1 (p>0.05), and FVC had significant differences (p<0.05). In measuring foot pressure to measure balance, both women aged 65 and above and young women in their 20s had a significant decrease in anterior foot pressure, and a significant increase in posterior foot pressure (p<0.05). Conclusion: The results of this study did not positively affect the vital capacity of elderly women with FHP. However, the significant increase in vital capacity of young women in their 20s suggests that contraction of the abdominal muscle is necessary during forced expiration. Therefore, it is believed that proper application and therapeutic interventions should be combined when applying Figure-8 brace.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.25 no.1
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• pp.1-7
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• 2019

Background: The purpose of this study is investigate the effects of cervical range of motion (ROM) and forward head posture (FHP) on cervical manual traction in normal adults. Methods: The subjects were randomly assigned to either the experimental group(Female 9, Male 6) who conducted the manual cervical traction or the control group(Female 9, Male 6) who did not conduct the any intervention. The subject in the EG have conducted the 1 set of 10 minutes of manual cervical traction per day, 2 times a week for 6 weeks. The cervical ROM was measured by the digital inclinometer and The factors of FHP was measured by cranial vertebral angle (CVA) and cranial rotation angle (CRA). Results: Comparing the cervical ROM and FHP between the experimental and control groups before and after the experiment, it could be seen that flexion, extension, right lateral flexion, left lateral flexion, CVA and CRA of the experimental group has been increased. Thus, cervical manual traction was resulted in the increased cervical ROM and decrease FHP. Conclusion: In this study, it was confirmed that cervical manual traction affects increase cervical ROM and decrease FHP that play a important role in neck stability and mobility.

• 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.8 no.4
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• pp.19-27
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• 2020

Purpose : We aimed to investigate the effect of cranio-cervical flexion exercises(CCFE) with visual feedback(VF) on the muscle activity of the upper trapezius in forward head posture (FHP) and whether deficits in proprioception affect the changes in muscle activity. Methods : Twenty subjects with FHP were assigned to one of 2 groups according to deficits in proprioception. The muscle activity of the upper trapezius during arm movement under three exercise conditions (resting, CCFE, and VF + CCFE). Repeated-measures analysis of variance was used to compare differences in muscle activity according to the exercise conditions between the groups and to analyze the interactions between groups and conditions. Results : Significant differences were observed in muscle activity according to the exercise condition (p<.05), with no significant differences between the groups. The muscle activity of the upper trapezius was significantly different between the resting and VF +CCFE conditions (p<.05), with no significant difference between the resting and CCFE conditions (p>.05). Conclusion : The results of this study showed that the CCFE combined with VF are an effective intervention for FHP to train deep muscles selectively. In addition, the loss of proprioceptive sensation is not related to changes in muscle activity during exercises.

• Journal of the Korean Society of Physical Medicine
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• v.16 no.3
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• pp.55-64
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• 2021

PURPOSE: The purpose of this study was to apply dynamic neuromuscular stabilization (DNS) to subjects with forward head posture (FHP) and to compare its effects on respiratory function as against the conventional neck stabilization exercise and neck stretching and extensor strengthening exercises. METHODS: The whole-body posture measurement system was used to measure the degree of FHP, and a spirometer and a respiratory gas analyzer were used to measure the respiratory function. After the intervention was completed, the changes over time were analyzed in the DNS group, the neck stabilization exercise group, and the neck stretching and extensor strengthening exercise group. The inter-group difference in the changes was also analyzed. A repeated ANOVA was performed to compare the respiratory function according to the period between the three groups, and the least significant difference (LSD) method was used for the post hoc test. RESULTS: After the 6-week exercise period, respiratory functions, such as forced vital capacity (FVC), forced expiratory volume for 1 second (FEV1), forced expiratory volume for 1 sec/forced vital capacity (FEV1/FVC), maximum oxygen intake (VO₂max), and the volume of expired gas (VE), significantly improved according to the period (p < .05), but no inter-group differences were found. CONCLUSION: DNS is an effective training method, and can be applied along with neck stabilization exercise and neck stretching and extensor strengthening exercises, which are widely used in clinical practice, to people with FHP who cannot directly perform neck exercises to improve their respiratory function.

• Physical Therapy Rehabilitation Science
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• v.11 no.2
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• pp.189-197
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• 2022

Objective: The purpose of this study was to investigate the effect of a lower trapezius strengthening exercise program on an unstable support surface on pain, neck dysfunction, psychosocial factors, and postural alignment in neck pain patients with forward head posture. Design: A randomized controlled trial Methods: A total of 36 neck pain patients participated in this study. Screening tests were performed and assigned to experimental group (n=18) and control group (n=18) using randomization program. Both groups performed the lower trapezius strengthening exercise program. In addition, in the experimental group, an exercise program for lower trapezius muscle strengthening was performed on an unstable support surface. All interventions were performed 3 times a week, for a total of 5 weeks. quadruple visual analogue scale (QVAS), neck disability index (NDI), short form (SF)-12, and postural alignment were measured before and after the intervention to compare their effectiveness. Results: Both groups showed significant differences in QVAS, NDI, SF-12, and postural alignment before and after intervention (p<0.05). In addition, the experimental group showed significant differences in NDI and postural alignment compared to the control group (p<0.05). Conclusions: The lower trapezius strengthening exercise program on unstable support surfaces is an effective intervention method with clinical significance in improving neck disability and postural alignment in patients with neck pain with forward head posture.

• 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.