• Journal of Oral Medicine and Pain
• /
• v.24 no.2
• /
• pp.189-206
• /
• 1999

This study was performed to investigate the factors affecting muscle activity and cephalometric variables according to change of head postures. For this study, 150 patients with temporomandibular disorders and 80 dental students without any signs and symptoms of temporomandibular disorders were selected as the patients group and as the normal group, respectively. Head position to body-midline in frontal plane and upper quarter posture to body plumb line in sagittal plane were observed clinically and electromyographic(EMG) activity of anterior temporalis, masseter, sternocleidomastoideus, and trapezius on clenching were recorded with $BioEMG^{(R)}$ in four head postures, which were natural head posture(NHP), forward head posture(FHP), $20^{\circ}$ upward head posture(UHP), and $20^{\circ}$ downward head posture(DHP). Cephaloradiographs were also taken in the same head postures as in EMG taking, but that was taken only in NHP for the patient group. Cephalometric variables measured were SN angle, CVT angle, atlas inclination angle, occlusal plane angle, Me-C2 angle, pharyngeal width, occiput~axis distance, area of pharyngeal space, and cervical curvature. The data were analyzed by SAS statistical program. The results of this study were as follows : 1. Between the patient and the normal group, there were significant difference in distance from plumb line to acromion, eye-tragus angle, electromyographic activity of the four muscles, and cephalometric variables of linear measurement. 2. There was no consistent pattern of correlation between upper quarter posture, EMG activity and cephalometric variables in any case without relation to cervical curvature and head position in frontal plane. 3. Sternocleidomastoid muscle only showed variation of electromyographic activty with changes of head postures, but all the muscles did show correlation with head postures. 4. All the cephalometric variables measured in this study showed difference of mean value by head posture, and CVT angle, pharyngeal width, occiput-atlas distance, and area of pharyngeal space showed correlation between these variables with change from NHP to FHP, and from NHP to UHP.

• Physical Therapy Rehabilitation Science
• /
• v.5 no.2
• /
• pp.101-105
• /
• 2016

Objective: The purpose of this study was to measure the change in pain threshold of levator scapular muscle, carniovertebral angle, and head position angle when applying a head-weight device on healthy adult. Design: Cross-sectional study. Methods: This study was conducted with 21 healthy adult male and female who voluntarily agreed to participate in this study after being informed of the purpose and method of this study. After measuring the cervical angle and pain threshold of levator scapular muscle, subject was instructed to walk for 5 minutes on a treadmill at a speed of less than 5 km/h while wearing after wearing head-weight device of 0.5 kg. Then, cervical spine angle and pain threshold of levator scapula muscle were re-measured. Measurement of cervical spine angle was conducted with photo by using the Bluebeam Revu software and the pain pressure thresholds (PPTs) were measured using an electronic algometer over potential trigger points on the body. Results: The results cervical angle showed a significant change, from $49.62^{\circ}$ to $52.10^{\circ}$ (p<0.05). PPT showed a significant change, from 30.71 to 36.89 (p<0.05). Conclusions: These findings suggest that applying head-weight device has a positive influence on increasing cervical angle and reducing pain when applied as a therapeutic intervention method of forward head posture.

• Journal of Oral Medicine and Pain
• /
• v.21 no.2
• /
• pp.393-405
• /
• 1996

This study was performed to investigate the effects of changes of head posture and cervical spine shape on the mandibular resting or clenching electromyographic(EMG) activity in anterior temporalis(TA), masseter(MM), sternocleidomastoid muscle(SCM) and trapezius insertion(TI). 30 patients with Temporomandibular Disorders(TMDs) participated in this study. EMG activity($\mu$V) at rest and clenching was observed in four head postures, namely natural head posture(NHP), forward head posture(FHP), upward head posture(UHP), and downward head posture(DHP). For taking in upward or downward head posture head was inclined 10$^{\circ}$ upward or downward and CROM$^\textregistered$(cervical-range-of motion, Performance attainment Inc., USA) was used to maintain same posture during the procedure, and BioEMG$^\textregistered$ (Bioelectromyograph, Bioresearch Inc., USA) was used to record EMG activity in the above four muscles at eight locations on both sides. The recorded EMG activity($\mu\textrm{V}$) were compared and analyzed by cervical spine shape such as the head position from plum line, cervical curvature, and cervical inclination. Head position from plum line was measured in vertical plate calibrated with cm scale, comical curvature by radius was measured with adjustable curved ruler, and cervical inclination by cervical vertebrae tangent(CVT)was measured in lateral cephalograph. The results obtained were as follows : 1. Mean value of head position from plum line, cervical curvature, and cervical inclination were 4.8cm, 26.7cm, and 86.6$^{\circ}$, respectively, And There were no correlationship among these items. 2. For resting EMG activity by head posture, the value in anterior temporalis was higher at FHP than at DHP, the value in masseter was higher at FHP than at NHP, and DHP, the value in sternocleidomastoid muscle was higher at UHP than at NHP, and the value in trapezius insertion was higher at FHP and DHP than, NHP and UHP. The clenching EMG activity, however, did not show any difference by head posture. 3. Comparison of resting and clenching EMG activity between higher and lower groups by head position from plum line, cervical curvature, and cervical inclination did not show any significant difference. From this result, the author concluded that the cervical spine shape had not significantly affected to EMG activity in usual patients with TMDs.

• Journal of the Korean Society of Physical Medicine
• /
• v.10 no.2
• /
• pp.89-94
• /
• 2015

PURPOSE: The aim of this study was to determine the effect of device considering Mckenzie type for the subjects with forward head posture (FHP). METHODS: The subjects were 35 patients with FHP (mean age was $23.7{\pm}2.8$ years; mean height; $172.1{\pm}11.7$, mean weight; $65.8{\pm}13.9$, mean NDI(Neck Disability Index; $3.7{\pm}3.2$, mean FHP; $6.7{\pm}2.2$). We measured the posture with the Body style S-8.0(LU Commerce, South Korea) to evaluate the FHP. We collected the surface EMG(Myosystem 1400, Noraxon, USA) data to quantify changes in normalized activation levels of muscles in SternoCleidoMastoid muscle(SCM), Scalenus Anterior(SA), Trapezius upper fiber(TU) and Splenius Cervicis(SC), during the subjects were instructed to glide their head into a "chin-in" position for a retraction without and with device. RESULTS: The condition with device significantly decreased the %RVC of SA($90.84{\pm}40.54$), SCM($74.98{\pm}43.65$) and TU($67.60{\pm}47.83$) compared to the condition without device(SA;$100.39{\pm}56.32$, SCM;$119.03{\pm}109.26$, Trapezius;$80.55{\pm}39.27$). But the %RVC of capitis($65.87{\pm}47.83$) with device was increased($70.82{\pm}52.78$). There was significant difference in the %RVC between SCM and Trapezius muscle in two conditions. CONCLUSION: New device for FHP reduces the EMG activities of the TU, SCM and SA muscle. We have to develop the function of feedback to facilitate the motion in the future.

• Journal of International Academy of Physical Therapy Research
• /
• v.10 no.4
• /
• pp.1897-1902
• /
• 2019

Background: Tension-type headaches, which make up the highest proportion of headaches, are prone to develop into chronic tension-type headaches (CTTH). The characteristic of CTTH in patients is that the active myofascial trigger point (ATrP) which causes pain in the muscles of the back of the head is increased, compared to the normal headache and moves the head position forward. Objective: The aim of this study was to investigate the effects of myofascial release (MFR) and posture correction in effectively improving neck function and sleep quality in the symptoms of CTTH patients. Design: Observer-blind study Methods: To reduce ATrP, MFR was applied and exercise was also applied to correct posture. The subjects of this study were 48 individuals randomly divided into three groups; The MFR group using the MFR technique; The MFR with exercise group subject to both the MFR technique and forward head position correction exercises (MFREx), and the control group. MFR and MFREx groups were given the relevant interventions twice a week for four consecutive weeks, and went through the number ATrPs, range of motion (ROM) of neck, Neck Disability Index (NDI) and the Pittsburgh Sleep Quality Index (PSQI) before and after the intervention. A physical therapist, who was fully familiar with the measuring methods of the equipment, was the measurer and not aware of the target's condition was blinded to take measurements only before and after intervention. Results: There was a significant improvement in the ATrP, Neck ROM, NDI and PSQI in the group of patients to whom the MFR technique and MFREx were applied. MFREx was more effective in increasing neck mobility. Conclusions: According to this study, the application of MFR is effective in improving neck movement and sleep quality in chronic tension headache patients.

• Journal of The Korean Society of Integrative Medicine
• /
• v.8 no.1
• /
• 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.

• Physical Therapy Korea
• /
• v.27 no.4
• /
• pp.272-277
• /
• 2020

Background: Forward head posture (FHP) is common postural malalignment. FHP is described relatively extension to upper cervical and lower cervical is relatively flexion. Although several researchers mentioned the lower cervical flexion posture in FHP, most of the studies related to FHP is focused on the deep cervical flexor function. Objects: The purposes of present study is to compare the cervical strength (upper cervical extension [UCE], lower cervical extension [LCE], upper cervical flexion [UCF], lower cervical flexion [LCF]) between individuals with and without FHP. Methods: Fifty-one participants are recruited. Participants who have the craniovertebral angle (CVA) less than 48 degree were classified to the FHP group (n = 24) and the others were included in without FHP group (n = 27). The cervical strength (UCE, LCE, UCF, LCF) were measured using Smart KEMA strength sensor and the strength data was normalized by body weight. All strength measurement conducted at head and neck neutral position in sitting. Independent t-test was used to compare the cervical strength between individuals with and without FHP. Results: The mean value of CVA was greater in without FHP group than with FHP group (p < 0.000). The strength value of UCF (p < 0.002) and LCE (p < 0.001) was significant less in FHP group than without FHP group. But no significant differences were seen in the LCF and UCE strength between two groups. Conclusion: UCF and LCE weakness in FHP group should be considered to evaluate and manage the individuals with FHP.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.13 no.1
• /
• pp.95-99
• /
• 1991

Several authors have proposed techniques and devices by which the correct position of the proximal segment can be maintained both during fixation and postoperatively. Schendel, Epker, Lake, Worms, Ive and Poulton have been discussed the problem of condylar distration in mandibular orthognathic surgery. This study described have showed the some advantages forward repositioning of the condyle head in vertical ramus osteotomy which used with the Mini-Hoffmann sets in external skeletal pin fixation extraorally in 19 cases.

• Korean Journal of Applied Biomechanics
• /
• v.15 no.4
• /
• pp.181-189
• /
• 2005

To know the proper impact posture and changes for the various clubs, changes of impact variables according to the change of golf club length was investigated. Swing motions of three male low handicappers including a professional were taken using two high-speed video cameras. Four clubs iron 7, iron 5, iron 3 and driver (wood 1) were selected for this experiment. Three dimensional motion analysis techniques were used to get the kinematical variables. Mathcad and Kwon3D motion analysis program were used to analyze the position, distance and angle data in three dimensions. Major findings of this study were as follows. 1. Lateral position of the head remained more right side of the target up to 3.5cm compared to the setup as the length of the club increased. 2. Left shoulder raised up to 5cm and right shoulder lowered up to 2.5cm compared to setup. The shoulder line opened slightly (maximum 11 degrees) to the target line. 3. Forward lean angle of the trunk decreased up to 4 degrees (more erected) compared to setup. 4. Side lean angle of the trunk increased compared to setup and increased up to 16 degrees as the club length increased. 5. The pelvis moved to the target line direction horizontally and opened up to 31 degrees. Right hip moves laterally to the grip position at the setup. 6. Flexion of the left leg maintained almost constantly but the right leg flexed up to 11 degrees compared to setup. 7. Left arm is straightened but the right arm flexed about 20degrees compared to straight. 8. Center of the shoulders were in front of the knees and toes of the feet. 9. Hands moved to the left (8.7cm), forward (5.7cm) and upward (11.6cm) compared to the setup. This is because of the rotation of pelvis and shoulders. 10. Shaft angle to the ground was smaller than the lie angle of the clubs but it increased close to the lie of the clubs at impact.

• Journal of the Korea Academia-Industrial cooperation Society
• /
• v.20 no.12
• /
• pp.645-651
• /
• 2019

This study examined the correlation between the forward head posture (FHP), temporomandibular joint disorder (TMD), and temporomandibular joint quantitative somatosensory sensation. This study examined the correlation between the temporomandibular joint function and somatosensory sensation according to the change in FHP after the intervention on the head posture in 62 subjects (22.15 ± 2.56 years) Biofeedback training was administered to the FHP, which was performed 12 times for a total of four weeks. To assess the FHP, the craneovertebral angle (CVA) was examined. The temporomandibular joint (TMJ) function was measured by the Therapeutic Range of Motion Scale and the left and right lateral deviation, and the sensation of vibration threshold was measured to confirm the change in somatic sensation. Multiple regression analysis was performed to confirm the influence of each variable and Pearson's correlation analysis was performed to assess the correlation. Changes in the temporal joint function (p<.001) and somatic sensation (p<.001) were correlated significantly with the changes in CVA. These results show that there is a significant correlation between the frontal head position, TMJ function, and somatosensory sensation. These results provide a new paradigm for the treatment of jaw joints for patients suffering from TMD and provide a basis for the future treatment of the temporomandibular joint.