• Journal of International Academy of Physical Therapy Research
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• v.11 no.1
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• pp.1960-1968
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• 2020

Background: The alignment of the neck and shoulder is important in people with forward head posture. However, previous studies have mainly conducted fragmentary studies on the neck and shoulders, and studies on the combined movement of the neck and shoulders are incomplete. Objective: To investigate the effects of 6 week dynamic exercise program using Thera-band on craniovertebral angle (CVA) in adults with forward head posture. Design: Quasi-experimental study. Methods: The study was conducted on 24 adults with forward head posture and experimented with neck and shoulder exercises and divided them into groups of neck exercises, shoulder exercises, and neck and shoulder exercises to measure CVA values before and after the experiment. The neck exercise program included flexion and extension muscles of the neck and shoulder exercises included dynamic exercise of the upper extremities such as the trapezius muscles and serratus anterior muscle. The CVA results were measured using PA200. Results: Following the interventions, neck exercise group showed significant improvement in CVA (P<.05), but shoulder exercise group and combined exercise group did not show any significant results (P>.05). However, both groups showed some positive results. Significant differences were seen in the comparisons between the three groups (P<.05), and the results of the post-hoc test showed significant differences in neck exercise group and shoulder exercise, neck exercise and combine exercise group. Conclusion: This study suggested that the Thera-band neck exercise is beneficial for foward head posture patients and is expected to be used in clinical trials.

• International journal of advanced smart convergence
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• v.7 no.1
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• pp.33-41
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• 2018

This study was designed to provide basic data for developing exercise program that helps correcting posture by knowing the effect of strengthening and elongation exercises of upper extremity muscle to forward head posture correction. In this study determined subjects whether they had forward head posture or not. On the basis of the New York state posture rating, if a subject's posture is match up with the normal standard posture, gives 5 points and if the posture is slightly get out of the normal standard posture, gives 3 points and if the posture is apparently get out of the standard, gives 1 points. When determining the forward head posture, if talus, humerus and outer ear center are on the same line, it is determined as normal and if outer ear center is off the line less than 1.0cm, it is a slight deformation and if outer ear center is off the line more than 1.0cm, it is a high deformation. In the study selected people who have more than 1 cm gap between two vertical lines start from outer ear center and acromion separately as subjects. Length between the ideal alignment line measured by using goniometer and temporal region showed statistically significant decrease as $2.36{\pm}1.07cm$ before the intervention and $1.06{\pm}0.88cm$ after the intervention. After 4 weeks of neck and chest extensor muscle exercise, the group who exercised both showed increase in range of neck joint motion and neck flexion of the forward head posture. Meanwhile the group who only exercised neck extensor muscle only and the group who only exercised chest extensor muscle didn't showed statistically significant result. That only the group who exercised both muscles showed significant result is the different with studies before. Because this study didn't target patient who had a lesion, couldn't compare effect of the conservative manner and exercise. However, this study provides the fact that the group who exercised both neck and chest muscle had more effect than the control group.

• Journal of The Korean Society of Integrative Medicine
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• v.12 no.3
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• pp.71-81
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• 2024

Purpose : In this study, we compared the effects of ankle, McKenzie, and cervical stabilization exercises in individuals with a forward head posture. Outcome measures investigated included the neck disability index, craniovertebral angle (CVA), cranial rotation angle (CRA), and thickness of the longus colli muscle (LC) and carotid artery (CA) post-intervention. Methods : The study included 20 individuals with a forward head posture, who were assigned to an experimental group (EG, individuals performed ankle exercises) or control group (CG, individuals performed McKenzie and cervical stabilization exercises). The EG intervention was specifically designed to enhance proprioception in the ankle joint and strengthen the ankle muscles to improve overall stability and function. In contrast, CG interventions aimed to improve neck muscle balance and cervical spine alignment. Paired t-tests were used to analyze intragroup changes and independent t-tests to determine intergroup differences pre-and post-intervention. The significance level for all statistical tests was set at α=.05. Results : We observed significant post-intervention improvements in both groups, specifically, in the CVA, CRA, and LC and CA thickness (p<.05). These results indicate that ankle, McKenzie, and cervical stabilization exercises were useful for neck posture correction, improved muscle balance, and enhanced blood flow to the neck. Conclusion : This study underscores the positive effects of ankle, McKenzie, and cervical stabilization exercises in individuals with a forward head posture. Our study highlights the benefits of these exercises for posture correction and overall neck health and the clinical effectiveness and usefulness of ankle exercises as an important intervention to improve forward head posture.

• 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.

• Journal of Oral Medicine and Pain
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• v.22 no.1
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• pp.95-109
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• 1997

The purpose of this research is to investigate the influence on mandibular movements and TMJ sounds with changes of head and neck posture. For the research, twenty patients who had complained of TMJ sounds without any other symptoms of cranio-mandibular disorders, were selected as subjects for measurements of TMJ sounds, and radiographs on transcranial view of TMJ were taken on ten of the subjects. From NHP, UHP, DHP and FHP, aspects of mandibular movement and TMJ sound were investigated from each posture. Aspects of mandibular movement and TMJ sound were observed by measuring total vibration energy(Integral), peak amplitude, maximum amound of mouth opening, and TMJ sound-emitting point using Sonopak for windows (version 1.33) and Bio-EGN(Bioresearch Inc. WI. U.S.A.). Head and neck movement-measuring instrument, CROM(perfomance attainment Inc. U.S.A.) was to maintain even head posture. Degrees of inclination of UHP and DHP were determined at 30' and distance of FHP was 4cm. The results obtained were as follows. 1. Total vibration energy and peak amplitude of TMJ sounds were decreased more on UHP and on UHP and increased more on DHP and FHP than that on NHP. 2. At the maximum mouth opening, distance of TMJ sound-emitting point were decreased more on UHP and increased more on DHP and FHP than that on NHP. 3. The amounts of the maximum mouth opening were increased more on UHP and decreased more on DHP and FHP than that on NHP. 4. For the changes of the head posture with mouth opening observed in radiograph, condylar head was positioned more lower-anteriorly on UHP, and more upper-posteriorly on DHP and FHP than that on NHP. From the results obtained as above, considering positive influence of the change of head and neck posture, avoiding down-head and forward-head posture, and recommending upper- head posture can prevent the progress of temporomandibular disorder and lead to successful treatment for the patients with temporomandibular joint sounds.

• Physical Therapy Rehabilitation Science
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• v.13 no.3
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• pp.343-353
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• 2024

Objective: Long-term imbalances in the muscles around the neck could the functional resting length of the muscles, resulting in a chronic forward head posture. This study aimed to assess the effects of combining posture correction exercises with extracorporeal shockwave therapy on muscle activity, neck function and pain in adults with forward head posture. Design: Pretest-posttest two groups design. Methods: A total of 22 adults, diagnosed with forward head posture, participated in the study. Random assignment allocated 11 participants to the posture correction exercise (PCE) group, while the other 11 were assigned to the posture correction exercise group combined with extracorporeal shockwave therapy (ESWT). In the combined group, ESWT was administered twice a week for four weeks, delivering 1,000 impulses in a radial pattern to the levator scapulae and upper trapezius muscles. The PCE group performed a exercise program for approximately 30 minutes, three times a week, over the same four-week period. The PCE focused on strengthening weakened muscles and stretching of shortened muscles. Results: Both the PCE group and the combined group with ESWT exhibited a significant increase in lower trapezius muscle activity within groups (p<0.05). Moreover, the craniovertebral angle and neck disability index showed significant improvements in both groups (p<0.05). While the pressure pain thresholds tended to increase only in the combined group, the difference was not statistically significant (p>0.05). Conclusions: This suggests that both the PCE program and the combination with ESWT can be effective in enhancing posture and reducing pain in individuals with forward head posture.

• Journal of the Korean Society of Physical Medicine
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• v.9 no.4
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• pp.425-432
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• 2014

PURPOSE: The purpose of this study was to investigate that the differences in sternocleidomastoid muscle activity, neck rotation angle, neck lateral bending angle and neck lateral bending onset time between conditions with and without visual biofeedback during neck rotation. METHODS: Ten male and four female adults with condition of forward head posture were recruited in this study. Subjects conducted to left and right maximal neck rotation under the conditions with and without visual biofeedback. During neck rotation, kinematic data of neck rotation, neck lateral bending movement, and electromyography activities of bilateral sternocleidomastold muscles were collected. Differences in dependent variables between conditions with and without visual biofeedback were analyzed using paired t-test. RESULTS: There were significant decreases in lateral bending angle, while lateral bending movement onset time was delayed significantly when applying visual biofeedback (p<.05). However, there were no significant differences in the activation of left and right sternocleidomastoid muscles and neck rotation angle between conditions with and without visual biofeedback (p>.05). CONCLUSION: These findings suggest that visual biofeedback may be effective for axial rotation of cervical spine during neck rotation in adults with forward head posture.

• Journal of The Korean Society of Integrative Medicine
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• v.4 no.1
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• pp.13-20
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• 2016

Purpose : The purpose of this study was to compare the effect of exercise on the neck muscles activities between scapular stability and McKenzie stretch exercise in the forward head posture subjects. Method : After measuring cervical alignment using the Global Posture System, 20 volunteers with forward head posture posture were selected and divided into two groups. The experimental group A(n=15) and Experimental group B(n=15) participated in respectively and McKenzie neck stretching exercise, three times per week for 4 weeks. The scapular stabilization exercise program was comprised middle and lower trapezius strength exercises and the stretching exercise program was comprised levator scapulae and upper trapezius stretching exercise. The activities of the muscles of the posterior neck was then measured using electromyography. Result : After the intervention, there was significant difference of a electromyography activity changes between the pre-test and post-test in the experimental group. Conclusion : This study showed that both scapular stabilization and McKenzie neck stretching exercises are more effective for reducing neck muscles activities.

• PNF and Movement
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• v.20 no.3
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• pp.331-340
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• 2022

Purpose: Thisstudy aimed to identify the effect of varying the expansibility of elastic tape on the onset time of muscle contraction during neck extension for forward head posture syndrome. Methods: Forty-five young adults with forward head posture syndrome volunteered to participate and were randomly assigned to one of three groups according to the expansibility of the elastic tape (25%, 50%, 75%). The onset time of muscle contraction for the neck extensor during neck extension was measured using an electromyographic system (Free EMG, BTS, Italy). Multivariate analysis of variance was employed to determine the effect of different expansibilities of elastic tape on the onset time of muscle contraction during neck extension for forward head posture syndrome. When there was a statistically significant difference by MANOVA, Scheffe was used as a post-hoc test. The level of significance was set at α=0.05. Results: In the comparison of the onset time of muscle contraction of varying elastic tape expansibilities and measurement times, there was a significant difference between the groups (Lt. UT, Lt. SCM, Rt. SCM) (p < 0.05), but there was no significant difference in the interaction between the measurement time and the group, between the measurement time (p > 0.05). Conclusion: In the neck extension, 75% of the tape extensibility in the Lt. UT and both SCM shortened the muscle contraction onset time.

• Physical Therapy Rehabilitation Science
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• v.5 no.4
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• pp.178-184
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• 2016

Objective: Tension-type headache is caused by hormones, foods, irritants, stress, obesity, fatigue, and neck and head trigger points-prolonged abnormal posture. The purpose of this study was to evaluate the effects of relaxation approach on head posture, static postural stability, and headache in persons with tension-type headache. Design: Randomized controlled trial. Methods: Thirty-five persons with tension-type headache participated in this study. This study was a pretest-posttest with a control group design for a duration of 4 weeks (60 min/3 times/1 wk). The participants were randomly allocated to the relaxation approach group (n=18) and the control group with conventional rehabilitation including thermotherapy and transcutaneous electrical stimulation for the same period (n=17). Outcome measures involved forward head posture (FHP), foot pressure, neck disability index (NDI), and six-item headache impact test (HIT-6). Results: Relaxation approach and control groups improved significantly in the amount of forward head posture, neck disability index, and six-item headache impact test scores after training (p<0.05). The control group was found to be significantly different in the amount of FHP, backward foot pressure, NDI, and HIT-6 after training compared to before training (p<0.05). The relaxation approach group significantly improved in forward head posture, neck disability index, and six-item headache impact test compared with control group after training (p<0.05). Neck disability index and six-item headache impact test significantly improved after training compared with before training in the control group (p<0.05). However, the foot pressure was not significantly different between relaxation approach and control groups. Conclusions: This study suggests that treatment with relaxation approach combined with self-exercise would be effective in reducing the amount of forward head posture, neck disability and headache impacts.