• PNF and Movement
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• v.13 no.2
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• pp.89-93
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• 2015

Purpose: This study aimed to verify the effect of integrated patterns (IPs) of PNF on individuals with malalignment using upper extremity and lower extremity patterns simultaneously. This information was then compared to the effect of bowling exercises on malalignment. The study population included individuals in their twenties with malalignment in their posture. Methods: Individuals with malalignment (40 participants in total) were divided into 2 groups based on trunk inclination and side deviation. In one group, IPs of PNF were used as interventions, while the other group used bowling exercises. This process was completed over the course of four weeks. The IP group used two patterns simultaneously: flexion-adduction-external rotation and extension-abduction-internal rotation. These patterns were used in the upper and lower extremities and were crossed diagonally. Results: The trunk inclination decreased in the IP and the bowling group. In the IP group, the degree of inclination decreased from 0.94 to 0.33. The side deviation also decreased to 1.53 (p < 0.05). In the bowling group, the two measured values decreased significantly (p < 0.05). Conclusion: Compared to the bowling exercises used in the bowling group, the results of this study indicate that the use of IPs had a significant effect on trunk inclination and side deviation for malalignment posture patients. Individuals can easily improve malalignment using IPs of PNF (for example, at home or at their office), which suggests that they are not required to seek assistance from a fitness or bowling center, which may save them time.

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

• Journal of the Korean Society of Physical Medicine
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• v.14 no.2
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• pp.53-61
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• 2019

PURPOSE: Forward head posture (FHP) is a head-on-trunk malalignment that results in musculoskeletal dysfunction and neck pain. To improve forward head posture, both the craniocervical flexion exercise (CCFE) and the visual guide (VG) technique have been used. This study compared the immediate effects of CCFE and VG combined with CCFE on craniovertebral angle (CVA), as well as on the activity of the sternocleidomastoid (SCM) and anterior scalene (AS) muscles during CCFE in subjects with FHP. METHODS: In total, 16 subjects (nine males, seven females) with FHP were recruited using the G-power software. Each subject conducted CCFE and CCFE combined with VG in random order. The CVA was recorded using a digital camera and the ImageJ image analysis software. The EMG data of SCM and AS were measured by surface electromyography. A paired T-test was used to assess differences between the effects of the CCFE and VG combined with CCFE interventions in the same group. RESULTS: The CVA was significantly greater for CCFE combined with the VG than for CCFE alone (p<.05). The activity of the SCM and AS muscles was also significantly greater when the VG was combined with CCFE than during CCFE alone across all craniocervical flexion exercise phases (p<.05). CONCLUSION: Use of the VG technique combined with CCFE improved FHP in subjects with FHP compared to CCFE alone.

• Journal of The Korean Society of Integrative Medicine
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• v.9 no.4
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• pp.149-158
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• 2021

Purpose : Forward head posture (FHP) is one of the most common postural malalignment of the cranio-cervical region. Previous studies have reported that FHP might affect both temporomandibular joint (TMJ) and cervical muscles, but still remains unclear. The purpose of this study was to compare the changes of craniovertebral angle (CVA) and muscle properties after smartphone use in healthy individuals with and without FHP. Methods : Fifteen healthy individuals aged 18 to 22 years were included. CVA was evaluated using Dartfish motion analysis, and the subjects were divided into two groups according to their CVA: a FHP group (n = 7, CVA less than 48 °) and a control group (n = 8, CVA more than 48 °). MyotonPro was used to measure muscle properties of masseter, digastric and sternocleidomastoid muscles (SCM). Each subject underwent 15-minutes of smartphone task (web browsing or video watching) in relaxed sitting posture. CVA and muscles properties were assessed both before and after the smartphone task. Results : There were significant changes in post measurements of CVA between the groups. Masseter muscle showed significant differences in pre and post measurements of all muscle properties, and digastric muscle showed significance only in muscle tone. Amount of changes (post-pre), however, showed no significant difference in this study. Conclusion : 15-minutes of smartphone task did not affect CVA and muscle properties of masseter, digastric and SCM in both groups, however, there were significant changes in pre and post measurements of CVA and some muscle properties of masseter and digastric muscles. Therefore, CVA, masseter and digastric muscles might be significantly changed in a heavy duration of smartphone usage more than 15-minutes. Further studies are needed regarding duration of smartphone task, assessments in other various TMJ muscle groups, and participants with pathological FHP conditions.

• Journal of Korean Physical Therapy Science
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• v.26 no.1
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• pp.9-14
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• 2019

Background: Pes planus, or flat foot, causes lower limb malalignment and foot pain during walking or exercise. Therefore, a highly reliable evaluation method to accurately diagnose flat feet is necessary. This study investigated the intra-and inter-rater reliability of the navicular drop test in different postures. Design: Cross sectional study. Methods: Forty healthy volunteers performed the navicular drop test in three different combinations of non-weight-bearing and weight-bearing postures (standing/standing, sitting/sitting, and sitting/standing). Two examiners alternately performed the measurements five times in each subject, and in each posture. Significant differences in measurements were obtained among the three postures, with the highest navicular drop being observed in the sitting/standing posture. Results: Inter-rater reliability was high in the sitting/standing and sitting/sitting postures. Intra-rater reliability was high in all three postures. In the sitting/sitting and sitting/standing postures, large navicular drop values and high inter- and intra-rater reliability were observed. Conclusion: Therefore, the sitting/standing and sitting/sitting postures are recommended for use in navicular drop tests to diagnose flat feet.

• The Journal of Korean Physical Therapy
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• v.24 no.6
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• pp.419-422
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• 2012

Purpose: Malalignment of the lower limbs may increases the difficulty of maintaining equilibrium. The purpose of this study was to study the effects of genu varum and poor posture in the sagittal plane on postural stability. Methods: We had 27 subjects with varus and 27 normal subjects participate in this study. Subjects for whom the distance between the medial epicondyles in the knee joint was more than 3 cm were classified as varus group, and subjects for whom the distance was less than 3 cm were classified as normal group. The measurements of static and dynamic stability were used overall stability index (OSI), anterioposterior stability index (APSI), and mediolateral stability index (MLSI) using a Biodex balance system. Results: When measuring the static stability index, there were significant differences in the mediolateral stability index between the varus and control groups. When measuring the dynamic stability index, there were significant differences in the overall, anteriorposterior, and mediolateral stability index between the varus and control groups. These results demonstrated that genu varum affects mediolateral movement in static stability, and overall, anterioposterior and mediolateral movements in dynamic stability. Conclusion: As genu varum affects static and dynamic stability in young adults, it increases the risk of injuries or falls. Exercise and surgery are required for realigning the genu varum. Future studies about postural stability in young children and elderly people who have a risk of falls due to lower postural control ability, are needed, as well as in young adults.

• PNF and Movement
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• v.12 no.4
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• pp.243-248
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• 2014

Purpose: The transverse abdominis and themultifidus muscle are located in the core. They surround one's trunk and help in body stabilization. Specifically, they control spine articulation to maintain posture and balance. Therefore, weakened deep muscle in the trunk may cause spinal malalignment. This study aims to compare the correlation between the thickness of the transverse abdominis and the multifidus muscle and the spine alignment among college students in their 20s. Methods: This study measured the thickness of the transverse abdominis and the multifidus muscle of 42 healthy college students in their 20s using ultrasonic waves. The thickness of the muscle was measured for the length of the cross-section except for fascia. The thickness of the left and right muscles was measured, and the mean value was calculated. As the thickness of the transverse abdominis can increase because of pressure during exhalation, it was measured at the last moment of exhalation. Spinal alignment was measured by the kyphosis angle, lordosis angle, pelvic tilt, trunk inclination, lateral deviation, trunk imbalance, and surface rotation using Formetric III, which is a three-dimensional imaging equipment. They were measured for three times, and the mean values were calculated. The general characteristics of the subjects were analyzed using descriptive statistics. The correlations between each factor were analyzed using Pearson's correlation analysis. Results: The transverse abdominis showed asignificant correlation with trunk inclination (p<.05). The multifidus muscle showed a significant positive correlation with pelvic tilt and a negative correlation with surface rotation (p<.05). Conclusion: The thickness of transverse abdominis and the multifidus muscle appears to influence spinal alignment. Specifically, the multifidus muscle, which plays an important role on the sagittal plane, influences surface rotation, thus making it an important muscle for scoliosis patients. Therefore, a strengthening training program for the transverse abdominis and the multifidus muscle is necessary according to specific purposes among adults with spinal malalignment.

• Journal of the Korean Society of Radiology
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• v.8 no.2
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• pp.89-96
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• 2014

This paper tries to examine whether the application of joint mobilization to subjects who have the forward head posture due to malalignment in the cervical joint has influence on posture changes and functions in the cervical joint. The subjects were 39 students from G University in Gyeongsangbuk-do. The cervical joint mobilization was applied to 20 subjects and not to 19. The students with a cervical lordosis angle of $21^{\circ}C$ or less, an anterior weight bearing (AWB) of 15mm or greater, and a cervical extension ROM of $70^{\circ}C$ or less in terms of radiography were selected as subjects under their voluntary agreement. The patients actively performed the joint mobilization slowly 8 times per session while therapists continuously applied sustained accessory glide to their painful joints 3 times per week for 4 weeks along with the cervical expansion and flexion in SNAGS among other Mulligan's (1995) techniques. The measurement was carried out in terms of radiographic inspection and neck disability indexes. As a result of the experiment, it turned out that the subjects with the forward head posture had changes in the cervical AWB and ARA, the ranges of expansion and flexion, and the NDI(Neck Disability Index) after the intervention for the experimental group by applying cervical joint mobilization. There were no changes observed in the control group. In conclusion, the application of joint mobilization turned out to have influence on the improvement of cervical joint postures, and craniocervical region functions.