• The Journal of the Korea Contents Association
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• v.11 no.12
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• pp.800-806
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• 2011

The objective of this study was to identify the effect of lumbar lordotic curve adjustment on head and neck posture in older adults. Methods Twenty healthy older participants (mean age 71.32) were photographed while watching monitor in sitting with or without lumbar roll support(length 28cm, diameter 10cm). The upper cervical angle and lower cervical angle were measured using the NIH ImageJ 1.32. Comparisons between upper and lower cervical angle with or without lumbar roll support were made using paired-t test analysis. Results Subjects demonstrated a significant difference in the mean upper and lower cervical angle. Mean difference of the upper cervical angle was about $2.83^{\circ}$ with and without lumbar roll support(p<0.005). Mean difference of the lower cervical angle was about $4.44^{\circ}$ with and without lumbar roll support(p<0.0001). Conclusions This study showed that healthy older adults demonstrated more ability to maintain an upright posture of cervical spine during lumbar lordotic curve maintenance with lumbar roll support than without lumbar roll support. When the clinicians consider improvement of the head and neck posture in older adults, they must incorporate adjustment in the lumbar region.

• Physical Therapy Korea
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• v.30 no.3
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• pp.184-193
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• 2023

Background: Studies investigating the immediate effects of a single intervention to correct forward head posture are rare. Objects: This study aimed to compare the changes in treatment effects in patients with forward head posture and neck pain after manual and self-exercise therapy over a 1-hour period. Methods: Twenty-eight participants were randomly divided into manual and self-exercise therapy groups. Following the initial evaluation, manual or self-exercise therapy was applied to each group for 30 minutes each in the prone, supine, and sitting positions. The variables measured were the craniovertebral angle (CVA), stress level, pain level, and sternocleidomastoid (SCM) stiffness. After the intervention, re-evaluation was conducted immediately, 30 minutes later, and 1 hour later. Two-way analysis of variance (ANOVA) was used to compare the maintenance of treatment effects between the two groups. Results: Based on the two-way mixed ANOVA variance, there was no interaction between the groups and time for all variables, and no main effects were found between the groups. However, a significant effect of time was observed (p < 0.05). Post hoc tests using Bonferroni's correction revealed that in both groups, the CVA, pain, and stress showed significant improvements immediately after the intervention compared with before the intervention, and these treatment effects were maintained for up to 1 hour after the treatment (p < 0.0083) in the manual therapy group. However, the stress level was maintained until 30 minutes later (p < 0.0083) in the self-exercise group. There was no significant decrease in right SCM stiffness before and after the intervention; however, left SCM stiffness significantly decreased after the self-exercise intervention (p < 0.0083). Conclusion: Both manual and self-exercise therapy for 30 minutes were effective in reducing forward head posture related to the CVA, pain, and stress levels. These effects persisted for at least 30 minutes.

• 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.10 no.2
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• pp.89-94
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• 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.

• Physical Therapy Korea
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• v.31 no.2
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• pp.159-166
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• 2024

Background: For instance, forward head posture (FHP), characterized by the forward movement of the head relative to the spine, places significant stress on the neck and upper back muscles, disrupting the biomechanical balance of the body. Objects: The objective of this study was to probe the biomechanical effects of FHP on musculoskeletal health through a relative analysis of 26 adults diagnosed with FHP and 26 healthy controls. Methods: In this study, we evaluated the biomechanical impacts of FHP. Participants adjusted their head positions and underwent muscle strength tests, including electromyography assessments and the Biering-Sørensen test for trunk muscle endurance. Data analysis was conducted using Kinovea (Kinovea) and IBM SPSS software ver. 26.0 (IBM Co.) to compare muscle activities between groups with normal and FHPs. Results: The study shows that individuals with FHP have significantly lower muscle activity, endurance, and spinal extension in the erector spinae compared to those without, highlighting the detrimental effects of FHP on these muscles. Conclusion: This study underscores the impact of FHP on erector spinae function and emphasizes the need for posture correction to enhance musculoskeletal health and guide future research on intervention strategies.

• The Journal of Korean Physical Therapy
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• v.24 no.5
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• pp.334-339
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• 2012

Purpose: This study was conducted in order to compare the ability to control postural sway during perturbation when stroke patients received postural sway induced by head rotation. Methods: This study included 15 stroke patients and 15 healthy adults. Each group was measured by 3D motion analysis for determination of the angle of the neck in static position and by balance performance monitor for estimation of swaying angle in both neutral posture and head rotation position. These results were then analyzed in order to compare the healthy control group and the stroke patients group. Results: In both static posture ($60.7{\pm}4.81$) and dynamic posture ($51.46{\pm}6.87$, $70.8{\pm}6.55$), significant decreases were observed in the angle of head rotation of the patient group, compared to the healthy group (p<0.05), and significant decreases were observed in the sway angle of the patient group when in the neutral position ($3.62{\pm}7$, $24{\pm}0.60$) and head rotation ($3.04{\pm}0.80$, $51.46{\pm}6.87$), compared to the healthy group (p<0.05). Conclusion: According to these findings, patients with stroke tend to restrict the ROM of head rotation and swaying angle in dynamic posture and maintain their posture instability using limitation of head movement relative to the trunk and sway angle of area which is larger than that of affected side in unaffected side.

• Physical Therapy Korea
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• v.12 no.4
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• pp.41-47
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• 2005

The purpose of this study was to determine the intra-rater and inter-rater reliability of various forward head posture measurements. Ten healthy adults (age, $20.4{\pm}2.2$ yrs; height, $164.0{\pm}5.5$ cm; weight, $58.7{\pm}7.3$ kg) participated in the study. They were free of injury and neurologic deficits in the upper extremities and neck at the time of testing. The subjects were asked to perform head forward posture by under the guidance of physical therapists. Markers were placed on the C7 spinous process, mastoid process, tragus of the ear, outer canthus, and forehead. Measurement 1 for forward head posture assessment was measured as the angle between the horizontal line through C7 and the line connecting the C7 spinous process with the tragus of the ear. Measurement 2 was measured as the angle between the C7 spinous process, the mastoid process and the outer canthus. Measurement 3 was measured as two kinds of angles the HT (head tilt) angle is between the line from the midpoint of forehead to the tragus line and Y-axis at the tragus point. The NF (neck flexion) angle is between the line from the tragus to the C7 line and the Y-axis at the C7. Intra-rater, inter-rater reliability and coefficient of variation was assessed by comparing the measured values from three kinds of measurements of forward head posture. The intra-rater reliability was indicated by intraclass correlation coefficients [ICC(1,1)] and inter-rater reliability was shown by intraclass correlation coefficients [ICC(3,k)]. The results of study were as follows: ICC(1,1) values for intra-rater reliability of three measurements were in the 'excellent' category. ICC(3,k) values for inter-rater reliability of three measurements were also in the 'excellent' category. The coefficient of variation of method 2 had a lower value than method 1 and method 3. This data means that the measured value of method 2 was less scattered. Further research is needed to determine whether the validity of all measurements is revealed in the 'excellent' category.

• Journal of International Academy of Physical Therapy Research
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• v.9 no.4
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• pp.1663-1668
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• 2018

This study was conducted to examine the effects of Evjenth-Hamberg stretching of the sternocleidomastoid, upper trapezius, and pectoralis major on the lung function of adults with forward neck posture. The subjects were 20 adult students in P university located in Pohang, Korea, whose degree of head forward displacement measured according to NEW YORK state posture test was mild. The subjects were randomly and equally assigned to the Evjenth-Hamberg Stretching group (EHSG, n=10) and the control group (CG, n=10). Their forced vital capacity (FVC), slow vital capacity (SVC), and maximal voluntary ventilation (MVV) were measured before and after the experiment. In within-group comparison, only the EHSG experienced statistically significant improvement in FVC, forced expiratory volume in the first second (FEV1), and peak expiratory flow (PEE) after the experiment, compared to before the experiment (.05

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.23 no.1
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• pp.63-72
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• 2017

Background: The purpose of this case study was to investigate into the effect of complex exercise program on the postural change, gait and balance ability in elementary school students with forward head posture. Methods: Four patients with forward head posture were recruited. They were evaluated pre-treatment, and after 6weeks, using neck disability index (NDI), numeric pain rating scale (NPRS), balance ability, foot pressure (fore foot/rear foot peak pressure ratio, F/R ratio), gait ability (cadence, toe out angle, stance phase). Results: First, the angle of forward head posture (craniovertebral angle; CVA and cranialrotation angle; CRA) was decreased in all subjects. The NPRS and NDI were decreased in all subjects. Also, The cadence, toe out angle and F/R ratio were increased in all subjects. The stance phase of gait cycle was positively change in all subjects. Lastly, the static balance ability improved in all subjects. Conclusion: According to the results above, the complex exercise program for students with forward head posture can help improve the postural change, gait and balance ability. Also, the complex exercise program was able to select interventions depending on the patient's condition and the desired goal.

• Physical Therapy Korea
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• v.28 no.1
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• pp.18-26
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• 2021

Previous studies have reported that deep neck flexor (DNF) exercise can improve neck problems, including neck pain, forward head posture, and headache, by targeting the deep and superficial muscles of the neck. Despite the prevailing opinion across studies, the benefits of DNF can vary according to the type of neck problems and the outcome measures adopted, ranging from positive outcomes to non-significant benefits. A meta-analysis was conducted in this study to assess conclusive evidence of the impact of DNF exercise on individuals with neck problems. We used PUBMED, MEDLINE, NDSL, EMBASE, and Web of Science to search for primary studies and the key terms used in these searches were "forward head posture (FHP)," "biofeedback," "pressure biofeedback unit," "stabilizer," "headache," and "neck pain." Twenty-four eligible studies were included in this meta-analysis and were coded according to the type of neck problems and outcome measures described, such as pain, endurance, involvement of neck muscle, craniovertebral angle (CVA), neck disability index (NDI), cervical range of motion (CROM), radiographs of the neck, posture, strength, endurance, and headache disability index. The overall effect size of the DNF exercise was 0.489. The effect sizes of the neck problems were 0.556 (neck pain), -1.278 (FHP), 0.176 (headache), and 1.850 (mix). The effect sizes of outcome measures were 1.045 (pain), 0.966 (endurance), 0.894 (deep neck flexor), 0.608 (superficial neck flexor), 0.487 (CVA), 0.409 (NDI), and 0.252 (CROM). According to the results of this study, DNF exercise can effectively reduce neck pain. Thus, DNF exercise is highly recommend as an effective exercise method for individuals suffering from neck pain.