• Journal of The Korean Society of Integrative Medicine
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• v.12 no.3
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• pp.143-153
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• 2024

Purpose : Forward head posture (FHP), characterized by the anterior positioning of the head relative to the spine, is a common postural deviation that can lead to neck pain, reduced mobility, and muscle imbalances. Recently, high-frequency deep heat therapy (HFDT) has been gaining attention for the intervention of FHP. This research aims to investigate the efficacy of HFDT in comparison to instrument assisted soft-tissue mobilization (IASTM) for treating FHP among 30 young adults. Methods : Participants were randomly assigned to either the HFDT or IASTM group. The study focused on examining changes in neck joint mobility, pain thresholds, rounded shoulder distance, lower trapezius muscle strength, and neck dysfunction. Measurements were taken before and after the interventions. Paired t-tests were used for within-group analyses, and independent t-tests were employed for between-group comparisons. The statistical significance level α was set to .05. Results : Statistically significant improvements were observed across all measured parameters in both groups (p<.05). The HFDT group showed significantly greater enhancements in neck joint mobility, pain thresholds, rounded shoulder distance, lower trapezius muscle strength, and neck dysfunction parameters. Specifically, HFDT was more effective than IASTM in improving neck joint mobility, right upper trapezius pain threshold, left rounded shoulder distance, and right lower trapezius strength. The only exceptions were neck flexion range of motion, left upper trapezius pain threshold, right rounded shoulder distance, and left lower trapezius strength, where no significant differences were found between the groups. Conclusion : The findings suggest that HFDT, by combining the benefits of high-frequency therapy and manual therapy, effectively alleviates upper trapezius muscle pain and tension, enhances neck mobility, and strengthens lower trapezius muscles. Thus, HFDT could be considered a valuable intervention for clinicians aiming to address FHP and associated musculoskeletal problems.

• PNF and Movement
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• v.5 no.2
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• pp.1-10
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• 2007

Purpose : The purpose of this study was conducted to find treatment of forward head posture and shoulder instability with proprioceptive neuromuscular facilitation concept. Methods : This is literature study with books, seminar note and international course. Results : Forward head posture and shoulder instability has related each other. Forward head posture will make muscle instability, weakness and stiffness on neck and shoulder girdle. It will make pain also. Important muscle are suboccipital muscles, omohyoid muscle, sternoclaidomastoid muscle, scaleni, pectoralis minor, levator scapular and digastric. Conclusion : Treatment of the forward head posture and shoulder instability is provided. It is that treatment of stiff muscle with eccentric muscle work, muscle elongation, muscle strengthening at the structure level and at the functional level for daily activities.

• Journal of the Korean Society of Physical Medicine
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• v.13 no.3
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• pp.121-132
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• 2018

PURPOSE: This study was conducted to investigate the effects of type of exercise on neck disability, pain, and postural changes in subjects with forward head posture. METHODS: Two independent researchers conducted a search using KISS, RISS, DBpia (domestic), PubMed, OVID, and Science Direct (overseas) databases. We selected randomized controlled clinical trials by searching using the terms "forward head posture", "exercise therapy", and "therapeutic exercise". Studies published from 2007 to December 2017 were included. PEDro Scale was used to evaluate the quality of the selected studies, and meta-analysis was conducted using the CMA program. This review was registered at PROSPERO (CRD42018068633). RESULTS: Of the total 13768 studies searched, 17 were selected. Positive effects on neck disability were achieved with the base and biomechanical elements (ES=1.63, 95% confidence interval [CI] .49 to 2.75) as well as base, modulator, and biomechanical elements (ES=1.50, 95% [CI] .69 to 2.30). Neck pain improved with the base, modulator, and biomechanical elements (ES=1.96, 95% [CI] 1.08 to 2.82), while postural changes improved with biomechanical elements (ES=1.45, 95% [CI] .64 to 2.25). Additionally, type of exercise had a positive effect. CONCLUSION: The most effective exercises for neck disability are of the base and biomechanical elements, while the most effective types for neck pain are of the base, modulator, and biomechanical elements and the most effective exercise for posture is of biomechanical elements. Combined exercises targeting biomechanical elements were effective at treating disability, pain, and postural changes.

• Journal of the Korean Society of Physical Medicine
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• v.11 no.2
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• pp.41-52
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• 2016

PURPOSE: This study was conducted to compare the levels of usage of the superficial neck muscles during head rotation in forward head posture and in multimodal postures for improvement of cervical rotation movement impairment. METHODS: To acquire electromyography (EMG) signals from the sternocleidomastoid (SCM-M), upper trapezius (UPT-M), and the splenius capitis (SPC-M) muscles, 11 subjects practiced right rotation of the head in forward head postures (FHP), upright sitting postures (USP), upright sitting postures with supported arms (SUP), standing postures with the arms leaning against the wall (WSP), and four feet postures (FFP), respectively. RESULTS: The left SCM-M was used significantly more in the FFP compared to the FHP, but not in other postures (p<0.01). The left UPT-M was used significantly more in all postures other than the FHP. The right SPC-M was used significantly more in the FFP (p<0.001) and significantly less (p<0.05) in the SUP compared to the FHP. CONCLUSION: During the rotation of the head, although the usage of the SPC-M significantly decreased in SUP compared to FHP but the usage of the SCM-M and UPT-M did not decrease significantly in other postures compared to FHP. Further research is necessary to prove the hypothesis that special postures may reduce the activity of the superficial neck muscles during head rotation.

• Physical Therapy Korea
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• v.30 no.4
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• pp.261-267
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• 2023

Forward head posture (FHP) is a musculoskeletal disorder that causes neck pain. Several exercise interventions have been used in South Korea to improve craniovertebral angle (CVA) and relieve neck pain. There has been no domestic literature review study over the past 5 years that has investigated trends and effects of exercise intervention methods for CVA with neck pain. This domestic literature review aimed to evaluate the trends and effects of exercise interventions on CVA and neck pain in persons with FHP. A review of domestic literature published in Korean or English language between 2018 and 2022 was performed. Literature search was conducted on Google Scholar and Korea Citation Index by using the following keywords: "exercise," "exercise therapy," "exercise program," "forward head posture," and "neck pain." Ten studies were included in this review. All of the studies showed positive improvements after intervention programs that included exercises. Notably, four of these studies demonstrated significant differences in results between the experimental and control groups. Among the 10 studies, nine measured visual analogue scale or numerical rating scale scores and reported significant reductions in pain following interventions, including exercise programs. Five of these studies showed significant differences in results between the experimental and control groups. Furthermore, six studies that used neck disability index exhibited a significant decrease in symptoms after implementing intervention programs that included exercise, and significant differences in results were found between the experimental and control groups. This domestic literature review provides consistent evidence to support the application of various exercise intervention programs to improve CVA and relieve neck pain from FHP. Further studies are warranted to review the effects of various exercise interventions on FHP reported not only in domestic but also in international literature.

• Journal of International Academy of Physical Therapy Research
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• v.10 no.3
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• pp.1862-1867
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• 2019

Background: The importance of postural stabilization and cervical mobilization in subjects with pain from the anterior head posture is drawing more attention. However, studies on head and neck stabilizing intervention after mobilization are lacking. Objective: To examine the effects of Kinesiotaping and posture setting exercise on forward head posture (FHP). Design: Crossover Study Design Methods: The subjects were 17 male and female college students in their 20s with FHP. They were randomized into the Kinesiology taping group (KTG) with 9 subjects and posture stabilizing exercise group (PSEG) with 8 subjects. The intervention was conducted for 4 weeks, and changes in pain, craniovertebral angle (CVA), and proprioception were observed before and after intervention. Results: Pain was significantly reduced in the KTG and PSEG both before and after intervention. CVA and proprioception were significantly increased only in the PSEG. The differences in CVA and proprioception between the two groups were significant. Conclusions: These findings suggest that the application of posture setting exercise could decrease pain, proprioceptive error and increase CVA on FHP.

• The Journal of Korean Physical Therapy
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• v.30 no.2
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• pp.47-53
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• 2018

Purpose: To find the effect of visual feedback of head angle with using a mobile posture-aware system on craniocervical angle and neck and shoulder muscles fatigue for preventing or decreasing the forward head posture. Methods: Twenty-four healthy young adults in Chungbuk to participate in this study. The subjects started to watch a movie clip for 10 minutes with visual feedback in $0^{\circ}$, $30^{\circ}$, and $60^{\circ}$ of head angles. During the task, surface electromyography (EMG) was used to collect data from the upper trapezius (UT), sternocleidomasetoid muscle (SCM), cervical erecter spinae (CES) during watching the smartphone. Craniocervical angles were measured using a sagittal-view photograph of the subject in a sitting posture. A one-way repeated analysis of variance with a significant level of 0.05 used for statistical analysis. Results: Craniocervical angle with $0^{\circ}$ visual feedback was significantly greater than $30^{\circ}$ and $60^{\circ}$. Craniocervical angle with $30^{\circ}$ visual feedback was significantly greater than $60^{\circ}$. In addition, MDF of UT muscles in $0^{\circ}$ and $30^{\circ}$ of visual feedback was significantly greater than $60^{\circ}$. Conclusion: We concluded that $0^{\circ}$ visual feedback of head angle with using a mobile posture-aware system would be beneficial to prevent or decrease forward head posture during watching a smartphone. We also could recommend using of $30^{\circ}$ visual feedback in case of caring UT muscle fatigue primarily.

• Journal of the Korean Society of Physical Medicine
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• v.8 no.4
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• pp.601-608
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• 2013

PURPOSE: The purpose of this study was to investigate the effect of distance between trunk and desk on forward head posture and muscle activity of neck and shoulder muscles during computer work. METHODS: Twenty subjects who have healthy conditions were asked to perform computer work in two conditions (distance between trunk and desk was 0 and 15 cm). Forward head angle was analyzed with a SIMI motion analysis system. Surface electromyography recorded the upper trapezius and splenius capitis muscles. The significance of differences in distance between trunk and desk (0cm and 15cm) was tested by paired t-test. The alpha level was set at .05. RESULTS: The results showed that the change of forward head angle was significantly higher during the computer work when the distance between trunk and desk was 15cm than 0cm. The muscle activity of upper trapezius and splenius capitis was also significantly higher during the computer work when the distance between trunk and desk was 15cm than 0cm. CONCLUSION: Our study suggest that the distance between trunk and desk was should minimized for prevention of forward head posture during computer work.

• Physical Therapy Korea
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• v.26 no.2
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• pp.61-68
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• 2019

Background: Forward head posture (FHP) is a postural alignment of the cervical vertebrae that leads to increased gravitational load on cervical segmental motions. The overhead arm lift test assesses the ability to actively dissociate and control low cervical flexion and move the shoulders through overhead flexion. Objects: The purpose of this study was to explore muscle activities in the upper trapezius (UT), serratus anterior (SA), sternocleidomastoid (SCM), and lower trapezius (LT) alongside changes in head position during the overhead arm lift test in individuals with FHP. Methods: Fifteen subjects with forward head posture and fifteen subjects with normal subjcects were enrolled in this study. The patients performed the overhead arm lift test, and muscle activities of the UT, SCM, SA, and LT were measured using surface electromyography and by evaluating changes in head position. Independent t-tests were used to detect significant differences between the two groups and Cohen's d was calculated to measure the size of the mean difference between the groups. Results: The FHP group demonstrated significantly increased muscle activity of the UT ($32.46{\pm}7.64$), SCM ($12.79{\pm}4.01$), and LT ($45.65{\pm}10.52$) and significantly decreased activity in the SA ($26.65{\pm}6.15$) than the normal group. The change in head position was significantly higher in the FHP group ($6.66{\pm}2.08$) than the normal group. Effect sizes for all parameters assessed were large between the two groups. Conclusion: The subjects with excessive FHP displayed were unable to fix their heads in position during the overhead arm lift test. The overhead arm lift test can thus be used in clinical settings to confirm control of the neck in these subjects.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.21 no.6
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• pp.468-474
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• 2020

The aim of this study was to compare the effect of a horseback riding simulator, Slings and Kendall Exercise on a cranio-vertebral angle and the neck pain of the Forward Head Posture. This study included 30 young people with forward head posture. They were randomly divided into three groups. Each group performed the exercises for six weeks three times a week from September 2018 to November 2018. The variations of cranio-vertebral angle and neck pain were analyzed using paired t-tests and a one-way ANOVA test. The results of the study are as follows. Three groups showed significant variations of cranio-vertebral angle and neck pain (p < 0.05). But comparison of cranio-vertebral angle and neck pain between the groups showed no significant difference (p > 0.05). This study found that each exercise group for forward head posture was effective for inducing normal cervical alignment and neck pain relief. Therefore, various exercises can improve the forward head posture.