• Journal of the Korea Society of Computer and Information
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• v.25 no.8
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• pp.145-150
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• 2020

Forward head posture is one of the most recognized types of poor head and neck alignment. Poor head and neck alignment posture is a major contributor to compromised balance and neck pain, due to abnormal joint position sense and proprioception. Kinesio taping is an intervention method used clinically for the management of pain. Kinesio taping may produce its effects through pain reduction, stimulation of blood circulation, induction of muscle relaxation which provides correction of joint position, and providing stability to the muscles and joints without limiting the range of motion. Many studies have proved that kinesio taping has positive effects on the reduction of pain and improves alignment, on the other hand, some studies have not found. Kinesio taping may provide immediate pain relief and improved alignment following the application, but there is insufficient evidence to support sustained relief beyond that time and they recommended future studies to examine the benefits of kinesio taping as this would have a greater value in clinical practice. Therefore, this study is to investigate the effects of kinesio taping on the alignment of head posture and dynamic balance ability in people with forward head posture.

• 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.

• 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.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.29 no.1
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• pp.11-23
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• 2023

Purpose: This study aimed to determine the effects of cervico-thoracic (C-T) mobilization technique and therapeutic exercise on muscle activity, craniovertebral angle (CVA), and neck disability index (NDI) in patients with neck pain. Methods: : A total of 30 patients with neck pain were included and divided into C-T mobilization combined with Pilates group (Experimental group; EG) and thoracic mobilization and self-exercise (Control group; CG) group; each group consisted of 15 patients. The exercises were performed by patients in both groups three times a week, for four weeks. NDI was used to measure functional disability and sEMG was used to measure muscle activity. Results: The EG participants showed significant improvement in the CVA and NDI after the intervention than the CG (p<.05). While both groups presented after intervention decreased muscle activity(upper trapezius), there were no statistically significant differences between the groups (p>.05). Conclusion: The findings of this study suggest that thoracic mobilization technique combined with Pilates exercise may have beneficial effects on CVA and NDI in patients with neck pain and forward head posture.

• Journal of the Korean Society of Physical Medicine
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• v.17 no.2
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• pp.29-40
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• 2022

PURPOSE: This study examined the effects of an exercise program for the thoracic spine and scapula rather than the neck, which is the primary site of pain. METHODS: Thirty-two elementary school teachers with a forward head posture (FHP) were assigned randomly to either the experimental group (n = 16) or the control group (n = 16). The experimental group performed scapular stabilization exercise (SSE) and thoracic extension exercise (TEE), and the control group performed cervical self-myofascial release exercise and stretching exercise. The pulmonary functions, pain, craniovertebral angle (CVA), and cervical range of motion (CROM) were measured before the intervention and six weeks after. RESULTS: The within-group comparisons showed that the VAS and CROM (except for extension) in both groups were significantly different before and after the intervention (p < .05). The changes in the maximum inspiratory pressure (MIP), maximum expiratory pressure (MEP), forced vital capacity (FVC), forced expiratory volume at 1 sec (FEV1), and CVA were significant only in the experimental group (p < .05). The between-group comparisons showed a significant difference in the FVC, FEV1, VAS, CVA, and left lateral flexion (p < .05). CONCLUSION: The combination of SSE and TEE in the experimental group was more effective in improving the FHP and breathing ability. Moreover, the experimental group and control combination appeared to be effective in reducing pain and improving the CROM. The combination of SSE and TEE, which are exercises that do not target the cervical spine directly, was effective in improving the posture, respiration, neck pain, and CROM in elementary school teachers with FHP.

• 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 Korean Physical Therapy Science
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• v.19 no.3
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• pp.31-38
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• 2012

Background : The purpose of this study was to evaluate the effect of the kinesio taping on the forward head posture and to reduce secondary pain and attitude transformation by applying kinesio taping. Methods : The subjects were the C university students(n = 30) in Chung-buk district without medical history. They were divided into two groups:experimental group(N = 15) and control group(N = 15). Control group was heard verbal instructions to keep right attitude and Experimental group was applied to kinesio taping. Change of an attitude, such as an angle, distance, CROM, CVA, CRA prices, before and after experiment was measured respectively. Result : The results of this study showed that in comparison of pre and post changes, experimental group noticeable changes in angle, CROMSI and CVA(p<.05). Angle, CROMSI and CVA were significant differed between groups(p<.05). Conclusion : Kinesio taping application was seemed to be effective on the improvement of forward head position. Therefore, it is suggested that Kinesio taping application should be one the potential methods to facillitate the forward head position. Comprehensive research is required about a point of time and duration for intervention in clinical approach for subjects.

• Journal of Korean Neurosurgical Society
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• v.58 no.5
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• pp.454-461
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• 2015

Objective : In this study, we aimed to investigate the underlying ethiological factors in chiari malformation (CM) type-I (CMI) via performing volumetric and morphometric length-angle measurements. Methods : A total of 66 individuals [33 patients (20-65 years) with CMI and 33 control subjects] were included in this study. In sagittal MR images, tonsillar herniation length and concurrent anomalies were evaluated. Supratentorial, infratentorial, and total intracranial volumes were measured using Cavalieri method. Various cranial distances and angles were used to evaluate the platybasia and posterior cranial fossa (PCF) development. Results : Tonsillar herniation length was measured $9.09{\pm}3.39mm$ below foramen magnum in CM group. Tonsillar herniation/concurrent syringomyelia, concavity/defect of clivus, herniation of bulbus and fourth ventricle, basilar invagination and craniovertebral junction abnormality rates were 30.3, 27, 18, 2, 3, and 3 percent, respectively. Absence of cisterna magna was encountered in 87.9% of the patients. Total, IT and ST volumes and distance between Chamberlain line and tip of dens axis, Klaus index, clivus length, distance between internal occipital protuberance and opisthion were significantly decreased in patient group. Also in patient group, it was found that Welcher basal angle/Boogard angle increased and tentorial slope angle decreased. Conclusion : Mean cranial volume and length-angle measurement values significantly decreased and there was a congenital abnormality association in nearly 81.5 percent of the CM cases. As a result, it was concluded that CM ethiology can be attributed to multifactorial causes. Moreover, congenital defects can also give rise to this condition.

• 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.