The Effect of Corrective Exercise and TECAR therapy on neck alignments and pain in Forward Head Posture Patients

교정 운동과 TECAR 치료가 전방머리자세를 가진 환자의 목정렬과 통증에 미치는 영향

  • 박시은 (우송대학교 물리치료학과) ;
  • 이형렬 (상계 바론 정형외과) ;
  • 박신준 (강동대학교 물리치료과)
  • Received : 2018.08.20
  • Accepted : 2018.11.20
  • Published : 2018.11.28


This study investigated the effects of corrective exercise and TECAR on cervical alignment, pain threshold, and pain in forward head posture patients. The subject includes 30 forward head posture patients. In the intervention methods, the experimental group combined corrective exercise and TECAR treatment. Only the corrective exercise was applied to the control group. Assessments were made on cervico vertebra angle (CV angle), pain pressure threshold (PPT) and neck disability index (NDI) visual analog scale (VAS). The intervention was conducted six times a week for two weeks. Both groups showed significant differences in CV angle, PPT, NDI, and VAS. Also, PPT, NDI, and VAS excluding CV angle were significantly improved in the study group compared to the control group. These results suggest that the intervention method that combines corrective exercise and TECAR treatment has a more positive effect on pain and ADL ability of forward head posture patient.


Forward head posture;Corrective exercise;TECAR therapy;CV angle;Pressure pain threshold

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Fig. 1. Thoracic extension strengthening exercise

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Fig. 2. Backward locking in quadruped position

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Fig. 3. Quadruped active cervical rotation

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Fig. 4. Application of TECAR Therapy. Physical therapist weared the mobile electrode in the middle of forearm(circle) and fixed electrode was positioned under patients upper back(square)

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Fig. 5. Intensity of radio frequence therapeutique.

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Fig. 6. Neck angle measurement

Table 1. General characteristics of subjects

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Table 2. Comparison of the outcome of CVA and PPT in pre and post-test among groups

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Table 3. Comparison of the outcome of VAS and NDI in pre and post-test among groups

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  1. K. Mekhora, C. B. Liston, S. Nanthavanij & J. H. Cole. (2000). The effect of ergonomic intervention on discomfort in computer users with tension neck syndrome. International Journal of Industrial Ergonomics, 26(3), 367-379.
  2. H. C. Kwon & D. H. Jeong. (2001). Comparison of electromyographic activities in the neck region according to the screen height and document holder position. The Journal of Korean Physical Therapy, 13(3), 829-837.
  3. P. Pillastrini et al. (2016). Effectiveness of global postural re-education in patients with chronic nonspecific neck pain: randomized controlled trial. Physical therapy, 96(9), 1408-1416.
  4. S. Y. Park & W. G. Yoo. (2013). Effect of sustained typing work on changes in scapular position, pressure pain sensitivity and upper trapezius activity. Journal of occupational health, 55(3), 167-172.
  5. R. D. Ferch, A. Shad, T. A. Cadoux-Hudson & P. J. Teddy. (2004). Anterior correction of cervical kyphotic deformity: effects on myelopathy, neck pain, and sagittal alignment. Journal of Neurosurgery: Spine, 100(1), 13-19.
  6. J. C. Cho, E. S. Lee & S. W. Lee. (2017). Upper thoracic spine mobilization and mobility exercise versus upper cervical spine mobilization and stabilization exercise in individuals with forward head posture: a randomized clinical trial. BMC musculoskeletal disorders, 18(1), 525-534.
  7. W. G. Yoo & D. H. An. (2009). The relationship between the active cervical range of motion and changes in head and neck posture after continuous VDT work. Industrial health, 47(2), 183-188.
  8. B. Y. Im, Y. Kim, Y. J. Chung & S. J. Hwang. (2015). Effects of scapular stabilization exercise on neck posture and muscle activation in individuals with neck pain and forward head posture. Journal of physical therapy science, 28(3), 951-955.
  9. W. S. Bae, K. C. Lee & Y. H. Kim. (2016). Comparison between McKenzie stretch exercise and scapula stability exercise on neck muscle activation in the forward head posture. Journal of The Korean Society of Integrative Medicine, 4(1), 13-20.
  10. K. Harman, C. L. Hubley-Kozey & H. Butler. (2005). Effectiveness of an exercise program to improve forward head posture in normal adults: a randomized, controlled 10-week trial. Journal of Manual & Manipulative Therapy, 13(3), 163-176.
  11. S. Khayatzadeh et al. (2017). Cervical spine muscle-tendon unit length differences between neutral and forward head postures: biomechanical study using human cadaveric specimens. Physical therapy, 97(7), 756-766.
  12. F. P. Kendall, E. K. McCreary, P. G. Provance, M. M. Rodgers & W. A. Romani. (2005). Muscles, testing and function: with posture and pain (Kendall, Muscles). Philadelphia: Lippincott Williams & Wilkins
  13. M. A. Finley & R. Y. Lee. (2003). Effect of sitting posture on 3-dimensional scapular kinematics measured by skin-mounted electromagnetic tracking sensors. Archives of physical medicine and rehabilitation, 84(4), 563-568.
  14. K. T. Lau, K. Y. Cheung, M. H. Chan, K. Y. Lo & T. T. W. Chiu. (2010). Relationships between sagittal postures of thoracic and cervical spine, presence of neck pain, neck pain severity and disability. Manual therapy, 15(5), 457-462.
  15. J. Quek, Y. H. Pua, R. A. Clark & A. L. Bryant. (2013). Effects of thoracic kyphosis and forward head posture on cervical range of motion in older adults. Manual therapy, 18(1), 65-71.
  16. K. Harman, C. L. Hubley-Kozey & H. Butler. (2005). Effectiveness of an exercise program to improve forward head posture in normal adults: a randomized, controlled 10-week trial. Journal of Manual & Manipulative Therapy, 13(3), 163-176.
  17. S. S. Lynch, C. A. Thigpen, J. P. Mihalik, W. E. Prentice & D. Padua. (2010). The effects of an exercise intervention on forward head and rounded shoulder postures in elite swimmers. British journal of sports medicine, 44(5), 376-381.
  18. H. R. Lee, J. H. Shim & D. W. Oh. (2017). Effects of High-frequency Diathermy Integrated into Suboccipital Release on Tenderness and Neck Mobility and Disability in People with Chronic Tension-type Headache. Physical Therapy Korea, 24(2), 37-47.
  19. J. Bohnert & O. Dossel. (2010). Effects of time varying currents and magnetic fields in the frequency range of 1 kHz to 1 MHz to the human body-a simulation study. Conf Proc IEEE Eng Med Biol Soc. 2010, 6805-6808.
  20. K. Takahashi, T. Suyama, M. Onodera, S. Hirabayashi, N. Tsuzuki & L. Zhong-Shi. (2001). Clinical effects of capacitive electric transfer hyperthermia therapy for lumbago. Journal of Physical Therapy Science, 11(1), 45-51.
  21. W. K. Oh, E. G. Lee & B. C. Shin. (2009). Clinical effect of bong chuna manual therapy and acupuncture treatment for improving cervical curvature of turtle neck syndrome and measurement method of radiography. Journal of Oriental Rehabilitation Medicine, 19(1), 113-124.
  22. S. Sahrmann. (2010). Movement system impairment syndromes of the extremities, cervical and thoracic spines-e-book. Elsevier Health Sciences.
  23. S. J. Park, T. H. Kim, J. H. Go & P. S. Youn. (2017). The impact of convergence balance training and taping on spasticity and balance ability in patients with chronic stroke. Journal of Digital Convergence, 15(7), 297-306.
  24. S. G. Cho. (2001). Effects of acupuncture on upper back myofascial pain and pain pressure threshold. J Korean Acupunct Moxibustion Soc, 18, 1-10.
  25. P. E. Bijur, W. Silver & E. J. Gallagher. (2001). Reliability of the visual analog scale for measurement of acute pain. Academic emergency medicine, 8(12), 1153-1157.
  26. H. Vernon & S. Mior. (1991). The neck diability index: a study of reliability and validity. J Manipulative Physio Ther, 14(7), 409-415.
  27. I. K. Kee, J. S. Byun,J. K. Jung & J. K. Choi. (2016). The presence of altered craniocervical posture and mobility in smartphone-addicted teenagers with temporomandibular disorders. Journal of physical therapy science, 28(2), 339-346.
  28. A. G. Silva, T. D. Punt, P. Sharples, J. P. Vilas-Boas & M. I. Johnson. (2009). Head posture and neck pain of chronic nontraumatic origin: a comparison between patients and pain-free persons. Archives of physical medicine and rehabilitation, 90(4), 669-674.
  29. S. S. Lynch, C. A. Thigpen, J. P. Mihalik, W. E. Prentice & D. Padua. (2010). The effects of an exercise intervention on forward head and rounded shoulder postures in elite swimmers. British journal of sports medicine, 44(5), 376-381.
  30. S. H. Ahn & H. S. Jung. (2013). A Validity Study of Craniovertebral Angle Measurement on Forward Head Posture. Research Journal of Complementary and Alternative Medicine, 4, 145-153.
  31. S. Sahrmann. (2002). Diagnosis and treatment of movement impairment syndromes. Mosby, Elsevier Health Sciences.
  32. W. P. Hanten, R. M. Lucio, J. L. Russell & D. Brunt. (1991). Assessment of total head excursion and resting head posture. Archives of physical medicine and rehabilitation, 72(11), 877-880.
  33. L. J. Haughie, I. M. Fiebert & K. E. Roach. (1995). Relationship of forward head posture and cervical backward bending to neck pain. Journal of Manual & Manipulative Therapy, 3(3), 91-97.
  34. M. Tepper, M. M. R. Vollenbroek-Hutten, H. J. Hermens & C. T. Baten. (2003). The effect of an ergonomic computer device on muscle activity of the upper trapezius muscle during typing. Applied ergonomics, 34(2), 125-130.