Journal of the Korean Society of Physical Medicine (대한물리의학회지)

The Korean Society of Physical Medicine (대한물리의학회)
권호 표지
DOI QR코드

DOI QR Code

The Effect of Dynamic Neuromuscular Stabilization (DNS) on the Respiratory Function of Subjects with Forward Head Posture (FHP)

  • Bae, Won-Sik (Department of Physical Therapy, Kyungnam College of Information & Technology)
  • Received : 2021.07.13
  • Accepted : 2021.08.02
  • Published : 2021.08.31
Download PDF
⟨ Previous Next ⟩

Abstract

PURPOSE: The purpose of this study was to apply dynamic neuromuscular stabilization (DNS) to subjects with forward head posture (FHP) and to compare its effects on respiratory function as against the conventional neck stabilization exercise and neck stretching and extensor strengthening exercises. METHODS: The whole-body posture measurement system was used to measure the degree of FHP, and a spirometer and a respiratory gas analyzer were used to measure the respiratory function. After the intervention was completed, the changes over time were analyzed in the DNS group, the neck stabilization exercise group, and the neck stretching and extensor strengthening exercise group. The inter-group difference in the changes was also analyzed. A repeated ANOVA was performed to compare the respiratory function according to the period between the three groups, and the least significant difference (LSD) method was used for the post hoc test. RESULTS: After the 6-week exercise period, respiratory functions, such as forced vital capacity (FVC), forced expiratory volume for 1 second (FEV1), forced expiratory volume for 1 sec/forced vital capacity (FEV1/FVC), maximum oxygen intake (VO2max), and the volume of expired gas (VE), significantly improved according to the period (p < .05), but no inter-group differences were found. CONCLUSION: DNS is an effective training method, and can be applied along with neck stabilization exercise and neck stretching and extensor strengthening exercises, which are widely used in clinical practice, to people with FHP who cannot directly perform neck exercises to improve their respiratory function.

Keywords

Acknowledgement

This study is a summary of Wonsik Bae's doctoral dissertation (2017).

References

  1. Dunleavy K, Goldberg A. Comparison of cervical range of motion in two seated postural conditions in adults 50 or older with cervical pain. J Man Manip Ther. 2013;21(1):33-9. https://doi.org/10.1179/2042618612Y.0000000017
  2. Okuro RT, Morcillo AM, Ribeiro MA, et al. Mouth breathing and forward head posture: effects on respirat ory biomechanics and exercise capacity in children. J Bras Pneumol. 2011;37(4):471-9. https://doi.org/10.1590/S1806-37132011000400009
  3. Silveira WD, Mello FC, Guimaraes FS, et al. Postural alterations and pulmonary function of mouth-breathing children. Braz J Otorhinolaryngol. 2010;76(6):683-6. https://doi.org/10.1590/S1808-86942010000600002
  4. Correa EC, Berzin F. Mouth breathing syndrome: cervical muscles recruitment during nasal inspiration before and after respiratory and postural exercises on Swiss ball. Int J Pediatr Otorhinolaryngol. 2008;72(9):1335-43. https://doi.org/10.1016/j.ijporl.2008.05.012
  5. Lima LC, Barauna MA, Sologurem MJ, et al. Postural alterations in children with mouth breathing assessed by computerized biophotogrammetry. J Appl Oral Sci. 2004;12(3):232-7. https://doi.org/10.1590/S1678-77572004000300014
  6. Liu JX, Thornell LE, Pedrosa-Domellof F. Muscle spindles in the deep muscles of the human neck: a morphological and immunocytochemical study. J Histochem Cytochem. 2003;51(2):175-86. https://doi.org/10.1177/002215540305100206
  7. Han JT, Park SJ, Kim YJ, et al. Effects of forward head posture on forced vital capacity and respiratory muscles activity. J Phys Ther Sci. 2016;28(1):128-31. https://doi.org/10.1589/jpts.28.128
  8. Santos TV, Ruas G, Sande de LA, et al. Influence of forward leaning and incentive spirometry on inspired volumes and inspiratory electromyographic activity during breathing exercises in healthy subjects. J Electromyogr Kinesiol. 2012;22(6):961-7. https://doi.org/10.1016/j.jelekin.2012.05.001
  9. Kolar P. Facilitation of agonist-antagonist coactivation by reflex stimulation methods in: Craig Liebenson: Rehabilitation of the spine-A practitioner's manual (2nd ed). Baltimore. Lippincott Williams & Wilkins. 2007.
  10. Kolar P, Sulc J, Kyncl M, et al. Postural function of the diaphragm in persons with and without chronic low back pain. J Orthop Sports Phys Ther. 2012;42(4):352-62. https://doi.org/10.2519/jospt.2012.3830
  11. Frank C, Kobesova A, Kolar P. Dynamic neuromuscular stabilization & sports rehabilitation. Int J Sports Phys Ther. 2013;8(1):62-73.
  12. Harman K, Hubley-Kozey CL, Butler H. Effectiveness of an exercise program to improve forward head posture in normal adults: a randomized, controlled 10-week trial. J Man Manipulative Ther. 2005;13(3):163-76. https://doi.org/10.1179/106698105790824888
  13. Kolar P, Kucera M, Lewit K, et al. Clinical rehabilitation. Praha. Alena Kobesova. 2013.
  14. Jull GA, Falla D, Vicenzino B, et al. The effect of therapeutic exercise on activation of the deep cervical flexor muscles in people with chronic neck pain. Man Ther. 2009;14(6):696-701. https://doi.org/10.1016/j.math.2009.05.004
  15. McKenzie R. Treat your own neck (5th ed). Waikanae. Spinal publications. 2011.
  16. Park JH, Moon OK, Wang JS, et al. The effects of continuous antagonist strengthening and Evjenth-Hamberg stretching on improvement of forward head posture. Journal of the Korea Entertainment Industry Association. 2013;7(2):109-15. https://doi.org/10.21184/jkeia.2013.06.7.2.109
  17. Kapreli E, Vourazanis E, Strimpakos N. Neck pain causes respiratory dysfunction. Med Hypotheses. 2008;70(5):1009-13. https://doi.org/10.1016/j.mehy.2007.07.050
  18. Jang C. The effects of breathing exercise on forward head posture. Doctor's Degree. Daegu University. 2010.
  19. Lee JC. The effects of abdominal respiratory exercise by forward head posture adult's respiratory function and respiratory muscle strength. Master's Degree. Daegu University. 2015.
  20. Almeida VP, Guimaraes FS, Moco VJ, et al. Correlation between pulmonary function, posture, and body composition in patients with asthma. Rev Port Pneumol. 2013;19(5):204-10. https://doi.org/10.1016/j.rppneu.2013.03.004
  21. Bae WS, Lee KC, Park SW, et al. Effect of the changes in forward head posture and neutral head posture on respiratory. J Korean Soc Integr Med. 2017;5(1):67-74. https://doi.org/10.15268/ksim.2017.5.1.067
  22. Kang JI, Jeong DK. The effect of exhalation breathing exercise on respiratory synergist muscle activity and pulmonary functions in patients with forward head posture. J Korean Phys Ther. 2016;28(2):149-54. https://doi.org/10.18857/jkpt.2016.28.2.149
  23. Kim SY. The effects of Mckenzie exercise on forward head posture and respiratory function. Master's Degree. Pusan Catholic University. 2014.
  24. Whaley MH, Brubaker PH, Otto RM, et al. ACSM's guidelines for exercise testing and prescription (7th ed). New York. Lippincott Williams & Wilkins. 2005.
  25. Davis GM, Kofsky PR, Kelsey JC, et al. Cardiorespiratory fitness and muscular strength of wheelchair users. Can Med Assoc J. 1981;125(12):1317-23.
  26. Lee MH, Joo M. Correlations between craniovertebral angle(CVA) and cardiorespiratory function in young adults. J Korean Soc Phys Med. 2014;9(1):107-13. https://doi.org/10.13066/kspm.2014.9.1.107
  27. Nam KW. Cardiovascular and pulmonary physical therapy. Seoul. Panmuneducation. 2012.
  28. Alfred PF, Elias JA, Fishman JA, et al. Fishman's pulmonary diseases and disorders (4th ed). New York. Mc Graw Hill. 2008.
  29. Chen CF, Lien IN, Wu MC. Respiratory function in patients with spinal cord injuries. Paraplegia. 1990;28(2):81-6.