• Journal of The Korean Society of Integrative Medicine
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• v.7 no.4
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• pp.265-272
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• 2019

Purpose : Excessive computer use frequently results in musculoskeletal disorders of the neck and shoulder such as forward head posture (FHP). The purpose of this study was to investigate effects of neck and shoulder exercise program on spino-pelvic alignment and the correlation between change in head and neck posture and spino-pelvic alignment in FHP. Methods : The study included 44 participants with FHP. The participants performed the exercise for correction of FHP 2-3 times a week for 4 weeks. We examined whole spine X-ray images in the lateral standing position with both arms crossed. We measured anterior head translation distance (AHT), craniovertebral angle (CVA), cervical lordosis (CL), thoracic kyphosis (TK), lumbosacral lordosis (LSL), sacral slope (SS), pelvic tilt (PT), and pelvic incidence (PI) of the subjects. The association between change in AHT and each spino-pelvic parameter was also subjected to Pearson's correlation coefficient analysis. Results : There were statistically significant differences before and after exercise in the parameters of AHT, CVA, and SS (p<.05). Significant negative correlation was observed between the change in AHT and CVA (r=-.768, p<.001), and CL (r=-.388, p<.05). There was significant positive correlation between the change in AHT and SS (r=.328, p<.05), and PI (r=.333, p<.05). However, no significant correlation was observed in change in AHT with that of TK, LSL, and PT. Conclusion : Based on the above results, we conclude that there is a relationship between change in AHT, which is a parameter associated with forward displacement of the head, and that of CVA, CL, SS, and PI after exercise in cases of FHP.

• Journal of the Korean Society of Physical Medicine
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• v.15 no.3
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• pp.51-59
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• 2020

PURPOSE: The purpose of this study was to provide clinical basic data to reduce pain and improve function by comparing neck muscle activity and neck alignment using self-stretching and passive stretching exercises for chronic neck pain caused by forward head posture. METHODS: The subjects were divided into 15 subjects assigned to perform self-stretching exercise and 15 subjects assigned to perform passive stretching exercise. The intervention was conducted for a total of 4 weeks. The muscle activity in the neck was measured by surface electromyography (EMG) before intervention, and craniovertebral and cranial rotation angles were measured by X-ray. The 4-week intervention was conducted and the above items re-measured in the same manner and analyzed. RESULTS: Muscle activity within both groups after intervention using self-stretching or passive stretching exercise was significantly different (p < .05)(p < .01). Neck alignment of both groups was significantly different (p < .001)(p < .01). Further, muscle activities of the upper trapezius and splenius capitis muscles showed significant differences (p<.05). Lastly, neck alignment showed statistically significant difference (p < .05). CONCLUSION: Self-stretching exercise activated motor nerves as a posture correction exercise, thereby improving inhibition of muscle activity, muscle contraction delay, and pathological conditions of the muscle. For future research, interventions of self-stretching exercise will be needed for patients with chronic back pain accompanied by forward head posture, and various clinical studies on postural improvement of forward head posture by maintaining a normal muscle tone state are needed.

• Journal of The Korean Society of Integrative Medicine
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• v.8 no.3
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• pp.173-180
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• 2020

Purpose : The aim of this study was to assess the intra- and inter-rater reliability and validity of measurements of head, neck, and pelvis posture using a mobile application in subjects with forward head posture. Methods : Forty-eight volunteers (22 men, 26 women) participated in this study. Two raters independently examined whole body picture images in a lateral standing posture with arms crossed using a CA-Smart Posture Reminder (CA-SPR), and a rater took and calculated posture images twice to assess reliability. We measured five parameters: craniovertebral angle 1 (CVA1), anterior shoulder translation (AST), pelvic tilt (PT), knee angle (KA), and ankle angle (AA) in the subject's sagittal plane using CA-SPR. We examined whole spine X-ray images in the same position to assess validity. We measured four variables in the subjects: CVA2, translation distance (AHT), anterior pelvic plane (APP), and sacral slope (SS). The intra- and inter-rater reliability were calculated using the intraclass correlation coefficient (ICC). Convergent validity was calculated using Pearson's correlation coefficient. Results : The intra-rater reliability (ICC=.889 -.989) and inter-rater reliability (ICC=.800 -.980) were excellent for all variables measured using CA-SPR. The variables measured using CA-SPR and X-ray were significantly positively correlated (r=.623, p<.01). However, the correlation of the variables in the pelvis was not statistically significant. Conclusion : This study shows that a mobile application (CA-SPR) is a useful tool for measuring head and neck posture in subjects with forward head posture. However, further study is needed to measure pelvic variables when using a mobile application.

• Journal of The Korean Society of Integrative Medicine
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• v.3 no.4
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• pp.61-67
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• 2015

Purpose : The purpose of this study was to find out the effect of exercise on the angle and distance between scapular stability and McKenzie stretch exercise. Method : 30 volunteers took part in this experiment and we divided into three groups(experimental group A, experimental group B, control group C). Experimental group A performed scapular stabilization exercise and experimental group B performed McKenzie neck stretching exercise and control group didn't perform any exercise. Experimental group(A, B) received a total of 12 exercise session over a 4 week period (three times per week). Posture and craniovertebral angle changes of the neck using GPS measurements reported. Result : The CVA and distance change after exercise were significantly reduced in the experimental group A and B. Conclusion : Therefore, we have confirmed through experiments reducing a CVA and distance between scapular stabilization and McKenzie neck stretching exercises, whereby we would also be helpful to ensure the treatment of forward head posture.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.20 no.1
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• pp.1-7
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• 2014

Background: As the increase of forward head position, we studied the change of thickness of deep cervical flexor (DCF) compared of with sternocleidomastoid (SCM). we measured and analysed the change of thickness of the neck flexor for forward head position and cranio-cervical flexion exercise (CCFE). Methods: Using a cross-sectional design, we conducted the study selecting 35 healthy adults (12 males, 23 females). We measured the craniovertebral angle (CVA), instructed them to perform the CCFE, and measured the DCF and SCM using ultrasonography during the contraction and relaxation period. Results: Intra-reliability of SCM is .96, longus capitis is .92 and longus coli is .97. we compared according to the change of forward head position, Correlation of DCF is .841, and DCF/SCM is .754 by significant positive correlation. At the comparison of CCFE and Resting muscle thickness, SCM and DCF is .00, DCF/SCM is .68. Conclusion: There is a strong positive correlation between the change amount of DCF and DCF/SCM as the increase of CVA.

• Journal of Biomedical Engineering Research
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• v.37 no.3
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• pp.112-118
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• 2016

The neck pain is fairly common occurance. Forward head posture and text neck are poor postures which may be related with neck pain but the evidence is not enough. We developed the wearable sensor which can assess the head & neck posture in daily life. Microprocessor, Bluetooth low energy, and 3-axis accelerometer, rechargeable battery and vibratior for reminding are used to implement the wearable sensor. Real-time algorithm to parameterize the posture for one epoch is implemented which classifies the posture in the epoch into three classed; dynamic, static_good posture, and static_poor posture. Also the algorithm makes reminding to its wearer to give them the prolonged poor posture is detected. The mean error of measurement was 1.2 degree. The correlation coefficient between neck angle and craniovertebral angle was 0.9 or higher in all cases. With the pilot study on text neck syndrome was also quatified. Average of neck angle were 74.3 degree during the listening in the classroom and 57.8 degree during the smartphoning. Using the wearable sensor suggested, the poor postures of forward head posture and neck neck can be detected in real-time which can remind the wearer according to his/her setting.

• Journal of the Korea Convergence Society
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• v.9 no.12
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• pp.123-128
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• 2018

The aim of this study was to determine the effects of the action observation and visual feedback on the alignment, pain and function of forward head posture(FHP) and round shoulder(RS). A total of 24 participants with FHP and RSP were randomly assigned to general exercise(GE, n=8), action observation(AO, n=8), and visual feedback(VF, n=8). All subjects were exercised three times a week for four weeks. The groups were assessed for craniovertebral angle(CVA), round shoulder posture(RSP), visual analog scale(VAS), and neck disability index(NDI) before and after exercise, There was a significant difference in CVA in the GE, AO and RSP, VAS and NDI were significantly different in all groups. AO was more effective than GE, VF for VAS. The results of this study suggest that action observation may be effective to improve the FHP and RS.

• Journal of the Korean Society of Physical Medicine
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• v.14 no.1
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• pp.121-129
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• 2019

PURPOSE: This study was conducted to measure the effects of cervical stabilization exercises on neck pain, forward head posture, and the acoustic characteristics frequency and amplitude modulation of patients with chronic neck pain caused by forward head posture using pressure biofeedback. METHODS: 20 patients with chronic neck pain and voice disorders presenting at the S Exercise Center in Daegu, Korea, were included in the study. A cervical stabilization exercise program of 50 minutes per session was performed three times a week for eight weeks. Pressure biofeedback was utilized to determine the impact of the exercises on neck pain, forward head posture, and the acoustic characteristics of the patients. The measurements were taken prior to and after the intervention to determine any changes. RESULTS: A significant improvement in neck pain, craniovertebral angle and the acoustic characteristics frequency and amplitude modulation of the patients was demonstrated after the intervention (p<.05). CONCLUSION: Cervical stabilization exercises were demonstrated to have a significantly positive effect on neck pain, forward head posture, and vocalization stability in patients with chronic neck pain in the current study based on measurements taken using a pressure biofeedback system. This indicates that an improvement in forward head posture positively impacts postural stability and vocalization. Future studies investigating a greater range of interventions designed to improve neck pain and acoustical effects in patients with chronic neck pain and forward head posture patients are warranted.

• Journal of The Korean Society of Integrative Medicine
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• v.7 no.2
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• pp.189-195
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• 2019

Purpose : The purpose of this study was to investigate the effects of chin tuck exercise (CTE) on the craniovertebral angle (CVA), strength and endurance of deep cervical flexor (DCF) muscles in subjects with forward head posture(FHP). This study was performed on 30 subjects with FHP. Method : Thirty subjects were divided into two groups; modified CTE (n=15), conventional CTE (n=15). Both of the group performed the exercise 4 times a week for 6 weeks. The subjects performed CTE in two different methods; modified CTE, with device designed that help keep cervical lordois curve, and coventional CTE, without using device. The CVA was measured using Image software version. A pressure biofeedback unit was used to measure the strength and endurance of the DCF muscles. The data was analyzed by the paired t-test for comparing before and after changes of variables in each group and the independent t-test for comparing the between groups. Result : There was statistically significant difference of before and after strength and endurance of DCF muscles in modified CTE (p<0.05). There was statistically significant difference of before and after only endurance of DCF muscles in conventional CTE (p<0.05). There was statistically significant difference of between the two group in strength of DCF muscles (p<0.05). Conclusion : Muscle strength to stabilize the spine plays an important role in maintaining a good posture. Therefore, we suggest that the application of CTE with a device designed to maintain the lordotic curvature in the neck is likely to yield better outcomes in FHP subjects in future studies.

• Journal of The Korean Society of Integrative Medicine
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• v.9 no.3
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• pp.193-201
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• 2021

Purpose : The purpose of this study was to compare the effect of pelvic exercise on the CVA and spinal curve in adults with forward head posture compared to the group using only neck exercise when pelvic exercise was performed in parallel with conventional neck exercise. Methods : GPS 400 and Formetric were used to identify craniovertebral angle (CVA), thoracic kyphosis, lumbar lordosis, and pelvic torsion and were measured by an experienced research manager. Forward head posture (FHP) was selected for people whose angle between the line connecting the ear ball and the seventh cervical spine and the horizontal line is 50 degrees or less. The 30 selected students were randomly divided into 15 experimental groups and 15 control groups. Mackenzie exercise and sling exercise were performed for neck exercise in both the experimental group and the control group, and pelvic exercise using a Swiss ball was additionally performed in the experimental group. All data collected in this study were analyzed using SPSS statistics 21.0. Cervical vetebral angle (CVA), thoracic kyphosis, lumbar lordosis, and pelvic torsion were compared at 0 weeks, 3 weeks, and 6 weeks for each measurement factor using ANOVA with repeated measures. For the statistical significance test, the significance level of α was set to .05. Results : The changes of pelvic torsion, thoracic kyphosis and CVA due to pelvic exercise using Swiss Ball and neck exercise were changed over time, but lumbar lordosis were not changed. And there were no significant differences among the groups. Conclusion : In conclusion, the pelvic correction exercise is considered to be an effective exercise for correcting the FHP and requires regular pelvic correction exercises. We expect the results to be used in clinical trials.