• 대한물리의학회지
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• 제10권2호
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• pp.17-27
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• 2015

PURPOSE: The purpose of this study was to compare the effects of three interventions (intervention by passive range of motion exercise plus manual cervical traction, Mulligan's joint mobilization, and strengthening exercises) after Kaltenborn's joint mobilization on the cervical spine alignment, and muscle activity in patients with a forward head posture. METHODS: The subjects were 39 students from H University in Chungnam and C University in Jeonbuk. The subjects in each group attended training sessions three times a week for four weeks. We used one-way ANOVA and Scheffe's post hoc test to compare values between groups, and used paired t-test to compare the values of the dependent variables within groups. RESULTS: The results showed that the active intervention group experienced a significant increase compared to the passive intervention group in terms of the craniovertebral angle, cervical lordosis angle, and had significant decreases compared to the passive intervention group in terms of the upper trapezius muscle activity. The active intervention group also had significant increases in craniovertebral angle and decreased anterior scalene muscle activity than the active-assistive intervention group. The active-assistive intervention group had significant decreases compared to the active intervention group in terms of the serratus anterior, levator scapulae, and splenius capitis muscle activity. CONCLUSION: It appears that the subjects with a forward head posture had significant improvements in the cervical lordosis angle, cranial rotation angle, craniovertebral angle, and muscle activity after intervention by Mulligan's joint mobilization (active-assistive intervention component) and strengthening exercises (active intervention component) after applying Kaltenborn's joint mobilization.

• 대한물리치료과학회지
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• 제26권2호
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• pp.38-45
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• 2019

Purpose: This study purpose to comparison the effects of passive scapular alignment exercise and hold & relaxation technique on craniovertebral angle (C1~C7) with forward head posture due to using variety bag and using computer in healthy subjects. Design: Randomized Controlled Trial. Methods: 22 subjects were divide into two groups: PSAEx group and H/R group two groups. After exercise, the CVA were measured using C7 and tragus. Collected data were statistically analyzed by SPSS 20.2 Results: There were significant differences pre and post the exercise. Conclusion: PSAEx and H/R technique was effective to correct a abnormal CVA posture. The result of this study may helpful as basic data for orthopedic physical therapy.

• The Journal of Korean Physical Therapy
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• 제32권6호
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• pp.378-382
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• 2020

Purpose: This study aimed to examine the effects of forward head posture on the flexion-relaxation ratio (FRR) and muscle activity during sustained neck flexion and to investigate the correlation between craniovertebral angle and FRR. Methods: Nineteen subjects participated in this study and were allocated to a forward head posture (FHP) group or a non-forward head posture (NFHP) group. Craniovertebral angle (CVA) and FRR were measured in all subjects, and all participants performed a standardized cervical flexion-extension movement in two phases: Phase I, sustained cervical full flexion for 5s; and Phase II, cervical extension with the return to the starting position for 5s. The value of CVA has calculated three times, and the value of FRR was measured three times in order to obtain the mean value. Results: FRR values in the FHP and NFHP group were significantly different (p<0.05). Phase I was significantly different, but the Phase II was not significantly different between the FHP and NFHP group (p>0.05). There was a significant correlation between the muscle activity of Phase I and CVA (p<0.05). However, FRR and the muscle activity of the Phase II were not a significant correlation with the CVA (p>0.05). Conclusion: FHP increases the muscle activity of the cervical erector spinae during sustained neck flexion and reduces FRR, which can cause fatigue in the cervical erector spinae. In addition, for those with a smaller CVA, muscle activity of the cervical erector spinae is increased during sustained neck flexion, which can increase neck muscle tension.

• 한국엔터테인먼트산업학회논문지
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• 제14권8호
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• pp.231-236
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• 2020

본 연구의 목적은 40~50대 중년에서 두개척추각(CVA), 나이, BMI와의 상관관계를 알아보는 것이다. 신체 건강한 성인 남녀 40~50대 456명을 대상으로 3D 센서를 활용한 자세측정기를 활용하여 전방머리자세를 측정하였다. 연구결과 전체 중년의 CVA는 나이와는 높은 수준의 음의 상관관계가 있고((r=-.937; p<.01), BMI에 대해서는 매우 낮은 수준의 양의 상관관계(r=.056가 있음을 확인하였다. 성별에 따른 연구에서 중년 남성의 CVA는 나이와는 높은 수준의 음의 상관관계가 있었고(r=-.932; p<.01). BMI에 대해서는 매우 낮은 수준의 양의 상관관계(r=.071)가 있었다. 반면 중년 여성의 경우엔 나이에 대해서만 높은 수준의 음의 상관관계(r=.940, p<.01)가 나타났고 BMI에 대해서는 상관관계가 나타나지 않았다. 본 연구는 CVA가 남성과 여성 모두에서 연령과 유의 한 음의 상관관계를 가지고 있지만, BMI와 낮은 수준의 상관관계를 가지고 있음을 시사한다.

• 대한정형도수물리치료학회지
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• 제28권3호
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• pp.51-59
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• 2022

Background: This study aimed to investigate the effect of mobilization with movement (MWM) applied to the ankle joint, on the craniovertebral angle (CVA), pressure pain threshold, and neck disability index (NDI) in asymptomatic adults with a forward head posture (FHP). Methods: A total of 32 subjects with FHP were assigned to either the MWM group (N=16) or the cranio-cervical flexion exercise (CCFE) group (n=16). The CVA, pressure pain threshold and NDI were measured before and 4 weeks after the intervention. Results: A significant improvement in the CVA was observed in the MWM group (p<.05), whereas no significant changes (p>.05) were observed in the CCFE group. Both groups showed significant differences in the pressure pain threshold and NDI before and after the intervention (p<.05). Conclusion: The results of the study suggest that MWM applied to the ankle joint can effectively improve the CVA, pressure pain threshold, and NDI of adults with a forward head posture. Based on this study, the ankle MWM technique for dorsiflexion can be used as an objective research method for additional studies targeting FHP patients in the future.

• 대한물리의학회지
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• 제18권1호
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• pp.25-35
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• 2023

PURPOSE: This study examined the effects of applying mat Pilates and kinesio taping on the craniovertebral angle and muscle activity of adults in their 20s with a forward head posture. METHODS: The subjects were 20 adults in their 20s with a forward head posture: 10 from the Mat Pilates group (MPG) and 10 from the Kinesio taping group (KTG). Each group received the intervention for four weeks. The craniovertebral angle and muscle activity were measured before and after the intervention. Statistical analysis of this study was performed using SPSS Ver. 23.0 for Windows was used, and the statistical significance level was set to α = .05. RESULTS: The change in the craniovertebral angle within each group was decreased significantly after the intervention for both MPG and KTG (p < .05), but there was no significant difference in the comparison result of the difference in the amount of change between each group (p > .05). The change in muscle activity within each group did not show any significant change before and after the intervention in all the MPG and KTG muscles (p > .05), and there was no significant difference in all variables for the difference in the amount of change between each group (p > .05). CONCLUSION: Mat Pilates effectively reduced the CVA, but neither intervention significantly affected muscle activity.

• Physical Therapy Rehabilitation Science
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• 제11권4호
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• pp.454-463
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• 2022

Objective: The purpose of this study was to compare concurrent validity and test-retest reliability based on Craniovertebral angle of 'Angles video goniometer', a smart phone application for convenient range of motion measurement, and 'Image J', an analysis software with high reliability and validity. This was conducted to find out whether 'Angle video goniometer' can be used clinically. Design: Cross-sectional study Methods: Fifty subjects were imaged laterally, and the angle of the head and spine was measured using Image J and the Angles video goniometer, respectively, in a resting posture and a chin in posture. The level of concurrent validity between the two measurement methods and the level of inter-rater reliability and intra-rater reliability were analyzed. Results: For forty participants, the concurrent validity between Image J and Angles video goniometer showed very high validity with ICC of 0.997(0.995~0.999) and 0.994(0.994~0.998), CVME% 0.71~0.72%, SEM% 0.31~0.34, MDC% 0.86~0.94. The test-retest intra-rater reliability showed very high reliability ICC 0.994(0.991~0.996), CVME% 0.71%, SEM% 0.31~0.43, MDC% 0.86~1.19%. The test-retest inter-rater showed very high reliability ICC 0.995(0.992~0.997), CVME% 0.71%, SEM% 0.43~0.59%, MDC% 1.20~1.62% Conclusions: Angles video goniometer', a smartphone application, is a device with very high reliability and validity for craniovertebral angle measurement in healthy adults, and it is a device that can be easily used in clinical practice.

• 대한물리의학회지
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• 제18권4호
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• pp.145-154
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• 2023

PURPOSE: This study was conducted to investigate the effect of the sling exercise wearing a neck orthosis on the craniovertebral angle, muscle tension, and headaches in adults with a forward head posture and tension headache. METHODS: In this single-blinded, randomized, controlled, comparative study, a total of 22 adults with forward head postures and tension headaches were randomly assigned to the experimental group (sling exercise wearing a neck orthosis, n = 11) or the control group (sling exercise without a neck orthosis, n = 11). All participants undertook the sling exercise program (3×/week for 4 weeks). The craniovertebral angle, muscle tension, and headache were measured before and after the 4-week training. RESULTS: Significant improvements were observed in the craniovertebral angle, muscle tension, and headache in the experimental group (p < .05). This group also showed a larger decrease in the muscle tension and headache (upper trapezius, -4.97 Hz vs -1.70 Hz, p < .05; splenius capitis, -5.44 Hz vs -2.54 Hz, p < .05; headache, -19.73 score vs -14.64 score, p < .05, respectively). CONCLUSION: The sling exercise wearing a neck orthosis could be an effective way to relieve the symptoms caused by a forward head posture. It could also be a more effective way of decreasing muscle tension and headaches than the sling exercise without wearing a neck orthosis.

• PNF and Movement
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• 제22권1호
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• pp.1-11
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• 2024

Purpose: The prevalent use of mobile devices may contribute to musculoskeletal disorders, such as forward head posture (FHP), among users. The measurement of the craniovertebral angle (CVA) using photographic images is frequently employed in assessing FHP. Although manual CVA measurement using photographic images is reliable in clinical settings, computer programs or mobile applications to support tele-physical therapy are not yet fully developed. Therefore, in the current study, we propose an automatic method for extracting CVA from photographic images of FHP subjects to facilitate tele-physical therapy. Methods: To develop the automatic CVA measuring computer program, photographic images were obtained from 10 FHP participants. The location information obtained from the markers attached to the tragus and the spinous process of the seventh cervical vertebra were used as coordinates. Using these coordinates, straight line 1 was generated by connecting the seventh spinous process of the cervical vertebra and the tragus, while straight line 2 was drawn parallel to the coordinate obtained from the seventh spinous process of the cervical vertebra. The arc tangent function was used to calculate the angle between the two straight lines. The automatic CVA measurement computer program utilizing photographic images was developed using MATLAB (ver. 2016b). Results: The results showed that the automatic CVA measurement computer program demonstrated stable repeatability and high accuracy. Conclusion: The proposed approach was able to automatically estimate the CVA using photographic images. The developed computer program can potentially be used for easier and more reliable clinical assessment of FHP.

• 대한물리의학회지
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• 제19권1호
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• pp.61-68
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• 2024

PURPOSE: This study aimed to provide basic clinical data by analyzing the impact of motion observation training and stretching exercises for improving postures on the neck alignment and balance of stroke patients to enable them to accurately recognize the correct exercise method. METHODS: After sampling 20 stroke patients who met the selection criteria, this study randomly assigned 10 people who were administered the stretching exercise with observation training to the experimental group and 10 who received only the stretching exercise intervention to the control group by drawing lots. Next, neck alignment and balance were pre-tested. All interventions were conducted for 30 minutes, 3 times a week for 4 weeks, and when all the interventions were completed after 4 weeks, neck alignment and balance were re-measured in the same way as the pre-test. RESULTS: The comparison of changes in neck alignment and balance within the experimental and control groups showed statistically significant differences in the craniovertebral angle, cranial rotation angle, and balance (p < .05) (p < .01). Between the groups, statistically significant differences were found in the craniovertebral angle, cranial rotation angle, and balance (p < .05) (p < .01). CONCLUSION: A statistically significant difference in neck alignment and balance was observed in the group that underwent stretching exercises combined with observational training and a statistically significant difference was found between the groups. Therefore, it is believed that observation training should be used in clinical practice to improve forward head posture and restore balance in stroke patients.