• Physical Therapy Rehabilitation Science
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• v.10 no.3
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• pp.251-256
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• 2021

Objective: The forward head posture (FHP) is strongly related to the rounded shoulder posture (RSP), which is associated with shoulder pain. Design: Observational cross sectional study design Methods: A total of 37 were enrolled in the study, 22 individuals with FHP(experimental group) and 15 healthy adults(control group). Correlation with differences between groups was analysed through craniovertebral angle (CVA) representing FHP for both groups, neck disability index (NDI) indicating neck pain, disability of the arm, shoulder and hand (DASH) indicating shoulder pain. Results: There was a significant difference in the results of CVA, NDI, and DASH in FHP and healthy adults (p<0.05). Significant correlations were found between DASH and CVA in FHP participants (r = -0.656, p = 0.001). Also, in the regression analysis results of DASH and CVA, the regression model was found to be suitable and the variation in DASH could be explained by 43% (F = 15.118, p = 0.001). Conclusions: Shoulder pain and neck discomfort are potentially related, and an increase in shoulder pain can increase FHP.

• Physical Therapy Rehabilitation Science
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• v.10 no.2
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• pp.147-155
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• 2021

Objective: This study is to investigate the effect of real-time feedback from the therapist on posture, muscle strength, pain of subjects with forward head posture based on a non-face-to-face complex exercise program. Design: Two-group pretest-posttest design. Methods: Thirty healthy men and women in their twenties with forward head posture with a Craniovertebral angle of 52° or less were targeted, the final selection was made as 15 experimental groups who performed the non-face-to-face intervention program while receiving real-time feedback and 15 control subjects who performed the non-face-to-face intervention program without providing feedback. Six of them were eliminated, and a total of 24 were conducted as subjects. All exercise groups performed an exercise program three times a week, 30 minutes each, for a total of two weeks. Before and after exercise, Craniovertebral angle (CVA), CranioRotation angle (CRA), muscle strength, and tenderness threshold were evaluated. Results: Significant differences were shown in both groups in CVA, and tenderness threshold before and after exercise (p<0.05), and CRA, the left middle trapezius muscle strength, only in the experimental group (p<0.05). In the comparison of theamount of change between exercise groups, the group that received feedback on CVA, CRA and tenderness threshold showed a significant change than the group without feedback (p<0.05). Conclusions: As a result of this study, it can be seen that the therapist's real-time feedback is more effective in improving the forward head posture. This requires feedback from the therapist on posture correction during non-face-to-face exercise intervention.

• 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.

• The Journal of Korean Physical Therapy
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• v.34 no.4
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• pp.155-160
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• 2022

Purpose: This study was to identify the effect of cervical stabilization exercise with visual feedback on the craniovertebral angle and foot pressure in subjects with forward head posture. Methods: Thirty healthy adults were recruited in the study. Participants were randomly assigned to the stabilization exercise with visual feedback (SE-VF) group (n=15) or stabilization exercise (SE) group (n=15). The SE-VF group performed cervical stabilization exercise while sitting on a chair without a backrest and checking their side profile in real time a monitor 3m away. The SE group performed the same cervical stabilization exercise as the SE-VF group accompanied by without visual feedback. Craniovertebral angle (CVA) was measured to quantify forward head posture, and the foot pressure of the subjects were evaluated. Results: The foot pressure showed statistically significant differences pre and post in both midfoot and left metatarsal only in SE-VF group (p<0.05). Conclusion: These findings of this study showed that the cervical stabilization exercise with visual feedback was effective for the foot pressure of subjects. In addition, based on the results of this study, it is suggested that visual feedback will be effective in cervical stabilization exercise.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.22 no.1
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• pp.65-70
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• 2016

Background: To determine the correlation Between forward head posture and plantar pressor in a McKenzie Exercise. Methods: This study had a cross-sectional design. There are included 20 participants with forward head posture. We measured the craniovertebral angle (CVA), cranial rotation angle (CRA) by image obtained digital camera and the plantar pressure, static balance using Gait Analyzer each before and after McKenzie Exercise. Results: There was negative correlation between CVA and CRA (p<.05). There was negative correlation between CVA and fore foot(p<.05). There was positive correlation between CRA and both fore foot (p<.05). There was negative correlation between CVA and static balance(p<.05). There was positive correlation between CRA and static balance (p<.05). Conclusions: There is a correlation between the change a mount of forward head position and plantar pressure in the McKenzie Exercise.

• Journal of the Korean Society of Physical Medicine
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• v.13 no.2
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• pp.61-68
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• 2018

PURPOSE: This study aimed to examine the effects of self-stretching (SS) and joint mobilization (JM) on pain, craniovertebral angle (CVA), autonomic system function in chronic cervical pain patient with forward head posture (FHP). METHODS: A total of 30 male college students were selected as study subjects, and were divided into Group I (general physical therapy; GPT, n=10), Group II (GPT+SS, n=10), Group III (GPT+JM, n=10). All groups were evaluated three times a week for 4 weeks. Pain was measured by visual analogue scale (VAS), CVA was measured using digital goniometer and autonomic system function (heart rate; HR, skin conductivity; SC, LF norm, HF norm, LF/HF ratio) was measured by Biofeedback ProComp Infiniti. After 4 weeks, paired t-test was used to compare the changes within the group and one way ANOVA was used to compare those between the groups. RESULTS: In Group I, VAS was significantly decreased. In Group II and III was a significantly change in all items. In comparison between Group I and II was a difference in all items except HR. In comparison between Group I and III was a difference in all items. In comparison between Group II and III was a difference in VAS, LF norm and LF/HF ratio. CONCLUSION: This study showed that SS and JM can effectively reduce pain and normalize the autonomic system function.

• 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 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.

• PNF and Movement
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• v.15 no.2
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• pp.149-157
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• 2017

Purpose: The purpose of this study was to assess the effect of using smartphones for tele-rehabilitation on head position and neck dysfunction in workers with visual display terminal (VDT) syndromes over a four-week period. Methods: Sixteen VDT workers volunteered to participate in stretch exercise and posture education sessions. The subjects were divided into three groups as follows: five subjects in the visit group (VSG), six subjects in the video group (VEG), and five subjects in tele-rehabilitation group (TG). The subjects in all the groups performed the exercises three days per week for four weeks. Cranial rotation angle (CRA), craniovertebral angle (CVA) measurement, and neck disability index (NDI) tests were performed before and four weeks after the intervention. Results: No significant difference in the CRA and CVA variables was found among groups. No significant difference in the CRA variable was found within each group. A significant difference in the CRA variable was found in the VSG after the four-week intervention. No significant difference in NDI was found among the groups. The NDIs among all the groups were significantly decreased after the intervention when compared with the NDIs measured before the intervention. Conclusion: The use of smartphones in the tele-rehabilitation of VDT workers with neck pain was found to be as effective on neck function as the conventional intervention method. The tele-rehabilitation of VDT workers with neck dysfunctions may be presented as an alternative way.

• Physical Therapy Rehabilitation Science
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• v.11 no.4
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• pp.446-453
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• 2022

Objective: The popularization of smartphones can lead to abnormal cervical alignment in university students. The aim of this study was to investigate the relationship among smartphone screen time, cervical alignment, and muscle function in university students. Design: Cross-sectional study. Methods: Seventy-five university students participated in the study. They completed the evaluation of cervical alignment and muscle function, such as handgrip strength, proprioception, and muscle quality (tone, stiffness, and relaxation time). All participants recorded their general characteristics and individual smartphone screen time before the evaluation. They were evaluated craniovertebral angle (CVA) using smartphone application (angle meter 360) for measuring cervical alignment. The muscle function was assessed using a digital hand-held dynamometer, dual inclinometer, and MyotonPRO device. Results: Of all participants, twenty-five university students had forward head posture (CVA<49°, 33.33%). Independent t-test revealed that there were significant differences on smartphone screen time, muscle stiffness, and muscle relaxation between the participants with and without forward head posture (p<0.05). There were significant correlations between the smartphone screen time and the CVA, muscle tone, and muscle relaxation (r=-0.493, 0.250, and -0.500, respectively). Conclusions: The results indicate that the university students with forward head posture had high smartphone screen time and muscle stiffness compared to the students without forward head posture, and smartphone screen time might be associated with cervical alignment and muscle quality.