• PNF and Movement
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• v.20 no.3
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• pp.371-381
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• 2022

Purpose: Forward head posture (FHP) is known to cause pain, limit range of motion, and reduce quality of life. Joint mobilization is commonly used to correct FHP. However, no study has compared cervical, thoracic, and combined cervical and thoracic joint mobilization for FHP. The aim of this study was to investigate and compare the effects of each mobilization technique on range of motion in the sagittal plane and pain in patients with FHP. Methods: Forty-five patients were recruited and randomly divided into three groups: the mobilization group (CM; n = 15), the cervical and thoracic mobilization group (CTM; n = 15), and the thoracic mobilization group (TM; n = 15). Each intervention was performed in sets of three and repeated six times. Range of motion and pain were assessed pre- and post-intervention. The cervical range of motion was evaluated using a goniometer, and pain was evaluated using a visual analogue scale and pain thresholds of the suboccipital and upper trapezius muscles. Results: All groups showed an increase in range of motion post-intervention, but the increase in the CTM group was significantly greater than in the CM and TM groups (p < 0.05). Pain measured using the visual analogue scale decreased in all groups, but the decreases in the CM and CTM groups were significantly greater than in the TM group (p < 0.05). The pain thresholds of the suboccipital and upper trapezius muscles increased in all groups, but the increase in the CTM group was significantly greater than in the CM and TM groups (p < 0.05). Conclusion: Overall, our findings suggest that CTM may be more effective than CM or TM for improving cervical range of motion in the sagittal plane and pain in patients with FHP.

• Physical Therapy Korea
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• v.29 no.3
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• pp.180-186
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• 2022

Background: The craniocervical flexion test (CCFT) was developed for the activation and endurance of deep cervical flexors. However, the muscle thickness and muscle thickness changing ratio of the sternocleidomastoid (SCM) and deep cervical flexor (DCF) muscles in subjects with and without forward head posture (FHP) have not been reported. Objects: To determine the difference in thickness of the SCM and DCF muscles and the difference in the muscle thickness changing ratio between SCM, DCF, and DCF/SCM 20 mmHg and DCF/SCM 30 mmHg between subjects with and without FHP. Methods: Thirty subjects with and without FHP were enrolled. The muscle thickness of the SCM and DCF was measured when maintained at a baseline pressure of 20 mmHg and a maximum pressure of 30 mmHg using a pressure biofeedback unit during the CCFT. Ultrasonography was used to capture images of SCM and DCF muscle thickness during the CCFT, which was calculated using the picture archiving and communication system (PACS). Results: We observed a significant difference within the pressure main effect between SCM and DCF at a baseline pressure of 20 mmHg and a maximum pressure of 30 mmHg (p < 0.05). However, there was no significant difference in the muscle thickness and muscle thickness changing ratio for SCM and DCF during CCFT between subjects with and without FHP. Conclusion: There was no significant difference in the muscle thickness recruitment pattern during CCFT in posture changes between subjects with and without FHP.

• PNF and Movement
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• v.22 no.1
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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.

• Journal of International Academy of Physical Therapy Research
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• v.10 no.3
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• pp.1862-1867
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• 2019

Background: The importance of postural stabilization and cervical mobilization in subjects with pain from the anterior head posture is drawing more attention. However, studies on head and neck stabilizing intervention after mobilization are lacking. Objective: To examine the effects of Kinesiotaping and posture setting exercise on forward head posture (FHP). Design: Crossover Study Design Methods: The subjects were 17 male and female college students in their 20s with FHP. They were randomized into the Kinesiology taping group (KTG) with 9 subjects and posture stabilizing exercise group (PSEG) with 8 subjects. The intervention was conducted for 4 weeks, and changes in pain, craniovertebral angle (CVA), and proprioception were observed before and after intervention. Results: Pain was significantly reduced in the KTG and PSEG both before and after intervention. CVA and proprioception were significantly increased only in the PSEG. The differences in CVA and proprioception between the two groups were significant. Conclusions: These findings suggest that the application of posture setting exercise could decrease pain, proprioceptive error and increase CVA on FHP.

• Asian-Australasian Journal of Animal Sciences
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• v.26 no.4
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• pp.558-563
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• 2013

The present study was conducted to estimate energy requirements for maintenance in laying hens by using indirect calorimetry and energy balance. A total of 576 28-wk-old Nongda-3 laying hens with dwarf gene were randomly allocated into four ME intake levels (86.57, 124.45, 166.63 and 197.20 kcal/kg body weight $(BW)^{0.75}$ per d) with four replicates each. After a 4 d adaptation period, 36 hens from one replicate were maintained in one of the two respiration chambers to measure the heat production (HP) for 3 d during the feeding period and subsequent 3 d fast. Metabolizable energy (ME) intake was partitioned between heat increment (HI), HP associated with activity, fasting HP (FHP) and retained energy (RE). The equilibrium FHP may provide an estimate of NE requirements for maintenance (NEm). Results showed that HP, HI and RE in the fed state increased with ME intake level (p<0.05). Based on the regression of HP on ME intake, the estimated ME requirements for maintenance (MEm) was 113.09 kcal/kg $BW^{0.75}$ per d when ME intake equals HP. The FHP was decreased day by day with the lowest value on the third day of starvation. Except for lowest ME intake level, the FHP increased with ME intake level on the first day of starvation (p<0.05). The FHP at the two higher ME intake levels were greater than that at the two lower ME intake levels (p<0.05) but no difference was found between the two lower ME intake levels. Linear regression of HP from the fed state to zero ME intake yielded a value of 71.02 kcal/kg $BW^{0.75}$ per d, which is higher than the extrapolated FHP at zero ME intake (60.78, 65.23 and 62.14 kcal/kg $BW^{0.75}$ per d for the first, second and third day of fasting, respectively). Fasting time, lighting schedules, calculation methods and duration of adaptation of hens to changes in ME intake level should be properly established when using indirect calorimetry technique to estimate dietary NE content, MEm and NEm for laying hens.

• Korean small business review
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• v.42 no.3
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• pp.173-193
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• 2020

This study analyzes the effects of KOSDAQ-listed firms' convertible bonds, which have recently increased rapidly in number and size. Although KOSDAQ companies are called mid-size companies, KOSDAQ companies belong to SMEs. Furthermore, convertible bonds have traditionally been a critical capital raising tool for SMEs in the US and Europe. In Korea, KOSDAQ companies actively employ convertible bonds. Convertible bonds provide investment incentives for hesitant investors, allowing companies to raise capital at low interest rates. This study analyzes whether capital raising through issuance of convertible bonds by KOSDAQ companies affects their financial constraints. Financial constraints result from incomplete capital markets, which are embedded in most companies and countries.. In particular, financial constraints have a significant impact on the growth and survival of SMEs. The seminal study FHP(1988) is the most important and effective study of firm's financial constraints. We find that FHP's financial constraint measures show that convertible bond issuance would mitigate the financial constraints of KOSDAQ companies. However, the significance of the evidence is not strong.

• Journal of the Korean Society of Physical Medicine
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• v.11 no.3
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• pp.41-47
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• 2016

PURPOSE: Forward head posture (FHP) is one of the most common postural problems among white-collar workers who perform highly repetitive tasks in the same position. The aim of this study was to research the effects of thoracic and lumbar support fixtures on forward head posture (FHP) during visual display terminal (VDT) work. METHODS: The subjects were 36 healthy male students with no problems in their medical history or respiratory systems. The subjects were randomly assigned to three groups: control group (n=12), thoracic support fixtures (n=12), and lumbar support fixtures (n=12). We conducted a text typing task of the same content for 20 minutes, and evaluated the angles, including the craniovertebra angle (CVA), craniorotation angle (CRA) with photogrammetry. RESULTS: The thoracic and lumbar support fixture groups showed a statistically significant difference at the CVA and CRA to the control group (p<.05), and the post-hoc test showed an increase of the CVA and decrease of the CRA than the control group. However, when we compared the effects of thoracic and lumbar support fixtures on FHP, there was no significant difference in the difference in decrease of the CVA or increase of the CRA (p>.05). CONCLUSION: We determined that VDT work using thoracic and lumbar support fixtures has a positive effect on forward head posture in white-collar workers. Further studies are required to find the more effective location of support fixtures.

• Journal of Korean Physical Therapy Science
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• v.19 no.2
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• pp.17-24
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• 2012

Purpose : The purpose of this study was to show the effect of postural training through action observation (AO) on craniovertebral angle (CVA) and cranial rotation angle (CRA) of forward head posture (FHP). Methods : From 16 subjects of having the FHP who consist of postural training through the AO (n = 8) and control group (n = 8) were training to three times per one week during three weeks. FHP measurements for pre and post the intervention use to Wiz-pacs(Wiz-Picture Achiving Communication System) from X-ray change of CVA and CRA. Results : The study for the change within the group pre and post the intervention, CVA and CRA were found the significant differences only in the postural training group through the AO (p<.05). In the comparison of the rates of change between the groups pre and post the intervention CVA and CRA all showed the significant differences (p<.05), and in the comparison of the rates of average change of individual variables in each groups, the postural training group through the AO showed more change rates. Conclusion : The study suggests that when people with FHP received the postural training, the postural training through the AO resulted in more change into the correct postures.

• Journal of The Korean Society of Integrative Medicine
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• v.8 no.1
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• pp.113-124
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• 2020

Purpose : The purpose of this study was to investigate the effects of exercise intervention combined with 3D visual feedback and motion observation on postural alignment and cerebral cortical activity in subjects with forward head posture (FHP). Methods : The study included 28 participants with FHP, randomly divided into a 3D visual feedback plus motion observation group (n=14) or control group (n=14). The experimental group received corrective exercise combined with 3D visual feedback and motion observation for FHP, three times a week for four weeks. We examined cervical spine radiographs in the lateral standing position with both arms crossed to measure the craniovertebral angle (CVA) and cervical lordosis (CL). Relative alpha (RA) and beta waves (RB) were measured by wireless dry EEG. Results : The CVA value was significantly different between the groups, and the CL value was significantly different only in the experimental group. RA and RB values were not significantly different before and after intervention in the control group. RB values were significantly decreased before and after intervention in the experimental group. Conclusion : Based on the results of this study, we suggest that interventions combined with motion observation and 3D visual feedback may be effective as exercise methods to improve postural alignment and cerebral activity in subjects with FHP. Further research is required to generalize our results on technical supplementation complemented with 3D visual feedback devices.

• Journal of International Academy of Physical Therapy Research
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• v.11 no.3
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• pp.2119-2125
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• 2020

Background: Adults with forward head posture (FHP) often suffer from thoracic hyperkyphosis and thoracic dysfunction, and including reduction of the craniovertebral angle (CV angle) and tightening of the superficial neck muscles. In order to treat thoracic dysfunction, interventions aimed at improving thoracic mobility are necessary. Objectives: To examine the effects of maitland manual mobilization therapy on the thoracic spine in adults with FHP. Design: Single-blind randomized controlled trial. Methods: Thirty adults with FHP who met the selection criteria were randomized to the thoracic multiple joint mobilization (TMJM; n=15) group and the thoracic general joint mobilization (TGJM; n=15) group. Joint mobilizations were performed for 23 minutes a day for 4 weeks continuously, two times per week. Outcome measures were ImageJ, BTS FREE EMG 1000, neck disability Index (NDI). Results: Although changes in the left sternocleidomastoid muscle activity and NDI scores over time between the two groups differed, other variables were noted only changes observed over time. Muscle activity in the right sternocleidomastoid increased again in the TGJM group post-intervention and 2 weeks after the end of the experiment, but changes in other variables were retained or improved, confirming the lasting effects of thoracic joint mobilization. Conclusion: Thoracic multiple joint mobilization may be recommended as a more effective intervention for adults with FHP.