• 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.

• Journal of The Korean Society of Integrative Medicine
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• v.8 no.4
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• pp.117-123
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• 2020

Purpose : VDT (visual display terminal syndrome) can affect individuals who monitor or who work or play using video screens, including those of smartphones. In general, headache symptoms from overuse of these screens can appear due to eye fatigue, muscle pain in the joints of wrists or fingers, and muscle pain in the neck or shoulders. Many studies in the literature have supported standards that seek to prevent these symptoms. The incidence of musculoskeletal diseases caused by the use of smartphones is expected to increase rapidly, particularly among children and young adults, and these diseases are expected to develop into a societal problem. Therefore, in this study we investigate whether tension headaches that develop from smartphone usage can affect forward neck posture, neck pain, and quality of life. Methods : A total of 93 students from University participated in this study. We divided participants into two groups, those with tension headaches (n = 25) and those without (n = 68) and took forward neck measurements. Headaches were classified according to criteria from the International Headache Society and involved bilateral headache position, quality of pressing or tightening pain, mild or moderate pain intensity, and none due to daily physical activity. We surveyed participants using the smartphone addiction diagnosis questionnaire, the Neck Disability Index (NDI), the Headache Impact Test (HIT-6), and the Quality of Life Questionnaire. Results : Although we found no significant differences in tension headaches due to smartphone addiction diagnosis (p = 0.25), SF-36 life quality assessment (p = 0.06), and cranio-vertebral angle (p = 0.07), we found significant differences from the HIT-6 and the NDI (p <.05). Conclusion : Tension headaches are not correlated with smartphone addiction, quality of life, and forward neck angle but do have a correlation with the degree of cervical dysfunction and the effects of the headaches.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.23 no.1
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• pp.63-72
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• 2017

Background: The purpose of this case study was to investigate into the effect of complex exercise program on the postural change, gait and balance ability in elementary school students with forward head posture. Methods: Four patients with forward head posture were recruited. They were evaluated pre-treatment, and after 6weeks, using neck disability index (NDI), numeric pain rating scale (NPRS), balance ability, foot pressure (fore foot/rear foot peak pressure ratio, F/R ratio), gait ability (cadence, toe out angle, stance phase). Results: First, the angle of forward head posture (craniovertebral angle; CVA and cranialrotation angle; CRA) was decreased in all subjects. The NPRS and NDI were decreased in all subjects. Also, The cadence, toe out angle and F/R ratio were increased in all subjects. The stance phase of gait cycle was positively change in all subjects. Lastly, the static balance ability improved in all subjects. Conclusion: According to the results above, the complex exercise program for students with forward head posture can help improve the postural change, gait and balance ability. Also, the complex exercise program was able to select interventions depending on the patient's condition and the desired goal.

• Journal of Oral Medicine and Pain
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• v.22 no.1
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• pp.95-109
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• 1997

The purpose of this research is to investigate the influence on mandibular movements and TMJ sounds with changes of head and neck posture. For the research, twenty patients who had complained of TMJ sounds without any other symptoms of cranio-mandibular disorders, were selected as subjects for measurements of TMJ sounds, and radiographs on transcranial view of TMJ were taken on ten of the subjects. From NHP, UHP, DHP and FHP, aspects of mandibular movement and TMJ sound were investigated from each posture. Aspects of mandibular movement and TMJ sound were observed by measuring total vibration energy(Integral), peak amplitude, maximum amound of mouth opening, and TMJ sound-emitting point using Sonopak for windows (version 1.33) and Bio-EGN(Bioresearch Inc. WI. U.S.A.). Head and neck movement-measuring instrument, CROM(perfomance attainment Inc. U.S.A.) was to maintain even head posture. Degrees of inclination of UHP and DHP were determined at 30' and distance of FHP was 4cm. The results obtained were as follows. 1. Total vibration energy and peak amplitude of TMJ sounds were decreased more on UHP and on UHP and increased more on DHP and FHP than that on NHP. 2. At the maximum mouth opening, distance of TMJ sound-emitting point were decreased more on UHP and increased more on DHP and FHP than that on NHP. 3. The amounts of the maximum mouth opening were increased more on UHP and decreased more on DHP and FHP than that on NHP. 4. For the changes of the head posture with mouth opening observed in radiograph, condylar head was positioned more lower-anteriorly on UHP, and more upper-posteriorly on DHP and FHP than that on NHP. From the results obtained as above, considering positive influence of the change of head and neck posture, avoiding down-head and forward-head posture, and recommending upper- head posture can prevent the progress of temporomandibular disorder and lead to successful treatment for the patients with temporomandibular joint sounds.

• Journal of the Korean Society of Physical Medicine
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• v.11 no.1
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• pp.71-82
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• 2016

PURPOSE: The purpose of this case report was to determine the effect of therapeutic exercise on posture, pain, and muscle activity in two patients with forward head posture (FHP). METHODS: A-31-year-old male (patient A) and a 19-year-old women (patient B) presented with FHP, neck pain, and headache. The therapeutic exercise program consisted of cervical mobilization, deep cervical flexors strengthening, and cervical extensors stretching, for 40 min/d, 2 d/week, for 8 weeks. Neck pain (VAS), neck disability (NDI), cervical range of motion (CROM), lateral view of cervical spine X-ray (indicating the FHP), and asymmetrical neck and shoulder muscular activity ratio were measured before, after 4 weeks, and after 8 weeks of corrective exercise. RESULTS: VAS and NDI decreased in patients A and B after exercise compared to before the program. CROM increased in patients A and B at flexion, extension, side bending, and rotation after exercise compared to before the program. FHP decreased in patients A and B at distance after exercise compared to before the program. In addition, asymmetrical neck and shoulder muscles activity ratio improved in patients A and B after exercise compared to before the program. CONCLUSION: We demonstrated in a case report that therapeutic exercise increases ROM, decreases pain and disability of neck, FHP, and asymmetry muscle activity ratio in patients with FHP. These finding have clinical implications for therapeutic exercise in patients with 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.

• Journal of International Academy of Physical Therapy Research
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• v.10 no.2
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• pp.1763-1767
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• 2019

Background: Although previous researches have developed interventions for neck problems, headache, and temporomandibular disorder in patients with forward head posture (FHP), changes in masticatory muscle tone or stiffness as FHP worsening have not been investigated. Objective: To examine changes in masticatory muscle tone and stiffness through craniovertebral angle (CVA). Design: Cross sectional study Methods: The subjects were 21 healthy males with normal head posture. Three CVA were established for posture measurement in which the bilateral anterior temporal and masseter muscles were measured during the subjects maintained a series of postures. Results: The Right masseter muscle significantly increased in stiffness with advancing FHP (p < 0.05). No significant changes were observed in the muscle tone or stiffness of any other masticatory muscles, and no significant differences were found in bilateral masticatory muscle tone or stiffness in each measurement posture. Conclusions: This study suggests that the increased stiffness of the right masseter muscle as the FHP worsened requires consideration in physical therapy assessment and intervention.

• Physical Therapy Korea
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• v.22 no.4
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• pp.44-50
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• 2015

This study compared the effects of the initial head position (i.e., a HHP versus a relaxed head position) of subjects with and without a FHP on the thickness of the deep and superficial neck flexor muscles during CCF. The study recruited 6 subjects with a FHP and 10 subjects without a FHP. The subjects performed CCF in two different head positions: a HHP, with the head aligned so that the forehead and chin formed a horizontal line, and a relaxed head position (RHP), with the head aligned in a self-selected comfortable position. During the CCF exercise, the thickness of the longus colli (LCo) and the thickness of the sternocleidomastoid (SCM) were recorded using ultrasonography. The thickness of each muscle was measured by Image J software. The statistical analysis was performed with a two-way mixed-model analysis of variance. The thickness of the SCM differed significantly (p<.05) between the subjects with and without FHP. According to a post $h^{\circ}C$ independent t-test, the change in thickness of the SCM increased significantly during CCF in the subjects with FHP while adopting a HHP compared to that in the subjects without FHP. The change in thickness of the SCM was not significantly different between the two positions in subjects without FHP, and there was no significant change in thickness of the LCo muscle during the CCF exercise according to the initial position in both subjects with and without FHP. The results suggest that CCF should be performed in RHP to minimize contraction of the SCM in subjects with a FHP.

• Journal of the Korean Society of Clothing and Textiles
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• v.36 no.2
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• pp.179-193
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• 2012

The development of modern transportation technology has required many people in spaces (such as vehicle seats, airports, and train stations) for long periods. The public seats provided in these places are manufactured in a standard size; however, fatigue sets in if the seats are unsuitable for the person's physical size. For this reason, this study developed an air cushion vest that would enhance the comfort of vehicle seats. Passengers in vehicles, trains, airplanes, and buses were observed and surveyed to understand the demand for seat comfort. Our analysis found that the greatest source of discomfort was involuntary nodding of the head while asleep and discomfort around the waist area. For this reason, the air cushion vest was designed to support the head and the waist. The neck cushion of this vest was designed to strengthen head support to counter forward nodding because existing commercial neck cushions had no support for forward nodding. For the waist cushion, at lumbar and below-lumbar parts were chosen as the key parts to be supported, the cushion was designed to contain air at those parts. To cover the embedded waist cushion, the vest was designed to be long. The closure was constructed with zippers from the neck to waistline, and with invisible snaps from the waistline to the hemline so that the wearer could open them easily while seated. A subjective comfort evaluation was conducted to verify the effectiveness of the developed vest. In the test, the developed cushions received a better evaluation than cushions currently available on the market. The volume of the vest could be adjusted by the inflow and outflow of air. It was proven that the vest was effective in terms of comfort and portability. This shows that the developed vest could enhance passenger comfort while sitting on vehicle seats.

• The Journal of the Convergence on Culture Technology
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• v.5 no.4
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• pp.227-235
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• 2019

The purpose of this study was to investigate the effects of cervical vertebral height and shoulder stabilization on anterior head posture in people with turtle neck. The subjects of this study consisted of normal and healthy people with 30 turtle necks. Subjects were randomly assigned to shoulder stabilization exercise and cervical vertebrae exercise (30 men, 15 men and 15 women, height: $168.67{\pm}6.51$, $22.33{\pm}8.27$, $65.03{\pm}11.98$, and $28.66{\pm}1.91$), In the experimental group, shoulder stabilization exercise and cervical spine exercise were performed for 4 weeks. Deep neck flexor, leavator scapular, upper trapezius, rhomboid, and lower trapezius showed significant differences in shoulder stabilization and cervical vertebrae before and after the experiment. As a result, the CVA value decreased significantly and the muscle activity value increased significantly when exercise and Mckenzie program were applied. These results show that exercise and Mckenzie programs have a positive effect on turtle neck improvement.