• 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.

• Physical Therapy Rehabilitation Science
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• v.6 no.1
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• pp.33-38
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• 2017

Objective: This study tried to examine the muscle activity of the neck and trunk according to head posture changes during use of laptops. Design: Cross-sectional study. Methods: This study included nineteen young men and women. All subjects maintained each posture while practice typing on laptops for ten minutes with a 5-minute break between each posture. For the neutral head posture, the subjects practiced typing while pulling their chins down towards the Adam's apple and were able to look at their knees while having their external auditory meatus, acromion, and greater trochanter vertical to the ground. For the natural head posture, they practiced typing while balancing their posture between extension and flexion of the cervical vertebrae by themselves without any guidelines. While a forward head posture was created by having their heads face the front horizontal to the rope hanging from the ceiling, they practiced typing with their external auditory meatus located in the place which was 5 cm in front of the vertical plane. The subjects used general word process but practiced typing with accuracy and high speed. Muscle activities were randomly measured using surface electromyography according to each postures. Results: The research result had found that muscle activity with the natural head posture was more significantly reduced than that of the forward head posture in the sternocleidomastoid muscle, upper trapezius, cervical vertebral spinae, and thoracic vertebrae spinae muscles (p<0.05) and that the neutral head posture was more significantly reduced than that of forward head posture in the upper trapezius, cervical vertebral spinae, and thoracic vertebrae spinae muscle activity (p<0.05) with significant increases in lumbar spinae muscle activity (p<0.05). Also, muscle activity with the neutral head posture significantly increased more in the sternocleidomastoid muscle and lumbar spinae than that of the natural posture (p<0.05). Conclusions: Our study results suggest that in order to prevent musculoskeletal pain, the neutral head posture with use of laptops is effective in reducing load to the shoulders and vitalizing the postural muscles.

• Journal of The Korean Society of Integrative Medicine
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• v.9 no.1
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• pp.173-181
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• 2021

Purpose : The purpose of this study is to compare muscle activity after applying two muscle energy techniques (MET) to subjects with forward head posture to see if the post isometric relaxation (PIR) technique is more effective than the reciprocal inhibition (RI) technique. Methods : The muscle activity was measured using EMG after applying the PIR and RI techniques to 30 adults at K College. Subjects were selected for forward head posture whose ear center was 2.5 ㎝ front of the center of the shoulder. EMG equipment was used to measure muscle activity, and the measurement sites were measured in cervical flexor and extensor muscles. The experiment period was performed once a week for a total of two weeks, and after the pre-measurement was performed for 5 minutes PIR and RI exercise. In the PIR technique, the head is tilted back in a sitting position, and the experimenter applies resistance with the same force for 7~10 seconds and repeats 3-5 times after rest. In the RI technique, in a sitting position, the subject gives the force to bend the head forward, and the experimenter applies resistance with the same force for 7 to 10 seconds, and repeats 3 to 5 times after rest. Results : The result is same as the following. In the comparison of muscle activity, there was a significant decrease in both PIR and RI at 1 and 2 weeks. And there was a greater decrease in muscle activity in PIR. There was no difference in the comparison of decrease in muscle activity at 1 week and 2 week. Conclusion : Both PRI and RI can be said to be effective in improving the function of the forward head posture in the neck muscles. Therefore, the selection of the two techniques in clinical practice should be appropriately performed under the judgment of experts according to the patient's situation.

• Physical Therapy Korea
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• v.30 no.4
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• pp.261-267
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• 2023

Forward head posture (FHP) is a musculoskeletal disorder that causes neck pain. Several exercise interventions have been used in South Korea to improve craniovertebral angle (CVA) and relieve neck pain. There has been no domestic literature review study over the past 5 years that has investigated trends and effects of exercise intervention methods for CVA with neck pain. This domestic literature review aimed to evaluate the trends and effects of exercise interventions on CVA and neck pain in persons with FHP. A review of domestic literature published in Korean or English language between 2018 and 2022 was performed. Literature search was conducted on Google Scholar and Korea Citation Index by using the following keywords: "exercise," "exercise therapy," "exercise program," "forward head posture," and "neck pain." Ten studies were included in this review. All of the studies showed positive improvements after intervention programs that included exercises. Notably, four of these studies demonstrated significant differences in results between the experimental and control groups. Among the 10 studies, nine measured visual analogue scale or numerical rating scale scores and reported significant reductions in pain following interventions, including exercise programs. Five of these studies showed significant differences in results between the experimental and control groups. Furthermore, six studies that used neck disability index exhibited a significant decrease in symptoms after implementing intervention programs that included exercise, and significant differences in results were found between the experimental and control groups. This domestic literature review provides consistent evidence to support the application of various exercise intervention programs to improve CVA and relieve neck pain from FHP. Further studies are warranted to review the effects of various exercise interventions on FHP reported not only in domestic but also in international literature.

• Journal of Korea Entertainment Industry Association
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• v.13 no.6
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• pp.257-264
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• 2019

The purpose of this study was to investigate effective intervention(upper thoracic mobilization and upper cervical mobilization) methods for forward head posture. 32 subjects were divided into two groups: upper thoracic mobilization(UTM) and upper cervical mobilization(UCM) on three times a week for a total of four weeks. In both groups significant difference in forward head posture pre and post test(p <.01), significant difference between the two groups (p <.05, 95% CI: .157-.341). In both groups significant difference in neck disability index pre and post test(p <.01), significant difference between the two groups (p <.01, 95% CI: 1.273-8.728). In both groups significant difference in quality of life pre and post test(p<.05), significant difference between the two groups (p <.01, 95% CI: 4.234-18.391). The results of this study showed that the UTM was more effective than that of the forward head posture. It would be possible to provide more effective interventions for patients with forward head posture and also to prevent secondary musculoskeletal disorders due to forward head posture.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.28 no.3
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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.

• Journal of Fashion Business
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• v.27 no.4
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• pp.125-140
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• 2023

This study aimed to develop a smart wearable device for assessing the risk angle associated with turtle neck syndrome in patients with Video Display Terminal (VDT) syndrome. Turtle neck syndrome, characterized by forward head posture resulting from upper cross syndrome, leads to thoracic kyphosis. In this research, a stretch sensor was used to monitor the progression of turtle neck syndrome, and the sensor data was analyzed using a Universal Testing Machine (UTM) and the Gauge Factor (GF) calculation method. The scapula and cervical spine angles were measured at five stages, with 15-degree increments from 0° to 60°. During the experimental process, the stretch sensor was attached to the thoracic spine in three different lengths: 30mm, 50mm, and 100mm. Among these, the attachment method yielding the most reliable data was determined by measuring with three techniques (General Trim Adhesive, PU film, and Heat Transfer Machine), and clothing using the heat transfer machine was selected. The experimental results confirmed that the most significant change in thoracic kyphosis occurred at approximately 30° of forward head posture. Prolonged deformity can lead to various issues, highlighting the need for textile sensor solutions. The developed wearable device aims to provide users with real-time feedback on their turtle neck posture and incorporate features that can help prevent or improve the condition.

• Journal of the Korean Society of Physical Medicine
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• v.11 no.2
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• pp.41-52
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• 2016

PURPOSE: This study was conducted to compare the levels of usage of the superficial neck muscles during head rotation in forward head posture and in multimodal postures for improvement of cervical rotation movement impairment. METHODS: To acquire electromyography (EMG) signals from the sternocleidomastoid (SCM-M), upper trapezius (UPT-M), and the splenius capitis (SPC-M) muscles, 11 subjects practiced right rotation of the head in forward head postures (FHP), upright sitting postures (USP), upright sitting postures with supported arms (SUP), standing postures with the arms leaning against the wall (WSP), and four feet postures (FFP), respectively. RESULTS: The left SCM-M was used significantly more in the FFP compared to the FHP, but not in other postures (p<0.01). The left UPT-M was used significantly more in all postures other than the FHP. The right SPC-M was used significantly more in the FFP (p<0.001) and significantly less (p<0.05) in the SUP compared to the FHP. CONCLUSION: During the rotation of the head, although the usage of the SPC-M significantly decreased in SUP compared to FHP but the usage of the SCM-M and UPT-M did not decrease significantly in other postures compared to FHP. Further research is necessary to prove the hypothesis that special postures may reduce the activity of the superficial neck muscles during head rotation.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.28 no.1
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• pp.39-51
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• 2022

Background: The purpose of this study is to investigate the effect of neck and shoulder self-stretching exercise using audiovisual media on neck pain, postural alignment, and joint position error in women with chronic neck pain. Methods: The subjects included 20 women that gave consent to participate in the study voluntarily. They performed the self-stretching exercises using audiovisual media was carried out 20 minutes 5 times a week during 3 weeks. Neck disability index (NDI) and visual analogue scale (VAS) were used to measure the functional disability and pain, A pressure pain threshold was measured using an algometer, and a cervical range of motion (CROM) measurement tool was used to measure the range of motion and error of proprioceptive position sense of the cervical spine. To assess posture alignment, forward head angle (FHA), forward shoulder angle (FSA) were measured using image J software. Results: The neck pain intensity was statistically significantly within group (p<.05). Neck and shoulder functional disability were a statistically significant difference within group (p<.05). Splenius capitis and upper trapezius pressure pain threshold were statistically significant difference in within group (p<.05). The postural alignment was statistically significantly within group (p<.05). The cervical range of motion in neck extension, right and left lateral flexion were statistically significantly within group (p<.05). The joint position error in neck flexion, extension, right and left lateral flexion decreased statistically significantly within group (p<.05). Conclusion: Self-stretching exercise using audiovisual media increased the mobility of the neck, decreased neck pain and joint position error, and improved posture alignment. As a result, there was a positive effect by applying the self-stretching exercise using audiovisual media to people with neck pain. Based on this, it is thought that it can be used as the basis for research related to home training programs for healthy self-management.

• Journal of The Korean Society of Integrative Medicine
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• v.10 no.4
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• pp.23-34
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• 2022

Purpose : This study examined the effects of pain, neck dysfunction, psychosocial level, headache impact test (HIT), postural alignment, and trapezius muscle tone of the complex exercise program using dynamic taping in patients with tension headache and chronic neck pain with forward head posture. Methods : The design of this is a randomized controlled trial (RCT). Thirty-four patients with chronic neck pain were screened using a randomized assignment program and assigned to experimental group (n=17) and control group (n=17). Both groups underwent a complex exercise program. In addition, the experimental group dynamic taping was applied to the upper trapezius muscle. All interventions were applied three times per week for four weeks. The visual analogue scale (VAS), the neck disability index (NDI), short form-12 health survey questionnaire (SF-12), Headache impact test-6 (HIT-6), Craniovertebral angle (CVA), Cranial rotation angle (CRA), upper trapezius muscle tone were compared to evaluate the effect on intervention. Results : Both groups showed significant differences before and after the intervention in VAS, NDI, SF-12, HIT-6, and CVA, CRA (p<.05). In addition, significant differences in NDI and upper trapezius muscle tone were observed between the experimental group and control group (p<.05). Conclusion : A complex exercise program using dynamic taping for patients with tension headache and chronic neck pain with forward head posture are effective method with clinical significance in improving the function and reducing upper trapezius muscle tone.