• 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 Oral Medicine and Pain
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• v.21 no.2
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• pp.393-405
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• 1996

This study was performed to investigate the effects of changes of head posture and cervical spine shape on the mandibular resting or clenching electromyographic(EMG) activity in anterior temporalis(TA), masseter(MM), sternocleidomastoid muscle(SCM) and trapezius insertion(TI). 30 patients with Temporomandibular Disorders(TMDs) participated in this study. EMG activity($\mu$V) at rest and clenching was observed in four head postures, namely natural head posture(NHP), forward head posture(FHP), upward head posture(UHP), and downward head posture(DHP). For taking in upward or downward head posture head was inclined 10$^{\circ}$ upward or downward and CROM$^\textregistered$(cervical-range-of motion, Performance attainment Inc., USA) was used to maintain same posture during the procedure, and BioEMG$^\textregistered$ (Bioelectromyograph, Bioresearch Inc., USA) was used to record EMG activity in the above four muscles at eight locations on both sides. The recorded EMG activity($\mu\textrm{V}$) were compared and analyzed by cervical spine shape such as the head position from plum line, cervical curvature, and cervical inclination. Head position from plum line was measured in vertical plate calibrated with cm scale, comical curvature by radius was measured with adjustable curved ruler, and cervical inclination by cervical vertebrae tangent(CVT)was measured in lateral cephalograph. The results obtained were as follows : 1. Mean value of head position from plum line, cervical curvature, and cervical inclination were 4.8cm, 26.7cm, and 86.6$^{\circ}$, respectively, And There were no correlationship among these items. 2. For resting EMG activity by head posture, the value in anterior temporalis was higher at FHP than at DHP, the value in masseter was higher at FHP than at NHP, and DHP, the value in sternocleidomastoid muscle was higher at UHP than at NHP, and the value in trapezius insertion was higher at FHP and DHP than, NHP and UHP. The clenching EMG activity, however, did not show any difference by head posture. 3. Comparison of resting and clenching EMG activity between higher and lower groups by head position from plum line, cervical curvature, and cervical inclination did not show any significant difference. From this result, the author concluded that the cervical spine shape had not significantly affected to EMG activity in usual patients with TMDs.

• Journal of the Korean Society of Physical Medicine
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• v.17 no.4
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• pp.141-150
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• 2022

PURPOSE: This study was conducted to investigate the effects of non-elastic and elastic tapes on pain, craniovertebral angle, and balance in forward head posture (FHP) patients. METHODS: A total of 44 adults with FHP were randomly assigned to a group that performed a stretching exercise after non-elastic taping (n = 22) and another group that performed the stretching exercise after elastic taping (n = 22), respectively. The stretching exercise was performed five times a week for 30 minutes per session. The visual analogue scale was used to compare neck pain, the craniovertebral angle was measured to compare alignment, and the limit of stability was measured to compare balance. RESULTS: The groups that performed the stretching exercise after both elastic and non-elastic taping showed significant positive changes in pain and the craniovertebral angle of the head in pre- post measurements (p < .05). In the follow-up test for the pain and craniovertebral angle, there was no significant difference from the post-test in the non-elastic group (p > .05), but a significant difference was seen in the elastic group (p < .05). CONCLUSION: Stretching exercises with taping for patients with a FHP are more effective in improving pain and alignment. However, the short-duration tape application did not affect the balancing ability. When the non-elastic tape was used, the effect lasted longer than that of the elastic tape, and pain relief was effective in the case of the elastic tape. Therefore, tape therapy would be more effective if customized according to the patient's condition.

• Journal of The Korean Society of Integrative Medicine
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• v.9 no.3
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• pp.193-201
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• 2021

Purpose : The purpose of this study was to compare the effect of pelvic exercise on the CVA and spinal curve in adults with forward head posture compared to the group using only neck exercise when pelvic exercise was performed in parallel with conventional neck exercise. Methods : GPS 400 and Formetric were used to identify craniovertebral angle (CVA), thoracic kyphosis, lumbar lordosis, and pelvic torsion and were measured by an experienced research manager. Forward head posture (FHP) was selected for people whose angle between the line connecting the ear ball and the seventh cervical spine and the horizontal line is 50 degrees or less. The 30 selected students were randomly divided into 15 experimental groups and 15 control groups. Mackenzie exercise and sling exercise were performed for neck exercise in both the experimental group and the control group, and pelvic exercise using a Swiss ball was additionally performed in the experimental group. All data collected in this study were analyzed using SPSS statistics 21.0. Cervical vetebral angle (CVA), thoracic kyphosis, lumbar lordosis, and pelvic torsion were compared at 0 weeks, 3 weeks, and 6 weeks for each measurement factor using ANOVA with repeated measures. For the statistical significance test, the significance level of α was set to .05. Results : The changes of pelvic torsion, thoracic kyphosis and CVA due to pelvic exercise using Swiss Ball and neck exercise were changed over time, but lumbar lordosis were not changed. And there were no significant differences among the groups. Conclusion : In conclusion, the pelvic correction exercise is considered to be an effective exercise for correcting the FHP and requires regular pelvic correction exercises. We expect the results to be used in clinical trials.

• The Journal of Korean Physical Therapy
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• v.13 no.3
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• pp.769-776
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• 2001

This study were to review of muscle imbalance of head, cervical and shoulder region. Head, cervical and shoulder region is a complicated mechanical unit. interconnected by numerous soft tissue links. These links, or articulation are functionaly and reflexly interdependent on one another. The line of gravity falls anterior to the transverse axis of rotation for flexion and extension of the head and creates a flexion moment. which tends to tut the head forward, is counteracted by tension in the tectorial membrane, and ligamentum nuchae, and by activity of the neck extensors. Therefore, the flexion moment equilibrate with the extension moment. Changing of the equilibrium will make mid cervical straight. It will make forward head posture(FHP) also. FHP makes imbalance of suboccipital muscles, suprahyoid muscles and infrahyoid muscles. It has some relationship with temporomandibular joint, spine and equilibrium of pelvis.

• Journal of Korean Physical Therapy Science
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• v.18 no.2
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• pp.41-49
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• 2011

Purpose: The purpose of this study is to acknowledge the effects that have the strength exercise done only on the neck extensor, only on the thoracic extensor, and both the neck and the thoracic extensor on forward head posture(FHP) and cervical range of motion. Also is to discover which of the exercise is the most effective. Method: This experiment will be done by selecting 40 people who have 16cm or more FHP and they will be divided into four groups: three experimental groups and a control group. The first experimental group will do only the neck extensor strength exercise(NESE). The second experimental group will do only the thoracic extensorstrength exercise(TESE) and the third experimental group will do both the NESE and the TESE. The experimental groups will make a day three times each ten sets of extensor isometric strength exercise but the time will be increased from 4 to 6 and8 seconds until it will be done the ten sets. Then after four weeks, they will be compared which had the best results for the FHP and the cervical range of motion. Result: After the experiment, it was compared the experimental groups with the control group. Every experimental group had an improvement on their FHP and cervical range of motion. However, the only NESE and the only TESE did not have a significantly difference(p>.05). Only the group who did both the NESE and the TESE had a sign ificantly improvement compared to the control group. Conclusion: 1. The only NESE and the only TESE seem that had a positive effect on FHP and cervical range of motion. However, it cannot be conclude that it is effective. 2. When both the NESE and the TESE are done, it is showed statistically a significant difference(p<.05) on FHP and cervical range of motion. The refore, it would be note worthy if this exercise is used to improve the FHP and the cervical range of motion.

• Journal of Convergence for Information Technology
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• v.9 no.12
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• pp.208-215
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• 2019

The purpose of this study was to investigate the effects of deep neck flexion exercise(DNFE) and thoracic range of motion exerecise(TROM) on the pain and forward head position(FHP) in stroke patients. Thirty-six patients were randomly assigned to DNFE group, TROM group, and control group. pre and post intervention, pain(VAS), Craniovertebral angle(CVA), cranial rotation angle(CRA), FHP, and TROM were measured. As a result. The DNFE group and the TROM group showed significant differences in VAS, CVA, CRA, FHP, and TROM pre and post intervention(p <.05), and the two groups showed VAS, CVA, CRA, FHP, and TROM compared to the control group (p <.05). In conclusion, in patients with stroke, DNFE and TROM were effective in restoring FHP and neck pain. We hope that they will be used in the interventional program for stroke patients in clinical practice.

• Journal of International Academy of Physical Therapy Research
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• v.9 no.4
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• pp.1663-1668
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• 2018

This study was conducted to examine the effects of Evjenth-Hamberg stretching of the sternocleidomastoid, upper trapezius, and pectoralis major on the lung function of adults with forward neck posture. The subjects were 20 adult students in P university located in Pohang, Korea, whose degree of head forward displacement measured according to NEW YORK state posture test was mild. The subjects were randomly and equally assigned to the Evjenth-Hamberg Stretching group (EHSG, n=10) and the control group (CG, n=10). Their forced vital capacity (FVC), slow vital capacity (SVC), and maximal voluntary ventilation (MVV) were measured before and after the experiment. In within-group comparison, only the EHSG experienced statistically significant improvement in FVC, forced expiratory volume in the first second (FEV1), and peak expiratory flow (PEE) after the experiment, compared to before the experiment (.05

• Journal of International Academy of Physical Therapy Research
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• v.6 no.2
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• pp.871-877
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• 2015

This research was conducted to investigate the effect of continuous antagonistic muscle strengthening exercise and Evjenth-Hamberg stretching on the pulmonary function of university students with abnormal transformation of forward head posture(FHP). The results of study subject to the continuous antagonistic muscle strengthening(CAS) group(n=10) and Evjenth- Hamberg stretching(EHS) group(n=10) that was conducted 3 times a week for 6 weeks are as follow. FVC, IVC, and MVV all were shown to be significant in the pre post comparison between the CAS group and EHS group(p<.05), and significant difference was shown for MW between the two groups(p<.05) in which the CAS group showed better effect. Based on the results above, it is considered that combining continuous antagonistic muscle strengthening exercise has better effect on pulmonary function compared to application of only Evjenth-Hamberg stretching.

• Journal of International Academy of Physical Therapy Research
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• v.4 no.2
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• pp.633-639
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• 2013

This study aims to reveal the impact of continuous antagonist strengthening(CAS) and Evjenth-Hamberg stretching(EHS) on the cervical mobility in the university students with abnormal transformation of forward head posture(FHP). Our experiment was conducted 3 times a week for 6 weeks in a total of 20 individuals : continuous antagonist strengthening(CAS) group(n=10) & Evjenth-Hamberg stretching(EHS) group(n=10). In a pre and post comparison, both CAS group and EHS group appeared significantly in mSBI and SBA(p<.05) and the two-group comparison showed a significant difference(p<.05) : CAS group showed better effects. Thus, it is considered that the combined use with continuous antagonist strengthening(CAS) had better effects for cervical mobility than Evjenth-Hamberg stretching(EHS) alone.