• The Journal of Korean Physical Therapy
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• 제35권3호
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• pp.83-88
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• 2023

Purpose: This study was to investigate the effect of forward head posture (FHP) and round shoulder posture (RSP) on changes in muscle activities according to shoulder flexion and abduction tasks. Methods: Twenty-two male subjects with no history of neurological, musculoskeletal surgery or injuries, or pain in the spine region within the previous 3-month periods were recruited for this study. Craniovertebral angle (CVA) and Scapula Index were measured before performing 90° abduction and flexion tasks holding a 3kg dumbbell. Muscle activities were measured during the tasks. All measurements except height of the acromion were carried out in a sitting position at the height of the subject's knee angle of 90 degrees, and two tasks were randomly performed with the arm that the subject mainly use to throw the ball. The abduction and flexion angles were checked by the examiner using a goniometer beside the subject. Results: Correlation coefficient analysis between Scapular Index and upper trapezius muscle activity during shoulder abduction task showed significant positive correlation. No significant correlation was observed between CVA, Scapular Index, and other muscle activities. Conclusion: FHP showed increased muscle activation, making it difficult to change muscle activity under lower loads, and RSP was correlated with UT activation in shoulder abduction. Therefore, in the RSP, the loaded shoulder abduction is considered a potential risk factor for increasing shoulder muscle tension. This paper proposes an approach to treating RSP before FHP.

• Physical Therapy Rehabilitation Science
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• 제11권4호
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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.

• Physical Therapy Rehabilitation Science
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• 제10권3호
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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.

• 국제물리치료학회지
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• 제10권2호
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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.

• 한국산학기술학회논문지
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• 제22권3호
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• pp.291-296
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• 2021

본 연구는 머리전방자세가 증가함에 따른 턱관절의 최대 개구량, 관자근과 깨물근의 근활성도, 근육의 비대칭률에 미치는 영향을 알아보고자 진행하였다. 연구 참가자들의 머리척추각을 측정하여, 연구의 선정요구를 충족시키는 머리 척추각이 50° 이상인 대상자 50명(23.10±2.73세)을 선정하였다. 머리전방자세를 증가시키기 위해 머리척추각을 0%, 10%, 20%를 감소시켜 Control I, Control II, Control III으로 설정하였다. 각 조건에 따른 턱관절의 최대 개구량, 관자근과 깨물근의 근활성도와 비대칭률의 변화를 측정하였다. 연구 결과, 머리척추각의 감소에 따라 최대 개구량은 유의하게 감소하였다(p<.001). 조건 변화에 따른 근활성도 변화를 측정한 결과, 오른쪽 관자근과 깨물근 및 왼쪽 관자근의 근활성도는 감소하였으며(p<.001), 왼쪽 깨물근의 근활성도도 감소하였다(p<.01). 조건 변화에 따른 근육의 좌우 비대칭률을 측정한 결과 좌우 관자근의 비대칭률, 좌우 관자근과 깨물근을 더한 근육의 비대칭률은 증가하였다(p<.01). 본 연구 결과는 턱관절 부위에 대한 치료 전략과 종합적 진단을 세우고, 턱관절 장애 치료를 위해 사용된 도수치료와 치료적 운동의 이론적 근거를 제시하는 데 도움이 될 것으로 사료된다.

• 대한물리의학회지
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• 제17권4호
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• pp.1-13
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• 2022

PURPOSE: This study examined the effects of the craniovertebral angle, proprioception (joint error test), and the upper trapezius on the muscle tone when comparing cervical stabilization and scapula stabilization exercises and when two exercises were performed together. METHODS: The participants in this study agreed in advance, and this study was carried out by recruiting 27 university students in their twenties with mild frontal posture. The subjects were assigned randomly to three groups that performed cervical stabilization exercises, scapular stabilization exercises, and both cervical and scapular stabilization exercises. One-way repeated ANOVA was used to analyze the evaluation values of the 1^st, 3^rd, and 6^th weeks of exercise intervention within the group, and one-way ANOVA was used to compare the difference in the effects of exercise intervention among the three groups. RESULTS: Proprioception was significantly different in the cervical stabilization exercises (CSE) group and the cervical stabilization exercises + Scapular stabilization exercises (CSE+SSE) groups at three weeks, and there was a significant difference between the scapular stabilization exercises (SSE) group and the CSE+SSE group (p < .05). At six weeks, there was a significant difference between the CSE group and the CSE+SSE group, and there was a significant difference between the SSE group and the CSE+SSE group (p < .05). There was a significant difference between three and six weeks in the CSE group (p < .05). In the SSE group, there was a significant difference between pre and six weeks, and between three and six weeks (p < .05). In the CSE+SSE group, there was a significant difference between pre and three weeks, and between pre and six weeks (p < .05). On the other hand, there were no significant differences between CVA and muscular tone in all three groups (P > .05). CONCLUSION: In all groups, the proprioception (joint error test) showed significant improvement, and the CSE+SSE group showed greater improvement than the other groups. As a result, the appropriate combination of neck stabilization exercise and scapular stabilization exercise effectively improved proprioception in the presence of forward head posture (FHP).

• 대한통합의학회지
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• 제8권3호
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• pp.173-180
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• 2020

Purpose : The aim of this study was to assess the intra- and inter-rater reliability and validity of measurements of head, neck, and pelvis posture using a mobile application in subjects with forward head posture. Methods : Forty-eight volunteers (22 men, 26 women) participated in this study. Two raters independently examined whole body picture images in a lateral standing posture with arms crossed using a CA-Smart Posture Reminder (CA-SPR), and a rater took and calculated posture images twice to assess reliability. We measured five parameters: craniovertebral angle 1 (CVA1), anterior shoulder translation (AST), pelvic tilt (PT), knee angle (KA), and ankle angle (AA) in the subject's sagittal plane using CA-SPR. We examined whole spine X-ray images in the same position to assess validity. We measured four variables in the subjects: CVA2, translation distance (AHT), anterior pelvic plane (APP), and sacral slope (SS). The intra- and inter-rater reliability were calculated using the intraclass correlation coefficient (ICC). Convergent validity was calculated using Pearson's correlation coefficient. Results : The intra-rater reliability (ICC=.889 -.989) and inter-rater reliability (ICC=.800 -.980) were excellent for all variables measured using CA-SPR. The variables measured using CA-SPR and X-ray were significantly positively correlated (r=.623, p<.01). However, the correlation of the variables in the pelvis was not statistically significant. Conclusion : This study shows that a mobile application (CA-SPR) is a useful tool for measuring head and neck posture in subjects with forward head posture. However, further study is needed to measure pelvic variables when using a mobile application.

• 대한의용생체공학회:의공학회지
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• 제37권3호
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• pp.112-118
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• 2016

The neck pain is fairly common occurance. Forward head posture and text neck are poor postures which may be related with neck pain but the evidence is not enough. We developed the wearable sensor which can assess the head & neck posture in daily life. Microprocessor, Bluetooth low energy, and 3-axis accelerometer, rechargeable battery and vibratior for reminding are used to implement the wearable sensor. Real-time algorithm to parameterize the posture for one epoch is implemented which classifies the posture in the epoch into three classed; dynamic, static_good posture, and static_poor posture. Also the algorithm makes reminding to its wearer to give them the prolonged poor posture is detected. The mean error of measurement was 1.2 degree. The correlation coefficient between neck angle and craniovertebral angle was 0.9 or higher in all cases. With the pilot study on text neck syndrome was also quatified. Average of neck angle were 74.3 degree during the listening in the classroom and 57.8 degree during the smartphoning. Using the wearable sensor suggested, the poor postures of forward head posture and neck neck can be detected in real-time which can remind the wearer according to his/her setting.

• 대한통합의학회지
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• 제9권3호
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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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• 제25권5호
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• pp.311-315
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• 2013

Purpose: Forward head posture is a typical symptom in people who use computers for long periods of time. Respiration is a complex function involving co-operation of muscular, skeletal, and nervous systems. Abnormal posture can have a negative effect on respiratory function. The purpose of this study was to investigate the relationship between forward head posture and respiratory function in young adults. Methods: Forty-six healthy subjects participated in this study. Craniovertebral angle was measured for assessment of the forward head posture. The respiratory function of all subjects was evaluated by measuring forced vital capacity (FVC), forced expiratory volume at one second (FEV1), forced expiratory volume at one second/forced vital capacity (FEV1/FVC) ratio, and peak expiratory flow (PEF). The baseline of forward head posture was less than 49 degrees. Results: : Significant differences for predicted FVC and FEV1 were observed between the two groups, however, no statistically significant differences in FEV1/FVC ratio and PEF were observed between the two groups. Conclusion: Results of this study demonstrate that forward head posture has a negative effect on respiratory function in young adults.