• 대한통합의학회지
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• 제7권4호
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• pp.265-272
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• 2019

Purpose : Excessive computer use frequently results in musculoskeletal disorders of the neck and shoulder such as forward head posture (FHP). The purpose of this study was to investigate effects of neck and shoulder exercise program on spino-pelvic alignment and the correlation between change in head and neck posture and spino-pelvic alignment in FHP. Methods : The study included 44 participants with FHP. The participants performed the exercise for correction of FHP 2-3 times a week for 4 weeks. We examined whole spine X-ray images in the lateral standing position with both arms crossed. We measured anterior head translation distance (AHT), craniovertebral angle (CVA), cervical lordosis (CL), thoracic kyphosis (TK), lumbosacral lordosis (LSL), sacral slope (SS), pelvic tilt (PT), and pelvic incidence (PI) of the subjects. The association between change in AHT and each spino-pelvic parameter was also subjected to Pearson's correlation coefficient analysis. Results : There were statistically significant differences before and after exercise in the parameters of AHT, CVA, and SS (p<.05). Significant negative correlation was observed between the change in AHT and CVA (r=-.768, p<.001), and CL (r=-.388, p<.05). There was significant positive correlation between the change in AHT and SS (r=.328, p<.05), and PI (r=.333, p<.05). However, no significant correlation was observed in change in AHT with that of TK, LSL, and PT. Conclusion : Based on the above results, we conclude that there is a relationship between change in AHT, which is a parameter associated with forward displacement of the head, and that of CVA, CL, SS, and PI after exercise in cases of FHP.

• 대한물리의학회지
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• 제15권3호
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• pp.51-59
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• 2020

PURPOSE: The purpose of this study was to provide clinical basic data to reduce pain and improve function by comparing neck muscle activity and neck alignment using self-stretching and passive stretching exercises for chronic neck pain caused by forward head posture. METHODS: The subjects were divided into 15 subjects assigned to perform self-stretching exercise and 15 subjects assigned to perform passive stretching exercise. The intervention was conducted for a total of 4 weeks. The muscle activity in the neck was measured by surface electromyography (EMG) before intervention, and craniovertebral and cranial rotation angles were measured by X-ray. The 4-week intervention was conducted and the above items re-measured in the same manner and analyzed. RESULTS: Muscle activity within both groups after intervention using self-stretching or passive stretching exercise was significantly different (p < .05)(p < .01). Neck alignment of both groups was significantly different (p < .001)(p < .01). Further, muscle activities of the upper trapezius and splenius capitis muscles showed significant differences (p<.05). Lastly, neck alignment showed statistically significant difference (p < .05). CONCLUSION: Self-stretching exercise activated motor nerves as a posture correction exercise, thereby improving inhibition of muscle activity, muscle contraction delay, and pathological conditions of the muscle. For future research, interventions of self-stretching exercise will be needed for patients with chronic back pain accompanied by forward head posture, and various clinical studies on postural improvement of forward head posture by maintaining a normal muscle tone state are needed.

• 대한물리의학회지
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• 제15권3호
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• pp.117-125
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• 2020

PURPOSE: Aging causes changes in the postural alignment and gait due to changes in the nervous and musculoskeletal systems. On the other hand, the relationship between the changes in posture alignment and gait is unclear. This study examined the relationship between the postural alignment and spatiotemporal gait parameters in Korean elderly women. METHODS: Thirty-two-healthy elderly women participated in this study. All subjects were assessed for their posture alignment and gait ability. Stepwise multiple linear regression was performed to determine to what extent the postural alignments could explain the spatiotemporal gait parameters. RESULTS: Coronal head angle was moderately correlated with the velocity (r = -.51), normalized velocity (r = -.46) and gait-stability ratio (r = .58) (p < .05). The trunk angle was moderately correlated with the normalized velocity (r = -.32) and gait-stability ratio (r = .32) and weakly correlated with the velocity (r = -.28) (p < .05). The coronal shoulder angle was moderately correlated with the swing phase (r = -.57), stance phase (r = .56), single limb stance (r = -.56) and double limb stance (r = .51) (p < .05). The coronal head angle and trunk angle accounted for 36% of the variance in velocity, 33% variance in normalized velocity and 46% variance in the gait-stability ratio (p < .05). The coronal shoulder angle accounted for 32% variance in the swing phase, 32% variance in the stance phase, 31% variance in the single limb stance and 26% variance in the double limb stance (p < .05). CONCLUSION: Changes in posture alignment in elderly women may serve as a biomarker to predict a decrease in walking ability due to physical aging.

• 정형스포츠물리치료학회지
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• 제14권2호
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• pp.91-97
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• 2018

Purpose: The purpose of this study was to observe the effects of sport massage and McKenzie stretch exercise on forward head posture. To understand the effect, this study measured and analyzed body alignment of the neck. Methods: In this study, a total of 14 subjects with forward head posture were analyzed. Subjects were divided into two groups: group 1 (n=7) received a McKenzie stretch exercise and group 2 (n=7) received a McKenzie stretch exercise and a sport massage. The McKenzie stretch exercise was performed three times a week, for four weeks, while the sport massage was performed once a week. The body alignment of the neck (CVA, CRA) was measured using a goniometer. Results: The improvements in neck body alignments (CVA, CRA) after the McKenzie stretch exercise and sport massage were both significant (group 1: p<0.05; group 2: p<0.05), whereas the between-group comparison found no significant differences. Conclusions: In conclusion, our study confirmed that the McKenzie stretch exercise and sport massage had a significant positive effect on the body alignment of the neck. However, a study that included a greater number of subjects and a long-term treatment period is needed to generalize these results.

• The Journal of Korean Physical Therapy
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• 제25권6호
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• pp.386-392
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• 2013

Purpose: This study aimed to verify the impact of the time that the sitting posture is maintained on changes in muscle performance and head alignment. Methods: The subjects of this study were healthy adults aged between 20 and 30 years. Ninety-three subjects participated in this study (male: 57, female: 36). The subjects were divided into a one-hour group, a two-hour group, and a three-hour group. All the subjects adjusted the height of their chair to a comfortable position and then seat for one, two, or over three hours. Both prior to and after the experiment, the muscle performance (muscle strength, endurance, and flexibility) of the subjects was measured. Results: In the 2-hours and 3-hour group, muscle strength, flexibility and endurance reduced significantly before and after the study, and the head alignment significantly changed. Conclusion: Thease findings showed that sitting continuously for longer than two hours decreases muscle strength, endurance, and flexibility. A flexed posture affects the muscle performance of the lumbar region and may result in problematic postures, such as a forward head position.

• 한국융합학회논문지
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• 제9권12호
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• pp.123-128
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• 2018

본 연구는 머리전방자세와 둥근어깨자세에 대한 일반 운동과 동작관찰, 시각적 되먹임의 효과를 알아보고자 한다. 머리전방자세와 둥근어깨자세를 가진 24명으로 하였으며, 일반 운동군(8명), 동작관찰군(8명), 시각적 되먹임군(8명)으로 무작위 배분하였다. 모든 운동군은 주 3회, 총 4주간 운동하였다. 운동 전 후 머리척추각(CVA), 둥근어깨자세(RSP), 시각적 상사척도(VAS), 경부장애지수(NDI)를 평가하였다. 연구결과 CVA는 일반 운동군과 동작관찰군에서 유의한 변화를 보였으며, RSP, VAS, NDI의 경우 모든 운동군에서 유의한 변화를 보였다. 운동군 간 변화량 비교에서는 VAS에서 동작관찰군이 일반 운동군과 시각적 되먹임군보다 큰 변화량을 보였다. 본 연구결과 동작관찰이 머리전방자세와 둥근어깨자세의 개선에 효과가 있을 것이라고 사료된다.

• 한국전문물리치료학회지
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• 제30권3호
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• pp.174-183
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• 2023

Background: Office workers experience neck or back pain due to poor posture, such as flexed head and forward head posture, during long-term sedentary work. Posture correction is used to reduce pain caused by poor posture and ensures proper alignment of the body. Several assistive devices have been developed to assist in maintaining an ideal posture; however, there are limitations in practical use due to vast size, unproven long-term effects or inconsistency of maintaining posture alignment. We developed a headphone and necklace posture correction system (HANPCS) for posture correction using an inertial measurement unit (IMU) sensor that provides visual or auditory feedback. Objects: To demonstrate the test-retest reliability and concurrent validity of neck and upper trunk flexion measurements using a HANPCS, compared with a three-dimensional motion analysis system (3DMAS). Methods: Twenty-nine participants were included in this study. The HANPCS was applied to each participant. The angle for each action was measured simultaneously using the HANPCS and 3DMAS. The data were analyzed using the intraclass correlation coefficient (ICC) = [3,3] with 95% confidence intervals (CIs). Results: The angular measurements of the HANPCS for neck and upper trunk flexions showed high intra- (ICC = 0.954-0.971) and inter-day (ICC = 0.865-0.937) values, standard error of measurement (SEM) values (1.05°-2.04°), and minimal detectable change (MDC) values (2.92°-5.65°). Also, the angular measurements between the HANPCS and 3DMAS had excellent ICC values (> 0.90) for all sessions, which indicates high concurrent validity. Conclusion: Our study demonstrates that the HANPCS is as accurate in measuring angle as the gold standard, 3DMAS. Therefore, the HANPCS is reliable and valid because of its angular measurement reliability and validity.

• 대한통합의학회지
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• 제8권1호
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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.

• 국제물리치료학회지
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• 제7권2호
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• pp.1018-1024
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• 2016

The purpose of this study was to identify the effects of cervical alignment, pain, and physique to apply proprioceptive neuromuscular facilitation(PNF) techniques in patients with forward head posture (FHP). The subjects of this study were 24 patients diagnosed with FHP. They were randomly divided into two groups: a PNF group(n=12) and a control group(n=12). The intervention was performed a total of 24 times, 30 min a day, six times a week for four weeks. Data on cervical alignment(forward head displacement, FHD), pain(visual analog scale, VAS), and physique(height, weight, and body mass index) were obtained pre- and post-intervention. Two-way repeated measures ANOVA was used to compare the groups and time. For FHD, the VAS, and physique(height and BMI), there was an interaction effect for the groups and time(p<.001, BMI: p<.05) and main effects for time(p<.001, BMI: p<.05). For weight, there were main effects of time(p<.01). For FHD(p<.01) and the VAS(p<.05), there were main effects for the groups. In the PNF group, there were significant improvements in FHD, VAS, and physique. In the control group, there was a significant increase in FHD. The results of this study indicated that PNF intervention using scapular and upper extremity patterns effective in FHP positively. The use of a therapeutic intervention on physique changes may also be effective in improving poor posture and help to better patients' quality of life.

• 대한물리치료과학회지
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• 제26권2호
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• pp.61-73
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• 2019

Purpose: This study was to evaluate the effect of cranio-cervical flexion based trunk stabilization exercise on gross motor function and posture alignment change in children with spastic cerebral palsy. Design: Randomized Controlled Trial. Methods: Twenty-six children participated in this study. All subjects were randomly assigned to either the Cranio-Cervical Flexion Based Trunk Stabilization Exercise (CCFTS) group (n=13) or the Trunk Stabilization Exercise (TS) group (n=13). In both groups were trained general physical therapy for 10 minutes, in the CCFTS group was trained cranio-cervical flexion based trunk stabilization exercise for 20 minutes and in the TS group was trained trunk stabilization exercise for 20 minutes. The training was provided 2 times a week during 8 weeks. All subjects were measured with the Gross Motor Function Measure (GMFM) and Cranio-Vertebral Angle (CVA) before and after intervention. Results: The results showed that the CCFTS have increased significantly in GMFM (B, C, D and E-dimension) and CVA, and the TS group have increased significantly in GMFM (B, C D and E-dimension). In particular, the CCFTS group improved significantly than TS group in GMFM (B, C and D-dimension) and CVA. Therefore, the cranio-cervical flexion based trunk stabilization exercise improved gross motor function and posture alignment in children with spastic cerebral palsy. Conclusion: These results suggest that cranio-cervical flexion based trunk stabilization exercise is feasible and suitable for individuals with a spastic cerebral palsy and can be used in addition to conventional physical therapy.