Background: Because a forward-leaning posture can cause increased back muscle activity and pain. Therefore, an innovative method to reduce back muscle activity and pain is required.
Objects: This study aimed to investigate the effects of a head support on muscle activity and pain in a forward-leaning posture.
Methods: A total of 14 male and 16 female students (average age, 21.65 ± 2.37 years; height, 166.15 ± 7.90 cm; and weight, 60.65 ± 9.00 kg) were recruited for the experiment. Two of them were excluded due to musculoskeletal disorders. The muscle activity and pain in the forward-leaning posture were assessed while participants washed dishes for 7 minutes with and without a head support. The condition of using a head support was randomly performed with a 5-minutes break. To confirm a lumbar flexion angle of 30° during the experiment, myoVIDEO was used, and surface electromyography was used to measure muscle activity. Pain was assessed using a 10-point visual analog scale (VAS). The Wilcoxon signed-rank test was used to analyze the data, with p < 0.05 indicating statistical significance.
Results: The cervical, thoracic, and lumbar erector spinae muscle activities significantly decreased with the use of the head support, but there was no significant change in the gluteus maximus. There was a significant decrease in the VAS score for the lumbar erector spinae (p < 0.05), but there was no significant change in the VAS score for the cervical region.
Conclusion: The use of a head support in a forward-leaning posture reduced cervical, thoracic, and lumbar erector muscle activity and pain. Therefore, it could be recommended during working in a forward-leaning posture, such as during dishwashing, cooking, and working as a factory employee.

INTRODUCTION
MATERIALS AND METHODS
    1. Participants
    2. Equipment
    3. Procedures
    4. Statistics
RESULTS
DISCUSSION
CONCLUSIONS
ACKNOWLEDGEMENTS
CONFLICTS OF INTEREST
AUTHOR CONTRIBUTIONS
REFERENCES

• Kang-hee Kim(Department of Physical Therapy, College of Health and Medical Science, Cheongju University, Cheongju, Korea)
• Yoon-hee Ko(Department of Physical Therapy, College of Health and Medical Science, Cheongju University, Cheongju, Korea)
• Tae-lim Yoon(Department of Physical Therapy, College of Health and Medical Science, Cheongju University, Cheongju, Korea) Corresponding Author