Background: The craniocervical flexion test (CCFT) was developed for the activation and endurance of deep cervical flexors. However, the muscle thickness and muscle thickness changing ratio of the sternocleidomastoid (SCM) and deep cervical flexor (DCF) muscles in subjects with and without forward head posture (FHP) have not been reported.
Objects: To determine the difference in thickness of the SCM and DCF muscles and the difference in the muscle thickness changing ratio between SCM, DCF, and DCF/SCM 20 mmHg and DCF/SCM 30 mmHg between subjects with and without FHP.
Methods: Thirty subjects with and without FHP were enrolled. The muscle thickness of the SCM and DCF was measured when maintained at a baseline pressure of 20 mmHg and a maximum pressure of 30 mmHg using a pressure biofeedback unit during the CCFT. Ultrasonography was used to capture images of SCM and DCF muscle thickness during the CCFT, which was calculated using the picture archiving and communication system (PACS).
Results: We observed a significant difference within the pressure main effect between SCM and DCF at a baseline pressure of 20 mmHg and a maximum pressure of 30 mmHg (p < 0.05). However, there was no significant difference in the muscle thickness and muscle thickness changing ratio for SCM and DCF during CCFT between subjects with and without FHP.
Conclusion: There was no significant difference in the muscle thickness recruitment pattern during CCFT in posture changes between subjects with and without FHP.

INTRODUCTION
MATERIALS AND METHODS
    1. Subjects
    2. Instrumentation
    3. Experimental Procedure
    4. Statistical Analysis
RESULTS
DISCUSSION
CONCLUSIONS
FUNDING
ACKNOWLEDGEMENTS
CONFLICTS OF INTEREST
AUTHOR CONTRIBUTION
ORCID
REFERENCES

• Jae-hyun Lee(Department of Physical Therapy, The Graduate School, Yonsei University)
• Ui-jae Hwang(Kinetic Ergocise Based on Movement Analysis Laboratory,Department of Physical Therapy, College of Software and Digital Healthcare Convergence, Yonsei University, Wonju, Korea)
• Oh-yun Kwon(Kinetic Ergocise Based on Movement Analysis Laboratory,Department of Physical Therapy, College of Software and Digital Healthcare Convergence, Yonsei University, Wonju, Korea) Corresponding Author