이 연구의 목적은 6주간의 플라이오메트릭 트레이닝이 태권 시범선수의 서전트 점프, 자세 조절 및 하체 부상 준거에 미치는 영향을 보고자 하였다. 이 연구에 참여한 대상자는 대학 태권 시범선수 20 명을 대상으로 운동군 10명과 통제군 10명을 무작위로 분류하였다. 운동군은 주 3회, 60분, 6주간 실시하였고, 통제군은 일반적인 훈련을 하였으며, 사전 사후 서전트 점프, 배근력, 자세 조절 및 하체 부상 준거를 측정하였다. 연구 결과, 배근력에서는 유의하지 않았으나 서전트 점프에서는 유의한 증가가 있었다. 자세 조절에서는 앞쪽은 경우 유의하지 않았으나 좌·우 후방 외쪽과 안쪽에서는 유의한 증가가 있었고, 종합점수 결과 하체 부상의 위험성은 없는 것으로 나타났다. 결론적으로 플라이오메트릭 트레이닝은 순발력, 자세 조절, 하체 부상 방지 및 재활에 적극적으로 활용할 필요가 있는 훈련 방법이다.

Background: Forward head posture (FHP) causes various posture imbalances associated with the head and neck. Myofascial release is an effective treatment method used for relaxing muscles and reducing muscle hyperactivity, but no studies have been conducted on suboccipital and neck muscles related to FHP. Objects: The purpose of this study was to investigate the immediate effect of roller massages on the cranio-cervical flexion (CCF) range of motion (ROM) and CCF strength applied to suboccipital and neck muscles in subject with forward head posture. Methods: Twenty-four FHP subjects (male: 13, female: 11) were recruited for this study. All subjects were recruited with a craniovertebral angle (CVA) of 53 degrees or less and a head tilt angle (HTA) of 20.66 degrees or higher. CCF strength was measured using Pressure biofeedback unit (PBU) in the supine posture and CCF ROM was measured using smartphone-based inclinometer. Roller massage (RM) was applied to suboccipital and neck muscles for 2 minutes and CCF ROM and strength were remeasured. Results: These results of this study showed that CCF ROM was a significant difference in CCF ROM before and after RM (p < 0.05). CCF strength also showed a significant difference before and after RM (p < 0.05). Conclusion: RM method might be recommended to increase the immediate ROM and strength of CCF in subjects with forward head posture.

Background: Flat-back posture refers to a posture in which the pelvis is tilted backward, the lumbar spine is bent, the upper thoracic spine is increasingly bent, and the lower thoracic spine is straight. Given that most of the day is spent sitting, we need to develop exercise programs and devices that are suitable for people who spend less time exercising than sitting. Objects: This study investigated the effects of resistance footrest exercise on spine posture angles in visual display terminal (VDT) workers with flat back. Methods: We measured the upper lumbar angle (ULA) and lower lumbar angle (LLA) using a flexible ruler for the ULA and LLA. Then, after 1 week of resistance footrest exercise designed to strengthen the lumbar spine musculature, we measured these angles again. We measured each angle three times and then compared measurements from before and after exercise. Results: There were no significant differences in the ULA following the strengthening exercise, but significant differences were observed in LLA. Conclusion: The resistance footrest exercise strengthened the muscles affecting the pelvic and lumbar lordotic angles, and increases in the LLA were changed. This suggests that the role of the lower lumbar spine in the lumbar lordotic curve is greater than that of the upper lumbar spine. In addition, considering the contemporary tendency to lead fairly sedentary lives, these results indicate that exercising while seated can be effective.

Background: Trunk flexor-extensor muscles’ co-activation and upright posture are important for spinal stability. Abdominal bracing and maximal expiration are being used as exercises to excel torso co-contraction. However, no study has on comparison of the effect of this exercise on multifidus in the upright sitting posture. Objectives: This study aims to verify the effectiveness of abdominal bracing and expiration maneuvers in lumbo-pelvic upright sitting. Design: Cross-sectional study. Methods: Eighteen healthy women were recruited for this study. The multifidus muscle thickness of all subjects was measured in three sitting conditions (lumbo-pelvic upright sitting, lumbo-pelvic upright sitting with abdominal bracing, and lumbo-pelvic upright sitting with maximum expiration) using ultrasound. One-way repeated measure analysis of variance was used for the evaluation. Results: Compared to lumbo-pelvic upright sitting, lumbo-pelvic upright sitting with abdominal bracing and lumbo-pelvic upright sitting with maximum expiration were associated with significantly increment of muscle thickness. There was no significant difference in muscle thickness between lumbo-pelvic upright sitting with abdominal bracing and lumbo-pelvic upright sitting with maximum expiration. Conclusion: Abdominal bracing and maximum expiration could be beneficial to increasing lumbar multifidus thickness in lumbo-pelvic upright sitting.

Background: Individuals with forward head posture (FHP) have neck pain. To correct the FHP, a posture correction band is commonly used. However, we do not know the posture correction band influenced the pulmonary function in individuals with FHP. Objects: This study aimed to elucidate the effects of the posture correction band on the pulmonary function in young adults with neck pain and FHP and to monitor how the pulmonary function changed over time. Methods: Twenty subjects with chronic neck pain and forward head posture were recruited. Subjects performed pulmonary function test four times: before, immediately, and 2 hours after wearing the postural band, and immediately after undressing the postural band. Vital capacity (VC), forced vital capacity (FVC), peak expiratory flow (PEF), and forced expiratory volume at one second (FEV1) were measured. The modified Borg dyspnea scale was used to measure each subject’s responses to the posture correction band. The mixed-effect linear regression was used to the effect of the posture correction band over time. Results: There were no significant differences in VC, FVC, PEF, FEV1 values over time (p > 0.05), although all values slightly decreased after applying posture correction band. However, the score of the modified Borg scale significantly changed after wearing the postural bands (p < 0.05), indicating the subject felt discomfort with posture correction band during breathing. Conclusion: Because the posture correction band did not change the pulmonary function over time, but it induces psychological discomforts during breathing in people with FHP. Therefore, this posture correction band can be used for FHP realignment after discussion with the subjects.

Background: Forward head posture (FHP) is common postural malalignment. FHP is described relatively extension to upper cervical and lower cervical is relatively flexion. Although several researchers mentioned the lower cervical flexion posture in FHP, most of the studies related to FHP is focused on the deep cervical flexor function. Objects: The purposes of present study is to compare the cervical strength (upper cervical extension [UCE], lower cervical extension [LCE], upper cervical flexion [UCF], lower cervical flexion [LCF]) between individuals with and without FHP. Methods: Fifty-one participants are recruited. Participants who have the craniovertebral angle (CVA) less than 48 degree were classified to the FHP group (n = 24) and the others were included in without FHP group (n = 27). The cervical strength (UCE, LCE, UCF, LCF) were measured using Smart KEMA strength sensor and the strength data was normalized by body weight. All strength measurement conducted at head and neck neutral position in sitting. Independent t-test was used to compare the cervical strength between individuals with and without FHP. Results: The mean value of CVA was greater in without FHP group than with FHP group (p < 0.000). The strength value of UCF (p < 0.002) and LCE (p < 0.001) was significant less in FHP group than without FHP group. But no significant differences were seen in the LCF and UCE strength between two groups. Conclusion: UCF and LCE weakness in FHP group should be considered to evaluate and manage the individuals with FHP.

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.

Background: Adults with forward head posture (FHP) often suffer from thoracic hyperkyphosis and thoracic dysfunction, and including reduction of the craniovertebral angle (CV angle) and tightening of the superficial neck muscles. In order to treat thoracic dysfunction, interventions aimed at improving thoracic mobility are necessary. Objectives: To examine the effects of maitland manual mobilization therapy on the thoracic spine in adults with FHP. Design: Single-blind randomized controlled trial. Methods: Thirty adults with FHP who met the selection criteria were randomized to the thoracic multiple joint mobilization (TMJM; n=15) group and the thoracic general joint mobilization (TGJM; n=15) group. Joint mobilizations were performed for 23 minutes a day for 4 weeks continuously, two times per week. Outcome measures were ImageJ, BTS FREE EMG 1000, neck disability Index (NDI). Results: Although changes in the left sternocleidomastoid muscle activity and NDI scores over time between the two groups differed, other variables were noted only changes observed over time. Muscle activity in the right sternocleidomastoid increased again in the TGJM group post-intervention and 2 weeks after the end of the experiment, but changes in other variables were retained or improved, confirming the lasting effects of thoracic joint mobilization. Conclusion: Thoracic multiple joint mobilization may be recommended as a more effective intervention for adults with FHP.

Background: Backward walking exercise may offer some unique and potentially beneficial differences compared with forward walking exercise. There is still a lack of research on backward walking exercises and forward head posture. Objects: The purpose of this study was to determine the effect of backward walking exercise on college students forward head posture in their 20s. Methods: Twenty-one subjects participated in the experiment. The subjects were those with a craniovertebral angle (CVA) of 55 degrees or less who understood the purpose and method of this study and voluntarily agreed. A camera capable of taking pictures of the lateral plane was installed at a distance of 1.5 meters before exercising. Pictures were taken before walking backward, and after walking for 15 minutes on the treadmill, the images were taken in the same way. The composition of the backward walking exercise was walking at a rate of 1.0 for 5 minutes, and the remaining 10 minutes were walking at a rate of 1.5. Wilcoxon signed rank test was used to compare CVA and craniorotational angle (CRA) before and after exercise. Results: As a result of this study, there was a significant difference in CVA before and after exercise (p < 0.05). There was a significant difference in CRA before and after exercise (p < 0.05). Conclusion: The backward walking exercise and verbal command seems to have positively influenced the changes in CVA and CRA among college students in their 20s. It seems that studies to confirm balance or muscle activity as well as changes in forward head posture through the long-term intervention of the backward walking exercise should be conducted.

Background: The alignment of the neck and shoulder is important in people with forward head posture. However, previous studies have mainly conducted fragmentary studies on the neck and shoulders, and studies on the combined movement of the neck and shoulders are incomplete. Objective: To investigate the effects of 6 week dynamic exercise program using Thera-band on craniovertebral angle (CVA) in adults with forward head posture. Design: Quasi-experimental study. Methods: The study was conducted on 24 adults with forward head posture and experimented with neck and shoulder exercises and divided them into groups of neck exercises, shoulder exercises, and neck and shoulder exercises to measure CVA values before and after the experiment. The neck exercise program included flexion and extension muscles of the neck and shoulder exercises included dynamic exercise of the upper extremities such as the trapezius muscles and serratus anterior muscle. The CVA results were measured using PA200. Results: Following the interventions, neck exercise group showed significant improvement in CVA (P<.05), but shoulder exercise group and combined exercise group did not show any significant results (P>.05). However, both groups showed some positive results. Significant differences were seen in the comparisons between the three groups (P<.05), and the results of the posthoc test showed significant differences in neck exercise group and shoulder exercise, neck exercise and combine exercise group. Conclusion: This study suggested that the Thera-band neck exercise is beneficial for foward head posture patients and is expected to be used in clinical trials.

Background: Due to aging, blood flow rate decreases, also posture and chewing habit may be changed. Objective: To identify that changes in blood velocity in the common carotid arteries (CCAs) in old persons with unilateral chewing habit (UCH) and forward head posture (FHP) in the elderly. Design: An observational cross-sectional study. Methods: Chewing habits, FHP, and CCAs velocities were assessed in 85 elderly subjects. Chewing habits were measured by visual observation. CCAs measured the peak systolic velocity (PSV), end-diastolic velocity (EDV), minimum diastolic velocity, and resistivity index. The subjects were divided into UCH and bilateral chewing habit groups depending on chewing habit. The subjects were also divided into >49 degrees and <49 degrees for comparison of blood flow between the left and right CCAs. Results: In the UCH, the chewing side had significantly higher EDV (P=.003), PSV (P=.023) than the non-chewing side. There was no significant difference in velocity between the CCAs in the FHP. Conclusion: This study shows that the blood flow velocity of the chewing side of UCH was higher, and unilateral chewing affects the CCAs velocity and thus highlight the importance of chewing habit in the elderly than head posture.

Background: Tension-type headaches, which make up the highest proportion of headaches, are prone to develop into chronic tension-type headaches (CTTH). The characteristic of CTTH in patients is that the active myofascial trigger point (ATrP) which causes pain in the muscles of the back of the head is increased, compared to the normal headache and moves the head position forward. Objective: The aim of this study was to investigate the effects of myofascial release (MFR) and posture correction in effectively improving neck function and sleep quality in the symptoms of CTTH patients. Design: Observer-blind study Methods: To reduce ATrP, MFR was applied and exercise was also applied to correct posture. The subjects of this study were 48 individuals randomly divided into three groups; The MFR group using the MFR technique; The MFR with exercise group subject to both the MFR technique and forward head position correction exercises (MFREx), and the control group. MFR and MFREx groups were given the relevant interventions twice a week for four consecutive weeks, and went through the number ATrPs, range of motion (ROM) of neck, Neck Disability Index (NDI) and the Pittsburgh Sleep Quality Index (PSQI) before and after the intervention. A physical therapist, who was fully familiar with the measuring methods of the equipment, was the measurer and not aware of the target's condition was blinded to take measurements only before and after intervention. Results: There was a significant improvement in the ATrP, Neck ROM, NDI and PSQI in the group of patients to whom the MFR technique and MFREx were applied. MFREx was more effective in increasing neck mobility. Conclusions: According to this study, the application of MFR is effective in improving neck movement and sleep quality in chronic tension headache patients.

이 연구는 D시에 근무하는 공무원 998명(남성:615명, 여성:383명)을 대상으로 체형분석을 통해 체형 불균형 정도를 평가하고자 하였다. 이 연구에 참여한 연구대상자의 직장근무경력은 남성 21.1±8.4년, 여성 18.5±9.6년이며, 평균연령은 남성:47.4±7세; 여성:43.8±8.4세이다. 연구 결과로 통증이 있거나 좋지 않은 부위가 있는 남성은 416명으로 전체 남성의 67.6%, 여성은 297명으로 전체 여성의 77.5%로 여성 직원이 남성 직원보다 약 10%정도 높은 비율로 근골격계 통증을 호소하고 있었다. 또한, 규칙적인 운동을 하고 있는 직원은 남성 293명(47.6%), 여성 168명(43.9%)으로 조사되었다. 정적체형 측정(관 상면, 시상면) 결과 통증이 있는 남성 416명 중 비운동자 322(52.4%)명의 목의 긴장도를 살펴본 결과 4.54±2.6kg이었고, 통증이 있는 여성 297명 중 비운동자 215명(56.1%)의 목의 긴장도는 2.47±1.5kg로 나타났다. 이러한 연구 결과를 토대로 오랫동안 앉아서 근무하는 대표적인 직업형태인 공무원은 자세 습관, 운동습관 등이 일자목과 같은 체형불균형에 상당 연관성이 있으며 이러한 체형불균형은 근골격 계 질환에도 영향을 미칠 수 있다는 것을 확인할 수 있었다.

Background: Cervical dysfunction is a common pathomechanical marker in individuals with forward head posture (FHP). To overcome the limitations of the isometric chin-tuck (ICT) exercise, dynamic neuromuscular stabilization (DNS), which emphasizes an entire spinal chain exercise, has recently shown promising clinical results. Objects: Purpose of this study was to compare the immediate effects between ICT and DNS techniques. Methods: 43 young subjects (mean age, 24.0±5.0 years) were recruited. Group of subjects with FHP were measured under baseline, ICT, and DNS conditions. Outcome measures included sitting height, longus colli (LC) and sternocleidomastoid (SCM) muscle thickness and LC/SCM thickness ratio. One-way repeated measures ANOVA was used to compare the continuous dependent variables among FHP, ICT, and DNS conditions at p<.016. Results: Both ICT and DNS exercise conditions yielded significantly increased LC muscle thickness, LC/SCM thickness ratio and sitting height than did FHP condition (p<.0001, respectively). Sitting height was significantly greater in DNS exercise than in the ICT exercise (p<.0001). Conclusion: The present results demonstrated that sitting height was greater in the DNS exercise than in the ICT exercise, as well as both corrective postural training exercises were effective on LC/SCM muscle balance ratio when compared with the baseline FHP condition. Therefore, it is considered that DNS exercise can be the recommended exercise for people with FHP.

Background: The importance of postural stabilization and cervical mobilization in subjects with pain from the anterior head posture is drawing more attention. However, studies on head and neck stabilizing intervention after mobilization are lacking. Objective: To examine the effects of Kinesiotaping and posture setting exercise on forward head posture (FHP). Design: Crossover Study Design Methods: The subjects were 17 male and female college students in their 20s with FHP. They were randomized into the Kinesiology taping group (KTG) with 9 subjects and posture stabilizing exercise group (PSEG) with 8 subjects. The intervention was conducted for 4 weeks, and changes in pain, craniovertebral angle (CVA), and proprioception were observed before and after intervention. Results: Pain was significantly reduced in the KTG and PSEG both before and after intervention. CVA and proprioception were significantly increased only in the PSEG. The differences in CVA and proprioception between the two groups were significant. Conclusions: These findings suggest that the application of posture setting exercise could decrease pain, proprioceptive error and increase CVA on FHP

Background : There is lack of studies on the effects of the bag-carrying style on the shoulder muscles and body alignment in adults with rounded shoulder posture (RSP). Objective: The purpose of this study was to investigate the effects of various bag-carrying styles on muscle tone, muscle stiffness and spinal alignment in 20 adults with RSP as they were walking on a treadmill. Design : Crossover Study Design. Methods: A subject performed treadmill walking for 15 minutes at a speed of 4 ㎞/ｈ while carrying three different types of bags: a backpack, a cross bag, and a shoulder bag. Results : The results showed that the main effect of timing was observed in the muscle tone for all the variables and in muscle stiffness only for the upper and lower trapezius muscles. As for the main effect of timing, the muscle tone of the upper trapezius and the pectoralis major significantly increased in all conditions, while the muscle tone of the lower trapezius significantly decreased in all conditions. The muscle stiffness of the upper trapezius significantly increased in all conditions, while the muscle stiffness of the lower trapezius significantly decreased in all conditions. As for the spinal alignment, the dimple distance data values significantly decreased for the cross-bag style. Conclusions : This study demonstrated that walking with a heavy bag, regardless of the bag-carrying style, increased muscle stiffness around the shoulders in adults with rounded shoulder posture, and walking with a crossbag also induced changes in spinal alignment.

Background: Individuals with mechanical neck pain show biomechanical and neurophysiological changes, including cervical spine muscle weakness. As a result of deep muscle weakness, it causes stability disability and reduced upper thoracic spine mobility, which finally leads to functional movement restriction such as limited range of motion and dysfunction. Recent studies have shown that thoracic spine manipulation and mobilization could reduce symptoms of mechanical neck pain in patients. Objects: The purpose of this study was to investigate the effects of thoracic mobility exercise on cervicothoracic function, posture feature, and pain intensity in individuals with mechanical neck pain. Methods: The study subjects were 26 persons who were randomly assigned to the experimental (with thoracic mobility exercise) and control groups (without thoracic mobility exercise), with 13 subjects in each group. The cervicothoracic function (neck functional disability level and cervicothoracic range of motion), posture feature, and pain rating (using a quadrupled visual analogue scale [QVAS]) were measured before, after 3 weeks, and after 6 weeks. Results: Statistically significant group-by-time interactions were found with repeated analyses of variance for the Korean neck disability index (KNDI), all cervical range of motion (CROM), all thoracic range of motion (TROM), cranial rotation angle, sagittal shoulder posture (SSP), and QVAS (p<.05). All groups showed significant improvements from all times in all the evaluated methods. The KNDI, CROM, TROM of left rotation, and SSP in the experimental group showed significant improvements after 3 weeks, and the TROM of the right rotation and QVAS in the experimental group showed significant improvements after 6 weeks when compared with the control group. Conclusion: Thoracic mobility exercise during 6 weeks might be effective intervention to improve the functional level, posture feature, and QVAS pain rating for managing individuals with mechanical neck pain.

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.

Background: Forward head posture (FHP) is a postural alignment of the cervical vertebrae that leads to increased gravitational load on cervical segmental motions. The overhead arm lift test assesses the ability to actively dissociate and control low cervical flexion and move the shoulders through overhead flexion. Objects: The purpose of this study was to explore muscle activities in the upper trapezius (UT), serratus anterior (SA), sternocleidomastoid (SCM), and lower trapezius (LT) alongside changes in head position during the overhead arm lift test in individuals with FHP. Methods: Fifteen subjects with forward head posture and fifteen subjects with normal subjcects were enrolled in this study. The patients performed the overhead arm lift test, and muscle activities of the UT, SCM, SA, and LT were measured using surface electromyography and by evaluating changes in head position. Independent t-tests were used to detect significant differences between the two groups and Cohen’s d was calculated to measure the size of the mean difference between the groups. Results: The FHP group demonstrated significantly increased muscle activity of the UT (32.46±7.64), SCM (12.79±4.01), and LT (45.65±10.52) and significantly decreased activity in the SA (26.65±6.15) than the normal group. The change in head position was significantly higher in the FHP group (6.66±2.08) than the normal group. Effect sizes for all parameters assessed were large between the two groups. Conclusion: The subjects with excessive FHP displayed were unable to fix their heads in position during the overhead arm lift test. The overhead arm lift test can thus be used in clinical settings to confirm control of the neck in these subjects.

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<p). In between-group comparison, the PEE of EHSG was statistically significantly higher than CG (.05<p). Regarding SVC, only the EHSG experienced statistically significant improvement in inspiratory vital capacity after the experiment, compared to before the experiment. With regard to MVV, only the EHSG experienced statistically significant improvement in their tidal volume during maximal voluntary ventilation after the experiment compared to before the experiment. Our results indicated that Evjenth- Hamberg stretching was an effective physical therapy intervention to improve the lung function of adults with FHP by correcting their head forward displacement.