The influence of cephalostatic ear rods on the positions of the head and neck during postural recordings

Evaluation of scapular mobilization and comparison to pectoralis minor stretching in individuals with rounded shoulder posture: A randomized controlled trial

BACKGROUND

Rounded shoulder posture (RSP) is a common postural condition which can alter scapular position. Although, there is no consensus on the relationship between posture and musculoskeletal dysfunction, some evidence suggests a significant relationship between RSP and shoulder dysfunction. Therefore, treatment of this postural condition is important. Various treatment methods are used to correct RSP. However, the effectiveness of scapular mobilization, (SM) as a method which can alter scapular kinematics, has not been investigated.

OBJECTIVE

To evaluate the effects of SM on scapular resting position in individuals with RSP, and to compare this technique to pectoralis minor self-stretching (PMS), and combined SM + PMS.

METHODS

52 healthy students (18 men and 34 women; mean age 23.67 ± 6.73 years) with RSP were randomly assigned to four groups (SM, PMS, combined SM + PMS, control). The mobilization group received SM, the stretching group performed self-PMS, and the combined group received SM + PMS. The control group received no treatment. Kinematics data to measure scapular protraction (cm), anterior tilt (°), internal rotation (°), and downward rotation (°) were captured with a motion analysis system before and after 5 sessions of group intervention.

RESULTS

All variables decreased significantly post-intervention compared to baseline values (P < 0.05). Internal rotation and downward rotation decreased significantly in the intervention groups compared to the control group (P < 0.05). No significant differences were observed between the intervention groups.

CONCLUSION

SM appears to be an effective technique to change scapular resting position in individuals with RSP. However, this technique was not superior to PMS or a combination of SM + PMS.

Assessment of intrasubject reliability of radiographic craniocervical posture of asymptomatic female subjects

OBJECTIVE

The objective of this study was to measure the reproducibility of the craniocervical posture (intrasubject reliability) of asymptomatic female subjects.

METHODS

Two radiographs of the craniocervical posture of 22 female subjects (mean ± SD: age, 28 ± 4.37 years; body mass index, 22.3 ± 3.24 kg/m(2)) in the sagittal view were taken 1 week apart and at the same time of day. Their posture was standardized in the self-balance position. Seven angles were measured in the digitalized radiographs and analyzed using the Alcimage software (Uberlândia, Minas Gerais, Brazil). Intraclass correlation coefficient (ICC), SEM, and 95% confidence intervals were analyzed.

RESULTS

Good-to-excellent ICC (ICC, 0.90-0.98) and small SEM (SEM, 0.25-0.70) were found.

CONCLUSION

The craniocervical posture of the subjects included in this study was reproducible (ie, intrasubject reliability) when measured a week apart using radiographs.

Comparison of reproducibility of natural head position using two methods

Lateral cephalometric radiographs have become virtually indispensable to orthodontists in the treatment of patients. They are important in orthodontic growth analysis, diagnosis, treatment planning, monitoring of therapy and evaluation of final treatment outcome.

AIM

The purpose of this study was to evaluate and compare the maximum reproducibility with minimum variation of natural head position using two methods, i.e. the mirror method and the fluid level device method.

MATERIALS AND METHODS

The study included two sets of 40 lateral cephalograms taken using two methods of obtaining natural head position: (1) The mirror method and (2) fluid level device method, with a time interval of 2 months. Inclusion criteria • Subjects were randomly selected aged between 18 to 26 years Exclusion criteria • History of orthodontic treatment • Any history of respiratory tract problem or chronic mouth breathing • Any congenital deformity • History of traumatically-induced deformity • History of myofacial pain syndrome • Any previous history of head and neck surgery.

RESULTS

The result showed that both the methods for obtaining natural head position-the mirror method and fluid level device method were comparable, but maximum reproducibility was more with the fluid level device as shown by the Dahlberg's coefficient and Bland-Altman plot. The minimum variance was seen with the fluid level device method as shown by Precision and Pearson correlation.

CONCLUSION

The mirror method and the fluid level device method used for obtaining natural head position were comparable without any significance, and the fluid level device method was more reproducible and showed less variance when compared to mirror method for obtaining natural head position.

CLINICAL SIGNIFICANCE

Fluid level device method was more reproducible and shows less variance when compared to mirror method for obtaining natural head position.

Relationship of TMJ osteoarthritis / osteoarthrosis to head posture and dentofacial morphology

OBJECTIVE

The purpose of this study was to test the hypothesis that there is a relationship between the temporomandibular joint (TMJ) osteoarthritis/osteoarthrosis (OA), head posture and dentofacial morphology.

DESIGN

Case-control study.

SUBJECTS AND METHODS

The subjects consisted of 34 Japanese females with TMJ OA (aged 24.7 +/- 6.1 years) and a control group of 25 healthy Japanese females (aged 23.6 +/- 1.3 years). Six cranio-cervical angular measurements were constructed for head posture analysis. Nine angular and three linear measurements were constructed for the skeletal hard tissue analysis. Five angular and one linear measurements were constructed for the dental hard tissue analysis. Unpaired t-tests were used to compare the mean differences of head posture measurements and dentofacial cephalometric measurements between the TMJ OA and the control group.

RESULTS

The TMJ OA group had significantly larger cranio-cervical angles (p < 0.05) and had more posteriorly rotated mandibles (p < 0.0001) than those in the control group. They also had a significantly shorter posterior facial height (p < 0.0001). The TMJ OA group had more retroclined lower incisors (p < 0.05).

CONCLUSION

These results suggest that an association may exist between TMJ OA, head posture and dentofacial morphology.

A comparison of the head and cervical posture between the self-balanced position and the Frankfurt method

Head and cervical posture evaluation has been a concern for many years, not only because of the purported relationship that exists between head and cervical posture in the presence of temporomandibular disorders, neck pain and headache, but also because of the biomechanical relationship between the head and cervical spine and dentofacial structures. Many methods have been suggested in an attempt to establish the best way to evaluate the position of the head using teleradiographs and cephalometric analysis. However, there is still no agreement as to which procedure is the best. The objective of this study was to evaluate the differences that exist between craniocervical measurements in lateral teleradiographs when comparing the position of the head in the self-balanced position to the position of the head using the Frankfurt method (Frankfurt plane parallel to the floor). Sixty-eight subjects who sought dental treatment in community health centres in Talca, Chile participated in this study. Rocabado analysis was used to measure the craniocervical variables. The Cobb analysis was used to measure cervical lordosis. A paired student t-test was used to evaluate the differences between both procedures, using an alpha of 0.05 and a power of 0.90. The use of the cephalostat changed only the craniocervical angle (P < 0.001). However, this change was minimal. No changes related to gender and age were found. More studies are needed to determine the variation between different procedures and to define a good procedure for evaluating head posture.

Immediate postural responses to total nasal obstruction

Twenty-five nasal breathing adults were radiographically examined before and after their nasal respiratory pattern had been artificially eliminated for a period of 1 hour. Six angular and six linear variables were measured to determine the extent of the postural reflexive behavior of the cranium, mandible, hyoid bone, tongue, and lips. All subjects coped in their own individual way with the environmental impact. The most generalized findings were parting of the lips (p < 0.05), a drop in mandibular position (p < 0.001), and a downward movement of the hyoid bone (p < 0.05). Cranial extension did not reach statistical significance (p = 0.06). The relevance of these findings relative to primate experiments and human clinical research is discussed. If the same postural reactions are maintained over a long-term period, they may be instrumental in influencing the vertical craniofacial growth pattern.

Posture in patients with shoulder overuse injuries and healthy individuals

Assessment of posture is an integral component of patient evaluation with shoulder overuse injuries. However, the professional literature contains relatively few studies that have assessed the relationship between posture, function, and injury. The purpose of this study was to determine the relationship and differences in postural variables within and between subjects with overuse injuries to the shoulder of healthy subjects. Thirty patient subjects and 30 healthy subjects matched for age and gender were recruited. Scapular protraction and rotation, forward head position, midthoracic curvature, and passive humeral elevation in the plane of the scapula were measured randomly in standing. All measurement techniques were standardized and validated. Intrarater and interrater reliability for all clinical measures were established before data collection. Forward head position was significantly greater (p < .001) in the patient group than the healthy group; humeral elevation was significantly greater (p < .001) in the healthy group than in the patient group and in the uninvolved shoulders (p < .01) than the involved shoulders within the patient group. Scapular protraction, rotation, midthoracic curvature, and scapular symmetry were not significantly different between groups. Scapula protraction and rotation were significantly related (p < .05) in the patient group. No other postural variables were related. Conclusions regarding the influence of posture to shoulder injury are inconclusive based on several confounding variables that may have affected the outcome.

Extracranial versus intracranial references in individual cephalometric analysis

This study was undertaken to determine whether angles SNA and ANB genuinely represent both the degree of maxillary prognathism and the intermaxillary relationship in natural head position (NHP). Pearson's r correlation coefficients were used to assess the associations between these angles, and variables based on NHP and extracranial reference lines. A large sample (n = 106) was used, comprising subjects with a variety of facial patterns. This was also divided into subgroups comprising subjects with similar facial configurations, determined by natural head position parameters. For the subgroups, SNA and ANB were not associated with the variables based on NHP, and showed high variations in subjects with similar facial patterns. SNA also showed statistically significant and high correlation with the inclination of the NSL to the true vertical.

Hyoid bone position and orientation in Class I and Class III malocclusions

Various studies have documented a variability of hyoid bone position in relation to changed mandibular position or head posture. The aim of this study was to investigate the hyoid bone position and inclination on the cephalometric radiographs of two groups of patients exhibiting Class I and Class III malocclusions. The radiographs were taken in both centric occlusion and wide-opened mandibular position, and 17 measurements were performed on both tracings. The findings reveal a statistically significant difference in the position and inclination of the hyoid bone in the two groups; Class III patients, especially the boys, show a more anterior position of the hyoid bone and also a reverse inclination. This might have an implication on the function of the suprahyoid and infrahyoid muscles and thus on the direction of mandibular growth.