Changes in upper-extremity muscle activities due to head position in subjects with a forward head posture and rounded shoulders

Cervical proprioception in Parkinson's disease and its correlation with manual dexterity function

OBJECTIVE

Cervical proprioception plays a crucial role in posture and movement control. This study aimed to determine the relationships of cervical proprioception, cervical muscle strength and endurance with manual dexterity and hand strength in individuals with idiopathic Parkinson's disease (PD).

METHODS

Twenty individuals with PD (mean age: 63.9 years) and 20 healthy individuals as a control group (mean age: 61.9 years) were recruited. Cervical joint position error (JPE), static endurance of neck muscles, activation of deep cervical flexor muscles (Craniocervical Flexion Test, CCFT), manual dexterity (Purdue Pegboard Test, PPT), cognitive and motor tasks of the PPT, finger tapping test (FTT), pinch strength, and grip strength were assessed.

RESULTS

Cervical JPE was significantly higher in individuals with PD than in controls (p < 0.05). The strength and endurance of the cervical muscles were significantly decreased in individuals with PD (p < 0.05). Cervical JPE measurements were negatively correlated with PPT, cognitive and motor tasks of the PPT in individuals with PD (all p < 0.05). The endurance of cervical flexor muscles was negatively correlated with PPT and cognitive PPT scores in the PD group (p < 0.05). In addition, a significant positive correlation was found between cervical flexor endurance and hand strength in the PD group (p < 0.05).

CONCLUSION

Cervical proprioception and the strength and endurance of cervical muscles decrease in individuals with PD compared to healthy individuals. Impairment of cervical proprioception appears to be associated with poorer upper extremity performance. Detailed evaluation of the cervical region in PD may help determine the factors affecting upper extremity function.

Head posture mediates the association of cognition with hand grip and pinch strength in older adults: an examination using structural equation modeling

BACKGROUND

The association of cognition with hand grip and pinch strength has been well-recognized in older adults. The authors sought to explore: (1) associations among forward head posture (FHP), cognition, and hand grip and pinch strength in older adults; and (2) the mediator role of FHP in these pathways using structural equation modeling (SEM).

METHODS

This cross-sectional study included 88 older adults (70.5% male; mean age = 68.75±3.87 years). Cognition was assessed by the Mini-Mental State Examination (MMSE), head posture by the Craniovertebral Angle (CVA) obtained from photographic analysis, hand grip strength by a handheld dynamometer, and pinch strength by a pinch meter. Using the two SEMs, a potential mediator role of the CVA was investigated. While the MMSE was addressed as an independent variable in both models, hand grip and pinch strength were addressed as dependent variables in model 1 and model 2, respectively.

RESULTS

The correlations between the CVA and MMSE (r = 0.310), hand grip strength (r = 0.370), and pinch strength (r = 0.274 to 0.292) were statistically significant (p < 0.001). In addition, significant associations were found between the MMSE and hand grip and pinch strength, ranging from 0.307 to 0.380 (p < 0.001). The mediation analysis showed that the standardized total (β = 0.41, p < 0.001) and indirect (mediated) effects (β = 0.12, p = 0.008) of the MMSE on hand grip strength were significant in model (1) The results were similar for model (2) The standardized total (β = 0.39, p = 0.001) and indirect effects (β = 0.10, p = 0.026) of the MMSE on pinch strength were significant. As a partial mediator in both models, the CVA explained 29% and 26% of the total effect in models 1 and 2, respectively.

CONCLUSIONS

The CVA was associated with the MMSE, hand grip strength, and pinch strength, and CVA partially mediates the association of the MMSE with grip and pinch strength in older adults, indicating that cognition had an effect on grip and pinch strength through an indirect path via head posture. This finding reveals that evaluating head posture and providing corrective therapeutic interventions as needed may be beneficial in reducing the negative impact of decreased cognition on motor functions in older adults.

Alterations in Cervical Nerve Root Function during Different Sitting Positions in Adults with and without Forward Head Posture: A Cross-Sectional Study

The current study aimed to determine whether participants with and without forward head posture (FHP) would respond differently in cervical nerve root function to various sitting positions. We measured peak-to-peak dermatomal somatosensory-evoked potentials (DSSEPs) in 30 participants with FHP and in 30 participants matched for age, sex, and body mass index (BMI) with normal head posture (NHP), defined as having a craniovertebral angle (CVA) >55°. Additional inclusion criteria for recruitment were individuals between the ages of 18 and 28 who were in good health and had no musculoskeletal pain. All 60 participants underwent C6, C7, and C8 DSSEPs evaluation. The measurements were taken in three positions: erect sitting, slouched sitting, and supine. We identified statistically significant differences in the cervical nerve root function in all postures between the NHP and FHP groups (p < 0.001), indicating that the FHP and NHP reacted differently in different positions. No significant differences between groups for the DSSEPs were identified for the supine position (p > 0.05), in contrast to the erect and slouched sitting positions, which showed a significant difference in nerve root function between the NHP and FHP (p < 0.001). The NHP group results were consistent with the prior literature and had the greatest DSSEP peaks when in the upright position. However, the participants in the FHP group demonstrated the largest peak-to-peak amplitude of DSSEPs while in the slouched position as opposed to an erect position. The optimal sitting posture for cervical nerve root function may be dependent upon the underlying CVA of a person, however, further research is needed to corroborate these findings.

Effect of high intensity laser therapy in the treatment of acute atlantoaxial rotatory subluxation: A case report

BACKGROUND

Sudden onset of acute torticollis in children is rare and is usually diagnosed as atlantoaxial rotatory subluxation (AARS). The common treatment for acute AARS without neurological symptoms is halter traction in conjunction with muscle relaxant and sedative agents, followed by cervicothoracic orthotic immobilization. To the best of our knowledge, a case of acute AARS treatment with high-intensity laser therapy (HILT) has not yet been reported so far.

OBJECTIVE

We aimed to report a case of acute AARS treatment with HILT successfully and to discuss about the clinical effect of HILT in AARS.

METHODS

We reported a 9-year-old girl with acute onset of torticollis visiting the rehabilitation outpatient department.

RESULS

The physical examination revealed a typical cock robin position without neurological symptoms. A series of evaluations, including open-mouth odontoid radiograph and soft tissue sonography, confirmed the diagnosis of acute AARS. The patient received HILT over the left suboccipital and upper back muscle groups, which started on the day of the first rehabilitation clinic visit, once a week, for four weeks. Torticollis and neck pain improved gradually with each session of HILT, and the symptoms resolved completely after the fourth session. Dynamic computed tomography (CT) of the cervical spine showed no evidence of obvious AARS after the treatment.

CONCLUSIONS

The patient had no complaints after HILT in a case of acute AARS resulting from a mechanical factor. Due to its pain-relief and muscle-release characteristics, HILT indicates the probable benefit of relaxation of spastic muscles for patients with AARS.

Evaluation of the Relationship Between Head Posture, Mandibular Movements and Emotional Tension

Introduction: The head, due to its structure and assigned functions, is a unique part of our body. In a number of studies, an association has been confirmed between the base of the head, the cervical spine, and temporomandibular joint disorders. Research objective: The aim of the study was to evaluate the correlation of spatial head position, temporomandibular joint mobility and emotional tension. Material and methods: The study comprised32 participants, aged 20 to 30 years. The position of the head in the sagittal and frontal planes was evaluated via the photogrammetric method. The mobility of the temporomandibular joints was assessed by measurements made with a ruler. Electrodermal activity was measured with the "Bitalino 3DP by BEEVERYCREATIVE" device, and stress intensity assessment was estimated using the PSS-10 scale. Results: A significant (p<0.01) linear correlation was found between electrodermal activity (EDA Min) and the values of angles describing head tilt (FHT1 and HTA). Higher EDA values are associated with higher angle values. No significant correlations (p>0.05) were found between mandibular mobility and EDA scores, or between mandibular mobility measurements and head position. Conclusions: The study revealed a relationship between head positioning and electrodermal EDA activity.

Corrective exercises administered online vs at the workplace for pain and function in the office workers with upper crossed syndrome: randomized controlled trial

Objective

To evaluate the effects of online-supervised versus workplace corrective exercises on neck–shoulder pain (NSP), sick leave, posture, workability, and muscular activity among office workers with the upper crossed syndrome (UCS).

Methods

We performed a parallel-group randomized control trial at Shahid Beheshti University, Tehran, Iran, assigning 36 office workers to online-supervised, workplace, and control groups (mean (SD) age 38.91 ± 3.87, 38.58 ± 7.34, 37.00 ± 8.12). Inclusion criteria were alignment alteration (forward head (≥ 45°), rounding shoulder (≥ 52°), rounding back (≥ 42°), and pain intensity ≥ 3 in neck and shoulder. The two intervention groups performed 8-week exercise program, while the control group continued usual activities. Primary (NSP and sick leave) and secondary outcomes [postural angles, workability, and muscular activity were measured by VAS, outcome evaluation questionnaire (OEQ), photogrammetry, workability index, and EMG, respectively, at the baseline and an 8-week follow-up].

Results

ANCOVA results revealed improvements for the online-supervised group versus control for NSP (P = 0.007), postural angles (P = 0.000, P = 0.001, P = 0.005), workability (P = 0.048, P = 0.042), and upper trapezius activation (P = 0.024, P = 0.016), respectively. Using paired t tests, both intervention groups improved from baseline to follow-up for NSP (P = 0.000, P = 0.002), forward head posture (P = 0.000, P = 0.000), round shoulders (P = 0.001, P = 0.031), and round back (P = 0.034, P = 0.008), respectively. Related parameters of workability (P = 0.041, P = 0.038), upper trapezius (P = 0.005, P = 0.005, P = 0.022), and serratus anterior (P = 0.020, P = 0.015) changed only in the online-supervised group.

Conclusion

Online-supervised corrective exercise seems to improve a range of parameters related to work performance. These findings are highly applicable in light of the ongoing COVID pandemic; many workers have to work from home.

Comparison of Surgeon Muscular Properties between Standard Operating Microscope and Digitally Assisted Vitreoretinal Surgery Systems

PURPOSE

To quantitatively analyze surgical ergonomics between standard operating microscope (SOM) and digitally assisted vitreoretinal surgery (DAVS) systems.

METHODS

The surgeon conducted procedures on 110 patients; 52 patients underwent a combined phacoemulsification and pars plana vitrectomy (Phaco-PPV group, 24 using SOM and 28 using DAVS), and 58 patients underwent phacoemulsification (Phaco group, 30 using SOM and 28 using DAVS). The surgeon's muscle tone and stiffness in the sternocleidomastoid (SCM) and the two positions of the upper trapezius (UT), which are 2 cm intervals along the UT muscle fibers, UT1 and UT2, were measured at preoperative, intraoperative, and postoperative time points.

RESULTS

In the Phaco-PPV group using the SOM, intraoperative muscle tone and stiffness were higher than pre- and postoperative values in the SCM (P<0.001, respectively), UT1 (P<0.001, respectively), and UT2 (P<0.001 and P<0.01, respectively). In the Phaco group using the SOM, intraoperative muscle tone and stiffness were higher than pre- and postoperative values in the SCM (P<0.001, respectively) and UT1 (P<0.001 and P<0.01, respectively). By contrast, when the surgeon used the DAVS, there were no differences in muscle properties at any measurement site or during any time point in the Phaco-PPV and Phaco groups (P>0.05).

CONCLUSIONS

This study provides quantitative measurement of retina surgeon ergonomics, suggesting that compared with a SOM, the DAVS can reduce intraoperative muscle fatigue.

Therapeutic routine with respiratory exercises improves posture, muscle activity, and respiratory pattern of patients with neck pain: a randomized controlled trial

Neck pain and forward head posture (FHP) are typical in prolonged smartphone users and need to be targeted for treatment. We aimed to compare the effect of a routine therapeutic program with and without respiratory exercises on smartphone users with FHP and non-specific chronic neck pain (NSCNP). Sixty patients (aged 24.7 ± 2.1 years) with FHP and NSCNP were randomly assigned to the routine therapeutic program (n = 20), combined respiratory exercises with a routine therapeutic program (n = 20), or control (n = 20) groups. At baseline, there was no difference among groups at all variables. Each programme was implemented three times a week for eight weeks. Primary Outcome was pain measured by visual analogue scale (VAS), and secondary ones were forward head angle, the activity of specific muscles, and respiratory patterns, measured by photogrammetry, electromyography and manual, respectively. All outcomes were measured at baseline and eight weeks post-treatment. We used the repeated measures analysis of variance to examine the interaction between time and group, paired t-test for intragroup comparison, one-way analysis of variance for intergroup comparison, and Tukey post hoc test at a significant level 95% was used. There were significant differences in the combined group compared with the routine therapeutic group (P = 0.03) for diaphragm muscle activation, respiratory balance (P = 0.01), and the number of breaths (P = 0.02). There were significant within-group changes from baseline to post-treatment in the combined group for all outcomes above, but no changes in the therapeutic exercise routine group. Despite respiratory pattern, none of the secondary outcomes proved to be superior in the combination group compared to the routine therapeutic program in smartphone users with FHP and NSCNP. Future studies with longer follow-up assessments could strengthen these results.

Trial registration: Current Controlled Trials using the IRCT website with ID number of, IRCT20200212046469N1 “Prospectively registered” at 04/03/2020.

Four weeks of exercise regimen for sedentary workers with rounded shoulder posture: a randomized controlled study

BACKGROUND

Rounded shoulder (RS) posture causes neck and shoulder pathologies. Mechanical correction taping (MCT) is often incorporated into postural corrective therapies; however, its effects on muscle stiffness are unclear.

OBJECTIVE

We investigated the effect of MCT with different tape fabrics, along with exercise, on upper trapezius and pectoralis minor muscle stiffness and the posture of sedentary workers.

DESIGN AND SETTING

A randomized controlled study was performed at Aydın Adnan Menderes University, Aydın, Turkey.

METHODS

The study included 39 workers with RS posture. Two intervention groups (performance tape: PT and classic tape: CT) were taped twice a week and administered a home exercise program for 4 weeks. The control (C) group performed only home exercises. RS was measured using an acromion-testing table (AT), stiffness using shear wave elastography ultrasound, and shoulder angle (SA) using a smartphone application at baseline and 4 weeks. Time and group interactions were determined using 3 × 2 mixed analysis of variance.

RESULTS

Intragroup analyses revealed a significant main effect of time on AT distance (η2 = 0.445) and SA (η2 = 0.325) in the PT and C groups (P < 0.05) and left upper trapezius stiffness (η2 = 0.287) in the CT and C groups (P < 0.05). In the post hoc analyses, no difference was noted between the groups from baseline to 4 weeks (P > 0.05).

CONCLUSION

Scapular MCT added to postural exercises did not show any difference between the intervention groups and controls in terms of muscle stiffness and posture in sedentary workers.

Text neck: An adverse postural phenomenon

BACKGROUND

The excessive use of hand-held mobile devices (HHMD) leads to a postural phenomenon known as text neck.

OBJECTIVE

The aim of this paper is to discuss the anatomical, biomechanical and muscle activation changes within the cervical and thoracic regions associated with the sustained, forward, flexed neck posture, observed with excessive usage of hand-held mobile devices. Additionally, this paper examines the relationship of gender, as well as the effects of carrying backpack loads by youth, on this forward, flexed neck posture.

METHODS

Multiple aspects of the text neck position that occur when an individual uses a HHMD are described.

RESULTS

Prolonged use of hand-held mobile devices results in adverse anatomical and biomechanical changes in the cervical and thoracic spine, muscular imbalances, and postural compensations, all of which contribute to muscular overuse and fatigue resulting in pain.

CONCLUSIONS

Physical therapists must educate their patients about proper posture while using hand-held mobile devices. Proper posture includes: holding the device close to eye level, using the device while standing or sitting and holding the device with a line of sight perpendicular to the surface of the device, using a larger screen, and texting with both hands. Also, because children are using hand held mobile devices at younger ages, parents and teachers must be educated about the dangers of prolonged use of hand-held devices.

Influence of Forward Head Posture on Cervicocephalic Kinesthesia and Electromyographic Activity of Neck Musculature in Asymptomatic Individuals

OBJECTIVE

The purpose of this study was to compare cervicocephalic kinesthesia and electromyographic (EMG) activity of neck muscles-upper trapezius (UT) and sternocleidomastoid (SCM)-between individuals with and without forward head posture (FHP) and to examine the correlation between cervicocephalic kinesthesia and craniovertebral angle (CVA).

METHODS

Twenty-two asymptomatic individuals with FHP and 22 without FHP were recruited for the present study. Craniovertebral angle was measured, and those with CVA ≤53° were assigned to the FHP group, whereas those with CVA >53° were assigned to the control group. Thereafter, cervicocephalic kinesthesia and EMG activity of the neck muscles were assessed. Cervicocephalic kinesthesia was measured using a head repositioning accuracy test for all cervical spine motions. EMG activity of the UT and SCM muscles was recorded at rest and during activity.

RESULTS

Position-sense error values were found to be significantly greater for all directions-ie, flexion, extension, side flexion, and rotation-in participants with FHP than those without (P < .05). EMG activity of the UT and SCM muscles was found to be significantly raised both at rest and during activity in individuals with FHP relative to the non-FHP group (P < .05). Position-sense error values showed a significant inverse correlation with CVA (P < .05).

CONCLUSION

Findings of the present study suggest that cervicocephalic kinesthesia and activation patterns of the neck muscles may be significantly altered in individuals with FHP. Also, cervicocephalic kinesthesia is significantly associated with the severity of FHP.

Does forward head posture change subacromial space in active or passive arm elevation?

Objectives: Forward head posture (FHP) is one of the most common musculoskeletal disorders that appears to affect the shoulder joint through the shared muscles between the head and neck area and the shoulder girdle. The present study compared the acromiohumeral distance between individuals with normal head and neck alignment and those with moderate and severe FHP in active and passive arm elevation.Methods: Based on the craniovertebral angle, 60 volunteers were selected and equally distributed among three groups, including group one with normal head and neck alignment, group two with moderate FHP and group three with severe FHP. The space between the humeral head and the acromion was measured in 10°, 45° and 60° of active and passive arm elevation as the acromiohumeral distance.Results: The acromiohumeral distance was only different between the three groups at 45° arm elevation angle, and this difference was significant between groups one and three. In active and passive arm elevation, increased arm elevation angle reduced the subacromial space significantly. Also, in each arm elevation angle, the subacromial space differed significantly between the active and passive arm elevations.Conclusions: The acromiohumeral distance was significantly lower in the severe FHP group than the group with normal head and neck alignment in the 45° active arm elevation angle, which could be due to the changed tension in tissues between active and passive arm elevation and also the maximum muscle activity in the 45° active arm elevation angle.

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.

Standing Up from a Chair with an Asymmetrical Initial Foot Position Decreases Trunk and Masticatory Muscle Activities in Healthy Young Men

This study aimed to identify the activation of lower extremity, trunk, and masticatory muscle and trunk kinematics of the initial foot position during the sit-to-stand (STS) movement. Sixteen young men participated in this cross-sectional pilot study and performed STS using both symmetrical and asymmetrical foot positions. Activation of the tibialis anterior (TA), gastrocnemius lateral head (GA), rectus femoris (RF), biceps femoris (BF), rectus abdominis, erector spinae (ES), sternocleidomastoid (SCM), upper trapezius (UT), temporalis (TE), and masseter muscles in the dominant side was determined. For trunk kinematics, head and trunk velocities, front-back (For-Back) and mediolateral (Med-Lat) weight translation rates, and trunk inclination were measured. GA, TA, BF, and RF activation significantly increased, whereas ES, SCM, UT, and TE activation significantly decreased when using the asymmetrical foot position. Head velocity, For-Back, Med-Lat, and trunk inclination were also significantly decreased. In conclusion, the asymmetrical foot position increases muscle activation in the lower extremities and decreases trunk inclination. In addition, ES, UT, and TE muscle activity decreases at the initial asymmetrical foot position.

Effect of forward head and rounded shoulder posture on hand grip strength in asymptomatic young adults: a cross-sectional study

Background

Forward head and rounded shoulder posture (FHRSP) is a common clinical postural misalignment. It leads to flexion posture of the spine which increases the amount of tension on the nerve roots, which inversely affects muscle strength and function of the upper extremity. So, this study was conducted to examine the effect of FHRSP on hand grip strength in asymptomatic young adults and to explore the relationship between the craniovertebral angle (CVA) and hand grip strength.

Results

There was no significant difference in hand grip strength between the groups (p = 0.812). There was no correlation between the CVA and right and left hand grip of the normal group (p = 0.840, 0.816 respectively), rounded shoulder posture (RSP) group (p = 0.523, 0.650 respectively), and FHRSP group (p = 0.855, 0.736 respectively). Regarding the right and left hand grip strength, there was no significant difference between the groups (p = 0.798, 0.826 respectively). The right hand grip strength was significantly higher than the left hand for all groups (p = 0.001).

Conclusion

This study displayed that hand grip strength was not affected by FHRSP nor RSP in asymptomatic young adults. Moreover, the degree of the CVA was not associated with an inverse effect on hand grip strength.

Exercises in Motor Development Positions. What Happens With the Activity of Antagonist Muscle Pairs? Pilot Study

Context: Exercises in motor development positions are employed to activate correct muscular patterns, but the effects on the activity of antagonist muscle pairs remain unknown. Objectives: To determine the effect of using exercises in motor development positions on the activity of antagonist muscle pairs. Another aim was to analyze if introducing some facilitators modifies the muscle activity in the different studied positions. Design: Controlled laboratory study using a single-group repeated measures design. Participants: A total of 21 right handed, healthy adults aged 41 years and older (10 males and 11 females). Setting: Workers of different departments at Maz Hospital. Intervention: Surface electromyography activity of muscle antagonist pairs upper trapezius/lower trapezius, serratus anterior/pectoralis major, and external abdominal oblique/lumbar paraspinal was measured in 3 positions: rest (supine decubitus), reflex turning 1, and modified Vöjta’s first position. Main Outcome Measures: Primary outcomes were mean normalized root mean square (averaged over 2 repetitions) of electromyography signals of antagonist muscle pairs in the 3 analyzed positions. Intraclass correlation coefficients (>.70) (model 3.2), type consistency, and 95% confidence interval were used to estimate the reliability and as exclusion criteria of measurements. Results: Analyzed positions had a significant effect on the activity of the muscles P < .001. There was a significant increase in the activity of the phasic musculature versus its tonic antagonists, except in the case of the external oblique/lumbar paraspinal in modified Vöjta’s first position. Adding possible facilitators such as gaze, breathing, or the combination of both did not show significant changes in the level of activation of the studied muscle groups. Conclusion: Ontogenetic developmental positions can be used to facilitate and improve the activation of phasic muscles.

Association Between Forward Head, Rounded Shoulders, and Increased Thoracic Kyphosis: A Review of the Literature

Objective

The purpose of this review was to explore the association between forward head posture, rounded shoulders, and increased thoracic kyphosis.

Methods

The PubMed, ERIC, and Cochrane databases were searched using the key words posture, head, shoulder, forward scapular posture, and thoracic kyphosis through December 2016.

Results

Our initial search yielded 6840 research studies, 6769 of which were excluded because they either were duplicates or did not satisfy the inclusion criteria. After the abstracts of the remaining studies were read, 15 were assessed for eligibility, and only 4 papers were included in the present review. Cervical lordosis values were found to be significantly associated with thoracic kyphosis values. Also, there were significant correlations between rounded shoulders and increased thoracic kyphosis.

Conclusion

Forward head posture, rounded shoulders, and increased thoracic kyphosis can exist alone or in any combination.

Correlations among visual analogue scale, neck disability index, shoulder joint range of motion, and muscle strength in young women with forward head posture

This study investigated the correlation between the neck disability index (NDI) and visual analogue scale (VAS), which are indicators of neck pain, shoulder joint range of motion (ROM), and muscle strength in women with a slight forward head posture. This study was carried out on 42 female college students attending Uiduk University in Gyeongju, Korea. The neck pain and disability index for each subject was measured using VAS and NDI, respectively. Two physiotherapists measured the shoulder joint ROM and muscle strengths of the subjects using a goniometer and a dynamometer, respectively. External rotation, internal rotation, and abduction of the shoulder joint were measured for each subject. A significant negative correlation between neck pain and shoulder joint ROM in external rotation and the muscle strength of the shoulder joint in abduction was found in the subjects. In addition, a significant positive correlation was observed between ROM in external rotation and muscle strength in abduction. This study showed a significant negative correlation between neck pain and ROM in external rotation as well as between neck pain and the muscle strength in abduction.

The effect of the shoulder stability exercise using resistant vibration stimulus on forward head posture and muscle activity

[Purpose] The purpose of this study was to analyze shoulder stabilization using resistant vibration stimulus during bodyblade exercise followed by forward head posture improvement. [Subjects and Methods] Craniovertebral angle and cranial rotation angle were measured with 24 patients who were diagnosed with forward head posture. The experimental group conducted bodyblade exercise for 6 weeks and all patients received conventional physical therapy. The craniovertebral angle and cranial rotation angle were measured using a diagnostic imaging device to measure the change in forward head posture. Sternocleidomastoid, upper trapezius and serratus anterior muscle activity were measured using surface electromyography, voluntary contraction was converting into a percentage and mean value was calculated. [Results] The experimental group showed a significant increase in the comparison of the results of both groups before and after the intervention. The comparing group showed no significant difference. The experimental group showed the significant difference in mean value after the intervention in the comparison between the groups. [Conclusion] Resistant vibration stimulus by bodyblade controlled shoulder muscle activity causing scapular stabilization followed by neck position stability improvement. Rehabilitation program that activates whole kinetic chain of proximal and distal muscles such as bodyblade will show more effective improvement when choosing rehabilitation program for neck and shoulder disease clinically.

Exercise training and postural correction improve upper extremity symptoms among touchscreen smartphone users

BACKGROUND

Repetitive movements and poor posture are associated with over-use of smartphones when texting or playing games and significantly contribute to the symptoms of pain and discomfort in the upper extremities.

OBJECTIVE

This study investigated the effect of exercise training and postural correction on disabilities of the arm, shoulder, and hand (DASH), hand grip and key pinch strength among smartphone users.

METHODS

One hundred university students were randomly divided into two groups; the experimental group participated in a 12-week programme of exercise training and postural corrections. The control group were instructed to follow their usual routine for smartphone utilization. Measurements of DASH scores, hand grip strength, and key pinch grip strength were conducted before and after 12 weeks for both groups.

RESULTS

There were no significant differences between the start values of both groups for DASH scores, hand grip strength, and key pinch strength (p > 0.05). However, there was a significant improvement in all outcomes measured in the experimental group (p < 0.05), with significant changes in the outcomes of the control group.

CONCLUSION

Postural correction combined with a selected exercise training programme improved the hand grip, key pinch grip strength, and upper extremity disability and symptoms associated with smartphone use among university students.

Effect of trapezius muscle strength on three-dimensional scapular kinematics

[Purpose] This study aimed to investigate the effect of trapezius muscle isometric strength on three-dimensional scapular kinematics in asymptomatic shoulders. [Subjects and Methods] Thirty asymptomatic subjects were included to the study. Isometric strengths of the upper, middle, and lower trapezius muscle were measured using a handheld dynamometer. Three-dimensional scapular kinematics was recorded by an electromagnetic tracking device during frontal and sagittal plane elevation. For each muscle, the cut-off value for muscle strength was determined with the upper bound of the 95% confidence interval, and Student's t-test was used to compare the scapular kinematics between subjects with relatively weaker or stronger trapezius muscles. [Results] Shoulders with stronger upper trapezius muscles showed greater upward scapular rotation at 30°, 60°, 90°, and 120° of elevation in the frontal plane. Shoulders with stronger middle trapezius had greater scapular upward rotation at 90° of elevation in the frontal plane. Shoulders with stronger lower trapezius showed greater scapular posterior tilt at 90° of elevation in the sagittal plane. [Conclusion] This study's findings showed that isometric strength of the trapezius muscle affects upward scapular rotation and posterior tilt in asymptomatic shoulders. Therefore, trapezius muscle strength should be assessed and potential weakness should be addressed in shoulder rehabilitation programs.

Effects of elastic band exercise on subjects with rounded shoulder posture and forward head posture

[Purpose] This study performed to investigate the effect of elastic band exercise program on the posture of subjects with rounded shoulder and forward head posture. [Subjects and Methods] The body length, forward shoulder angle, craniovertebral angle, and cranial rotation angle of participants (n=12) were measured before and after the exercise program. Furthermore, the thicknesses of the pectoralis major, rhomboid major, and upper trapezius were measured using an ultrasonographic imaging device. The exercises program was conducted with elastic bands, with 15 repetitions per set and 3 sets in total. [Results] The length of the pectoralis major, forward shoulder angle, and craniovertebral angle showed significant changes between before and after the exercise program, whereas the changes in the other measurements were not significant. The thickness of the upper trapezius showed a significant increase between before and after the elastic band exercise. [Conclusion] These findings suggest that the elastic band exercise program used in the study is effective for lengthening the pectoralis major and correcting rounded shoulder and forward head posture.

Correlation among scapular asymmetry, neck pain, and neck disability index (NDI) in young women with slight neck pain

[Purpose] This study aimed to investigate the correlations among scapular asymmetry, neck pain, and neck disability index in women in their 20s with slight neck pain. [Subjects and Methods] A total of 60 female students at U university in Gyeongsangbuk-do, South Korea, participated in this study. The lateral scapular slide test, which measures the distance between the thorax and scapula, was used to analyze the scapular asymmetry. The lateral scapular slide test was performed in three positions. The visual analogue scale and neck disability index were used to measure neck pain. [Results] In the lateral scapular slide test in position 3 (shoulder abduction at 90 degrees), the scapular left-right asymmetry and VAS showed a moderate positive linear relationship, with r=0.344. The VAS and NDI showed a moderate positive linear relationship, with r = 0.632. [Conclusion] Scapular asymmetry indicates imbalance of surrounding muscles of the scapula and is related to neck pain based on the results of measuring the distance from the thorax to the scapula.