Evaluation of Head and Cervical Spine Posture after Therapy with Maxillary Protraction Appliances / Evaluación de la Postura de la Cabeza y la Columna Cervical Después de la Terapia con Aparatos de Protracción Maxilar

SUMMARY: The objective of this study was to evaluate the changes of head and cervical spine posture of skeletal class malocclusion in adolescent with maxillary protraction. Thirty cases of skeletal class malocclusion were randomly selected from the Stomatological Hospital of Shanxi Medical University. High-quality lateral cephalograms were collected including pre- and posttreatment to compare the changes of head and cervical spine posture. Data were processed using SPSS 26.0 statistical software. The paired-t test was used to compare pre- and posttreatment mean angular measurements.A significant difference in the SNA(p<0.001), SNB(p<0.01), and ANB(p<0.001) between T1 and T2 showed an improvement in the sagittal relationships. A significant change was observed in middle cervical spine posture, while upper cervical spine posture variables showed no significant difference after treatment. Skeletal class with maxillary protraction appliance not only led to the improvement of sagittal relationship, but also changed the middle cervical spine posture.

El objetivo de este estudio fue evaluar los cambios en la postura de la cabeza y la columna cervical debido a la maloclusión clase esquelética en adolescentes con protracción maxilar. Treinta casos de maloclusión de clase esquelética fueron seleccionados al azar del Hospital Estomatológico de la Universidad Médica de Shanxi. Se recogieron cefalogramas laterales de alta calidad, incluidos el tratamiento previo y posterior, para comparar los cambios en la postura de la cabeza y la columna cervical. Los datos se procesaron con el software estadístico SPSS 26.0. Se utilizó la prueba t pareada para comparar las medidas angulares medias antes y después del tratamiento. Una diferencia significativa en SNA (p <0,001), SNB (p <0,01) y ANB (p <0,001) entre T1 y T2 mostró una mejora en las relaciones sagitales. Se observó un cambio significativo en la postura de la columna cervical media, mientras que las variables de postura de la columna cervical superior no mostraron diferencias significativas después del tratamiento. La clase esquelética con aparato de protracción maxilar no solo condujo a la mejora de la relación sagital, sino que también cambió la postura de la columna cervical media.

Effect of therapeutic exercise on functional disability and quality of life in patients with forward head posture and neck pain: a meta-analysis / 中国康复理论与实践

ObjectiveTo systematically analyze the effect of therapeutic exercise on neck function and quality of life in patients with neck pain and forward head posture. MethodsRandomized controlled trials about the effects of exercise training on forward head posture and neck pain were searched from PubMed, Web of science, Embase, Medline, Science Direct, EBSCO, Springlink, CNKI, VIP, and Wanfang Data from database establishment to April, 2022. The literature was screened by two researchers independently. Cochrane bias risk assessment tool and Physiotherapy Evidence Database Scale were used to evaluate the quality of the included articles. Revman 5.4 software was used for meta-analysis. ResultsA total of 416 patients from eleven literatures were included. Level 1a evidence indicated scapula stability training could effectively improve cranial vertebral angle (MD = 3.62, 95%CI 2.41 to 4.83, P < 0.001), and relieve pain (MD = 1.32, 95%CI 0.18 to 2.46, P = 0.02). Level 1b evidence indicated scapula stability training could reduce functional disability (MD = -0.92, 95%CI -1.11 to -0.74, P < 0.001). Level 1b evidence indicated deep cervical flexor training could improve cranial vertebral angle (MD = -0.83, 95%CI -1.56 to -0.10, P = 0.03), relieve pain (MD = 0.93, 95%CI 0.54 to 1.32, P < 0.001), and improve neck functional disability (MD = 2.17, 95%CI 1.39 to 2.95, P < 0.001). ConclusionScapula stability training and deep cervical flexor training can effectively improve cranial vertebral angle, relieve neck pain, and improve neck function.

Efeito da manipulação visceral na postura da cabeça para frente em sujeitos com dor pescoço crônica não específica - um estudo piloto / Effect of visceral manipulation on forward head posture in subjects with chronic non-specific neck pain ­ a pilot study

INTRODUÇÃO: A postura anterior da cabeça é considerada o desequilíbrio postural musculoesquelético mais comum, causando protrusão da cabeça anterior ao tronco. Os órgãos internos são interconectados e fixados posteriormente à coluna por meio das membranas de suporte. A tensão nessas membranas de suporte pode ainda causar restrições mecânicas, afetando a mobilidade do órgão visceral e a estrutura musculoesquelética associada em um mecanismo de mão dupla. OBJETIVO: Explorar o efeito da manipulação visceral específica de órgão na postura, incapacidade, força e dor em indivíduos com dor cervical crônica inespecífica. De acordo com a hipótese deste estudo, a manipulação visceral tem como objetivo explorar o efeito da manipulação da fáscia específica do órgão na postura, incapacidade, força e dor em indivíduos com dor cervical crônica inespecífica. MATERIAL E MÉTODO: cinco indivíduos com dor cervical inespecífica crônica com postura anterior da cabeça foram recrutados usando o método de amostragem de conveniência. Este estudo foi conduzido em um departamento de Fisioterapia de um hospital multi-especializado reconhecido, Mohali. Os indivíduos foram encaminhados após o diagnóstico de dor cervical crônica dos departamentos. Uma única sessão de manipulação visceral placebo foi administrada na primeira semana, seguida de uma única sessão de manipulação visceral da cúpula pleural e ligamentos pericárdicos na segunda semana. Aplicação móvel de tela de postura (postura), unidade de biofeedback de pressão (ativação muscular), Índice de Incapacidade Pescoço e Escalas Visuais Analógicas foram utilizados para medir os resultados pré e pós. RESULTADO: a comparação entre os grupos do desfecho mostrou diferença estatisticamente significativa na EAV (p = 0,001), aplicação da triagem postural (p = 0,02) e NDI (p = 0,07). Não foram observadas mudanças significativas no desfecho força. CONCLUSÃO: Sessão única de manipulação visceral da cúpula pleural e ligamentos pericárdicos pode se beneficiar na melhora da postura anterior da cabeça, incapacidade cervical e redução da dor.

INTRODUCTION: Forward head posture is considered to be the most common musculoskeletal postural imbalance causing protrusion of head anterior to trunk. Internal organs are interconnected and attached posteriorly to the spine through the support membranes. Tension in these support membranes may further cause mechanical restrictions, thereby affecting the mobility of the visceral organ and associated musculoskeletal structure in a two-way mechanism. OBJECTIVE: To explore the effect of organ-specific visceral manipulation on posture, disability, strength, and pain in subjects with chronic non-specific neck pain. According to this study hypothesis visceral manipulation aim to explore the effect of organ-specific fascia manipulation on posture, disability, strength, and pain in subjects with chronic non-specific neck pain. MATERIAL AND METHOD: Five subjects with chronic non-specific neck pain with forwarding head posture were recruited using a convenience sampling method. This study was conducted in a Physiotherapy department of a recognized multispecialty hospital, Mohali. Subjects were referred after diagnosis from chronic neck pain from the departments. A single session of placebo visceral manipulation was administered in the first week, followed by a single session of visceral manipulation of the pleural dome and pericardial ligaments in the second week. Posture screen mobile application (posture), Pressure biofeedback unit (muscular activation), Neck Disability Index, and Visual Analog Scales were used to measure the pre and post outcomes. RESULT: Between-group comparison of the outcome showed a statistically significant difference in the VAS (p=0.001), Posture screening application (p=0.02), and NDI (p=0.07). No significant changes were observed in the strength outcome. CONCLUSION: Single session of visceral manipulation for the pleural dome and pericardial ligaments may benefit in improving the forward head posture, neck disability and reducing the pain.

Efecto del entrenamiento de fuerza con característica socializadora y lúdica sobre la depresión en adultos mayores con anteposición de cabeza y cuello / Effect of strength training with socializing and playful characteristics on depression in older adults with forward head posture

RESUMEN Objetivo: El propósito de este estudio fue evaluar el efecto de un entrenamiento de fuerza con característica socializadora y lúdica sobre la depresión en adultos mayores con anteposición de cabeza y cuello de la ciudad de Talca (Chile). Material y métodos: Este estudio longitudinal se realizó en Club del Adulto Mayor de la ciudad de Talca. Participaron 132 sujetos que se dividieron en tres grupos de 44: dos grupos experimentales y un grupo control. A un grupo experimental se aplicó entrenamiento de fuerza convencional para la anteposición de cabeza y cuello; al otro grupo experimental se le realizó entrenamiento de fuerza con característica socializadora y lúdica; al grupo control se le realizó una evaluación inicial y final. Se aplicaron 2 sesiones semanales durante 4 meses a ambos grupos experimentales. Todos los participantes cumplieron los criterios de inclusión y exclusión: adultos mayores > 60 años, ángulo craneovertebral < 50 grados, índice de masa corporal con sobrepeso y obesidad tipo 1, sin patologías de columna vertebral. Resultados: Hubo cambios estadísticamente significativos en el grupo que recibió entrenamiento de fuerza con característica socializadora y lúdica sobre la disminución de la depresión (P < 0.05), y se obtiene un promedio de 3.6 puntos de disminución de la escala de depresión posterior a los 4 meses de entrenamiento. Conclusión: El entrenamiento de fuerza con característica socializadora y lúdica fue efectivo en un 72 % en la disminución de la depresión en los adultos mayores con anteposición de cabeza y cuello de la ciudad de Talca.

ABSTRACT Objective: The purpose of the study was to evaluate the effect of strength training with a socializing and playful characteristic on depression in older adults with forward head posture in the city of Talca (Chile). Material and methods: This longitudinal study was carried out in the Senior Adult Club of the city of Talca. 132 subjects participated, which were divided into three groups of 44: two experimental groups and one control group. Conventional strength training for forward head posture was applied to one experimental group, the other experimental group underwent strength training with socializing and playful characteristics, the control group underwent an initial and final evaluation. Two weekly sessions were carried out for 4 months in both experimental groups. All the participants fulfilled the inclusion and exclusion criteria: older adults > 60 years, craniovertebral angle < 50 degrees, body mass index with overweight and type 1 obesity, without spinal pathologies. Results: There were statistically significant changes in the group that received strength training with a socializing and playful characteristic on the decrease in depression (P <0.05), obtaining an average of 3.6 points of decrease in the depression scale after 4 months of training. Conclusion: Strength training with a socializing and playful characteristic was 72 % effective in reducing depression in older adults with forward head posture in the city of Talca.

Assessment and Comparison of the Head Posture and Craniofacial Growth in Vertical Dimension- A Cephalometric Study.

The aim of the present study was to examine as to whether any association can be found between the head posture and the craniofacial growth in the vertical direction.METHODSThe sample comprised of 150 subjects in the age group of 18 - 25 years and were further divided into three groups. These groups were classified into hypodivergent, normodivergent, and hyperdivergent according to the sella-nasion (SN) mandibular plane angle. The head posture was measured by calculating craniocervical and cervicohorizontal postural variables, recorded from the lateral cephalograms taken with the subjects standing with the head in the natural head position.RESULTSA clear pattern of association was found between the head posture and the vertical growth pattern. An extended head posture was seen in hyperdivergent group and flexion of the head was seen in hypodivergent group when compared to normodivergent cases (P<0.05, P<0.01). The findings were in agreement with the soft tissue stretching hypothesis according to which stronger forces are exerted on the facial skeleton whenever there is an increase in the tension in the soft tissue layer. When these forces are active for a long time during growth, they might restrict the growth of the maxilla and the mandible in forward direction and redirect it in a more caudal direction. Such a mechanism could explain the association between the extension of the head and the development of facial skeleton and in particular, the mandible.CONCLUSIONSThe cervical vertebral column area should be evaluated in routine cephalometric analysis and any deviation in the cervical column morphology and head posture should be registered. These registrations may prove useful when considering the diagnosis and evaluating the etiology, especially in patients with severe skeletal malocclusion and obstructive sleep apnea.

The Effects Of Smartphone Addiction On Childrens Cervical Posture And Range Of Motion

Background: This study examined the effects of smartphones addiction on cervical posture, and compared the cervical range of motion (ROM) between addicted and non-addicted boys and girls 8 to 13 years of age. Methods: Twenty-four boys and 26 girls were assigned to 2 groups; addicted group (score > 32, n=32) and non-addicted group (score ≤ to 32, n=18). Craniovertebral Angle (CVA) was assessed using side view photographs, forward head posture (FHP) was measured using ImageJ 64 software, and cervical ROM in each direction was measured using a cervical (CROM) device. Results: A forward multiple regression showed that addiction score and body mass index (BMI) were significant predictors of CVA (R2 =0.31, p<0.001). Twenty-three percent of the variability in CVA was related to addiction score. A forward logistic regression showed that addiction to smartphone use and BMI were significant predictors of having FHP, and participants who were addicted were more than four times as likely to have FHP than those who were not: Odds Ratio (OR) with 95 % confidence interval (CI)=4.5 (1.2, 10.7), p= 0.03. A significant reduction was found in mean cervical angle in addicted versus non-addicted boys (49.4±6.7 vs. 55.5±7.6,η2=0.5, p=0.03) and girls (47.3±6.3 vs. 52.9±6.1,η2=0.9, p=0.02). A significantly more limited cervical ROM found in most neck movements in addicted participants with FHP compared to participants without FHP. Conclusion: Children who are addicted to smartphones may develop faulty habitual posture due to constant neck flexion downward, which may place them at high risk of spine abnormalities.

Comparison of Vital Capacity and Balance between Elderly Women and Young Women with Forward Head Postures According to the Use of Figure-8 brace

PURPOSE: To improve pulmonary function and decrease in balance ability with increasing forward head position and vertebral curvature, we applied Figure-8 brace to confirm the immediate effect on vital capacity and balance and to see if it is applicable. METHODS: A total of 34 elderly women aged 65 or older and young women in their 20s with FHP were screened to measure vital capacity, measuring the forced expiratory volume in 1 second (FEV1) and forced vital capacity (FVC), and measuring the foot pressure to see the change in balance. For statistical analysis, the difference between pre and post values was compared using pared t-test. RESULTS: As a result of vital capacity measurements, there was no significant difference between FEV1 and FVC for women over 65 years old (p>0.05). Young women in their 20s had no significant difference in FEV1 (p>0.05), and FVC had significant differences (p<0.05). In measuring foot pressure to measure balance, both women aged 65 and above and young women in their 20s had a significant decrease in anterior foot pressure, and a significant increase in posterior foot pressure (p<0.05). CONCLUSION: The results of this study did not positively affect the vital capacity of elderly women with FHP. However, the significant increase in vital capacity of young women in their 20s suggests that contraction of the abdominal muscle is necessary during forced expiration. Therefore, it is believed that proper application and therapeutic interventions should be combined when applying Figure-8 brace.

The Effect of Postural Correction and Visual Feedback on Muscle Activity and Head Position Change During Overhead Arm Lift Test in Subjects with Forward Head Posture

PURPOSE: This study aimed to investigate the immediate effects of posture correction and real-time visual feedback using a video display on muscle activity and change of head position during overhead arm lift test in individuals with forward head posture. METHODS: Fifteen subjects with forward head posture and fifteen normal subjects who volunteered were included in this study. During both groups performed the overhead arm lift test, the muscle activity of the upper trapezius, serratus anterior, sternocleidomastoid, and lower trapezius muscle were measured using electromyography, and head position change was measured using photographs. Then, forward head posture group was asked to perform overhead arm lift test again after posture correction and real-time visual feedback using a video display respectively. One-way analysis of variance (ANOVA) was used to analyze four conditions: pre-test, posture correction, real-time visual feedback, and the control group. RESULTS: The upper trapezius and lower trapezius muscle activity significantly decreased posture correction, real-time visual feedback, and control group than pre-test of forward head posture group (p<0.05). The sternocleidomastoid muscle significantly decreased real-time visual feedback and control group than pre-test of forward head posture group. Head position change significantly decreased three conditions than pre-test of forward head posture group and real-time visual feedback and control group significantly decreased than posture correction. CONCLUSION: This study recommend for maintaining cervical stability during the overhead arm lift test, postural control using real-time visual feedback is more effective in subjects with forward head posture.

Relation of head posture and occlusal contact area using photo occlusion analysis

PURPOSE: Previous studies related with occlusal contact area were limited that interocclusal thickness level or the method of measurement has not been accurate in measuring. The purpose of this study was to investigate the relation between head posture and occlusal contact area using photo occlusion analysis. MATERIALS AND METHODS: 54 subjects with complete dentition (44 men, 10 women / 23 to 33 years of age) were included. To identify the relationship between head posture and occlusal contact area, subjects took interocclusal record in maximal intercuspal position with three different positions(supine position (0°) / inclined position (45°) / upright position (90°)) on the dental unit chair. Occlusal contact area was analyzed using photo occlusion analysis. Statistical analyses were performed with SPSS ver.25.0 at 95% confidence interval. RESULTS: Head posture has no significant effect on the changes of occlusal contact area (P > 0.05). CONCLUSION: When interocclusal relation is stable, head posture does not change a interocclusal record because head posture has no significant effect on occlusal contact area. Analysis of occlusal contact area using photo occlsion analysis device is useful due to its material property and simplicity.

Relación de las anomalías dentomaxilo-faciales sagitales con la postura corporal y el apoyo plantar / The relationship of sagittal dentomaxillofacial anomalies with body posture and plantar support

Introducción: la evaluación integral de los problemas posturales, el apoyo plantar y su influencia en los problemas maxilo-mandibulares implica un análisis del aparato estomatognático en relación biomecánica con todo el cuerpo humano, con visión multidisciplinaria. Objetivo: determinar la posible relación de las anomalías maxilo-mandibulares en el plano sagital con la postura corporal y apoyo plantar en estudiantes de séptimo grado de la ESBU "Eduardo Anoceto Rega", de la ciudad de Santa Clara. Materiales y métodos: estudio descriptivo­transversal de octubre a marzo del 2016-2017. El universo fueron 150 estudiantes de séptimo grado de la ESBU "Eduardo Anoceto Rega", en las edades de 12 y 13 años. La muestra 42 estudiantes seleccionados por un muestreo intencional y agrupados según el tipo de anomalía maxilo-mandibular sagital en síndrome de clase I, II y III. Se diseñó un modelo de consentimiento informado que estableció el compromiso de colaboración de los casos seleccionados. Se utilizó la prueba estadística Chi Cuadrado y se calculó el coeficiente V de Cramer. Resultados: predominaron los pacientes con postura corporal y apoyo plantar incorrectos, el mayor porcentaje fue de pies planos en las anomalías de clase II. Alta significación con predominio de pies valgos en los síndromes de clase II y pies varos en los síndromes de clase III. Conclusiones: se constató una relación entre la postura corporal incorrecta, alteraciones plantares y los síndromes de clase II y III (AU).

Introduction: The comprehensive evaluation of postural problems, plantar support and their influence on the maxilla-mandibular problems implies an analysis of the stomatognathic system, in biomechanical relation with the entire human body, from a multidisciplinary point of view. Objective: to determine the possible relationship of the maxilla-mandibular anomalies in the sagittal plane with body posture and plantar support, in seventhgrade students of the junior high school ¨Eduardo Anoceto Rega¨, of Santa Clara. Materials and methods: a descriptive, cross-sectional study carried out from October 2016 to March 2017. The universe were 150 seventh-grade students of the junior high school ¨Eduardo Anoceto Rega¨, aged 12 and 13 years. The sample was 42 students chosen by intentional sampling, grouped according to the type of sagittal maxilla-mandibular anomaly as Class I, II and III syndrome. A form of informed consent was elaborated establishing the collaboration compromise of the chosen cases. The chi squared statistical test was used and Cramer´s V coefficient was calculated. Results: Patients with incorrect body posture and plantar support predominated, the highest percent corresponding to valgus foot in class II syndromes and clubfeet in class III syndromes. Conclusions: a relationship between incorrect corporal posture, plantar alterations and class II and III syndromes (AU).

Breathing mode influence on craniofacial development and head posture / Influência do modo de respiração sobre o desenvolvimento craniofacial e a postura da cabeça

Abstract Objective The incidence of abnormal breathing and its consequences on craniofacial development is increasing, and is not limited to children with adenoid faces. The objective of this study was to evaluate the cephalometric differences in craniofacial structures and head posture between nasal breathing and oral breathing children and teenagers with a normal facial growth pattern. Method Ninety-eight 7-16 year-old patients with a normal facial growth pattern were clinically and radiographically evaluated. They were classified as either nasal breathing or oral breathing patients according to the predominant mode of breathing through clinical and historical evaluation, and breathing respiratory rate predomination as quantified by an airflow sensor. They were divided in two age groups (G1: 7-9) (G2: 10-16) to account for normal age-related facial growth. Results Oral breathing children (8.0 ± 0.7 years) showed less nasopharyngeal cross-sectional dimension (MPP) (p = 0.030), whereas other structures were similar to their nasal breathing counterparts (7.6 ± 0.9 years). However, oral breathing teenagers (12.3 ± 2.0 years) exhibited a greater palate length (ANS-PNS) (p = 0.049), a higher vertical dimension in the lower anterior face (Xi-ANS-Pm) (p = 0.015), and a lower position of the hyoid bone with respect to the mandibular plane (H-MP) (p = 0.017) than their nasal breathing counterparts (12.5 ± 1.9 years). No statistically significant differences were found in head posture. Conclusion Even in individuals with a normal facial growth pattern, when compared with nasal breathing individuals, oral breathing children present differences in airway dimensions. Among adolescents, these dissimilarities include structures in the facial development and hyoid bone position.

Resumo Objetivo A incidência da respiração anormal e de suas consequências no desenvolvimento craniofacial aumenta e não é limitada a crianças com fácies adenoideanas. O objetivo deste estudo foi avaliar as diferenças cefalométricas nas estruturas craniofaciais e na postura da cabeça entre crianças e adolescentes com respiração nasal e respiração bucal com padrão de crescimento facial normal. Método 98 pacientes com idades entre 7-16 anos com padrão de crescimento facial normal foram avaliados de forma clínica e radiológica. Eles foram classificados como pacientes com respiração nasal ou respiração bucal de acordo com a predominância do modo de respiração por meio da avaliação clínica e histórica e da predominância da frequência respiratória conforme qualificado por um sensor de fluxo de ar. Os pacientes foram divididos em duas faixas etárias (G1: 7 a 9) (G2: 10 a 16) para contabilizar o crescimento normal facial relacionado à idade. Resultados As crianças com respiração bucal (8,0 ± 0,7 anos) mostraram menor dimensão transversal nasofaríngea (MPP) (p = 0,030), ao passo que outras estruturas foram semelhantes a seus pares com respiração nasal (7,6 ± 0,9 anos). Contudo, os adolescentes com respiração bucal (12,3 ± 2,0 anos) mostraram maior comprimento do palato (espinha nasal anterior-espinha nasal posterior [ENA-ENP]) (p = 0,049), maior dimensão vertical na menor face anterior (Xi-ENA-Pm) (p = 0,015) e menor posição do osso hioide a respeito do plano mandibular (H-PM) (p = 0,017) do que seus pares com respiração nasal (12,5 ± 1,9 anos). Não foram constatadas diferenças estatisticamente significativas na postura da cabeça. Conclusão Mesmo em indivíduos com padrão de crescimento facial normal, em comparação com indivíduos com respiração nasal, as crianças com respiração bucal apresentam diferenças nas dimensões das vias aéreas. Entre os adolescentes, essas dissimilaridades incluem estruturas no desenvolvimento facial e na posição do osso hioide.

The Effect of Forward Head Posture and Tension Type Headache on Neck Movement: For Office Worker

PURPOSE: This study examined the effects of the forward head posture and tension type headache on neck movement among office workers. METHODS: The subjects were 6 male and 21 female patients composed of a forward head posture group, forward head posture group with a tension type headache and a normal group. Each group consisted of 2 males and 7 females. The cranio-vertebral angle of the head and the angle of motion of the neck were measured. SPSS 23.0 was used for data analysis and one-way ANOVA was performed for the mean comparison of the neck movements in the three groups. RESULTS: The participants had a limitation in the movement of all necks between the forward head posture group and forward head posture with tension type headache group compared to the normal subjects. The forward head posture with tension headache group had limited neck extension and lateral bending compared to the forward head posture group. CONCLUSION: Office workers have limitations in the movement of the neck when they are accompanied by forward head posture and tension headache. In particular, when accompanied with a tension headache, there is a restriction on the neck extension and side bending. This study is expected to provide basic data for the relief of tension headache and the treatment of forward head posture in office workers.

Effect of Scapular Brace on the Pulmonary Function and Foot Pressure of Elderly Women with Forward Head Posture

PURPOSE: Changes in the curvature of the vertebral columns of elderly women with increasing age causes various side effects and disorders. Therefore, this study was conducted to evaluate the effectiveness of the 8-figure scapular brace to improve pulmonary function and balance ability based on lung capacity and foot pressure by increasing the vertebral curvature. METHODS: Seventeen elderly women with a forward head posture were selected. Women were asked to wear the 8-figure scapular brace and the forced expiratory volume in 1 second (FEV1) and forced vital capacity (FVC) were measured, as were changes in foot pressure. Measurements were conducted three times each and the mean values were used for subsequent analyses. For static evaluation, we used the paired t-test to identify differences between pre and post values. RESULTS: There was no significant difference in FEV1 and FVC before and after use of the brace (p>0.05); however, there was a significant decrease in forefoot pressure and an increase in rearfoot pressure following application of the brace (p < 0.05). CONCLUSION: Application of the 8-figure scapular brace to correct vertebral curvature in elderly women influenced pressure distribution change from immediate effect body arrange of cervical and thoracic. However, wearing the 8-figure scapular brace may interfere with expansion of the chest and therefore respiratory muscle activity. Accordingly, it is necessary to apply appropriate treatment when wearing a scapular brace and to allow a sufficient intervention period while also providing therapeutic interventions such as posture correction or respiration training.

The Effect of Visual Feedback of Head Angles With Using a Mobile Posture-Aware System on Craniocervical Angle and Neck and Shoulder Muscles Fatigue During Watching the Smartphone

PURPOSE: To find the effect of visual feedback of head angle with using a mobile posture-aware system on craniocervical angle and neck and shoulder muscles fatigue for preventing or decreasing the forward head posture. METHODS: Twenty-four healthy young adults in Chungbuk to participate in this study. The subjects started to watch a movie clip for 10 minutes with visual feedback in 0°, 30°, and 60° of head angles. During the task, surface electromyography (EMG) was used to collect data from the upper trapezius (UT), sternocleidomasetoid muscle (SCM), cervical erecter spinae (CES) during watching the smartphone. Craniocervical angles were measured using a sagittal-view photograph of the subject in a sitting posture. A one-way repeated analysis of variance with a significant level of 0.05 used for statistical analysis. RESULTS: Craniocervical angle with 0° visual feedback was significantly greater than 30°and 60°. Craniocervical angle with 30° visual feedback was significantly greater than 60°. In addition, MDF of UT muscles in 0° and 30° of visual feedback was significantly greater than 60°. CONCLUSION: We concluded that 0° visual feedback of head angle with using a mobile posture-aware system would be beneficial to prevent or decrease forward head posture during watching a smartphone. We also could recommend using of 30° visual feedback in case of caring UT muscle fatigue primarily.

To study correlation between neck pain and cranio-vertebral angle in young adults

Introduction: Neck pain is a common disorder. Poor posture might result in muscular imbalance that causes a faulty relationship among various body parts. Forward head posture is one of the most common cervical abnormalities that predispose individuals toward pathological conditions, such as headache, neck pain, and temporomandibular disorders. Aim: The aim of the study was to find the relationship between CV angle and neck pain. Materials and method: 50 patients were evaluated and included in the study. They were evaluated for pain using Numerical Pain Rating Scale (NPRS) and the forward head posture was assessed by measuring CV angle. The total duration of the study was 6 months. Analysis was done using SPSS Version 20. Results: Spearman’s correlation test was used to find correlation between CV angle and neck pain and the r value was found to be -0.731 with the level of significance 0.01. Conclusion: A moderate to good negative correlation was found between CV angle and neck pain.

Effect of Self-Postural Control with Visual Feedback in the Foot Pressures in the Subject with Forward Head Posture

PURPOSE: The purpose of this study was to investigate the effect of self-postural control on foot pressure in subjects with forward head posture. METHODS: Forty-two healthy adults were recruited in this study. Participants were divided into two groups: The forward-head postural (FHP) group (craniovertebral angle0.05). CONCLUSION: We suggest that cervical posture control using visual feedback has a positive effect on the distribution of foot pressure in subjects with forward head posture.

Correlation of non-traumatic neck pain with cervical angle and shoulder retractor power in adult clerical population.

Background: A forward head posture (or chin poking) is perhaps the most common abnormality associated with NP and is commonly defined as the protrusion of the head in the sagittal plane so that the head is placed anterior to the trunk. Forward head posture can occur because of an anterior translation of the head, lower cervical flexion, or both, and it is claimed to be associated with an increase in upper-cervical extension. It is suggested that forward head posture leads to an increase in the compressive forces on the cervical apophyseal joints and posterior part of the vertebra and to changes in connective tissue length and strength (because of stretching of the anterior structures of the neck and shortening of the posterior muscles) resulting in pain. The objective of the study was to correlate neck pain with cervical angle and shoulder retractor power in non-traumatic neck pain patients. Methods: 50 clerical workers having non traumatic neck pain were included. Neck pain was measured on VAS, cervical angle was measured using photometric method and shoulder retractor power was measured. Results: VAS showed moderate positive correlation with cervical angles (0.63 and 0.72) and moderate negative correlation with shoulder retractor power (-0.59 and -0.71). A moderate positive correlation of craniocervical angle to VAS seen (0.66) whereas there was negative correlation with shoulder retractors I and II (-0.59 and -0.61) A positive correlation was seen between VAS and craniocervical angle but is moderately negative with shoulder retractors I (Rhomboids) and II (Middle trapezius) (0.78, 0.04, -0.69 and -0.64). Conclusion: A moderate increase in cranio vertebral & craniocervical angle showed plausible weakness in lower Trapezius and rhomboids among clerks` having Non-traumatic neck pain.

Long-Term Outcome and Recurrence of Abnormal Head Posture after Surgery in Patients with Nystagmus

PURPOSE: To evaluate the long-term outcome and recurrence of abnormal head posture after modified Kestenbaum surgery in patients with nystagmus. METHODS: The medical records of 46 patients who underwent modified Kestenbaum procedure in horizontal recti muscles for nystagmus with abnormal head turn were retrospectively reviewed. We assessed the effect of surgery by comparing preoperative and postoperative clinical data such as visual acuity (log MAR) and degree of head turn. A reoperation or abnormal head turn of 10degrees or more at final visit were defined as recurrence. Patients were divided into 2 groups according to the presence of recurrence or reoperation. Clinical factors associated with recurrence or reoperation were compared between the 2 groups. RESULTS: The mean visual acuity was 0.38 in the better eye and 0.42 in the worse eye before surgery, which improved to 0.15 and 0.21 after surgery (each p < 0.001), with a mean follow-up period of 124 months. The mean degree of head turn was 41.41degrees preoperatively and was changed to 2.61degrees postoperatively (p < 0.001). The recurrence rate was 23.9% and the reoperation rate was 10.9%. Mental retardation, amblyopia, preoperative visual acuity, degree of head turn, and presence of strabismus were not associated with recurrence or reoperation. The mean age at first surgery was significantly lower in the reoperation group (p = 0.009). The mean visual acuity in the better eye at postoperative 6 months and in better and worse eyes at postoperative 1 year was significantly worse in the reoperation group (p = 0.034, 0.012 and 0.009, respectively). CONCLUSIONS: The visual acuity and head turn was improved after modified Kestenbaum surgery in patients with nystagmus and abnormal head posture. The reoperation rates were associated with earlier age of first operation and worse postoperative visual acuity. However, further prospective studies are necessary to clarify these factors.

Design and Efficacy of Surgery for Horizontal Idiopathic Nystagmus with Abnormal Head Posture and Strabismus / 华中科技大学学报（医学）（英德文版）

The design and efficacy of surgery for horizontal idiopathic nystagmus (HIN) with abnormal head posture and strabismus were investigated.Different surgical procedures were selected according to the angle of head tum in 44 cases of HIN with abnormal head posture and strabismus.For patients with a head turn of 15° or less,the Anderson procedure was used; the yoke muscles were recessed upon slow-phase.For patients with a head turn between 15° and 25°,the surgery was designed as a Kestenbaum 5-4-4-5 procedure.For patients with a head turn of 25° or more,the surgery was designed as a Parks 5-8-6-7 procedure.The surgery to correct the abnormal head posture was performed on the fixating eye while that to correct the deviation was then performed on the non-fixating eye at the same time.The amount of surgery of the horizontal rectus muscles on the non-fixating eye was sum of the angle of head turn and the degree of deviation,which was calculated as follows:recession/resection amount of medial and lateral rectis/2× 5=angle of head turn±degree of deviation.The results showed as follows:(1)Visual acuity:the visual acuity in the primary ocular position increased two lines or more in 35 patients,accounting for 79.55％.Nine patients had no or only one-line improvement,accounting for 20.45％ of the entire study population; (2) The degree of deviation in the primary ocular position:37 cases had a normal primary ocular position or the degree of deviation ≤8Δ after surgery,accounting for 84.09％.Six patients had a residual degree of deviation of 8Δ-15△,accounting for 13.64％.One patient had a residual degree of deviation ＞20Δ,accounting for 2.27％ of the patients examined; (3) Abnormal head posture:34 patients had a normal head posture or a head turn of less than 5°,accounting for 72.27％.Eight patients had a residual head turn of 5°-15°,accounting for 18.18％.Two patients had a head turn of 15°- 25°,accounting for 4.55％.It was concluded that different surgical procedures based on the angle of head tum and the relationship between deviation and null zone can eliminate anomalous head posture,correct deviation,and improve vision acuity in the primary ocular position simultaneously.

Reproducibility and reliability of head posture obtained by the outer canthus indicator / 대한치과교정학회지

OBJECTIVE: The purposes of this study were to evaluate the reproducibility and reliability of head posture obtained by registering outer canthus as a soft tissue landmark with the Outer Canthus Indicator (OCI). METHODS: Twenty-one adults with normal facial morphology were enrolled in this study (mean age 27.5 +/- 1.72 years). To register initial head posture, height of the outer canthus from the ear rod plane was measured using OCI. Head posture was reproduced by moving the head upwards and downwards until the outer canthus was in a straight line with the indicator set at a registered height. After the head posture is reproduced by two operators after two days, lateral photographs were taken. Computerized photometric analyses of the photographs were performed. RESULTS: The head rotations around the transverse axis were 0.69 +/- 0.43degrees, 0.98 +/- 0.65degrees from each of the two operators. Standard errors were 0.09degrees and 0.14degrees each, which were similar to results from past research findings. There were no significant differences between the data from the two operators (p > 0.05). There were no correlations between the head rotation around the horizontal and vertical axes (p > 0.05). CONCLUSIONS: The present study suggests that OCI-registered head posture may minimize errors from vertical head rotation in cephalometry and photometry.