Evaluation of the Craniovertebral Angle in Standing versus Sitting Positions in Young Adults with and without Severe Forward Head Posture.

The purpose of this study was to examine the effects of standing versus sitting body position on the craniovertebral angle (CVA) in young adults without pathology; and to investigate whether mean differences between positional CVA measures in subjects with severe forward head posture (FHP) are distinct from age-matched controls with normal head posture. Ninety-eight young adults (68 women, 30 men) without pathology (OVERALL; n = 98) volunteered for the study; those with CVA > 53° were also included in a normal posture group (NORM; n = 14); those with CVA < 45° were also included in a severe FHP group (SEV; n = 15). CVA assessments were conducted in standing and sitting. Mean difference comparison of change in mean CVA between conditions revealed significantly (p < 0.05) higher CVA values in standing condition (OVERALL: 50.0 ± 5.2°; NORM: 56.6 ± 2.7°; SEV: 41.2 ± 3.2°) compared to sitting condition (OVERALL: 47.8 ± 5.7°; NORM: 55.9 ± 2.8°; SEV: 39.0 ± 4.0°). Mean difference comparison of between-group change in mean CVA between conditions revealed greater CVA change (p < 0.05) in the SEV group (2.2 ± 2.1°) versus the NORM group (0.8 ± 1.2°). Sitting CVA values may be lower (indicating greater FHP) than standing CVA values in young adults. Differences between standing and sitting CVA measures may be greater in young adults with severe FHP compared to peers with normal head posture. Study findings support standing as a standardized body position for CVA assessment in young adults without pathology.

The Effects of Postural Education or Corrective Exercise on the Craniovertebral Angle in Young Adults with Forward Head Posture: A Randomized Controlled Trial.

The purpose of this study was to compare the effects of three different intervention strategies, postural education (PE) and two corrective exercise programs (CEPs), on the craniovertebral angle (CVA) in young adults with forward head posture (FHP). A prospective four-arm parallel randomized controlled trial with repeated measures was performed. Seventy-nine healthy young adults (55 women, 24 men; mean age: 20.08 ± 2.19 years) with FHP were randomized into four groups: PE group, self-myofascial release + stretching group (SMRS), self-myofascial release + stretching + strengthening group (SMRSS), and a control group (CG). Participant CVA (°) was assessed before and after a 4-week intervention. Seventy-two participants completed the trial. Mean difference comparisons of within-group change in mean CVA revealed an increase in the PE (MD = 3.1, p < .01), SMRS (MD = 3.8, p < .01), and SMRSS (MD = 4.4, p < .01) groups. Mean difference comparison of between-group change in mean CVA supported greater CVA change in the SMRS and SMRSS groups compared to the CG (F(3, 68) = 5.26, p < .01, η2 = .188). All three interventions appear to be effective techniques for improving FHP in young adults, however CEPs may provide superior outcomes than PE alone. A 4-week CEP consisting of self-myofascial release + stretching may yield similar CVA enhancements as a CEP consisting of self-myofascial release + stretching + strengthening. Study findings can assist fitness professionals in designing evidence-based FHP intervention programs for young adults.

Evidence-Based Corrective Exercise Intervention for Forward Head Posture in Adolescents and Young Adults Without Musculoskeletal Pathology: A Critically Appraised Topic.

CLINICAL SCENARIO: Habitual overuse of cellphones is on the rise among adolescents and young adults. Those who maintain a flexed neck posture when using a cellphone for extended periods possess an elevated risk for developing forward head posture (FHP). Chronic FHP can lead to painful medical disorders affecting the head, neck, and shoulders. Both stretching and strengthening exercises are advocated interventions to address this postural abnormality; however, due to a wide range of corrective exercise programming in the literature, the decision for which exercises to prescribe for this condition can be challenging for clinicians. CLINICAL QUESTION: For adolescents and young adults without musculoskeletal pathology, what are the most frequent stretching and strengthening exercises incorporated into effective FHP intervention programs supported by current randomized control trials? SUMMARY OF KEY FINDINGS: A combined total of 5 stretches and 8 strengthening exercises were identified across 3 studies of level 1b evidence that successfully impacted FHP using a combined stretching and strengthening corrective exercise intervention. The supine chin tuck and a sternocleidomastoid stretch were utilized in all 3 studies, while scapular retraction and a pectoralis stretch were included in 2 of the 3 studies. CLINICAL BOTTOM LINE: Based on the results of this appraisal, the most frequent stretches and strengthening exercises incorporated into effective FHP intervention programs supported by current randomized control trials focused on adolescents or young adults without musculoskeletal pathology include a sternocleidomastoid stretch, pectoralis stretch, the supine chin tuck, and scapular retraction. STRENGTH OF RECOMMENDATION: There is "Good" to "Excellent" evidence from 3 level 1b randomized control trials to support the inclusion of a sternocleidomastoid stretch, pectoralis stretch, the supine chin tuck, and scapular retraction exercises into a corrective exercise program to address forward head posture.

Electromyographic response of the abdominal musculature to varying abdominal exercises.

This study examined the electromyographic (EMG) response of the upper rectus abdominis (URA), lower rectus abdominis (LRA), internal obliques (IOs), external obliques (EOs), and the rectus femoris (RF) during various abdominal exercises (crunch, supine V-up, prone V-up on ball, prone V-up on slide board, prone V-up on TRX, and prone V-up on Power Wheel). The subjects (n = 21) performed an isometric contraction of the abdominal musculature while performing these exercises. Testing revealed no statistically significant differences between any of the exercises with respect to the EOs, the URA, or the LRA. However, when examining the IO muscle, the supine V-up exercise displayed significantly greater muscle activity than did the slide exercise. In addition, EMG activity of the RF during the crunch was significantly less than in any of the other 5 exercises. These results indicate that when performing isometric abdominal exercises, non-equipment-based exercises stressed the abdominal muscles similarly to equipment-based exercises. Based on the findings of the current study, the benefit of training the abdominal musculature in an isometric fashion using commercial equipment could be called into question.