Effects of Exercise Type on Neck Disability, Pain, and Postural Changes in Subjects with Forward Head Posture: Systematic Review and Meta-Analysis

This systematic review and meta-analysis investigated whether the use of a lumbar roll reduced forward head posture (FHP) while sitting among individuals with or without musculoskeletal disorders. EMBASE, MEDLINE, and the Cochrane Library were systematically searched from their inception to August 2020. The quality of evidence for variables used in the meta-analysis was determined using the GRADE system. Five studies satisfied the criteria for data analysis. All studies included individuals without any spinal symptoms. Data from five studies on neck angle showed a statistically significant (p = 0.02) overall effect (standardized mean difference (SMD) = 0.77), indicating a lesser neck flexion angle while sitting with a lumbar roll than without it. Data from two studies on head angle showed a statistically significant (p = 0.04) overall effect (SMD = 0.47), indicating a lesser head extension angle while sitting with a lumbar roll than without it. In each meta-analysis, the quality of evidence was very low in the GRADE system. The use of a lumbar roll while sitting reduced FHP among individuals without spinal symptoms.

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The Relationship Between Forward Head Posture and Neck Pain: a Systematic Review and Meta-Analysis

Current Reviews in Musculoskeletal Medicine ◽

10.1007/s12178-019-09594-y ◽

2019 ◽

Vol 12 (4) ◽

pp. 562-577 ◽

Cited By ~ 4

Author(s):

Nesreen Fawzy Mahmoud ◽

Karima A. Hassan ◽

Salwa F. Abdelmajeed ◽

Ibraheem M. Moustafa ◽

Anabela G. Silva

Keyword(s):

Systematic Review ◽

Neck Pain ◽

Meta Analysis ◽

Forward Head Posture ◽

Head Posture ◽

The Relationship

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Chronic Primary Headache Subjects Have Greater Forward Head Posture than Asymptomatic and Episodic Primary Headache Sufferers: Systematic Review and Meta-analysis

Pain Medicine ◽

10.1093/pm/pnaa235 ◽

2020 ◽

Vol 21 (10) ◽

pp. 2465-2480

Author(s):

Ignacio Elizagaray-Garcia ◽

Hector Beltran-Alacreu ◽

Santiago Angulo-Díaz ◽

Miriam Garrigós-Pedrón ◽

Alfonso Gil-Martínez

Keyword(s):

Systematic Review ◽

Physical Examination ◽

Meta Analysis ◽

Primary Headache ◽

Study Groups ◽

Healthy Population ◽

Neck Muscle ◽

Range Of Movement ◽

Forward Head Posture ◽

Head Posture

Abstract Objective To summarize the cervical physical examination characteristics in subjects with chronic primary headache and compare those with a healthy population and a population with episodic primary headache. Design Systematic review and meta-analysis. Subjects Humans ≥18 years old. At least one of the study groups should be constituted by subjects diagnosed with one of the chronic primary headache subtypes according to the International Classification of Headache Disorders, 3rd Edition. Comparison Neck physical examination outcomes of subjects with chronic primary headache compared with a healthy population or subjects with episodic primary headache. Outcomes Forward head posture (FHP), cervical range of movement, motor control, neck muscle activity, and reproduction and resolution of symptoms. Methods Two reviewers assessed independently the MEDLINE, EMBASE, WOS, MEDES, PEDro, and CINAHL databases to select observational studies. First, both implemented an agreement for a search strategy. Then, they screened independently for duplicates, titles, abstracts, and full-text information. A meta-analysis was conducted to compare measures between groups. Results Twelve studies (N = 1,083) with moderate quality (mean ± SD = 7.75 ± 1.48 on the Newcastle Ottawa Scale) were selected for the qualitative analysis. The meta-analysis showed that patients with chronic primary headache presented greater forward head posture than asymptomatic participants (N = 275, Hg = 0.68, 95% CI = 0.25–1.1, Z = 3.14, P < 0.01) and patients with episodic primary headache (N = 268, Hg = 0.39, 95% CI = 0.13–0.65, Z = 2.98, P < 0.01). Conclusions There is moderate to strong evidence that patients with chronic primary headache present greater FHP than asymptomatic individuals and moderate evidence that patients with chronic primary headache present greater forward head posture than those with episodic primary headache.

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Effectiveness of Therapeutic Exercise on Forward Head Posture: A Systematic Review and Meta-analysis

Journal of Manipulative and Physiological Therapeutics ◽

10.1016/j.jmpt.2018.02.002 ◽

2018 ◽

Vol 41 (6) ◽

pp. 530-539 ◽

Cited By ~ 10

Author(s):

Rahman Sheikhhoseini ◽

Shahnaz Shahrbanian ◽

Parisa Sayyadi ◽

Kieran O’Sullivan

Keyword(s):

Systematic Review ◽

Meta Analysis ◽

Therapeutic Exercise ◽

Forward Head Posture ◽

Head Posture

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Exercise therapy for whiplash-associated disorders: a systematic review and meta-analysis

Scandinavian Journal of Pain ◽

10.1515/sjpain-2021-0064 ◽

2021 ◽

Vol 0 (0) ◽

Author(s):

Bruno Chrcanovic ◽

Johan Larsson ◽

Eva-Maj Malmström ◽

Hans Westergren ◽

Birgitta Häggman-Henrikson

Keyword(s):

Systematic Review ◽

Neck Pain ◽

Exercise Therapy ◽

Full Text ◽

Meta Analysis ◽

Current Evidence ◽

Positive Effects ◽

Current Evidence Base ◽

Whiplash Associated Disorders ◽

Neck Disability

Abstract Objectives Acute as well as chronic pain syndromes are common after whiplash trauma and exercise therapy is proposed as one possible intervention strategy. The aim of the present systematic review was to evaluate the effect of exercise therapy in patients with Whiplash-Associated Disorders for the improvement of neck pain and neck disability, compared with other therapeutic interventions, placebo interventions, no treatment, or waiting list. Content The review was registered in Prospero (CRD42017060356) and conducted in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. A literature search in PubMed, Scopus and Cochrane from inception until January 13, 2020 was combined with a hand search to identify eligible randomized controlled studies. Abstract screening, full text assessment and risk of bias assessment (Cochrane RoB 2.0) were conducted by two independent reviewers. Summary The search identified 4,103 articles. After removal of duplicates, screening of 2,921 abstracts and full text assessment of 100 articles, 27 articles that reported data for 2,127 patients were included. The included articles evaluated the effect of exercise therapy on neck pain, neck disability or other outcome measures and indicated some positive effects from exercise, but many studies lacked control groups not receiving active treatment. Studies on exercise that could be included in the random-effect meta-analysis showed significant short-term effects on neck pain and medium-term effects on neck disability. Outlook Despite a large number of articles published in the area of exercise therapy and Whiplash-Associated Disorders, the current evidence base is weak. The results from the present review with meta-analysis suggests that exercise therapy may provide additional effect for improvement of neck pain and disability in patients with Whiplash-Associated Disorders.

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Craniocervical and Cervical Spine Features of Patients with Temporomandibular Disorders: A Systematic Review and Meta-Analysis of Observational Studies

Journal of Clinical Medicine ◽

10.3390/jcm9092806 ◽

2020 ◽

Vol 9 (9) ◽

pp. 2806

Author(s):

Ferran Cuenca-Martínez ◽

Aida Herranz-Gómez ◽

Beatriz Madroñero-Miguel ◽

Álvaro Reina-Varona ◽

Roy La Touche ◽

...

Keyword(s):

Systematic Review ◽

Motor Control ◽

Temporomandibular Disorders ◽

Observational Studies ◽

Meta Analysis ◽

Emg Activity ◽

Limited Evidence ◽

Cervical Alignment ◽

Moderate Evidence ◽

Neck Disability

To assess neck disability with respect to jaw disability, craniocervical position, cervical alignment, and sensorimotor impairments in patients with temporomandibular disorders (TMD), a systematic review and meta-analysis of observational studies trials were conducted. The meta-analysis showed statistically significant differences in the association between neck disability and jaw disability (standardized mean difference (SMD), 0.72 (0.56–0.82)). However, results showed no significant differences for cervical alignment (SMD, 0.02 (−0.31–0.36)) or for the craniocervical position (SMD, −0.09 (−0.27–0.09)). There was moderate evidence for lower pressure pain thresholds (PPT) and for limited cervical range of motion (ROM). There was limited evidence for equal values for maximal strength between the patients with TMD and controls. There was also limited evidence for reduced cervical endurance and conflicting evidence for abnormal electromyographic (EMG) activity and motor control in TMD patients. Results showed a clinically relevant association between cervical and mandibular disability in patients with TMD. Regarding sensory-motor alterations, the most conclusive findings were observed in the reduction of PPT and cervical ROM, with moderate evidence of their presence in the patients with TMD. Lastly, the evidence on impaired motor control and cervical EMG activity in patients with TMD was conflicting.

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Effects of Deep Cervical Flexor Training on Forward Head Posture, Neck Pain, and Functional Status in Adolescents Using Computer Regularly

BioMed Research International ◽

10.1155/2020/8327565 ◽

2020 ◽

Vol 2020 ◽

pp. 1-7

Author(s):

Isha Sikka ◽

Chandan Chawla ◽

Shveta Seth ◽

Ahmad H. Alghadir ◽

Masood Khan

Keyword(s):

Neck Pain ◽

Functional Status ◽

Neck Disability Index ◽

Control Group ◽

Forward Head Posture ◽

Head Posture ◽

Photographic Analysis ◽

Significant Difference ◽

Neck Disability ◽

Experimental Group

In contemporary societies, computer use by children is a necessity and thus highly prevalent. Using computers for long hours is related to a higher risk of computer-related muscular disorders like forward head posture (FHP) and neck pain (NP). Deep cervical flexor (DCF) muscles are important head-on-neck posture stabilizers; thus, their training may lead to an improvement in FHP and NP. The aim of this study was to determine if 4 weeks of DCF training is effective in alleviating NP, improving FHP, and functional status in adolescent children using computers regularly, a pretest-posttest experimental group design was used. Subjects were randomly assigned into the experimental group (receiving DCF training and postural education) and the control group (receiving postural education only). 30 subjects with a mean age of 15.7 ± 1.725 years with NP and FHP using computers regularly participated in the study. Dependent variables were measured on day 1 (at baseline) and after 4 weeks of training. Photographic analysis was used for measuring FHP, visual analog scale for NP intensity, and neck disability index for functional status. Data analysis showed that in both groups, no significant improvement occurred in FHP. In both groups, there was a significant improvement in functional status and NP. There was no significant difference between both groups for FHP and NP. There was a significant improvement in functional status in the experimental group in comparison to the control group. Four weeks of DCF training does not cause a significant improvement in FHP in 13 to 18 years old adolescent children using computers regularly.

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