Neck Pain in Adults with Forward Head Posture: Effects of Craniovertebral Angle and Cervical Range of Motion

Background: Altered postural behaviours result in Forward head posture and thoracic kyphosis making it amenable to correction. The biomechanical strain, in presence of reduced strength of the core stabilizing musculature, in particular, if it is repeated or prolonged, is the predominant explanation for symptoms associated with forward head posture and thoracic kyphosis i.e., neck pain and reduced cervical range of motion. Objective: The aim of the present study was to investigate and compare the effect of postural awareness and conventional exercises on the cervical range of motion in patients with thoracic kyphosis and forward head posture. Methodology: This experimental study was conducted on 60 subjects both male and female of age group 20-35yrs. Subjects were randomly divided into two groups consisting of 30 subjects each. Group A received hot pack and postural advice and Group B received hot pack and stretching and strengthening exercises. All the subjects received a total intervention of 4 days (alternate days) per week for 4 weeks. Results: Intra-group significant differences were obtained between pre- and post-treatment for all evaluated variables (p˂0.01) in both groups. The inter-group comparison showed significant differences (p˂0.01) between post-treatment variables of Group A and Group B where, Group B showed greater improvement than Group A. Conclusion: The treatment given to both the groups together can be used to improve cervical range of motion, thoracic kyphosis, and forward head posture. This study may serve as a guideline for physiotherapists when making decisions regarding possible interventions. KEY WORDS: Cervical range of motion, Craniovertebral angle, Forward head posture, Kyphosis index, Neck disability index, Thoracic kyphosis.

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Increased Forward Head Posture and Restricted Cervical Range of Motion in Patients With Carpal Tunnel Syndrome

Journal of Orthopaedic and Sports Physical Therapy ◽

10.2519/jospt.2009.3058 ◽

2009 ◽

Vol 39 (9) ◽

pp. 658-664 ◽

Cited By ~ 39

Author(s):

Ana I. De-La-Llave-Rincón ◽

César Fernández-De-Las-PeÑas ◽

Domingo Palacios-CeÑa ◽

Joshua A. Cleland

Keyword(s):

Carpal Tunnel Syndrome ◽

Range Of Motion ◽

Carpal Tunnel ◽

Forward Head Posture ◽

Head Posture ◽

Cervical Range Of Motion ◽

Tunnel Syndrome

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Effects of thoracic kyphosis and forward head posture on cervical range of motion in older adults

Manual Therapy ◽

10.1016/j.math.2012.07.005 ◽

2013 ◽

Vol 18 (1) ◽

pp. 65-71 ◽

Cited By ~ 84

Author(s):

June Quek ◽

Yong-Hao Pua ◽

Ross A. Clark ◽

Adam L. Bryant

Keyword(s):

Older Adults ◽

Range Of Motion ◽

Thoracic Kyphosis ◽

Forward Head Posture ◽

Head Posture ◽

Cervical Range Of Motion

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Direction-Specific Impairments in Cervical Range of Motion in Women with Chronic Neck Pain: Influence of Head Posture and Gravitationally Induced Torque

PLoS ONE ◽

10.1371/journal.pone.0170274 ◽

2017 ◽

Vol 12 (1) ◽

pp. e0170274 ◽

Cited By ~ 3

Author(s):

Thomas Rudolfsson ◽

Martin Björklund ◽

Åsa Svedmark ◽

Divya Srinivasan ◽

Mats Djupsjöbacka

Keyword(s):

Neck Pain ◽

Range Of Motion ◽

Chronic Neck Pain ◽

Head Posture ◽

Cervical Range Of Motion

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Added Value of Diaphragm Myofascial Release on Forward Head Posture and Chest Expansion in Patients With Neck Pain: A Randomized Controlled Trial

10.21203/rs.3.rs-53279/v1 ◽

2020 ◽

Author(s):

Farzaneh Haghighat ◽

Razieh Moradi ◽

Mohammadreza Rezaie ◽

Nastaran Yarahmadi ◽

Farahnaz Ghaffarnejad

Keyword(s):

Neck Pain ◽

Functional Disability ◽

Controlled Trial ◽

Intervention Group ◽

Added Value ◽

Forward Head Posture ◽

Myofascial Release ◽

Head Posture ◽

Chest Expansion ◽

Craniovertebral Angle

Abstract Background: Despite the increasing use of diaphragm myofascial release technique in clinical practice, there is no study on the effect of this technique on musculoskeletal outcomes of patients with neck pain. The purpose of this study was to evaluate the added value of diaphragm myofascial release on forward head posture, chest expansion, and functional disability in patients with neck pain.Methods: In this randomized controlled trial, 46 women with neck pain between the age of 18 and 45 years old were randomly allocated to two groups; the intervention group received 4 diaphragm myofascial release techniques once a week, for 4 weeks. Both intervention and control groups received the same neck exercise program 3 times a week for 4 weeks. Forward head posture, chest expansion, and neck functional disability were measured using craniovertebral angle, circometry, and Copenhagen neck functional disability index, respectively, before and one day after treatment.Results: The results of the paired t-test showed significant increases in craniovertebral angle (control and intervention: P<0.001) and chest expansion (control: P=0.001, intervention<0.001) and a significant decrease in the functional disability score (control and intervention: P<0.001) of patients with neck pain in both groups. A significant greater craniovertebral angle (P=0.01) and chest expansion (P=0.03) were also seen in the intervention group compared with the controls.Conclusion: Adding diaphragm myofascial release to neck exercises was associated with significantly greater improvements in forward head posture and chest expansion than neck exercises alone. Therefore, the diaphragm myofascial release could be useful in the management of neck pain patients with FHP. Trial registration: IRCT20191116045461N1 (Iranian Registry of Clinical Trials). Registered 23 December 2019, https://en.irct.ir/trial/43741.

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The impact of 8 weeks selected corrective exercises on neck pain, range of motion in the shoulder and neck of lifesaver women who suffering from forward head posture and myofascial pain syndrome

Biomedical Research and Therapy ◽

10.15419/bmrat.v4i06.183 ◽

2017 ◽

Vol 4 (06) ◽

pp. 1420

Author(s):

Melody Tabatabaei ◽

Behrouz Barjasteh Mohebbi ◽

Alireza Rahimi

Keyword(s):

Neck Pain ◽

Range Of Motion ◽

Myofascial Pain ◽

Pain Syndrome ◽

Myofascial Pain Syndrome ◽

Analysis Of Covariance ◽

Forward Head Posture ◽

Head Posture ◽

Significant Difference ◽

The Impact

Background: The purpose of this research was studying the impact of 8 weeks selected corrective exercises on neck pain, range of motion in the shoulder and neck of lifesaver women who suffering from forward head posture and myofascial pain syndrome. Methods: The method of research is semi-experimental. The population consists of 30 lifesaver women who suffering from forward head posture and myofascial pain syndrome who they placed randomly in two groups of experimental (33±2.2) and control (33±2.5). Research plan was as the pre-test and post-test with control group. The exercise protocol was carried out by experimental groups for 8 weeks, 3 sessions per week, each session lasting 45 minutes. Studied variables include myofascial pain in the neck, shoulder and neck range of motion. The mean and standard deviation were used as descriptive statistics and in the section of inferential statistics analysis of covariance was used. Results: Results of research indicated that, the protocol on the reform exercise of neck pain (P=0.001), range of motion of shoulder joint (P=0.001) and neck range of motion (P=0.001) has significant difference. Conclusion: Therefore, lifesavers women can benefit from it as a training program to improve and prevent damage caused by head forward and myofascial pain syndrome.

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Dorsal Neck Muscle Fatigue Affects Cervical Range of Motion and Proprioception in Adults with the Forward Head Posture

The Journal of Korean Physical Therapy ◽

10.18857/jkpt.2020.32.5.319 ◽

2020 ◽

Vol 32 (5) ◽

pp. 319-324

Author(s):

Sang-Seok Yeo ◽

Jung-Won Kwon

Keyword(s):

Range Of Motion ◽

Muscle Fatigue ◽

Neck Muscle ◽

Forward Head Posture ◽

Head Posture ◽

Cervical Range Of Motion ◽

Neck Muscle Fatigue

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Prevalence of forward head posture and its impact on the activity of daily living among students of Adesh University – A cross-sectional study

10.25259/aujmsr_18_2020 ◽

2020 ◽

Vol 2 ◽

pp. 99-102

Author(s):

Sutantar Singh ◽

Kavita Kaushal ◽

Smriti Jasrotia

Keyword(s):

Neck Pain ◽

Daily Living ◽

Cross Sectional Study ◽

Survey Study ◽

Activity Of Daily Living ◽

Inclusion Criteria ◽

Cross Sectional ◽

Forward Head Posture ◽

Head Posture ◽

Craniovertebral Angle

Objectives: The aims and objectives of the study were to find the prevalence of forward head posture and to find its impact on activities of daily living in students of Adesh University. Materials and Methods: After the approval from Ethical Committee of Adesh University Survey study was done. A total of 200 subjects were taken according to the inclusion criteria, i.e., craniovertebral angle <53° from Adesh University, Bathinda by convenient sampling. CV angle was measured by knee registry application, and those who fit under inclusion criteria were given a Northwick park neck pain questionnaire to fill. Filled questionnaires were collected from the subjects. Results: The data of 200 subjects was analyzed and it is found that out of 200 subjects, 146 were having forward head posture, whereas 54 were having normal head posture. The 73% prevalence of forward head posture was found in students. The most of the students were having mild or no pain and numbness in the day and during sleeping. Out of students who have reported moderate or severe neck pain, 8.21% shows that they were having pain during the whole day. The students who reposted pain 54.79% show mild pain and 26.02% showed moderate pain while reading and watching TV. Conclusion: It is concluded from the results of this study that there is 73% prevalence of FHP that affects only a little or no activity of daily living.

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Effect of Deep Cervical Flexor training on Respiratory Functions in Chronic Neck Pain patients with Forward Head Posture

International Journal of Research in Pharmaceutical Sciences ◽

10.26452/ijrps.v11i4.3146 ◽

2020 ◽

Vol 11 (4) ◽

pp. 5287-5292

Author(s):

Sonia Pawaria ◽

Sheetal Kalra

Keyword(s):

Neck Pain ◽

Respiratory Muscles ◽

Chronic Neck Pain ◽

Control Group ◽

Baseline Measurement ◽

Forward Head Posture ◽

Head Posture ◽

Pulmonary Functions ◽

Conventional Physiotherapy ◽

Craniovertebral Angle

Protruded chin posture is one of the commonly seen postural problem associated with patients having chronic neck pain. It is also known by names Forward Head Posture (FHP) or anteriorly translated head posture. The FHP causes an alteration in mechanics of rib cage which leads to a reduction in mobility of thorax and abdomen, decreased movement of the diaphragm, reduced ventilatory effectiveness of diaphragm and reduced efficacy of abdominals and intercostals muscles during respiration. Therefore this study was executed to check the effectiveness of deep cervical flexor exercises on Craniovertebral angle and pulmonary functions. It was a comparative experimental study design. Based on the study's selection criteria, the total numbers of 100 subjects were taken and divided into Experimental and Control groups. In-depth Cervical flexor training with the conventional Physiotherapy was given to subjects of the experimental group. Control group subjects received only Conventional Physiotherapy for six weeks. The baseline measurement was taken on day one of the studies. The digital camera assessed the Forward head posture by measuring Craniovertebral Angle (CVA). Spirometry determined pulmonary functions (FEV1& FVC). All measurements were repeated at the end of the 6th week. The baseline measurement and measurement at the end of 6th week were compared by using the t-test. Considerable improvement in Craniovertebral angle and functional status of the lung, resulted in subjects who were given in-depth cervical flexor training along with the conventional Physiotherapy treatment (p< 0.05). Therefore it is suggested that deep cervical flexor exercises improve the head posture and also correct the biomechanics of respiratory muscles. Deep neck flexor training can be considered as an efficient technique in lessening protruded chin posture.

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Instrumental assessment of physiotherapy and onabolulinumtoxin-A on cervical and headache parameters in chronic migraine

Neurological Sciences ◽

10.1007/s10072-021-05491-w ◽

2021 ◽

Author(s):

Manuela Deodato ◽

Antonio Granato ◽

Caterina Borgino ◽

Alessandra Galmonte ◽

Paolo Manganotti

Keyword(s):

Pain Intensity ◽

Range Of Motion ◽

Chronic Migraine ◽

Combined Treatment ◽

Forward Head Posture ◽

Head Posture ◽

Cervical Range Of Motion ◽

Before And After ◽

Observational Cohort ◽

Postural Assessment

Abstract Introduction The purpose of the present study is to compare the effect of the physiotherapy to onabolulinumtoxin-A, and their combination, in relation to cervical and headache parameters in patients with chronic migraine. Methods This is an observational cohort study conducted by a headache center and a physiotherapy degree course on 30 patients with chronic migraine. The patients were distributed in three groups of treatments for three months: onabolulinumtoxin-A only, physiotherapy only, and onabolulinumtoxin-A plus physiotherapy. The patients were evaluated, before and after each treatment, using the following: the postural assessment software SAPO for the forward head posture; the CROM goniometer for the cervical range of motion; the Migraine Disability Assessment Score for headache parameters. Results After 3 months of each treatment, the scores obtained for the headache-related disability and the frequency of migraine decreased significantly for all groups, but the pain intensity scores changed significantly only in the onabolulinumtoxin-A (p = 0.01) and in the onabolulinumtoxin-A plus physiotherapy groups (p = 0.007). On the other hand, the forward head posture was reduced significantly in the physiotherapy (p = 0.002) and in the onabolulinumtoxin-A plus physiotherapy groups (p = 0.003). The cervical range of motion increased significantly in certain directions in the physiotherapy group and in the onabolulinumtoxin-A plus physiotherapy groups. Conclusions The physiotherapy improved the cervical parameters. The onabolulinumtoxin-A decreased pain intensity. As a consequence, it can be said that the combined treatment was more useful than a mono-therapy alone. From our results, it can be concluded that onabolulinumtoxin-A plus physiotherapy could be a good option in the management of chronic migraine.

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