Immediate Effect of Chin Tuck Exercises on Craniovertebral Angle and Shoulder Angle Among Collegiates with Forward Head Posture

Forward head posture (FHP) is the forward movement of the head that is caused by improper postural awareness and often results in muscular imbalance that causes pain. The forward head posture is found to be influenced by Craniovertebral Angle (CV) and shoulder angle (SA) that in turn causes rounded shoulder. These biomechanical changes prove to be a hindrance in maintaining neutral head posture and affects the structural integrity. A sample size of 43 were taken according to the selection criteria and the FHP was assessed through plumb line. Double tape was used as markers at tragus of the ear, C7 vertebrae and acromion process. Photos were taken and analyzed using AUTOCAD 2017 software and the results were obtained. A positive association found between the pre and post test results for CV angle with P=0.0001(P<0.05) and no significant association between the pre and posttest for SA with P=0.2 (P>0.05). The craniovertebral angle can be altered with the chin tuck exercises but has no effect on the shoulder angle, hence having no influence over the rounded shoulders but has some effect over the forward head posture.

Effect of Stretching and Strengthening Protocol on Forward Flexed Posture in Post-Menopausal Women

Background: Forward flexed posture is one of the most common structural change which occurs during menopause due to osteoporosis. Stretching and strengthening of cervical and thoracic spine muscles helps to alter the postural changes and maintain COG. This study thus, aims to see the effectiveness of the structured exercise protocol in post-menopausal women. Aims and Objective: To study the effectiveness of supervised and non-supervised stretching and strengthening protocol in post-menopausal women with forward posture. Materials and Methods: A total 40post-menopausal women with forward head posture were selected on the basis of selection criteria. They were randomly allocated in two groups A) Supervised Group= 20, B) Unsupervised Group=20 each. Forward flexed posture was assessed using Occiput to Wall Test and Craniovertebral Angle. Treatment was explained to both the groups. The pre and post measurements of the participants were recorded. Results: Statistical analysis was performed using the unpaired t test. Occiput to wall test and craniovertebral angle were used as the outcome measures for determining the effect of stretching and strengthening on forward neck posture. Comparing the pre-intervention and post-intervention values of occiput to wall test, a significant difference was seen following administration of protocol (p<0.0001). For craniovertebral angle, a significant difference was seen between pre-intervention and post-intervention values (p<0.0001). Also, it was seen that there was a significantly higher difference in the values of craniovertebral angle and occiput to wall test values in the supervised groups as compared to the unsupervised group. Conclusion: The current study demonstrated the effect of stretching and strengthening exercise in improving postural kyphosis in post-menopausal women. In addition, all variables of interest showed statistically significant post-treatment improvements in supervised group than unsupervised group.

EFFCIENCY OF TELEREHABILITATION ON PAIN AND FORWARD HEAD POSTURE AMONG STUDENTS WITH NONSPECIFIC NECK PAIN IN PANDEMIC SITUATION – A QUASI EXPERIMENTALSTUDY

INTRODUCTION: The neck pain and forward head posture are the most prevailing condition among the college students due to increased smart phone usage and causes activity limitation. At current situation providing rehabilitation via face to face increases the risk of spread of the pandemic(COVID 19). The deep neck flexor strengthening and ergonomic correction via telerehabilitation improves the functional activity among college students and limits the spread of disease. MATREIALS AND METHODOLGY: Subjects with (n=15), who fulfil the screening criteria were given the exercise protocol that is deep neck flexor strengthening and ergonomic correction via telerehabilitation mode for a period of 4 weeks and the outcome measures included neck pain and forward head posture. RESULT: There is a significant statistical difference between pre test and post test values of pain and forward head posture. CONCLUSION: Telerehabilitation platform provides a greater efficiency for treating pain and forward head posture among college students in pandemic situation.

Prevalence of Upper Cross Syndrome among Students of University of Balochistan, Quetta Pakistan

Objective: To assess the prevalence of upper crossed syndrome among students of Doctor of Physical Therapy (DPT) and Bachelors of Eastern Medicine and Surgery (BEMS) at university of Balochistan Quetta, Pakistan. Background: Upper cross syndrome is characterized as a pattern of tightness or over facilitation of chronically contracted and shortened muscles on one side and weakness or inhibition of chronically lengthened muscles on other side due to the muscle imbalance leading to postural abnormalities including, forward head posture, shoulder protraction, winging of scapula. These changes, in turn, lead to overstress of the cervical cranio-cervical junction, cervical and thoracic spine and shoulders, which can cause neck and/or jaw pain, headaches, and shoulder problems. The purpose of this study was to figure out the number of students of DPT and BEMS suffering from upper crossed syndrome at university of Balochistan Quetta, Pakistan. Methodology: A descriptive cross-sectional study was conducted. A self-constructed questionnaire having two parts, the first part comprised of demographics data while second part comprised of 18 questions and consent form was filled by 340 students both males and females from DPT and BEMS department. The Data was analyzed by Statistical Package for Social Sciences (SPSS) version 16. Results: The study participants had a mean age of ±21.85, most of them were, from 22-25 years n=182 (53.5%) age group, males n=178 (52.4%) and from 3rd semester n=107 (31.5%). The prevalence of upper cross syndrome in the current study was 45.0%. Conclusion: The study concludes that upper cross syndrome has high prevalence in the students of DPT and BEMS in faculty of pharmacy and health sciences, at university of Balochistan Quetta, Pakistan.

Design of an Electromyograph Equipped with Digital Neck Angle Elevation Gauge

The development of technology also affects human health, including body posture due to poor human position when using gadgets, both smartphones, and laptops. This study is design a tool that can measure the elevation of a person's neck angle equipped with electromyography, to help health workers, medical rehabilitation doctors to diagnose and provide treatment to patients with a bent head posture or forward head posture. In this research, an electromyography module is designed which consists of a series of instruments, a pre-amplifier circuit, a high pass filter, a low pass filter, and a dc offset regulator to be converted to digital so that it can be displayed on a laptop. In this study, the tapped muscle was the upper trapezius muscle using disposable electrodes. Meanwhile, to measure the angular elevation, the MPU 6050 sensor is used to measure the movement of the head forward. The frequency of the electromyography signal is 20-500 Hz. For software or display readings from this tool is Delphy. Meanwhile, the microcontroller used for ADC communication is Arduino Uno. From the research, it was found that the neck angle elevation gauge has a 0,597% error rate, for conditioning conducted on respondents, all respondents experienced a decrease in amplitude on the same frequency spectrum in the last ten minutes. Meanwhile, a drastic decrease occurred at the neck angle of 60°. Thus, it can be concluded that the forward position of the head affects the frequency spectrum of the neck muscles.

Kyphosis types of the spine cervical-thoracic junction

Introduction. The strengthening of thoracic kyphosis and forward head posture is one of the urgent problems of modern man. Such changes are most often detected for elderly and senile people. However, today these features are also detected for young people. Digital radiography can objectively assess the position of the cervical and thoracic vertebrae. However, the criteria for reliably registering the position of the vertebrae of the cervicalthoracic junction have not yet been developed.The aim of the study — to develop a method for assessing the position of the vertebrae of the cervical-thoracic junction according to digital radiographs; to develop a typology of the vertebra positions of the cervical-thoracic junction; to study the frequency of vertebral position types for the cervical-thoracic junction for different age groups.Materials and methods. Spine X-ray images in the sagittal plane for 141 adult patients with dorsopathies were studied. The selection of patients was random and there were four age groups: 32 persons aged 21 to 45, 32 persons aged 46 to 59, 50 persons aged 60 to 74 and 21 persons aged 75 to 88 year-old. The study was conducted on PC screen, without the patient′s presence. A single digital X-ray image of the spine for each patient in the sagittal plane was obtained. On the combined digital radiograph, the occipital vertical was drawn along all parts of the spine, starting from the external hillock of the occipital bone downwards, and the anteroposterior CV–TV axes of the vertebrae (r axes) were applied. At the points of intersection of the axes with the occipital vertical, the perpendiculars to the axis were restored, and the angles between the perpendiculars and the vertical — the angles of the anteroposterior axes of the vertebrae (r angles) — were measured. Statistical analysis was performed using the MS Offi ce Excel 2007 and Statistica 12 software packages.Results. It was found that the values of the anteroposterior axe angles r of CVII–TIII vertebrae can serve as criteria for determining the spatial position of the cervical-thoracic junction vertebrae. There are 4 types of the shape of the cervical-thoracic junction. Type I is a straightened kyphosis («giraffe neck»); type II is physiological («harmonious»); type III — enhanced kyphosis («bear withers»); type IV–hyperkyphosis («buffalo hump»). Types III and IV are accompanied by a forward displacement of the head. Straightened cervical-thoracic junction kyphosis — type I — was diagnosed in 21 (15 %) people, 52 (37 %) patients were assigned to type II, another 48 (34 %) patients had type III, and 20 (14 %) patients had type IV cervical-thoracic junction kyphosis. In young patients aged 21 to 45, as well as in middle-aged patients aged 46 to 59, the most common type was the harmonious type II of cervical-thoracic junction, in elderly patients aged 60 to 74 — type III and close to it in frequency was type III. In elderly patients aged 75 to 88, the IV type of the position of the vertebrae of the cervical-thoracic junction prevailed in frequency.Conclusion. The proposed diagnostic method allows to register the type of the vertebra positions in cervicalthoracic junction for each patient. Four position types of the cervical-thoracic junction vertebrae were determined: straightened kyphosis «giraffe neck», physiological kyphosis «harmonious», enhanced kyphosis «bear withers» and hyperkyphosis «buffalo hump». Increased kyphosis and hyperkyphosis are accompanied by a forward head posture.