[논문]앉은 자세에서 머리 위치가 머리/어깨의 자세와 근활성도에 미치는 영향

권중원; 남석현; 최용원; 김중선

[국내논문] 앉은 자세에서 머리 위치가 머리/어깨의 자세와 근활성도에 미치는 영향
The Effect of Different Head Positions in Sitting on Head/Shoulder Posture and Muscle Activity 원문보기

대한물리치료학회지 = The journal of Korean Society of Physical Therapy, v.25 no.4, 2013년, pp.217 - 223

권중원 (대구대학교 대학원 재활과학과) , 남석현 (대구대학교 대학원 재활과학과) , 최용원 (대구대학교 대학원 재활과학과) , 김중선 (대구대학교 대학원 재활과학과)

Abstract ▼ AI-Helper

Purpose: This study was to investigate whether the two different head postures, natural and ideal head posture, affect head/shoulder posture and muscle activity. Methods: Thirty healthy subjects with the forward head and round shoulder posture were participated in this study. This study utilized a within-subjects design with subjects being positioned into two sitting positions: natural head posture (NHP) and ideal head posture (IHP). Forward head angle (FHA) and forward shoulder angle (FSA) of each subject were measured for assessing the head/shoulder posture and muscle activities of upper trapezius (UT), lower trapezius (LT), and serratus anterior (SA) during the forward overhead reaching. Results: There were significant increases in both FHA and FSA after taking IHP, which showed greater angles than in taking NHP. In change of muscle activities, there were significant decreases in both LT and SA after taking IHP, which showed lower activities than in taking a NHP, whereas there was no significant change in UT. Conclusion: These findings demonstrate that postural alterations associated with forward head and rounded shoulder postures could alter scapular kinetics and muscle activity during the forward overhead reaching.

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제안 방법

FHA and FSA of each subject were measured 3 times, for 3 separate days and the average angles both in NHP and IHP were used for subsequent analysis.
5 m from the wall. Next, the subjects sit 40 cm in 40 cm front of background wall, bent forward 3 times, reached overhead 3 times, and were instructed to sit looking straight ahead in their comfortable and natural resting posture. This procedure has been used in previous published studies.
First, we did not differentiate between the upper and lower cervical spine kinetics and the deep and superficial cervical and sub-occipital muscles were not measured in this study. Second, the personal postural habits of the subjects were not been assessed in this study as the aim was to assess the influence of two pre-defined head postures on head/shoulder angle and muscle activity. In conclusion, this study showed that all defined sitting positions with natural and ideal head postures resulted in various changes in head-neck and neck-shoulder angles and muscle activation.
The %MVIC was measured three times and there was a 60 seconds rest period between each of the three trials. The mean %MVIC over the ascending phase of motion was averaged for repetitions three trials and used for statistical analyses.
In addition, ideal head/shoulder posture results in altered scapular as well as muscle activity of the shoulder girdle. Therefore, this study supports for the clinical theory that postural alterations associated with forward head and rounded shoulder postures can alter scapular kinetics and muscle activity during the forward overhead reaching. Moreover, taking ideal head/shoulder posture may contribute to the therapeutic strategy for the individual with forward head and round shoulder.
This study utilized a within-subjects design with subjects being positioned into two sitting positions: natural head posture (NHP) and ideal head posture (IHP). In a natural head posture, subjects were instructed to sit in a comfortable position so that subjects feels natural with a verbal instruction like as ‘sit as you usually do’, while looking conveniently forward (Figure 1).

대상 데이터

FSA was measured from the vertical posteriorly to a line connecting the C7 marker and the acromial marker. Digital camera was placed on a tripod 1 m high and 3.5 m from the wall. Next, the subjects sit 40 cm in 40 cm front of background wall, bent forward 3 times, reached overhead 3 times, and were instructed to sit looking straight ahead in their comfortable and natural resting posture.
EMG data were collected using a four channel surface EMG system (MP30, Biopack, USA). Recording of EMG signals was accomplished using preamplified electrode (Biopac System, Biopack, USA).
Thirty healthy subjects with the forward head and round shoulder posture were participated in this study (Table 1). Forward head and rounded shoulder posture were defined as forward head angle (FHA) ≤54.

데이터처리

0 for Windows. The paired t-test was used to compare the dependent variables between NHP and IHP. All measurements were shown as average ± standard deviation and were verified at a significant level p<0.

성능/효과

Postural angles, the FHA and FSA, were measured for kinetics of upper trunk, and muscle activities such as UT, LT, and SA were assessed for movement pattern of scapular during the loaded shoulder flexion between NHP and IHP. As a result, comparing the position of the NHP with the IHP, the FHA and FSA were significantly increased, and muscle activities of LT and SA were significantly decreased in the self-applied head posture, but UT muscle was not. These results imply that shoulder kinetics and movement patterns change for the better in assuming an IHP.
In change of postural angles, there were significant increases in both FHA and FSA after taking an IHP, which showed greater angles than in taking a NHP; FHA and FSA were 51.72 and 47.67, respectively, and they were 53.84 and 52.55 in taking a IHP (p<0.05)(Table 2).
Second, the personal postural habits of the subjects were not been assessed in this study as the aim was to assess the influence of two pre-defined head postures on head/shoulder angle and muscle activity. In conclusion, this study showed that all defined sitting positions with natural and ideal head postures resulted in various changes in head-neck and neck-shoulder angles and muscle activation. In addition, ideal head/shoulder posture results in altered scapular as well as muscle activity of the shoulder girdle.
^5,12,21 Therefore, we believe that lower activity of serratus anterior may be playing a key role in alterations of scapular kinetics. Moreover, our results showed less amounts of lower trapezius activity between NHP and IHP, suggesting the alteration in kinetics was likely the result of lower serratus anterior activity. Many previous studies have reported that alterations in upper and lower trapezius timing and activity play an important role in controlling and producing scapular anterior/posterior tilting and upward/downward rotation during the forward overhead reaching.

후속연구

Moreover, taking ideal head/shoulder posture may contribute to the therapeutic strategy for the individual with forward head and round shoulder. Future studies should determine scapular kinetics and muscle activity in patients with shoulder pain forward head and rounded shoulder postures, and the effects of interventions to improve posture for shoulder pain and disability.

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