Comparative Immediate Effects of Isometric Chin-tuck and Dynamic Neuromuscular Stabilization on Neck Flexor Muscle Thickness and Upright Sitting Height Posture원문보기
Shin, Ji-won
(Sports Movement Artificial Robotics Technology Institute, Department of Physical Therapy, Yonsei University)
,
Yoon, Hyun-sik
(Chungnam National University Hospital)
,
Park, Ji-ho
(Sports Movement Artificial Robotics Technology Institute, Department of Physical Therapy, Yonsei University)
,
Kim, Ha-yeon
(Translational Research Center for Rehabilitation Robots, National Rehabilitation Center)
,
You, Joshua (Sung) H.
(Sports Movement Artificial Robotics Technology Institute, Department of Physical Therapy, Yonsei University)
Background: Cervical dysfunction is a common pathomechanical marker in individuals with forward head posture (FHP). To overcome the limitations of the isometric chin-tuck (ICT) exercise, dynamic neuromuscular stabilization (DNS), which emphasizes an entire spinal chain exercise, has recently shown p...
Background: Cervical dysfunction is a common pathomechanical marker in individuals with forward head posture (FHP). To overcome the limitations of the isometric chin-tuck (ICT) exercise, dynamic neuromuscular stabilization (DNS), which emphasizes an entire spinal chain exercise, has recently shown promising clinical results. Objects: Purpose of this study was to compare the immediate effects between ICT and DNS techniques. Methods: 43 young subjects (mean age, $24.0{\pm}5.0$ years) were recruited. Group of subjects with FHP were measured under baseline, ICT, and DNS conditions. Outcome measures included sitting height, longus colli (LC) and sternocleidomastoid (SCM) muscle thickness and LC/SCM thickness ratio. One-way repeated measures ANOVA was used to compare the continuous dependent variables among FHP, ICT, and DNS conditions at p<.016. Results: Both ICT and DNS exercise conditions yielded significantly increased LC muscle thickness, LC/SCM thickness ratio and sitting height than did FHP condition (p<.0001, respectively). Sitting height was significantly greater in DNS exercise than in the ICT exercise (p<.0001). Conclusion: The present results demonstrated that sitting height was greater in the DNS exercise than in the ICT exercise, as well as both corrective postural training exercises were effective on LC/SCM muscle balance ratio when compared with the baseline FHP condition. Therefore, it is considered that DNS exercise can be the recommended exercise for people with FHP.
Background: Cervical dysfunction is a common pathomechanical marker in individuals with forward head posture (FHP). To overcome the limitations of the isometric chin-tuck (ICT) exercise, dynamic neuromuscular stabilization (DNS), which emphasizes an entire spinal chain exercise, has recently shown promising clinical results. Objects: Purpose of this study was to compare the immediate effects between ICT and DNS techniques. Methods: 43 young subjects (mean age, $24.0{\pm}5.0$ years) were recruited. Group of subjects with FHP were measured under baseline, ICT, and DNS conditions. Outcome measures included sitting height, longus colli (LC) and sternocleidomastoid (SCM) muscle thickness and LC/SCM thickness ratio. One-way repeated measures ANOVA was used to compare the continuous dependent variables among FHP, ICT, and DNS conditions at p<.016. Results: Both ICT and DNS exercise conditions yielded significantly increased LC muscle thickness, LC/SCM thickness ratio and sitting height than did FHP condition (p<.0001, respectively). Sitting height was significantly greater in DNS exercise than in the ICT exercise (p<.0001). Conclusion: The present results demonstrated that sitting height was greater in the DNS exercise than in the ICT exercise, as well as both corrective postural training exercises were effective on LC/SCM muscle balance ratio when compared with the baseline FHP condition. Therefore, it is considered that DNS exercise can be the recommended exercise for people with FHP.
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문제 정의
These findings suggest that such increased neck flexor muscle thickness balance is closely linked with balanced core stabilization of the global cervical-thoracic-lumbopelvic chains. This study provides important conceptual and therapeutic evidence for clinicians when designing and implementing effective deep neck flexor muscle stabilization techniques for individuals with FHP. Therefore, it is considered that DNS exercise can be the recommended exercise for people with FHP.
가설 설정
The purpose of the present study was to compare the two stabilization exercises to activate or facilitate the deep neck flexor muscles effectively, while providing an optimal upright spinal stabilization, by comparing between the local cervical chain-based ICT and integrated entire segmental chain-based DNS techniques. We hypothesized that integrated entire segmental chain-based DNS would produce superior effects on the LC/SCM muscle thickness balance ratio and spinal upright height as compared with the local cervical chain-based ICT in participants with FHP.
제안 방법
The height of the chair was determined individually where triple 90° flexion of the hip, knee, and ankle joints occurred for each subject considering the height of the subject. Each subject implemented the two training conditions five sets of ten repetitions, which lasted for 20 minutes, with a 3-minute resting interval. The two exercises were performed in a random order with a 30-minute resting interval.
First, the baseline FHP testing condition was determined as follows: each subject was asked to demonstrate his or her typical sitting posture of FHP (upper cervical extension and mid-lower cervical flexion) and upper thoracic kyphosis, which resembled a smartphone-viewing posture (Singla and Veqar, 2017).
For the sitting height measurement, the subjects were instructed to sit comfortably on a chair with triple 90° flexion of the hip, knee, and ankle joints.
Statistical analyses included descriptive means, standard deviations, and parametric analysis of variance. One-way repeated measures ANOVA was used to compare the dependent variables in LC muscle thickness, SCM muscle thickness, muscle thickness imbalance ratio, and sitting height across the FHP, ICT, and DNS conditions.
The present study involves a single-factor independent-measures design in which a group of subjects with FHP was measured under the following three conditions: baseline, ICT, and DNS. The outcome measures included sitting height measurement, and the LC and SCM muscle thickness and the associated LC/SCM muscle thickness balance ratio to determine better exercise condition among the two conditions.
Therefore, proper regulation of the ISSS is paramount for the successful management of the cervical or lumbar spinal pathology associated with either the entire cervical-thoracic-lumbopelvic segmental chain instability or one segmental chain instability (Frank et al, 2013). The purpose of the present study was to compare the two stabilization exercises to activate or facilitate the deep neck flexor muscles effectively, while providing an optimal upright spinal stabilization, by comparing between the local cervical chain-based ICT and integrated entire segmental chain-based DNS techniques. We hypothesized that integrated entire segmental chain-based DNS would produce superior effects on the LC/SCM muscle thickness balance ratio and spinal upright height as compared with the local cervical chain-based ICT in participants with FHP.
The purpose of this study was to compare the immediate effects between two different exercises approaches on LC, SCM muscle thickness, LC/SCM thickness ratio and upright posture height in the sitting position in adults with FHP. Group of 43 young subjects with FHP were measured under baseline, during ICT, and DNS conditions.
대상 데이터
Convenience samples of 43 young subjects (mean age, 24.0±5.0 years) were recruited from a major university setting (Table 1).
The purpose of this study was to compare the immediate effects between two different exercises approaches on LC, SCM muscle thickness, LC/SCM thickness ratio and upright posture height in the sitting position in adults with FHP. Group of 43 young subjects with FHP were measured under baseline, during ICT, and DNS conditions. Two training conditions were randomly implemented in five sets, which lasted for 30-40 minutes, with a 5-minute resting interval.
데이터처리
Statistical analyses included descriptive means, standard deviations, and parametric analysis of variance. One-way repeated measures ANOVA was used to compare the dependent variables in LC muscle thickness, SCM muscle thickness, muscle thickness imbalance ratio, and sitting height across the FHP, ICT, and DNS conditions. The post-hoc analyses were performed.
성능/효과
The present study highlights important immediate therapeutic effects of two different exercises approaches on muscle thickness and upright posture height in the sitting position in adults with FHP. The results of present study demonstrated that DNS exercise showed more significant differences between the baseline and exercise on the sitting height ratio than in ICT exercise for individuals with FHP. This study also revealed that ICT and DNS exercises showed more significant differences between the FHP (baseline) and exercise on the LC thickness, LC/SCM ratio and sitting height ratio.
This findings were in line with our hypothesis that integrated entire segmental chain-based DNS would produce a greater effect on spinal upright height than the local cervical chain-based ICT in participants with FHP. The present ultrasonography data analysis demonstrated that the muscle balance more substantially improved after DNS and ICT exercises than FHP condition.
The results of present study demonstrated that DNS exercise showed more significant differences between the baseline and exercise on the sitting height ratio than in ICT exercise for individuals with FHP. This study also revealed that ICT and DNS exercises showed more significant differences between the FHP (baseline) and exercise on the LC thickness, LC/SCM ratio and sitting height ratio.
후속연구
Another limitation is that the present study examined the immediate effect of local and global core stabilization techniques; hence, whether such effects may have a long-term change in terms of deep neck flexor muscle motor control and postural changes in individuals with FHP is unknown. This study invites future research to ascertain this assumption so that we may comfortably generalize our novel findings when providing effective clinical management associated with core instability and FHP.
참고문헌 (23)
Amiri Arimi S, Mohseni Bandpei MA, Javanshir K, et al. The effect of different exercise programs on size and function of deep cervical flexor muscles in patients with chronic nonspecific neck pain. Am J Phys Med Rehabil. 2017;96(8):582-588. https://doi.org/10.1097/PHM.0000000000000721
Bogin B, Varela-Silva MI. Leg length, body proportion, and health: A review with a note on beauty. Int J Environ Res Public Health. 2010;7(3):1047-1075. https://doi.org/10.3390/ijerph7031047
Borghuis J, Hof AL, Lemmink KA. The importance of sensory-motor control in providing core stability. Sports Med. 2008;38(11):893-916. https://doi.org/10.2165/00007256-200838110-00002
Caneiro JP, O'Sullivan P, Burnett A, et al. The influence of different sitting postures on head/neck posture and muscle activity. Man Ther. 2010;15(1):54-60. https://doi.org/10.1016/j.math.2009.06.002
Cha YJ, Yoon H, Jung DH, et al. The best lumbothoracic-cervical chain stabilization exercise for longus colli activation. J Med Imaging Health Inform. 2018;8(1):84-87. https://doi.org/10.1166/jmihi.2018.2237
Clark M, Lucett S. NASM Essentials of corrective exercise training. Philadelphia, Lippincott Williams & Wilkins. 2010:316-326,351-360.
Falla D, Jull G, Alba PD, et al. An electromyographic analysis of the deep cervical flexor muscles in performance of craniocervical flexion. Phys Ther. 2003;83(10):899-906.
Falla D, Jull G, Russell T, et al. Effect of neck exercise on sitting posture in patients with chronic neck pain. Phys Ther. 2007;87(4):408-417. https://doi.org/10.2522/ptj.20060009
Javanshir K, Mohseni-Bandpei MA, Rezasoltani A, et al. Ultrasonography of longus colli muscle: A reliability study on healthy subjects and patients with chronic neck pain. J Bodyw Mov Ther. 2011;15(1):50-56. https://doi.org/10.1016/j.jbmt.2009.07.005
Jones FP, Hanson JA, Gray FE. Head balance and sitting posture II: The role of the sternomastoid muscle. J. Psychol. 1961;52(2):363-367. https://doi.org/10.1080/00223980.1961.9916536
Jull GA, Falla D, Vicenzino B, et al. The effect of therapeutic exercise on activation of the deep cervical flexor muscles in people with chronic neck pain. Man Ther. 2009;14(6):696-701. https://doi.org/10.1016/j.math.2009.05.004
Kendall FP, McCreary EK, Provance PG. Muscles, Testing and Function: With Posture and Pain. 4th ed. Baltimore, Williams and Wilkins. 1993.
Kobesova A, Kolar P. Developmental kinesiology: three levels of motor control in the assessment and treatment of the motor system. J Bodyw Mov Ther. 2014;18(1):23-33. https://doi.org/0.1016/j.jbmt.2013.04.002
Kolar P, Kobesova A, Valouchova P, Bitnar P. Dynamic Neuromuscular Stabilization: Developmental kinesiology: breathing stereotypes and postural-locomotion function. Recognizing and treating breathing disorders. 2nd ed. Edinburgh, Churchill Livingstone. 2014:13-16.
Lee JJ, Kim DH, Yu KH, et al. Comparison of isometric cervical flexor and isometric cervical extensor system exercises on patients with neuromuscular imbalance and cervical crossed syndrome associated forward head posture. Biomed Mater Eng. 2018 29(3):289-298. https://doi.org/10.3233/BME-181728
Liebenson C. Rehabilitation of the Spine: A Practitioner's Manual. 2nd ed. Philadelphia, Lippincott Williams & Wilkins. 2007:513-530, 852-870.
Page P, Frank C, Lardner R. Assessment and Treatment of Muscle Imbalance: The Janda Approach. Champlain, Human Kinetics. 2010: 5-12,27-42,53-55.
Romero-Franco N, Martinez-Lopez E, Lomas-Vega R, et al. Effects of proprioceptive training program on core stability and center of gravity control in sprinters. J Strength Cond Res. 2012;26(8):2071-2077. https://doi.org/10.1519/JSC.b013e31823b06e6
Sawyer QL. Effects of forward head rounded shoulder posture on shoulder girdle flexibility, range of motion, and strength. Chapel hill, University of North Carolina, Master Thesis. 2006.
Schmidt S, Amereller M, Franz M, et al. A literature review on optimum and preferred joint angles in automotive sitting posture. Appl Ergon. 2014; 5(2):247-260. https://doi.org/10.1016/j.apergo.013.04.09
Singla D, Veqar Z. Association between forward head, rounded shoulders, and increased thoracic kyphosis: A review of the literature. J Chiropr Med. 2017;16(3):220-229. https://doi.org/10.1016/j.jcm.2017.3.004
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