Kim, Dajeong
(Department of Physical Therapy, Yongin University)
,
An, Hojung
(Department of Physical Therapy, Dongnam Health University)
,
Kim, Nyeonjun
(Department of Physical Therapy, Pohang University)
,
Kim, Ayeon
(Department of Physical Therapy, Yongin University)
,
Hong, Geurin
(Department of Physical Therapy, Yongin University)
,
Kim, Soonhee
(Department of Physical Therapy, Yongin University)
Background: Adults with forward head posture (FHP) often suffer from thoracic hyperkyphosis and thoracic dysfunction, and including reduction of the craniovertebral angle (CV angle) and tightening of the superficial neck muscles. In order to treat thoracic dysfunction, interventions aimed at improvi...
Background: Adults with forward head posture (FHP) often suffer from thoracic hyperkyphosis and thoracic dysfunction, and including reduction of the craniovertebral angle (CV angle) and tightening of the superficial neck muscles. In order to treat thoracic dysfunction, interventions aimed at improving thoracic mobility are necessary. Objectives: To examine the effects of maitland manual mobilization therapy on the thoracic spine in adults with FHP. Design: Single-blind randomized controlled trial. Methods: Thirty adults with FHP who met the selection criteria were randomized to the thoracic multiple joint mobilization (TMJM; n=15) group and the thoracic general joint mobilization (TGJM; n=15) group. Joint mobilizations were performed for 23 minutes a day for 4 weeks continuously, two times per week. Outcome measures were ImageJ, BTS FREE EMG 1000, neck disability Index (NDI). Results: Although changes in the left sternocleidomastoid muscle activity and NDI scores over time between the two groups differed, other variables were noted only changes observed over time. Muscle activity in the right sternocleidomastoid increased again in the TGJM group post-intervention and 2 weeks after the end of the experiment, but changes in other variables were retained or improved, confirming the lasting effects of thoracic joint mobilization. Conclusion: Thoracic multiple joint mobilization may be recommended as a more effective intervention for adults with FHP.
Background: Adults with forward head posture (FHP) often suffer from thoracic hyperkyphosis and thoracic dysfunction, and including reduction of the craniovertebral angle (CV angle) and tightening of the superficial neck muscles. In order to treat thoracic dysfunction, interventions aimed at improving thoracic mobility are necessary. Objectives: To examine the effects of maitland manual mobilization therapy on the thoracic spine in adults with FHP. Design: Single-blind randomized controlled trial. Methods: Thirty adults with FHP who met the selection criteria were randomized to the thoracic multiple joint mobilization (TMJM; n=15) group and the thoracic general joint mobilization (TGJM; n=15) group. Joint mobilizations were performed for 23 minutes a day for 4 weeks continuously, two times per week. Outcome measures were ImageJ, BTS FREE EMG 1000, neck disability Index (NDI). Results: Although changes in the left sternocleidomastoid muscle activity and NDI scores over time between the two groups differed, other variables were noted only changes observed over time. Muscle activity in the right sternocleidomastoid increased again in the TGJM group post-intervention and 2 weeks after the end of the experiment, but changes in other variables were retained or improved, confirming the lasting effects of thoracic joint mobilization. Conclusion: Thoracic multiple joint mobilization may be recommended as a more effective intervention for adults with FHP.
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제안 방법
All subjects were assessed pre-test, post-test 4 weeks after the intervention, and at follow-up 2 weeks after the end of the experiment. Each session was conducted for 23 minutes per day, twice a week for 4 weeks.
To measure cervical muscle activity in the subjects’ posture during task performance, subjects adopted a sitting position and a desk with a medium height was placed between the xiphoid process of the sternum and umbilicus. Subjects were then asked to adopt a comfortable position and look at their smartphones for 1 minute with both elbow joints on the desk to measure muscle contraction data from both the sternocleidomastoid and the upper trapezius muscles.
The study was a single-blinded and randomized-controlled clinical trial. All subjects the order was randomly selected using an opaque envelope by the researcher, who has no conflict of interest with the present study.
This study examined whether imbalance in the pattern of muscle activity was improved in adults with FHP by measuring cervical muscle activity, superficial postural muscle activity, and sternocleidomastoid and upper trapezius muscle activity by analyzing it using the %MVC method. A relative reduction in muscle activity of the superficial muscles of the neck and shoulders following the intervention may thus be regarded as a positive result.
대상 데이터
A sticker was attached as a reference point on the tragus and the seventh cervical (C7) spinous process of subjects before they were asked to sit in a comfortable position. A portable camera (Samsung GALAXY S10+; Samsung, Seoul, South Korea) was installed 1 m from the subjects. The subjects were performed self-balanced postures (SBP) three times.
All subjects the order was randomly selected using an opaque envelope by the researcher, who has no conflict of interest with the present study. A subject recruitment notice was posted for 2 weeks on a campus bulletin board at D University in Suwon-si, South Korea, to recruit 60 adult males and females who agreed to participate in the study. The selection criteria were adult females or males in their 20s who agreed to participate and had 1) a CV angle of <51˚, 2) no known neurological disease or surgery in the cervical or thoracic regions in the previous 3 months,11 and3) no cerebrovascular diseases such as headaches, dizziness, or vomiting.
성능/효과
Based on the above results, we conclude that both groups showed significant differences in time lapse and that the maintenance and improvement of all variables, excluding the right sternocleidomastoid muscle activity, 2 weeks after the end of the experiment suggest that thoracic joint mobilization can be an effective intervention method for improving FHP.
In this study, the effect on cervical alignment, muscle activity and NDI was confirmed by applying different thoracic joint mobilization techniques for 4 weeks to adults with FHP. The TMJM and TGJM groups both showed significant differences in all variables after the 4-week intervention, with significant intergroup differences in left sternocleidomastoid muscle activity and NDI.
In this study, the effect on cervical alignment, muscle activity and NDI was confirmed by applying different thoracic joint mobilization techniques for 4 weeks to adults with FHP. The TMJM and TGJM groups both showed significant differences in all variables after the 4-week intervention, with significant intergroup differences in left sternocleidomastoid muscle activity and NDI. However, no significant intergroup difference in other variables was found.
후속연구
Therefore, future research should focus on various age groups and a longer study period on segments that are direct sources of pain and low mobility in patients, rather than on a limited number of segments by dividing them into upper thoracic (T1–T4), middle thoracic (T5–T9), and lower thoracic (T10–T12).
Therefore, future research should focus on various age groups and a longer study period on segments that are direct sources of pain and low mobility in patients, rather than on a limited number of segments by dividing them into upper thoracic (T1–T4), middle thoracic (T5–T9), and lower thoracic (T10–T12). Using the two different application methods for the same duration, future studies need to investigate in detail differences in effects by confirming changes in posture factors and muscle activities; we hope to confirm these effects in a larger cohort using other assessment tools.
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