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Introduction: Computers and visual display devices have become indispensable in our daily lives. The frequent use of these devices has led to the emergence of computer vision syndrome (CVS). Coupled with poor ergonomics, musculoskeletal diseases are on the rise due to excessive computer use. Accordingly, this study investigates the association between CVS and forward-headed and kyphotic posture in undergraduate IT students. Materials and Methods: We conducted an observational cross-sectional study involving 300 undergraduate IT students. We used a modified CVS questionnaire to assess CVS and the Kinovea software to diagnose forward head posture. We also used the occiput wall distance test to assess kyphosis. Results: In this study, a majority of undergraduate students (88%, 264 out of 300) exhibited CVS, resulting in forward head posture and kyphosis. There was a significant association between CVS, forward head posture, and kyphosis. Conclusion: Computer vision syndrome is strongly associated with forward head posture and kyphosis. Prolonged computer device usage leads to changes in body posture, affecting the neck, shoulders, elbows, wrists/hands, upper back, and lower back. [ABSTRACT FROM AUTHOR]

The presence of spinal arches is crucial for maintaining good body posture, reducing pressure on joints, and preventing deformities caused by misalignment. Engaging in exercises that focus on correcting body alignment, such as walking backward, can enhance posture and various related factors. A group of 46 female students suffering from forward head posture was selected (age: 22.89 ± 2.31 years, height: 1.63 ± 0.05 m, weight: 60.01 ± 5.41 kg, body mass index: 22.38 ± 1.28 kg/m2) and randomly divided into two groups. The intervention group participated in three exercise sessions per week for four weeks, while the control group did not receive any intervention during the study. Changes in the craniovertebral angle, proprioception, resistance, and foot pressure were measured using photogrammetry, head-neck angle examination with a laser pointer, a balance measuring device, and a foot scanner. The results of this study showed that the training program had a significant effect on the craniovertebral angle (P = 0.001), neck proprioception (P = 0.001), balance (P = 0.001), and sole pressure (P = 0.001). Likewise, the results of the group comparison revealed significant differences in various variables, such as the craniovertebral angle (P = 0.001), neck proprioception (P = 0.001), balance (P = 0.001), and plantar pressure (P ≥ 0.05). This study demonstrated that walking backward enhanced the craniovertebral angle, proprioception, balance, and alterations in the plantar center of pressure. Therefore, this exercise is recommended as a complementary therapeutic approach for individuals with forward head posture. [ABSTRACT FROM AUTHOR]

Forward head posture (FHP) has become a prevailing health issue in modern society as people spend more time on computers and smartphones. FHP is a posture where the head is forward and the anterior and posterior curvatures of the lower cervical and upper thoracic spines are both, respectively, exaggerated. FHP is often associated with neck pain, bad static balance, and hunched shoulders or back. To prevent this, consciously maintaining good posture is important. Therefore, in this study, we propose a system that gives users real-time, accurate information about their neck posture, and it also encourages them to maintain a good posture. This inexpensive system utilizes a single inertial measurement unit sensor and a Raspberry Pi system to detect the changes in state that can progress to an FHP. It retrieves data from the sensor attached to the user's cervical spine to indicate their real-time posture. In a real-world office environment experiment with ten male participants, the system accurately detected the transition to the FHP state for more than 10 s, with a delay of less than 0.5 s, and it also provided personalized feedback to encourage them to maintain good posture. All ten participants recognized that their average craniovertebral angle had to be increased after receiving visual alerts regarding their poor postures in real time. The results indicate that the system has potential for widespread applications. [ABSTRACT FROM AUTHOR]

Background: The craniovertebral (CV) junction is crucial for head support, mobility, and protecting the upper spinal cord and vital nerve structures. Disorders in this area can cause severe symptoms such as neck pain, restricted movement, and neurological issues such as headaches and balance problems. Exercise and physical activity improves muscle strength, flexibility, joint stability, reducing pain, and enhancing joint function, while specifically for the CV junction, exercise can relieve muscle tension, boost blood flow, and improve posture, although the specific impact on CV junction health remains underexplored. Methods: A comprehensive literature search was conducted using databases MEDLINE, Cochrane, Lilacs, and ScienceDirect, alongside manual searches through reference lists. The review focuses on exercise and CV junction issues and includes randomized controlled trials, cohort or case–control studies, and systematic reviews. Primary outcomes include pain levels, joint mobility, function, and quality of life. Results: Results yield four meta-analyses with corrective exercise and conventional exercise in improving forward head posture risk difference 0.00 (−0.09, 0.09) 95% confidence interval (CI), between cervical and thoracic exercises odds ratio 1.04 (0.59, 1.84) 95% CI. Comparing exercise treatment and physiotherapy showed risk difference 0.11 (−0.10, 0.32) 95% CI and the comparative analysis between training and no treatment showed risk difference 0.09 (−0.01, 0.20) 95% CI. Conclusion: Exercise-based rehabilitation programs tailored to patients with CV junction problems offer robust evidence, benefiting clinical management, and prevention efforts.

Purpose Forward head posture (FHP) may affect postural stability and balance. This study examines how smartphone texting while balancing, as a dual task, influences the body’s centre of pressure (CoP) during single-leg standing in individuals with FHP compared to those with normal posture. Methods The study utilized a randomized repeated measures design to assess single-leg standing balance and CoP across six conditions. Fifty participants, divided into two groups (25 with FHP and 25 with normal posture), underwent testing sequences involving non-smartphone usage (NU; single task), one-handed smartphone usage (1H; dual task), and two-handed smartphone usage (2H; dual task) on both soft and hard surfaces. Results The study found that individuals with FHP showed increased CoP sway compared to those with normal posture across all conditions. Both 1H and 2H increased sway compared to non-usage for both groups, with a notable difference in FHP individuals on soft surfaces, where 2H led to greater sway. Conclusions Individuals with FHP are at a higher risk of balance issues during both NU and smartphone use, particularly during 2H. These results highlight the importance of addressing the impact of FHP on balance control and implementing interventions to reduce associated risks.

Forward Head Posture (FHP) involves the anterior positioning of the head relative to the shoul-ders, often associated with muscular imbalances. It is known that individuals with FHP expe-rience shortening of craniocervical extensors and cervical flexors. However, contrary to the understanding of flexion in the craniocervical extension subaxial region, a study has reported flexion in the craniovertebral spinal vertebrae among individuals with FHP. The aim of this study was to examine the consistency of biomechanical study results conducted for FHP. The relevant studies were investigated in PubMed and Google Scholar databases using the key-words “forward head posture OR cervical sagittal alignment OR cervical spine AND biome-chanics OR kinetic analysis OR kinematic analysis.” During the research selection process, only nine studies relevant to the purpose of our study were identified. Out of these nine studies, four conducted kinematic analysis related to FHP formation, while six conducted kinetic analy-sis. During the comparison of these studies, five inconsistencies were identified. Biomechanical studies on FHP reveal conflicting findings, suggesting potential variability in the biomechanics of FHP formation across individuals. However, drawing definitive conclusions requires further exploration through additional biomechanical investigations on FHP in the future.

Abstract Individuals with psychotic disorders often lead sedentary lives, heightening the risk of developing forward head posture. Forward head posture affects upper cervical vertebrae, raising the likelihood of daily discomforts like skeletal misalignment, neck pain, and reduced cardiorespiratory fitness. Improving cardiorespiratory fitness in psychotic disorders is relevant, given its proven benefits in enhancing physical and mental health. This study investigates forward head posture by measuring craniovertebral angles in psychotic disorders and the relationship with reduced cardiorespiratory fitness. To determine whether forward head posture is specific to psychotic disorders, we also included individuals with autism spectrum disorder and healthy controls. Among 85 participants (32 psychotic disorders, 26 autism spectrum disorder, 27 healthy controls), photogrammetric quantification revealed a significantly lower mean craniocervical angle in psychotic disorders compared to autism spectrum disorder (p =

Introduction: Long-term physical contact while using a smartphone causes poor posture which leads to musculoskeletal disorders. The purpose of this study was to determine the efficacy of YWTL exercises on posture in motor and cognitive dual tasks during smartphone use. Methodology: Based on eligibility criteria for recruitment, 118 subjects were chosen. After being informed about the study, participants were allocated into two groups: Group A (the control group) and Group B (the experimental group). 59 individuals were allocated to each group. Before the initiation of interventions, each participant's personal information, including age, height, weight, BMI, occupation, and screen time, was collected. Primary outcome measures CVA, CHA, and SSP were evaluated at the start of the intervention and three weeks later after the intervention. Results: The result of the study revealed that both groups' interventions effectively improved forward head posture affected by prolonged use of smartphones. All outcome measures showed a statistically significant improvement after 3 weeks. However, on comparison between both groups, the YWTL exercises group had a more clinically significant reduction in outcomes. Conclusion: The study's findings indicated that the application of 3 weeks of YWTL exercises combined with neck isometrics is an effective method to reduce the cranio-horizontal angle, craniovertebral angle, and sagittal shoulder angle consequently resulting in a reduction of forward head posture. [ABSTRACT FROM AUTHOR]

BACKGROUND: People with forward head posture (FHP) and rounded shoulder posture (RSP) may experience shifts in scapular position and alterations in the strength of the muscles surrounding the scapula. Therefore, a reliable scapula position and scapula muscle strength test are required to identified scapula problem and provided appropriate intervention programs. OBJECTIVE: This study aimed to determine the reliability of scapular position measurements obtained using a modified digital inclinometer and palpation meter, as well as muscle strength using a hand-held dynamometer (HHD) in individuals with FHP and RSP. METHODS: Thirty healthy subjects underwent scapular position tests (upward rotation, anterior tilt, depression, and protraction) and strength tests of periscapular muscles (serratus anterior, upper trapezius, middle trapezius, and lower trapezius) on both the dominant and non-dominant sides. The reliability of the measurements was confirmed by computing the intraclass correlation coefficient (ICC), standard error of measurement (SEM), and minimal clinically important difference (MCID). Test and re-tests were conducted over a period of one week and actual values for each measurement were also obtained and assessed. RESULTS: The ICC ranged from 0.802 to 0.935 for the scapular position tests and from 0.808 to 0.949 for muscle strength tests on the dominant and non-dominant sides. For scapular position tests, SEM values ranged from 0.3 cm to 0.6 cm (protraction and depression), from 1.0∘ to 1.7∘ (upward rotation and anterior tilt) and MCID values ranged from 0.7 cm to 1.6 cm (protraction and depression), from 2.8∘ to 4.7∘ (upward rotation and anterior tilt). Regarding muscle strength tests, SEM and MCID values were in the range 14.4N–27.3N and 39.9N–75.7N, respectively. CONCLUSIONS: Scapular position and periscapular muscle strength can be reproducibly measured in healthy subjects individuals with FHP and RSP. These instruments can hence be recommended for evaluating these functional traits in subjects with FHP and RSP. [ABSTRACT FROM AUTHOR]

Muscle activity of the anterior and posterior elements of the cervical spine, both together actively contribute to the balance of the head position over the neck. Increasing muscular tension of the one cervical muscle group could induce poor motor control of cervical spine joints, this might contribute to the anterior position of the head with neck, known as forward head posture (FHP). We propose posterior neck weighting as an innovative orthosis to correct head posture within FHP participants and improve co-related mechanical neck pain. Sixty-one participants with FHP; were randomly assigned to one of two groups posterior cervical weighing orthosis (PCWO) or deep cervical flexion (DCF) exercise. Each participant has been assessed for change in Craniovertebral Angle (CVA) as an indicator for FHP severity, and neck disability index (NDI). Wilcoxon Signed Rank Test showed a statistically significant change difference regarding the degree of CVA improvements, and the score of NDI of pre-and post-intervention of the PCWO group (p < 0.0001), (p < 0.0001), and of the DCF group (p < 0.0001), (p = 0.0039), respectively. Mann–Whitney Test, showed a statistically significant difference between groups for CVA improvement (p < 0.0001), and NDI (p = 0.045). No correlation between CVA and NDI scores within the PCWO group (r = 0.129, p = 0.473), and within the DCF exercise group (r = 0.073, p = 0.71). PCWO is a novel and innovative neck orthosis that is considered a promising intervention to correct FHP and improve correlated neck disability. [ABSTRACT FROM AUTHOR]

Background: Recent studies have found forward head posture (FHP) is associated with altered physiology. There is a lack of research into whether FHP is associated with altered gait parameters when cognitively challenged. Our hypothesis is that individuals with FHP and those without will demonstrate different responses when undergoing dual-task assessment. Methods: Forty-five asymptomatic participants with FHP, defined as a craniovertebral angle (CVA) < 50°, were matched to forty-five participants with normal head posture (NHP) with a CVA > 55°. Participants walked along a 10 m platform under a control condition (no cognitive load) while an optical motion-capture system assessed gait kinematics. Secondly, participants were assessed under a dual-task cognitive load condition to identify the impact on gait kinematics. Results: Under the single-task condition, there were no significant differences for any gait parameter. In the dual-task condition, 12/13 gait parameters were significantly altered for the FHP vs. NHP group (p < 0.01). A calculation of the dual-task cost (DTC) percentage showed significant increases in all gait parameters in participants with FHP (p < 0.02). Correlations between the CVA and gait parameters were not significant for the single-task condition, but all gait parameters were correlated to CVA for the dual-task condition (p < 0.01). The correlation between CVA and DTC for all gait variables was significant (p < 0.04). Conclusions: This study demonstrates that FHP significantly increases the cognitive cost during walking, highlighting the importance of proper postural alignment for maintaining cognitive function under a dual-task condition. [ABSTRACT FROM AUTHOR]

Background: Myofascial Trigger Points (MTrPs) play a significant role in the pathogenesis of Tension Type Headache (TTH). Abnormal cranio-cervical posture has been linked to various types of headaches. However, the correlation between MTrPs sensitivity, cervical postural alignment, and clinical measures of headache has not been extensively studied in patients with TTH. Objectives: To investigate the relationship between MTrPs sensitivity in cervical and pericranial muscles, cervical postural abnormality, and clinical headache parameters in patients with TTH. Furthermore, to investigate the effect of sex on the examined variables and their association with headache type (episodic vs chronic TTH). Methods: A total of 72 patients with TTH of both sexes were enrolled in this study. Headache frequency and disability as clinical measures of headache, pressure pain threshold (PPT) of bilateral upper trapezius (UT) and suboccipital (SUB) muscles, cervical lordosis angle (CA), and anterior head translation (AHT) were measured. Results: Pericranial MTrPs sensitivity did not demonstrate any correlation with clinical headache parameters or cervical postural abnormality. However, there was a significant correlation between the frequency of headaches and the level of disability (r = 0.32, P < 0.05). In addition, episodic TTH was more prevalent in females who exhibited greater AHT and MTrPs sensitivity of both bilateral UT and right SUB muscles than males. Conclusions: There was no correlation found between the frequency of headaches and the level of disability with measures of cervical posture alignment or MTrPs sensitivity in individuals with TTH.. Based on findings, Clinicians should consider sex differences when assessing patients with TTH. [ABSTRACT FROM AUTHOR]

Introduction: Forward head posture is one of the most common postural abnormalities among students, which affects their postural control (balance). Although there is a trend toward using exergames to improve balance, the effectiveness of exergames specifically designed to improve balance in students with forward head posture is unclear. Therefore, the present study aimed to investigate the effect of exergames on the static balance of children with forward head posture. Methods: In this quasi-experimental study carried out using a pre-test, post-test, and a control group design, 30 boys with forward head posture in Takestan City with an age range of 7 to 12 years old were purposively selected and assigned to two groups, namely the Exergames and the Control groups. In the pre-test phase, the participants performed three attempts of the Stork test (static balance). The intervention phase was carried out over eight weeks with two sessions per week, each session lasting 30 minutes, during which the participants performed the relevant exercises. Following the training phase, the post-test phase was conducted, where the participants performed the static balance test as in the pre-test phase. The data were analyzed by univariate analysis of covariance. Results: The results showed that exergames significantly improved the static balance of children with forward head posture (F=22.94, P=0.001). Conclusion: In general, the results of the present study highlight the importance of exergames in the static balance of children with head forward posture, and it is recommended that the benefits of these exercises should be used to improve static balance. [ABSTRACT FROM AUTHOR]

Individuals with psychotic disorders often lead sedentary lives, heightening the risk of developing forward head posture. Forward head posture affects upper cervical vertebrae, raising the likelihood of daily discomforts like skeletal misalignment, neck pain, and reduced cardiorespiratory fitness. Improving cardiorespiratory fitness in psychotic disorders is relevant, given its proven benefits in enhancing physical and mental health. This study investigates forward head posture by measuring craniovertebral angles in psychotic disorders and the relationship with reduced cardiorespiratory fitness. To determine whether forward head posture is specific to psychotic disorders, we also included individuals with autism spectrum disorder and healthy controls. Among 85 participants (32 psychotic disorders, 26 autism spectrum disorder, 27 healthy controls), photogrammetric quantification revealed a significantly lower mean craniocervical angle in psychotic disorders compared to autism spectrum disorder (p = < 0.02) and the healthy control group (p = < 0.01). Reduced craniovertebral angle is related to diminished cardiorespiratory fitness in psychosis (R2 = 0.45, p = < 0.01) but not in other control groups. This study found reduced craniovertebral angles, indicating forward head posture in psychotic disorders. Moreover, this relates to diminished cardiorespiratory fitness. Further research is needed to examine the underlying causes and to investigate whether this can be reversed through physical therapy. [ABSTRACT FROM AUTHOR]

Currently, the market for wearable devices is expanding, with a growing trend towards the use of these devices for continuous-monitoring applications. Among these, real-time posture monitoring and assessment stands out as a crucial application given the rising prevalence of conditions like forward head posture (FHP). This paper proposes a wearable device that combines the acquisition of electromyographic signals from the cervical region with inertial data from inertial measurement units (IMUs) to assess the occurrence of FHP. To improve electronics integration and wearability, e-textiles are explored for the development of surface electrodes and conductive tracks that connect the different electronic modules. Tensile strength and abrasion tests of 22 samples consisting of textile electrodes and conductive tracks produced with three fiber types (two from Shieldex and one from Imbut) were conducted. Imbut's Elitex fiber outperformed Shieldex's fibers in both tests. The developed surface electromyography (sEMG) acquisition hardware and textile electrodes were also tested and benchmarked against an electromyography (EMG) gold standard in dynamic and isometric conditions, with results showing slightly better root mean square error (RMSE) values (for 4 × 2 textile electrodes (10.02%) in comparison to commercial Ag/AgCl electrodes (11.11%). The posture monitoring module was also validated in terms of joint angle estimation and presented an overall error of 4.77° for a controlled angular velocity of 40°/s as benchmarked against a UR10 robotic arm. [ABSTRACT FROM AUTHOR]

Objective: Forward head posture (FHP) is a common postural disorder that alters shoulder function. This study examined the efficacy of a corrective program involving postural correction exercises (PCEs), scapular stabilization exercises (SSEs), and kinesiotaping (KT) on improving craniovertebral angle (CVA), scapular position, and dominant hand grip strength (HGS) in individuals with FHP. Methods: Sixty subjects (8 males and 52 females, 18–40 years old) were randomly allocated into four equal groups: Group A: received PCEs only, Group B: received PCEs and SSEs, Group C: received PCEs and KT, Group D: received PCEs, SSEs and KT. All subjects received treatment for 4 weeks (4 times/week) and postural advice. Outcome measures included cranio‐vertebral angle (CVA), scapular position using Lateral Scapular Slide Test and dominant HGS using a CAMRY dynamometer that were assessed at baseline and 4 weeks post intervention. Results: Comparing all groups post training revealed that there were statistically significant increases (p < 0.05) in all measured variables (CVA, scapular position and dominant HGS) in favor of group (D). Conclusion: Combination of PCEs, SSEs and KT interventions has achieved the best gains in terms of CVA, dominant HGS and regaining optimal scapular position in FHP subjects. [ABSTRACT FROM AUTHOR]

Purpose. Forward head posture (FHP) may affect postural stability and balance. This study examines how smartphone texting while balancing, as a dual task, influences the body's centre of pressure (CoP) during single-leg standing in individuals with FHP compared to those with normal posture. Methods. The study utilized a randomized repeated measures design to assess single-leg standing balance and CoP across six conditions. Fifty participants, divided into two groups (25 with FHP and 25 with normal posture), underwent testing sequences involving non-smartphone usage (NU; single task), one-handed smartphone usage (1H; dual task), and two-handed smartphone usage (2H; dual task) on both soft and hard surfaces. Results. The study found that individuals with FHP showed increased CoP sway compared to those with normal posture across all conditions. Both 1H and 2H increased sway compared to non-usage for both groups, with a notable difference in FHP individuals on soft surfaces, where 2H led to greater sway. Conclusions. Individuals with FHP are at a higher risk of balance issues during both NU and smartphone use, particularly during 2H. These results highlight the importance of addressing the impact of FHP on balance control and implementing interventions to reduce associated risks. [ABSTRACT FROM AUTHOR]

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Non-specific neck pain (NSNP) is one of the most significant health problems especially with frequent use of media devices as computers and cell phones that may be associated with some faulty postures as forward head posture or rounded shoulders. The aim of this study was to investigate the relation of neck, head and shoulders angles: cranio-cervical angle (CVA), forward shoulder angle (FSA), coronal shoulder angle (CSA) and sagittal head tilt angle (SHT) with the non-specific neck pain. A total of ‏ 100 females with non-specific neck pain, whose ages were ranged between 18-25 years old. Numeric Pain Rating Scale (NPRS) and Digital Camera were used to assess neck pain, and neck different angles of cervical and shoulders, respectively. There was indicated a positive and significant correlation between NPRS and FSA (P < 0.045), while there were non-significant correlations between NPRS and other variables (P > 0.05). It was found that there was a significant positive correlation between forward shoulder angle and non-specific neck pain in the sample of female participants. However, no significant associations were observed between neck pain intensity and CCA, CSA, and SHT. Addressing and improving forward shoulder angles may be a potential strategy to reduce neck pain in individuals with non-specific neck pain.

Purpose: Forward head posture (FHP) is the most common cervical postural fault in the sagittal plane that can cause various issues and conditions. The purpose of this study is to determine the prevalence of FHP among sports-involved children and to examine the differences in craniovertebral angle (CVA) with regard to gender, age, neck pain, and the sports in which they participate. Methods: A cross-sectional study was conducted among 154 sports-involved children (76 males and 78 females), aged 11–14, participating in various sports (basketball, football, volleyball, and athletics). After obtaining signed consent, photography of the sagittal view was performed in a standing position, which was then used to measure the CVA using the Web Plot Digitizer software. A questionnaire was used to gather data about gender, age, sports in which a participant is involved, presence of neck pain, and pain scale. Results: Among the 154 children, 37 (24.03%) exhibited FHP (15 males, 22 females). The mean CVA for the entire sample was 51.30° ± 6.20°. Female participants had a significantly lower CVA (p = .021) compared to male participants. No significant differences were found with regard to age, presence of neck pain, or engagement in a specific sport. Conclusion: FHP is present in sports-involved children, with a higher prevalence among females.

Abstract Purpose The study aimed to investigate whether there is a difference in pulmonary function between individuals with forward head posture and those with neutral head posture. Methods A systematic search was conducted using the ResearchGate, PubMed, and Scholar databases following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) protocol. The eligibility criteria for the studies were that they investigated the relationship between Forward Head Posture (FHP) and Forced Vital Capacity (FVC) and/or Forced Expiratory Volume in one second (FEV1). Results A total of four comparison studies and two correlation studies met the inclusion criteria for this study. Across these four studies, encompassing a total of 115 participants, the observed reduction range for FVC was between -0.25 L and -0.81 L, while the reduction values for FEV1 ranged from -0.16 to -0.93 L. According to the results of the correlation studies, a positive correlation was observed between craniovertebral angle (CVA) and dynamic pulmonary volumes. Conclusion The existing evidence indicates that FHP can potentially cause abnormalities in pulmonary function. In this context, it is suggested that individuals with FHP should be monitored for changes in pulmonary function.

Abstract Background Abnormal posture (e.g. loss of lordosis) has been associated with the occurrence of musculoskeletal pain. Stretching tight muscles while strengthening the antagonists represents the most common method to treat the assumed muscle imbalance. However, despite its high popularity, there is no quantitative synthesis of the available evidence examining the effectiveness of the stretch-and-strengthen approach. Methods A systematic review with meta-analysis was conducted, searching PubMed, Web of Science and Google Scholar. We included controlled clinical trials investigating the effects of stretching or strengthening on spinal and lumbopelvic posture (e.g., pelvic tilt, lumbar lordosis, thoracic kyphosis, head tilt) in healthy individuals. Effect sizes were pooled using robust variance estimation. To rate the certainty about the evidence, the GRADE approach was applied. Results A total of 23 studies with 969 participants were identified. Neither acute (d = 0.01, p = 0.97) nor chronic stretching (d=-0.19, p = 0.16) had an impact on posture. Chronic strengthening was associated with large improvements (d=-0.83, p = 0.01), but no study examined acute effects. Strengthening was superior (d = 0.81, p = 0.004) to stretching. Sub-analyses found strengthening to be effective in the thoracic and cervical spine (d=-1.04, p = 0.005) but not in the lumbar and lumbopelvic region (d=-0.23, p = 0.25). Stretching was ineffective in all locations (p > 0.05). Conclusion Moderate-certainty evidence does not support the use of stretching as a treatment of muscle imbalance. In contrast, therapists should focus on strengthening programs targeting weakened muscles.

Objective Research conducted in recent decades indicates that rehabilitation exercises have a significant impact on improving complications associated with the upper limbs. Therefore, the aim of the present study is to review the effect of various exercise protocols on the improvement of upper crossed syndrome. Methods This study was a systematic review, involving a search for articles in both Farsi and English from December 2011 to April 2023. The search was conducted across specialized databases including PubMed, WOS, Scopus, SID, Magiran, ISC, Science Direct, JCR, and Google Scholar. Ultimately, 10 articles focusing on different exercise protocols for individuals with upper crossed syndrome were identified and examined. Results Six articles addressed the effect of various exercise protocols on posture improvement in individuals suffering from upper crossed syndrome, indicating that these exercises contribute to achieving proper posture. Additionally, four articles investigated the impact of different exercise protocols on enhancing dynamic and static balance in individuals with upper crossed syndrome, demonstrating a significant improvement in both static and dynamic balance through the implementation of these exercise protocols. Conclusion The findings of this review study highlight the efficacy of corrective exercises in ameliorating upper crossed syndrome.

Abstract Objectives The traditional understanding of craniocervical alignment emphasizes specific anatomical landmarks. However, recent research has challenged the reliance on forward head posture as the primary diagnostic criterion for neck pain. An advanced relationship exists between neck pain and craniocervical alignment, which requires a deeper exploration of diverse postures and movement patterns using advanced techniques, such as clustering analysis. We aimed to explore the complex relationship between craniocervical alignment, and neck pain and to categorize alignment patterns in individuals with nonspecific neck pain using the K-means algorithm. Methods This study included 229 office workers with nonspecific neck pain who applied unsupervised machine learning techniques. The craniocervical angles (CCA) during rest, protraction, and retraction were measured using two-dimensional video analysis, and neck pain severity was assessed using the Northwick Park Neck Pain Questionnaire (NPQ). CCA during sitting upright in a comfortable position was assessed to evaluate the resting CCA. The average of midpoints between repeated protraction and retraction measures was considered as the midpoint CCA. The K-means algorithm helped categorize participants into alignment clusters based on age, sex and CCA data. Results We found no significant correlation between NPQ scores and CCA data, challenging the traditional understanding of neck pain and alignment. We observed a significant difference in age (F = 140.14, p

Purpose:The effectiveness of neck stabilization exercises in reducing the pain of patients with neck pain has been reported in previous studies. Most of the interventions to improve thoracic mobility are dedicated to manual therapy, and the role of exercise therapy has received less attention. Therefore, the aim of this study was to compare the effect of neck stabilization exercises with and without thoracic mobility exercises on pain, proprioception, and posture of women with chronic neck pain and forward head posture.Methods:36 women with chronic neck pain and forward head posture were randomly divided into three groups of control, stabilization exercises, and stabilization exercises with thoracic mobility. The intervention groups did the exercises for 8 weeks, 3 sessions a week, and 45-60 minutes, and the control group continued their normal life. Pain, proprioception, and forward head posture angle were evaluated by visual analogue scale, cervical-cephalic relocation test, and craniovertebral angle, respectively. Data analysis was performed using repeated measure ANOVA and Bonferroni's post hoc test at an error level of 0.05 and using SPSS software version 26.Results:The stabilization exercises group with and without thoracic mobility showed significant improvement in proprioception, pain, and posture compared to the control group (p≤0.001). There was no significant difference between the experimental groups (p≥0.05). However, the stabilization exercises group with thoracic mobility had more improvement in posture and pain.Conclusion:Performing neck stabilization with and without thoracic mobility exercises is an effective intervention in improving posture, proprioception, and reducing pain in women with chronic neck pain. Therefore, the use of this exercise protocol is recommended as an effective treatment approach for women with neck pain.

Background: Upper crossed syndrome (UCS) is a prevalent postural issue among adolescents, with a rapid increase in its occurrence. This study aimed to investigate the impact of scapular stabilization exercises on alignment, joint position sense, and functional stability of the upper limbs in adolescent girls with UCS.Methods: This randomized, controlled trial, double-blind study was conducted in December 2022 at the Laboratory of Sport Science of Bu-Ali Sina University, Hamedan, Iran. The study included 48 adolescent girls with UCS. The participants were randomly assigned into either the experimental or the control group. The experimental group performed scapular stabilization exercises for eight weeks and the control group received no intervention. The outcome measures were kyphosis angle measured by a flexible ruler, forward head and rounded shoulder angles measured by photography and Kinovea software, shoulder joint position sense measured by a goniometer, and upper limb functional stability measured by the upper quarter Y-balance test. The assessments were done before and after the intervention.Results: The results showed that the experimental group improved significantly more than the control group on all the outcome measures (P

Forward head posture (FHP) is a common postural problem experienced by most people. However, its effect on brain activity is still unknown. Accordingly, we aimed to observe changes in brain waves at rest to determine the effect of FHP on the nervous systems. A total of 33 computer users (Male = 17; Female = 16; age = 22.18 ± 1.88) were examined in both FHP and neutral posture. For each session, brain waves were measured for 5 min, and then muscle mechanical properties and cranio-vertebral angle (CVA) were measured. Changes in brain waves between the neutral posture and FHP were prominent in gamma waves. A notable increase was confirmed in the frontal and parietal lobes. That is, eight channels in the frontal lobe and all channels in the parietal lobe showed a significant increase in FHP compared to neutral posture. Additionally, FHP changes were associated with a decrease in CVA (p < 0.001), an increase in levator scapulae tone (Right, p = 0.014; Left, p = 0.001), and an increase in right sternocleidomastoid stiffness (p = 0.002), and a decrease in platysma elasticity (Right, p = 0.039; Left, p = 0.017). The change in CVA was found to have a negative correlation with the gamma activity (P7, p = 0.044; P8, p = 0.004). Therefore, increased gamma wave activity in FHP appears to be related to CVA decrease due to external force that was applied to the nervous system and cervical spine. [ABSTRACT FROM AUTHOR]

Purpose: The study aimed to investigate whether there is a difference in pulmonary function between individuals with forward head posture and those with neutral head posture. Methods: A systematic search was conducted using the ResearchGate, PubMed, and Scholar databases following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) protocol. The eligibility criteria for the studies were that they investigated the relationship between Forward Head Posture (FHP) and Forced Vital Capacity (FVC) and/or Forced Expiratory Volume in one second (FEV1). Results: A total of four comparison studies and two correlation studies met the inclusion criteria for this study. Across these four studies, encompassing a total of 115 participants, the observed reduction range for FVC was between -0.25 L and -0.81 L, while the reduction values for FEV1 ranged from -0.16 to -0.93 L. According to the results of the correlation studies, a positive correlation was observed between craniovertebral angle (CVA) and dynamic pulmonary volumes. Conclusion: The existing evidence indicates that FHP can potentially cause abnormalities in pulmonary function. In this context, it is suggested that individuals with FHP should be monitored for changes in pulmonary function. [ABSTRACT FROM AUTHOR]

Background: Abnormal posture (e.g. loss of lordosis) has been associated with the occurrence of musculoskeletal pain. Stretching tight muscles while strengthening the antagonists represents the most common method to treat the assumed muscle imbalance. However, despite its high popularity, there is no quantitative synthesis of the available evidence examining the effectiveness of the stretch-and-strengthen approach. Methods: A systematic review with meta-analysis was conducted, searching PubMed, Web of Science and Google Scholar. We included controlled clinical trials investigating the effects of stretching or strengthening on spinal and lumbopelvic posture (e.g., pelvic tilt, lumbar lordosis, thoracic kyphosis, head tilt) in healthy individuals. Effect sizes were pooled using robust variance estimation. To rate the certainty about the evidence, the GRADE approach was applied. Results: A total of 23 studies with 969 participants were identified. Neither acute (d = 0.01, p = 0.97) nor chronic stretching (d=-0.19, p = 0.16) had an impact on posture. Chronic strengthening was associated with large improvements (d=-0.83, p = 0.01), but no study examined acute effects. Strengthening was superior (d = 0.81, p = 0.004) to stretching. Sub-analyses found strengthening to be effective in the thoracic and cervical spine (d=-1.04, p = 0.005) but not in the lumbar and lumbopelvic region (d=-0.23, p = 0.25). Stretching was ineffective in all locations (p > 0.05). Conclusion: Moderate-certainty evidence does not support the use of stretching as a treatment of muscle imbalance. In contrast, therapists should focus on strengthening programs targeting weakened muscles. Key Points: • Stretching of tight muscles and strengthening of weak muscles is popular in treating muscular imbalance of the pelvis and spine. While combined interventions have previously been meta-analyzed and shown to be effective, the effectiveness of both used in isolation has not been investigated. • This meta-analysis found no effects of stretching on posture while strengthening can improve imbalances/posture. • Additional studies including higher stretching volumes and intensities are warranted. [ABSTRACT FROM AUTHOR]

Objectives: The traditional understanding of craniocervical alignment emphasizes specific anatomical landmarks. However, recent research has challenged the reliance on forward head posture as the primary diagnostic criterion for neck pain. An advanced relationship exists between neck pain and craniocervical alignment, which requires a deeper exploration of diverse postures and movement patterns using advanced techniques, such as clustering analysis. We aimed to explore the complex relationship between craniocervical alignment, and neck pain and to categorize alignment patterns in individuals with nonspecific neck pain using the K-means algorithm. Methods: This study included 229 office workers with nonspecific neck pain who applied unsupervised machine learning techniques. The craniocervical angles (CCA) during rest, protraction, and retraction were measured using two-dimensional video analysis, and neck pain severity was assessed using the Northwick Park Neck Pain Questionnaire (NPQ). CCA during sitting upright in a comfortable position was assessed to evaluate the resting CCA. The average of midpoints between repeated protraction and retraction measures was considered as the midpoint CCA. The K-means algorithm helped categorize participants into alignment clusters based on age, sex and CCA data. Results: We found no significant correlation between NPQ scores and CCA data, challenging the traditional understanding of neck pain and alignment. We observed a significant difference in age (F = 140.14, p < 0.001), NPQ total score (F = 115.83, p < 0.001), resting CCA (F = 79.22, p < 0.001), CCA during protraction (F = 33.98, p < 0.001), CCA during retraction (F = 40.40, p < 0.001), and midpoint CCA (F = 66.92, p < 0.001) among the three clusters and healthy controls. Cluster 1 was characterized by the lowest resting and midpoint CCA, and CCA during pro- and -retraction, indicating a significant forward head posture and a pattern of retraction restriction. Cluster 2, the oldest group, showed CCA measurements similar to healthy controls, yet reported the highest NPQ scores. Cluster 3 exhibited the highest CCA during protraction and retraction, suggesting a limitation in protraction movement. Discussion: Analyzing 229 office workers, three distinct alignment patterns were identified, each with unique postural characteristics; therefore, treatments addressing posture should be individualized and not generalized across the population. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Physical Medicine & Rehabilitation Sciences is the property of Turkiye Klinikleri and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Upper crossed syndrome (UCS) is a prevalent postural issue among adolescents, with a rapid increase in its occurrence. This study aimed to investigate the impact of scapular stabilization exercises on alignment, joint position sense, and functional stability of the upper limbs in adolescent girls with UCS. Methods: This randomized, controlled trial, double-blind study was conducted in December 2022 at the Laboratory of Sport Science of Bu-Ali Sina University, Hamedan, Iran. The study included 48 adolescent girls with UCS. The participants were randomly assigned into either the experimental or the control group. The experimental group performed scapular stabilization exercises for eight weeks and the control group received no intervention. The outcome measures were kyphosis angle measured by a flexible ruler, forward head and rounded shoulder angles measured by photography and Kinovea software, shoulder joint position sense measured by a goniometer, and upper limb functional stability measured by the upper quarter Y-balance test. The assessments were done before and after the intervention. Results: The results showed that the experimental group improved significantly more than the control group on all the outcome measures (P<0.05). The experimental group had a significant decrease in kyphosis (P=0.001, 95%CI=[3.05%, 7.27%]), forward head (P=0.001, 95%CI=[4.21%, 7.70%]), rounded shoulder (P=0.001, 95%CI=[5.01%, 8.40%]) angles, and in joint reposition error (P=0.001, 95%CI=[1.07%, 2.89%]). Also, there was a significant improvement in upper limb functional stability in the right (P=0.042, 95%CI=[-3.56%, -0.91%]) and left (P=0.032, 95%CI=[-4.31%, -0.20%]) directions, as compared with the control group. Conclusion: The study results indicated that scapular stabilization exercises can improve alignment, joint position sense, and functional stability of the upper limbs in adolescent girls with UCS. Therefore, these exercises could be an effective intervention for preventing or treating UCS and its associated problems. [ABSTRACT FROM AUTHOR]

Background: Forward head posture (FHP) and altered cervical lordotic curvatures are common spine displacements often associated with neck pain and disability. Two primary categories for determining FHP exist: radiographic and postural measurements. Methods: This study investigated the correlation between the craniovertebral angle (CVA), the radiographically measured C2–C7 sagittal vertical axis (SVA), and cervical lordosis (absolute rotation angle: ARA C2–C7) in a sample of participants with chronic myofascial pain (CMP). In 120 participants, we performed both a postural measurement of the CVA and a lateral cervical radiograph, where the C2–C7 SVA and ARA C2–C7 were measured. A linear-regression R2 value to assess the correlation between the CVA, C2–C7 SVA, and ARA C2–C7 was sought. Results: A statistically significant weak linear fit was identified (Spearman's r = 0.549; R2 = 0.30, p < 0.001) between the CVA and C2–C7 SVA, having considerable variation between the two measures. A statistically significant linear fit (very weak) was identified for the lordosis ARA C2–C7 and the CVA: Spearman's r = 0.524; R2 = 0.275; p < 0.001. A value of 50° for the CVA corresponded to a value of 20 mm for the C2–C7 SVA on an X-ray. Conclusion: While the CVA and radiographic C2–C7 SVA are weakly correlated in an individual, they seem to represent different aspects of sagittal cervical balance. The CVA cannot replace radiographically measured cervical lordosis. We recommend that more emphasis be given to radiographic measures of sagittal cervical alignment than the CVA when considering patient interventions. [ABSTRACT FROM AUTHOR]

Stroke is a significant health problem that may result in long-term functional deficits. Balance and walking problems are among the most common post-stroke deficits, and they may negatively affect quality of life. Our aim in this study was to investigate the effects of cervical mobilization on balance and gait parameters after stroke. Participants were 24 adults (aged 30–65 years), who scored 24 or above on the Standardized Mini-Mental State Exam (MMSE) and no more than 3 on the Modified Rankin scale. Participants were randomly assigned to either an experimental Bobath therapy and cervical mobilization group (n = 12) or a control group who received Bobath therapy and a sham application (n = 12). Both groups received 60 minutes of Bobath therapy three times a week for four weeks; additionally, the experimental group received 15 minutes of cervical mobilization in each session, while the control group received 15 minutes of spinal sham mobilization each session. Pre and post treatment, we assessed all participants' demographic characteristics, gait parameters, balance parameters, and forward head posture values using a clinical data assessment form, spatiotemporal gait analysis (LEGSystm), portable computerized kinesthetic balance device (SportKAT 550), and craniovertebral angle (CVA), respectively. The groups showed no significant differences in their initial demographic and clinical characteristics (age, sex, stroke duration and disability levels.). In comparing changes on variables of interest, we observed significant experimental versus control group improvements in balance parameters except for their left side balance score (right side, left side, forward, backward and total balance scores were significant at p =.003, p =.089, p <.001, p =.022, p <.001, respectively), gait parameters (stride number, stride length, stride time, stride velocity, cadance at p =.007, p =.019, p =.013, p =.005, p =.001, respectively) and CVA (p <.001). Also, there were findings in favor of the experimental group on the modified timed up and go test on walk out, mid turn, walk back and total times (p =.028, p =.001, p =.016, and p =.001, respectively),but not for sit-to-stand time or stand-to-sit time. Clinicians involved in stroke rehabilitation should assess and treat the cervical region to enhance rehabilitation effectiveness. [ABSTRACT FROM AUTHOR]

Poor posture and sedentary lifestyle cause Forward Head Posture (FHP). To correct this, a Posture Correction Band (PCB) is commonly used. However, the efficacy of PCB vs. McKenzie's Exercises on pulmonary function and chest expansion in asymptomatic individuals with FHP was not known. Objective : This study aimed to determine the efficacy of PCB vs. McKenzie's Exercises on the Pulmonary function and chest expansion in asymptomatic population with FHP. Methodology: A Randomized control trial was conducted on forty-two subjects with FHP. Subjects were divided in two groups. G1 group was educated as per McKenzie's exercises to perform once daily for a month. The Pulmonary function test and chest expansion of this group was performed before and after the McKenzie exercises. G2 group wore PCB for 2 h daily for a month and their PFT and chest expansion was recorded before and after the trial. FVC, FEV1, FEV1/FVC ratio, PEFR and Chest expansion were measured. Results: The P-value of FVC, FEV1, FEV1/FVC ratio and PEFR between the groups (treatment group) was significant as 0.000, 0.000, 0.000 and 0.02 respectively. The chest expansion was non-significant between the groups (treatment group) with P-value as 0.553, 0.493 and 0.699 at axillary, 4th intercostal and xiphisternum level respectively. The P-value of FVC, FEV1, FEV1/FVC ratio and PEFR between the groups (control group) was non-significant as 0.682, 0.149, 0.424 and 0.414 respectively. The chest expansion was also non-significant between the groups (control group) with P-value as 0.853, 0.651 and 0.763 at axillary, 4th intercostal and xiphisternum level. Conclusion: The study concluded that there were significant effects of both Posture Correction Band and Mc'Kenzie exercises on pulmonary function with greater difference seen with PCB and non-significant effects on chest expansion in terms of P-values in treatment group. [ABSTRACT FROM AUTHOR]

Background and objectives. Forward head posture is associated with weakness in deep cervical short flexor & shortening of the opposing cervical extensor & Pectoralis muscles. Deep cervical flexor (DCF) has a major postural function in supporting and straightening the cervical lordosis. There were few studies on the correlation between craniovertebral angle & vertical mandibular opening. So there was a need to evaluate the effect of deep cervical muscle strengthening on forward head posture and vertical mandibular opening and find out the correlation between vertical mandibular opening (VMO) and craniovertebral angle(CVA). Materials and methods. A total of 84 subjects were included in an experimental study. Subjects were screened according to the inclusion and exclusion criteria. Selected CVA were assessed using MB ruler software (ICC= 0.88). Selected VMO was measured using a ruler (ICC= 0.95-0.96). Subjects received DCF strengthening using pressure biofeedback, 2 sets of 10 repetitions, 5 days per week for 4 weeks. “Paired t test” was used within the group to test the change in quantitative data, pre-intervention and post-intervention. For the correlation between VMO & CVA, Pearson’s correlation coefficient test was used. Results. Strengthening of DCF using pressure biofeedback was effective in improving CVA & VMO (p value

Forward head posture (FHP) has become a prevailing health issue in modern society as people spend more time on computers and smartphones. FHP is a posture where the head is forward and the anterior and posterior curvatures of the lower cervical and upper thoracic spines are both, respectively, exaggerated. FHP is often associated with neck pain, bad static balance, and hunched shoulders or back. To prevent this, consciously maintaining good posture is important. Therefore, in this study, we propose a system that gives users real-time, accurate information about their neck posture, and it also encourages them to maintain a good posture. This inexpensive system utilizes a single inertial measurement unit sensor and a Raspberry Pi system to detect the changes in state that can progress to an FHP. It retrieves data from the sensor attached to the user’s cervical spine to indicate their real-time posture. In a real-world office environment experiment with ten male participants, the system accurately detected the transition to the FHP state for more than 10 s, with a delay of less than 0.5 s, and it also provided personalized feedback to encourage them to maintain good posture. All ten participants recognized that their average craniovertebral angle had to be increased after receiving visual alerts regarding their poor postures in real time. The results indicate that the system has potential for widespread applications.

The purpose of this randomized controlled trial was to evaluate the effectiveness of the Myofascial Release Technique (MRT) along with Cognitive Behavioral Therapy (CBT) on pain, craniovertebral angle (CVA), and neck disability in university students with chronic neck pain and forward head posture. A total of sixty-six eligible participants with chronic neck pain and forward head posture were randomized into the Myofascial Release Therapy (MRT) group (n = 33) and MRT and Cognitive Behavior Therapy (CBT) group (n = 33). Clinical outcomes included neck pain measured using the numerical pain rating scale, neck disability measured through the neck disability index, and forward head posture measured through the cranial vertebral angle. The outcomes were assessed at baseline and the four and eight weeks after the intervention. Both groups showed significant improvement in pain intensity, CVA, and neck disability after the intervention. However, the CBT group demonstrated greater improvements than the MRT group. The difference in outcomes between the groups was statistically significant. Myofascial Release Therapy combined with CBT is an effective treatment method for patients with chronic neck pain and forward head posture. [ABSTRACT FROM AUTHOR]

Purpose: Kinesio taping is most widely used to correct postural dysfunction. Forward head and rounded shoulder posture (RSP) are common postural dysfunctions in the upper quadrant. Despite claims that Kinesio taping can be used to correct upper quadrant postural dysfunction, this seems to be controversial. Thus, our purpose is to determine the effect of Kinesio taping in subjects with upper quadrant postural dysfunction. Methods: The electronic databases searched include PubMed, EMBASE, Scopus, Cochrane and PEDro were searched from April 2001 to April 2023. Studies searched were included if they met the eligibility criteria. The Cochrane Collaboration's tool was used to assess the risk of bias. RevMan 5.3 software was used for meta-analysis. Results: Nine RCTs involving 293 participants were included. The present meta-analysis demonstrated significant differences between Kinesio taping groups and control groups in terms of forward shoulder angle (FSA). No significant difference was found regarding craniovertebral angle (CVA) and pain. Conclusion: In subjects with RSP, Kinesio taping is beneficial in correcting FSA and does not show improvement in CVA and pain. The findings of this meta-analysis should be interpreted with caution due to the low quality of the evidence. [ABSTRACT FROM AUTHOR]

Background: Upper Cross Syndrome (UCS) is now a commonly emerging syndrome in the presently existent population. In terms of clinical features, it can be defined as a postural disorder resulting from constriction of the pectoral muscles coupled with weakness of the trapezius and deep neck flexors, leading to forward-facing head stance, rounded shoulders, and kyphosis of the thoracic cavity. Comprehensive documentation of the incidence of this syndrome in multiparous communities is lacking in the literature. As a result, a study was carried out to ascertain the prevalence of UCS in multiparous women. Objective: To determine the prevalence of UCS in multiparous women. Methods: This study was approved by the Ethical Committee and the Protocol Committee (protocol no. 629/2022-2023). The subjects of the prospective cohort study were women who are multiparous and reside in Karad, Maharashtra, India. Using cluster sampling, 76 multiparous participants were included. Assessments were conducted for individuals within the age range of 23 to 58 years, evaluating them based on Craniovertebral Angle (CVA), Forward Head Posture (FHP), pectoralis minor tightness, and deep neck flexor strength. Results: This research looked at 76 participants involved in the study out of which 66.7% were prone to upper cross syndrome. Conclusion: The prevalence of UCS was notably high among multiparous women, with poor posture habits identified as a significant risk factor. [ABSTRACT FROM AUTHOR]

Forward Head Posture (FHP) refers to a condition where the head protrudes forward, significantly contributing to neck pain and being associated with decreased productivity and psychological distress. This study investigates the nuanced classification of FHP and proposes a universally applicable methodology for its identification and analysis using deep learning. Leveraging the Korean Facial Image (K-FACE) dataset, rigorous image preprocessing with the Yolo-v8 model was conducted to facilitate accurate measurement of the CranioVertebral Angle (CVA) from various perspectives. The study meticulously evaluated the classification effectiveness of three advanced deep learning models: EfficientNet-B7, NFNet-F7, and ResNet-152. Among these, EfficientNet-B7 demonstrated superior performance with an accuracy of 0.69 and a recall score of 0.69 compared to other models. Additionally, comparisons based on camera angles within the EfficientNet-B7 model highlighted its excellence, particularly at the ±75° angle. The importance of image regions in EfficientNet-B7 was confirmed through Grad-CAM analysis, emphasizing the critical role of the neck region in accurately classifying FHP images. This comprehensive performance comparison and the proposed detailed classification methodology underscore the potential for generalization in FHP classification. Furthermore, by leveraging a unique dataset and employing state-of-the-art classification techniques, this research offers a novel perspective on the discourse surrounding FHP. Future research could integrate expanded facial image datasets and apply transfer learning techniques to further enhance the precision of FHP classification, thereby improving diagnostic accuracy and offering targeted interventions for individuals experiencing neck pain associated with FHP. [ABSTRACT FROM AUTHOR]

Despite numerous attempts to correct forward head posture (FHP), definitive evidence-based screening and diagnostic methods remain elusive. This study proposes a preliminary diagnostic methodology for FHP, utilizing a noninvasive body angle measurement system as a screening test for FHP and incorporating radiological parameters for sagittal alignment. We enrolled 145 adolescents for FHP screening. The forward neck tilt angle (FNTA), defined as the angle between the vertical line and the line connecting the participant's acromion and tragus, was measured using the POM-Checker (a noninvasive depth sensor-based body angle measurement system). A whole-spine standing lateral radiograph was obtained, and eight sagittal alignment parameters were measured. Statistical analyses of the association between the FNTA and eight sagittal alignment parameters were conducted. We used 70% of the participant data to establish a preliminary diagnostic model for FHP based on FNTA and each sagittal alignment parameter. The accuracy of the model was evaluated using the remaining 30% of the participant data. All radiological parameters of sagittal alignment showed weak statistical significance with respect to FNTA (best case: r = 0.16, p = 0.0500; cranial tilt). The proposed preliminary diagnostic model for FHP demonstrated 95.35% agreement. Notably, the model using FNTA without radiological parameters accurately identified (100%) participants who required radiographic scanning for FHP diagnosis. Owing to the weak statistical significance of the association between radiological parameters and external body angle, both factors must be considered for accurate FHP diagnosis. When a clear and severe angle variation is observed in an external body angle check, medical professionals should perform radiographic scanning for an accurate FHP diagnosis. In conclusion, FNTA assessment of FNTA through the proposed preliminary diagnostic model is a significant screening factor for selecting participants who must undergo radiographic scanning so that a diagnosis of FHP can be obtained. [ABSTRACT FROM AUTHOR]

To evaluate the accuracy of and determine the best cutoff point for craniovertebral angle (CVA) and forward shoulder angle (FSA) in discriminating between two groups of individuals with different severities of forward head posture (FHP). A sample of 90 subjects aged 20–50 who had different severities of FHP was recruited. Participants were categorized into two groups based on observational method, namely individuals with slight FHP and those with moderate-to-severe FHP. The CVA and FSA were assessed using the photographic device. The accuracy of these measures was determined by calculation of sensitivity, specificity, area under the receiver operating characteristic curve, likelihood ratio (LR), and predictive value (PV). Our results show that CVA has high sensitivity (0.93) and acceptable area under the curve (0.88) in discriminating between the two groups of FHP (P <.01), but FSA cannot discriminate between the two groups of FHP (P =.06). The LR and PV results show that the CVA has a low negative LR (0.13) and a large negative PV (0.93). The best cutoff point for CVA was determined at 45.5 degrees. Overall, the results of the present study showed that CVA has a good accuracy in discriminating between two groups of individuals with slight and moderate-to-severe FHP. It can be valuable in correctly identifying the slight FHP and screening the moderate and severe grades of the FHP. Researchers and clinicians can also use the optimal cutoff point for the CVA obtained in this study to accurately quantify and classify the severity of the FHP. [ABSTRACT FROM AUTHOR]

Forward Head Posture (FHP) is when the head leans forward due to factors such as heavy backpacks or poor computer ergonomics. FHP can lead to neck strain and discomfort as well as potential long-term issues such as arthritis. Treatment options include specialized exercises, orthopedic devices, manual therapy, physical exercises, and visual feedback techniques, along with guidance from specialists in physical medicine and rehabilitation. In this study, a visual feedback-based approach was used to address FHP in female students. The study spanned ten days and included a visual feedback group and a control group. The results showed significant improvements in maximum head angle deviation in the visual feedback group compared to the control group; however, there was no significant change in the DFA number, indicating stability in policy control by the central nervous system. The study demonstrated that visual feedback sessions led to immediate benefits, with participants progressively acquiring skills involving the maintenance of proper head positioning. The test results indicated that the neck angle decreased to less than 15 degrees, indicating a return to a normal state. The versatility of the developed affordable and easy-to-use device and the potential for using smartphone motion sensors for similar visual feedback systems are discussed in this paper as well. The study suggests the promising potential of visual feedback in healthcare, including remote monitoring and smartphone-based solutions. [ABSTRACT FROM AUTHOR]

Introduction: Forward head posture (FHP) is one of the most common positional deviations. Frequent users often exhibit incorrect posture because of the rising popularity of media devices, such as smartphones and computers. This posture leads to changes in muscle activity in cervical flexion and extension. It is defined by hyperextension of the upper cervical vertebrae and forward translation of the cervical vertebrae. This study evaluates the effect of dry needles as a new method in the upper trapezius muscle on the neck's angles and range of motion (ROM) in individuals with FHP. Materials and Methods: In this quasi-experimental interventional study, 18 women with FHP underwent a dry needle session. The photogrammetry of the cranio-vertebral angle measured the degree of FHP. Visual analog scale (VAS), pain pressure threshold (PPT), cranio-vertebral angle (CVA) and cranio-horizontal angles (CHA), ROM, scapular index (SI), and forward shoulder translation (FST) were assessed before and after the intervention. Results: The results demonstrated that after the intervention, right and left PPT, flexion, and proper neck rotation, right and left SI, CVA, and CHA were significantly improved (P<0.05). Conclusion: The results showed that one session of dry needling with stretching exercises intervention could improve PPT, ROM, SI, CVA, and CHA and consequently improve FHP. [ABSTRACT FROM AUTHOR]

Background and objectives. Forward head posture is associated with weakness in deep cervical short flexor & shortening of the opposing cervical extensor & Pectoralis muscles. Deep cervical flexor (DCF) has a major postural function in supporting and straightening the cervical lordosis. There were few studies on the correlation between craniovertebral angle & vertical mandibular opening. So there was a need to evaluate the effect of deep cervical muscle strengthening on forward head posture and vertical mandibular opening and find out the correlation between vertical mandibular opening (VMO) and craniovertebral angle(CVA). Materials and methods. A total of 84 subjects were included in an experimental study. Subjects were screened according to the inclusion and exclusion criteria. Selected CVA were assessed using MB ruler software (ICC= 0.88). Selected VMO was measured using a ruler (ICC= 0.95-0.96). Subjects received DCF strengthening using pressure biofeedback, 2 sets of 10 repetitions, 5 days per week for 4 weeks. “Paired t test” was used within the group to test the change in quantitative data, pre-intervention and post-intervention. For the correlation between VMO & CVA, Pearson’s correlation coefficient test was used. Results. Strengthening of DCF using pressure biofeedback was effective in improving CVA & VMO (p value <0.0001) and moderate the positive correlation (r=0.4509) exist between CVA & VMO (p value <0.0001). Conclusions. The study concluded that strengthening of deep cervical flexors using pressure biofeedback is effective on improving vertical mandibular opening & craniovertebral angle in young adults (18-30 years) with forward head posture. [ABSTRACT FROM AUTHOR]

• Compared with healthy people, migraine patients presented more forward head posture (FHP). • Kyphotic angle was also significantly higher in patients with migraine. • Patients with migraine had higher Neck Disability Index (NDI) and VAS score. • The DIERS Formetric 4D motion imaging system is important diagnostic tool to assess posture analysis in migraine. The purpose of the current study was to investigate the forward head posture (FHP), thoracic kyphosis and their relationships between individuals with migraine and healthy controls using the DIERS Formetric 4D motion imaging system. In this observational case-control study, a total of 39 migraine patients and 44 healthy subjects were enrolled. FHP and thoracic kyphosis were assessed by using the 4D Formetric DIERS system. The visual analogue scale (VAS) and Neck Disability Index (NDI) was used to evaluate neck pain and neck disability. Headache status were evaluated through Migraine Disability Assessment (MIDAS) and Numeric Pain Rating Scale (NPRS) questionnaires. The fleche cervicale (57.72 ± 13.72 mm vs. 40.00 ± 4.75 mm; p < 0.001) and kyphotic angle (57.39 ± 8.76° vs. 38.21 ± 5.67°; p < 0.001) were significantly higher in patients with migraine compared to control group. When NDI categories were compared, the migraine group showed significantly increase in the number of patients with moderate or severe disability (p < 0.001). A positive correlation was found between fleche cervicale and thoracic kyphosis (r = 0.71, p < 0.001). This study revealed that patients with migraine exhibited a greater FHP and thoracic kyphosis compared to the control group. A 3-dimensional objective measurement may be a reliable diagnostic tool to evaluate posture analysis in clinical practice in the future. [ABSTRACT FROM AUTHOR]

Objective: This study investigated the influence of fear of falling, forward head posture (FHP), cervical proprioception, dynamic balance, and sensory integration on fall risk in older adults. Methods: Thirty-one participants were evaluated using tests designed to detect fall risk. FHP was assessed using a cervical range of motion device and craniovertebral angle (CVA) measurement. Results: Independent t tests were significant for Sensory Organization Test conditions 2 (P = .031) and 5 (P = .043) for FHP versus non-FHP groups. Regression analysis revealed that CVA could predict 16.7% variance in fall risk. Conclusion: CVA is a practical measure for measuring FHP and identifying fall risk in older adults. [ABSTRACT FROM AUTHOR]

Copyright of Annales Kinesiologiae is the property of Annales Kinesiologiae and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction- Neck pain is a most common complaint that we deal in the orthopedics OPD; most of which are IT professionals. In these individuals the incidence of forward head posture is high probably because of their vocational mismanagement. Materials and methods- A cross-sectional study was carried out from January 2019 to June 2019 during which total of 300 patients were taken into study. Clinical assessment of neck pain, head posture, range of motion and radiological assessment of Craniovertebral angle and anterior head translation was done. Results- Out of 300 patients, the major chunk was of males. On an average males used computers for 9.6 hours as compared to 9.2 hours of females. The average CVA was more in females (58.8). The average AHT was more in males (22.9). Discussion- As compared with the previous literature, our study showed 84.3% of males and 92.91 % of female participants had FHP. CVA was lower, while AHT was higher in both groups than the usual range. The mean anterior head translation in our sample was 18.8 mm, that was been found to be aberrant in prior research study. Conclusion- In our study we have found a negative correlation between the craniovertebral angle and anterior head translation resulting in forward head posture which can furthermore lead to early changes of cervical spondylosis in IT employees probably due to long hours of desktop usage resulting in fixed postural habit.