27 - Jpts 2014 785
27 - Jpts 2014 785
27 - Jpts 2014 785
Kyeong-Jin Lee1), Hee-Young Han1), Song-Hee Cheon, PT, PhD1), So-Hyun Park, PT, PhD1),
Min-Sik Yong, PT, PhD1)*
1) Department of Physical Therapy, Youngsan University: 288 Joonam-ro, Yangsan, Kyeongsangnam-
do, Republic of Korea
Abstract. [Purpose] The present study was performed to investigate whether forward head posture (FHP) affects
muscle activity. [Subjects and Methods] Twenty subjects attending Y university in Gyeongsangnam-do, Republic
of Korea. They were divided into two groups according to craniovertebral angle: a control group (n=10) and a FHP
group (n=10). Electromyography electrodes were attached to the upper fibers of the trapezius, middle fibers of the
trapezius, the splenii (splenius capitis and splenius cervicis), and the sternocleidomastoid (SCM) muscle to measure
muscle activity during the neck protraction and retraction. [Results] EMG activities of the middle trapezius, sple-
nii, and SCM muscle showed significant differences between the control group and the FHP group. However, the
EMG activity of the upper trapezius muscle showed no significant difference between the two groups during neck
protraction and retraction. [Conclusion] The results suggest that FHP alters the muscle activity in neck protraction
and retraction.
Key words: Forward head posture, Muscle activity, Electromyography
(This article was submitted Dec. 1, 2014, and was accepted Dec. 25, 2014)
INTRODUCTION load is imposed on the joint and muscle, thereby making the
problems caused by FHP chronic7).
When maintenance of musculoskeletal balance occurs, Recently, the use of computers or smart phones has
the stress and strain on the body are minimized, and this become increasingly common, and their use has made FHP
condition is considered proper posture1, 2). It is well-known more common3). Against this background, it has been sug-
that many factors including vision, the cerebellum and gested that further studies regarding FHP are necessary for
vestibular function have an influence on the maintenance of patients suffering from FHP. The present study investigated
balance3). In particular, Barett et al.4) stated that joint posi- whether there are differences in the muscle activities be-
tion sense plays an important role in the maintenance. Since tween subjects with forward head posture and with normal
the position sense is affected by mechanoreceptors located head posture.
in muscles, muscle-related problem are also considered to be
major factors influencing balance3, 5). SUBJECTS AND METHODS
Forward head posture (FHP) is one of the most common
types of postural abnormality, and it is generally described as Twenty subjects attending Y university in Gyeongsang-
an anterior position of the head in relation to the vertical line nam-do, the Republic of Korea participated in the present
of the body’s center of gravity6, 7). Many researchers have study. They were divided into two groups according to the
reported that several factors, including headache, neck pain, craniovertebral angle: a control group (n=10) and a FHP
and musculoskeletal disorders such as temporomandibular group (n=10) (Table 1). Lateral views of each subjects were
disorders or rounded shoulders, are related to FHP1, 8). In photographed to measure the craniovertebral angle which
addition, FHP leads to lengthening and weakness of the an- was defined as the angle between the horizontal line pass-
terior cervical muscles as well as shortening of the posterior ing through C7 and the line extending from the tragus of
cervical muscles. If imbalances in cervical muscles resulting the external auditory meatus to C7. The base of camera was
from postural misalignment are prolonged, an excessive set at the height of the subjects shoulders. The tragus was
marked, and a pointer as taped to the skin overlying C7 spi-
nous process6, 9). Subjects with an angle less than 53° were
*Corresponding author. Min-Sik Yong (E-mail: peast4ever@ put in the FHP group2, 6, 10). All the subjects were informed
naver.com) of the purpose of the present study and provided their writ-
©2015 The Society of Physical Therapy Science. Published by IPEC Inc. ten informed consent prior to their participation. The present
This is an open-access article distributed under the terms of the Cre- study adhered to the ethical principles of the Declaration of
ative Commons Attribution Non-Commercial No Derivatives (by-nc- Helsinki.
nd) License <http://creativecommons.org/licenses/by-nc-nd/3.0/>. Electromyography activities were collected using a
978 J. Phys. Ther. Sci. Vol. 27, No. 3, 2015
by FHP, a possible reason why no significant difference was in whiplash patients and healthy individuals and the effect of the cranio-
cervical flexion action. Clin Biomech (Bristol, Avon), 2005, 20: 675–684.
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