Effects of Cervical Joint Manipulation on Joint Position Sense of Normal Adults

[Purpose] The purpose of this study was to identify the effects of cervical joint manipulation on joint position sense (JPS) of normal adults. [Subjects] Thirty normal adults were divided into a test group of 15 subjects and a control group of 15 subjects. [Methods] The test group was treated with cervical joint manipulation and massage, whereas the control group received only massage. Both groups were evaluated in terms of joint position error (JPE) using a digital dual clinometer before and after the interventions. [Results] The comparision of the pre- and post-test results revealed the test group exhibited statistically significant changes in flexion, extension, left lateral flexion, right lateral flexion, left rotation, and right rotation. On the other hand, the control group showed no statistically significant changes in any of the variables. [Conclusion]Cervical joint manipulation reduced JPE and improved joint position sence. Therefore, we consider its application to the treatment of patients with cervical problems in clinical practice is desirable.Key words: Cervical joint manipulation, Joint position sense, Joint position error     

Relationship of Forward Head Posture and Cervical Backward Bending to Neck Pain

Abstract

The purpose of this study was to investigate the relationship of forward head posture and cervical backward bending to neck pain. The subjects were fifty-four volunteer office workers, who spent at least four hours of their work day at a computer terminal (17 males and 37 females). Since all subjects reported having pain, the subjects who reported pain in four areas or more were considered the case group and those who reported pain in three areas or less were considered the control group. Measurements of forward head posture and cervical backward bending in both the natural sitting position and the erect sitting position were recorded by the Cervical Range of Motion Instrument (CROM). The results showed that compared to the control group, the case group subjects had more pain over the past thirty days, visited medical professionals more frequently during the past twelve months, and when describing a typical day reported greater pain. Additionally, members of the case group had greater forward head posture and less cervical backward bending in the natural sitting position and the erect sitting position. The results of this study support the belief that a relationship of forward head posture and cervical backward bending to neck pain exists.     

Comparison of Shoulder Muscles Activation for Shoulder Abduction between Forward Shoulder Posture and Asymptomatic Persons

[Purpose] This study investigated the differences in shoulder muscles activities during shoulder abduction between a forward shoulder posture group and asymptomatic group. [Subjects] Seven males with forward shoulder posture (FHS) and seven asymptomatic males were recruited. [Methods] We measured the upper and middle trapezius (UT and MT), serratus anterior (SA), and clavicle portion of the pectoralis major (cPM) in the right side during shoulder abduction. [Results] The activities of the UT and cPM in the FHS group were significantly more increased when compared with the asymptomatic group. The activities of the MT and SA in the FHS group were significantly more decreased when compared with the asymptomatic group. [Conclusion] We suggest that forward shoulder posture may become a potential risk factor evoking the various shoulder disorders.Key words: Forward shoulder posture, Scapular, Shoulder abduction     

The Influence of Lumbar Joint Mobilization on Joint Position Sense in Normal Adults

[Purpose] The purpose of this study was to determine the effects of lumbar joint mobilization on the joint position sense (JPS) of normal adults. [Subjects] A total of 30 normal adults were divided into an experimental group (n = 15) and a control group (n = 15). [Methods] The experimental group received lumbar joint mobilization and massage, and the control group received massage only. Both the experimental and control groups were evaluated for joint position error (JPE) by using a digital dual inclinometer before and after the experiment. [Results] In the before and after comparison for the experimental group, statistically significant differences were found in flexion, extension, left lateral flexion, and right lateral flexion. There was no statistically significant difference in the before and after comparison for the control group. [Conclusion] Because lumbar joint mobilization can reduce JPE and improve JPS, its use in the treatment of patients with lumbar problems is recommended.Key words: Gong’s mobilization, Joint position sense, Joint position error     

Characteristics of Upper Quadrant Posture of Young Women with Temporomandibular Disorders

[Purpose] This study aimed to investigate the characteristics of upper quadrant posture of young women with temporomandibular disorders. [Subjects] The participants were 19 female patients with temporomandibular disorders (patient group: mean age, 30.1 years) and 14 controls (control group: mean age, 24.6 years). [Methods] Outcome measures were the neck inclination angle (formed by a line connecting C7 and the ear tragus with a horizontal line), the angle of the shoulder (formed by a line connecting C7 and the acromial angle with a horizontal line), the cranial rotation angle (formed by a line connecting the ear tragus and the corner of the eye with a horizontal line), and the neck-length/shoulder-width ratio [the ratio of the neck length (from C7 to the tragus) to the width of the shoulder between the acromial angle]. The maximum range of mouth opening was measured using a scale. [Results] The neck inclination angle and maximum range of mouth opening were significantly smaller in the patient group than in the control group. No significant differences were observed in the other outcome measures between the two groups. [Conclusion] Temporomandibular disorders with limited mouth opening in young females are associated with the head position relative to the trunk.Key words: Posture, Temporomandibular disorders, Ultrasound-based three-dimensional motion analyser     

The Intra- and Inter-rater Reliabilities of the Forward Head Posture Assessment of Normal Healthy Subjects

[Purpose] Assessment of posture is an important goal of physical therapy interventions for preventing the progression of forward head posture (FHP). The purpose of this study was to determine the inter- and intra-rater reliabilities of the assessment of FHP. [Subjects and Methods] We recruited 45 participants (20 male subjects, 25 female subjects) from a university student population. Two physical therapists assessed FHP using images of head extension. FHP is characterized by the measurement of angles and distances between anatomical landmarks. Forward shoulder angle of 54° or less was defined as FHP. Intra- and inter-rater reliabilities were estimated using Kendall’s Taub correlation coefficients. [Results] Intra-class correlation of intra-rater measurements indicated an excellent level of reliability (0.91), and intra-class correlation of inter-rater measurements showed a good level of reliability in the assessment of FHP (0.75). [Conclusion] Assessment of FHP is an important component of evaluation and affects the design of the treatment regimen. The assessment of FHP was reliably measured by two physical therapists. It could therefore become a useful method for assessing FHP in the clinical setting. Future studies will be needed to provide more detailed quantitative data for accurate assessment of posture.Key words: Forward head posture, Reliability, Posture assessment     

Effect of Thoracic Stretching,Thoracic Extension Exercise and Exercises for Cervical and Scapular Posture on Thoracic Kyphosis Angle and Upper Thoracic Pain

[Purpose] The purpose of this study was to investigate the effect of thoracic stretching, a thoracic extension exercise and exercises for cervical and scapular posture on thoracic kyphosis angle and upper thoracic pain. [Subject] A 36-year-old male, who complained of upper thoracic pain at the T1–4 level with forward head and round shoulders, was the subject. [Methods] He performed thoracic stretching (session 1), a thoracic extension exercise (session 2), and muscle exercises for cervical and scapular posture (session 3). [Results] The upper thoracic pressure pain threshold increased after session 1, session 2, and session 3. The thoracic kyphosis angle decreased after session 1, session 2, and session 3. [Conclusion] We suggest that intervention for thoracic pain or kyphotic thoracic correction should use not only an approach for extending the thoracic muscles, but also an approach treating muscles in the cervical and scapular region.Key words: Kyphosis, Posture correction, Thoracic pain     

体位固定改良法在颈椎后路手术中应用的效果

目的探讨体位固定改良法在颈椎后路手术中应用的效果。方法将52例行颈椎后路手术的颈椎病患者,随机分成实验组和对照组,每组各26例。实验组患者手术体位采用改良法固定,对照组采用传统的体位固定法,观察两组患者体位固定的有效性及术中和术后并发症发生的情况。结果实验组体位固定的有效性优于对照组（P〈0.01）,术中无并发症发生;两组术后均无手术并发症的发生。结论颈椎后路手术患者体位采取改良法固定,其固定效果确切,有利于暴露术野,减少术中及术后并发症的发生,值得临床推广应用。     

The Effect of Pectoralis Muscle Stretching on the Resting Position of the Scapula in Persons with Varying Degrees of Forward Head/Rounded Shoulder Posture

Abstract

The purpose of this study was to evaluate whether a stretching program for the pectoralis muscle will affect the resting position of the scapula in persons with varying degrees of forward head/rounded shoulder posture (FHRSP). A convenience sample of healthy participants (n=38) with varying degrees of FHRSP was utilized. Each participant was classified into one of three groups: mild FHRSP/control, mild FHRSP/stretching, or moderate FHRSP/stretching. Resting scapular position was measured using the DiVeta technique. Those in the stretching group completed a twice-daily pectoralis stretching program for 14 days. All participants' scapular positions were re-measured. An ANCOVA was completed to evaluate whether post-intervention differences in the TSD were present among the three groups of participants. There were no differences among the three groups before intervention. Differences were found in the TSD among the three groups after intervention: between the control and moderate FHRSP/stretching group (p<0.0005) and between the mild and moderate FHRSP stretching groups (p=0.05). Persons with moderate FHRSP demonstrate improved resting scapular position following a two-week pectoralis stretching program.     

Impairment of Balance in Elderly Subjects with Type 2 Diabetes

[Purpose] The purpose of this study was to investigate balance among elderly subjects with type 2 diabetes. [Subjects and Methods] Twelve subjects with type 2 diabetes and 15 age-matched controls were examined. Balance was assessed by a computerized device while the subjects were standing. [Results] Subjects with diabetes exhibited significantly more sway than control subjects while standing on a balance platform. [Conclusion] Our findings suggest that diabetes impairs balance when compared with that in normal elderly subjects.Key words: Balance, Elderly, Type 2 diabetes     

Assessment of Knee Proprioception in the Anterior Cruciate Ligament Injury Risk Position in Healthy Subjects: A Cross-sectional Study

[Purpose] Knee joint proprioception combines sensory input from a variety of afferent receptors that encompasses the sensations of joint position and motion. Poor proprioception is one of the risk factors of anterior cruciate ligament injury. Most studies have favored testing knee joint position sense in the sagittal plane and non-weight-bearing position. One of the most common mechanisms of noncontact anterior cruciate ligament injury is dynamic knee valgus. No study has measured joint position sense in a manner relevant to the mechanism of injury. Therefore, the aim of this study was to measure knee joint position sense in the noncontact anterior cruciate ligament injury risk position and normal condition. [Subjects and Methods] Thirty healthy male athletes participated in the study. Joint position sense was evaluated by active reproduction of the anterior cruciate ligament injury risk position and normal condition. The dominant knees of subjects were tested. [Results] The results showed less accurate knee joint position sense in the noncontact anterior cruciate ligament injury risk position rather than the normal condition. [Conclusion] The poorer joint position sense in non-contact anterior cruciate ligament injury risk position compared with the normal condition may contribute to the increased incidence of anterior cruciate ligament injury.Key words: Anterior cruciate ligament, Proprioception, Injury risk position     

Effect of the Neck Retraction Taping (NRT) on Forward Head Posture and the Upper Trapezius Muscle during Computer Work

[Purpose] The purpose of this study was to investigate the effect of neck retraction taping on forward head posture and the upper trapezius muscle of computer workers during computer work. [Subjects] Twelve males aged 20–30 years were recruited. [Methods] We measured forward head angle and upper trapezius muscle activity during computer work before and after NRT. [Results] The FHP angle significantly decreased during computer work performed with NRT compared to without NRT. The UT muscle activity was also significantly decreased during computer work performed with NRT compared to without NRT. [Conclusion] We think that the taping tension provided by NRT may have provided a mechanical effect that prevented FHP. NRT may also encourage a proper head posture in patients unfamiliar with the neck retraction posture.Key words: Forward head posture, Neck retraction, Taping     

A Comparison of the Deep Cervical Flexor Muscle Thicknesses in Subjects with and without Neck Pain during Craniocervical Flexion Exercises

[Purpose] The purpose of the present study was to examine the amount of change in the thicknesses of the deep cervical flexor (DCF) and sternocleidomastoid (SCM) muscles in subjects with neck pain and subjects without neck pain during craniocervical flexion exercise (CCFE). [Subjects] The total number of subjects was 40, comprising 20 in the no-pain group (males 11, females 9) and 20 in the pain group (males 8, females 12). [Methods] Muscle images were obtained using ultrasound, and the thicknesses of the individual muscles were measured using the NIH ImageJ software. [Results] During CCFE, as pressure increased, the no-pain group recruited the DCF more than the pain group, while the pain group recruited the SCM more. [Conclusion] Selective DCF contraction exercises are considered very useful in the treatment of patients with neck pain.Key words: Craniocervical flexion exercise, Deep cervical flexor, Sternocleidomastoid     

Effectiveness of an Exercise Program to Improve Forward Head Posture in Normal Adults: A Randomized,Controlled 10-Week Trial

Abstract

Forward head posture (FHP) is most often described as excessive anterior positioning of the head in relation to a vertical reference line, involving increased cervical spine lordosis (head forward, middle cervical spine extended, lower cervical spine flexed) and rounded shoulders with thoracic kyphosis. Although exercise is routinely used to improve FHP, relatively little data exists on efficacy. The present study was designed to examine the impact of a 10-week targeted and progressive home exercise program on improving FHP. As improvement through exercise of postural alignment depends upon participants adhering to the program, we also looked at issues related to exercise compliance. Seventeen control (C) and 23 exercise (E) participants with a FHP deviation were part of this program. Pre- and post-exercise postural measurements of FHP were obtained from the sagittal plane using the Biotonix TM Postural Analysis System; in addition neck flexion range of motion was measured. Participants were randomly assigned to C or E groups. The E group performed neck extensor and pectoralis major stretches and deep neck flexor and shoulder retractor strengthening exercises for the 10-week period. Two-factor (group, pre-test/post-test) analysis of variance models were used to test main effects and interactions. There were no significant differences (p>0.05) between groups on any pre-test measure. For the E group, there were significant differences and interactions (p<0.05) between pre- and post-tests and also between the E and C groups at post-test for range of motion and one postural measurement. The results demonstrate that a short, home-based targeted exercise program can improve postural alignment related to FHP. These results provide a foundation for further development of postural improvement programs that include an exercise component.     

UCLP患者头位、颈椎位置的头影测量研究

目的：比较UCLP患者与无唇腭裂的错He患者头位、颈椎位置的差异。方法：选择15名UCLP患，年龄12－16岁，与按NSL－MP选择的错He患者比较自然头位和颈椎位置的差异，并与颅面形态指标行相关分析。结果：FH／VER和C1／Ver差异显著（P＜0．05）。结论：与无唇腭裂的错He患者相比，UCLP的患者的头位相对于垂直平面更伸展，第一颈椎更后倾。     

Balance Deficits are Correlated with Bronchial Obstruction Markers in Subjects with Asthma

[Purpose] Balance deficits are increasingly recognized in chronic obstructive pulmonary disease, but little is known regarding this issue in asthma. Our primary aim was to assess the correlation between postural balance and pulmonary function in adults with asthma. Secondarily, we aimed to correlate balance with functional capacity and body mass index in these subjects. [Methods] A cross-sectional study of 26 adults with asthma was performed in which they were subjected to stabilometry, pulmonary function testing, a 6-minute walking test, and nutritional assessment. [Results] We found significant correlations of forced expiratory volume at one second (ρ=−0.49) and total lung capacity (ρ=0.39) with mediolateral displacement with feet apart/eyes open. Significant correlations were observed between peak expiratory flow and a number of stabilometric parameters. There were several significant correlations between airway-specific conductance and the tasks performed on the force platform, especially one with the feet apart/eyes open. The Berg Balance Scale revealed significant correlations with mediolateral displacement, mediolateral range, and anteroposterior range for feet together/eyes closed (ρ=−0.49). There were no significant correlations between stabilometry, body mass index, and six-minute walking distance. [Conclusion] In adults with asthma, there is an association between balance and the bronchial obstruction markers. This finding may contribute to improvement of rehabilitation programs for these subjects.Key words: Asthma, Respiratory function tests, Postural balance     

Reliability of Pinch Strength Testing in Elderly Subjects with Unilateral Thumb Carpometacarpal Osteoarthritis

[Purpose] The aim of this study was to examine the test-retest reliability of pinch strength testing in elderly subjects with thumb CMC OA. [Subjects and Methods] A total of 27 patients with unilateral right-thumb CMC OA (mean ± SD age: 81.3 ± 4.7 years) were recruited. Each patient performed three pain-free maximal isometric contractions on each hand on two occasions, one week apart. Three different measurements were taken: tip, tripod, and key pinch strength. Intraclass correlation coefficient (ICC), standard error of measurement (SEM), and 95% limits of agreement (LOA) calculations were performed. [Results] Test-retest reliability of measurements of tip, tripod, and key pinch strength was excellent for the affected side (ICC=0.93, 0.96, and 0.99) and the contralateral thumb (ICC=0.91, 0.92, and 0.94). [Conclusions] The present results indicate that maximum pinch strength can be measured reliably using the Pinch Gauge Dynamometer, in patients with thumb CMC OA, which enables its use in research and in the clinic to determine the effect of interventions on improving pinch strength.Key words: Test-retest, Reliability, Pinch strength     

Rehabilitation Exercises to Induce Balanced Scapular Muscle Activity in an Anti-gravity Posture

[Purpose] The purpose of this study was to compare the intramuscular balance ratios of the upper trapezius muscle (UT) and the lower trapezius muscle (LT), and the intermuscular balance ratios of the UT and the serratus anterior muscle (SA) among prone extension (ProExt), prone horizontal abduction with external rotation (ProHAbd), forward flexion in the side-lying position (SideFlex), side-lying external rotation (SideEr), shoulder flexion with glenohumeral horizontal abduction load (FlexBand), and shoulder flexion with glenohumeral horizontal adduction load (FlexBall) in the standing posture. [Methods] The electromyographic (EMG) activities of the UT, LT and SA were measured during the tasks. The percentage of maximum voluntary isometric contraction (%MVIC) was calculated for each muscle, and the UT/LT ratios and the UT/SA ratios were compared among the tasks. [Results] The UT/LT ratio with the FlexBand was not significantly different from those of the four exercises in the side-lying and prone postures. The UT/SA ratio with the FlexBall demonstrated appropriate balanced activity. [Conclusion] In an anti-gravity posture, we recommend the FlexBand and the FlexBall for inducing balanced UT/LT and UT/SA ratios, respectively.Key words: Scapular muscle exercise, Balanced scapular muscle activity, Electromyography