Radiologic Assessment of Forward Head Posture and Its Relation to Myofascial Pain Syndrome

An, Sun; Yeo, Han Gyeol; Kim, Tae Uk; Hyun, Jung Keun; Kim, Jungyoon

doi:10.5535/arm.2014.38.6.821

Cited by 38 publications

(26 citation statements)

References 24 publications

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“…However, few studies have directly evaluated the relationship between forward head posture and MPS in neck and shoulder. Sun et al, examined the correlation between the presence of MPS and abnormal cervical sagittal alignment concluding that “there was no relationship between the forward head position and the presence, location, and number of trigger points” [ 38 ]. While Penas et al, highlighted the positive relationship between forward head posture and the presence of active trigger points [ 39 ].…”

Section: Discussionmentioning

confidence: 99%

Does improvement towards a normal cervical sagittal configuration aid in the management of cervical myofascial pain syndrome: a 1- year randomized controlled trial

Moustafa

Diab

Hegazy

et al. 2018

BMC Musculoskelet Disord

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BackgroundThere is a growing interest concerning the understanding of and rehabilitation of the sagittal configuration of the cervical spine as a clinical outcome. However, the literature on the topic specific to conservative treatment outcomes of patients with chronic myofascial cervical pain syndrome (CMCPS) has not adequately addressed the relationship between cervical sagittal alignment and improved pain, disability and range of motion.MethodsA randomized controlled study with a 1-year follow-up. Here, 120 (76 males) patients with chronic CMCPS and defined cervical sagittal posture abnormalities were randomly assigned to the control or an intervention group. Both groups received the Integrated neuromuscular inhibition technique (INIT); additionally, the intervention group received the denneroll cervical traction device. Alignment outcomes included two measures of sagittal posture: cervical angle (CV), and shoulder angle (SH). Patient relevant outcome measures included: neck pain intensity (NRS), neck disability (NDI), pressure pain thresholds (PPT), cervical range of motion using the CROM. Measures were assessed at three intervals: baseline, 10 weeks, and 1 year after the 10 week follow up.ResultsAfter 10 weeks of treatment, between group statistical analysis, showed equal improvements for both the intervention and control groups in NRS (p = 0.36) and NDI (p = 0.09). However, at 10 weeks, there were significant differences between groups favoring the intervention group for PPT (p<0.001) and all measures of CROM (p<0.001). Additionally, at 10 weeks the sagittal alignment variables showed significant differences favoring the intervention group for CV p<0.001 and SH (p<0.001) indicating improved CSA. Importantly, at the 1-year follow-up, between group analysis identified a regression back to baseline values for the control group for the non-significant group differences (NRS and NDI) at the 10-week mark. Thus, all variables were significantly different between groups favoring the intervention group at 1-year follow up: NRS (p<0.001), NDI (p<0.001), PPT p<0.001), CROM (p<0.001), CV (p<0.001), SH (p<0.001).ConclusionThe addition of the denneroll cervical orthotic to a multimodal program positively affected CMCPS outcomes at long term follow up. We speculate the improved sagittal cervical posture alignment outcomes contributed to our findings.Trial registrationPan African Clinical Trial Registry Clinical Trial Registry: PACTR201801002968301, registered 11 January 2018 (retrospectively registered).

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Section: Discussionmentioning

confidence: 99%

Does improvement towards a normal cervical sagittal configuration aid in the management of cervical myofascial pain syndrome: a 1- year randomized controlled trial

Moustafa

Diab

Hegazy

et al. 2018

BMC Musculoskelet Disord

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“…The exclusion criteria included: 1) a craniovertebral angle of > 53° when sitting, 2) a history of cervical trauma or surgery, 3) non-severe neck symptoms (neck disability index score > 15/50), and 4) non chronic neck pain or headaches occurring during the last six months (intensity, visual analogue scale < 3/10, frequency < 2 days/week, duration < 3 hours/day) 4 , 9 , 10 ) .…”

Section: Methodsmentioning

confidence: 99%

Deep cervical flexor training with a pressure biofeedback unit is an effective method for maintaining neck mobility and muscular endurance in college students with forward head posture

Kang¹

2015

J Phys Ther Sci

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[Purpose] This study investigated the effects of deep cervical flexor training on maintaining forward head posture, muscular endurance, and cervical mobility. It also examined the effectiveness of deep cervical flexor training with a pressure biofeedback unit. [Subjects and Methods] Twenty college students were recruited and randomly assigned to groups that underwent either deep cervical flexor training with a pressure biofeedback unit (experimental group, n=10) or conventional deep cervical flexor training (control group, n=10). The craniovertebral angle of each subject was measured with a lateral-view picture. Neck mobility was assessed using a cervical range of motion device and muscular endurance was measured using a pressure biofeedback unit. Both groups performed conventional deep cervical flexor exercises three times a week for six weeks. The experimental group underwent a pressure biofeedback unit training was 5 to10 minutes/day, thrice a week. [Results] Cervical range of motion in the experimental group increased significantly between the end of training and the end of the four week detraining period, compared to that in control group. [Conclusion] Deep cervical flexor training with a pressure biofeedback unit is a useful method for maintaining neck mobility and muscular endurance in people with forward head posture.

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“…It has been clear that age impacts the association between neck pain and FHP. Several authors considered age an important confounding factor affecting this relation [17,54,[56][57][58]. However, age was not controlled in many of the included studies either by matching age between groups or statistically [31,35,36,[38][39][40][41][42].…”

Section: Correlation Between Fhp and Neck Pain Measuresmentioning

confidence: 99%

The Relationship Between Forward Head Posture and Neck Pain: a Systematic Review and Meta-Analysis

Mahmoud

Hassan

Abdelmajeed

et al. 2019

Curr Rev Musculoskelet Med

160

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Purpose of Review Forward head posture (FHP) is the most common cervical postural fault in the sagittal plane that is found with different severity levels in almost all populations. Despite claims that FHP may be related to neck pain, this relation seems to be controversial. Thus, our purpose is to determine whether FHP differs between asymptomatic subjects and those with neck pain and to investigate if there is a relationship between head posture and neck pain. Recent Findings A total of 15 cross-sectional studies were eligible for inclusion for this systematic review and meta-analysis. Ten studies compared FHP between a group of asymptomatic participants and a group of participants with neck pain and an overall mean difference (MD) of 4.84 (95% CI = 0.14, 9.54), indicating a significant between-group difference, contrary to adolescent (MD = − 1.05; 95% CI = − 4.23, 2.12). Eight studies showed significant negative correlations between FHP and neck pain intensity (r = − 0.55; 95% CI = − 0.69, − 0.36) as well as disability (r = − 0.42; 95% CI = − 0.54, − 0.28) in adults and older adults, while in adolescents, only lifetime prevalence and doctor visits due to neck pain were significant predictors for FHP. Summary This systematic review found that age played an important role as a confounding factor in the relation between FHP and neck pain. Also, the results showed that adults with neck pain show increased FHP when compared to asymptomatic adults and that FHP is significantly correlated with neck pain measures in adults and older adults. No association was found between FHP and most of neck pain measures in adolescents.

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Radiologic Assessment of Forward Head Posture and Its Relation to Myofascial Pain Syndrome

Cited by 38 publications

References 24 publications

Does improvement towards a normal cervical sagittal configuration aid in the management of cervical myofascial pain syndrome: a 1- year randomized controlled trial

Does improvement towards a normal cervical sagittal configuration aid in the management of cervical myofascial pain syndrome: a 1- year randomized controlled trial

Deep cervical flexor training with a pressure biofeedback unit is an effective method for maintaining neck mobility and muscular endurance in college students with forward head posture

The Relationship Between Forward Head Posture and Neck Pain: a Systematic Review and Meta-Analysis

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