본문 바로가기
KERD
논문KCI 등재

Can Suboccipital Release Followed by Cranio-Cervical Flexion Exercise Improve Shoulder Range of Motion, Pain, and Muscle Activity of Scapular Upward Rotators in Subjects With Forward Head Posture?

1

조회

0

다운로드

3

인용

0

참고문헌

키워드

주제분류물리치료학

초록

Background: For the treatment of forward head posture (FHP) and forward shoulder posture, methods for strengthening scapular retractors and deep cervical flexors and stretching pectoralis and upper cervical extensors are generally used. No study has yet assessed whether suboccipital release (SR) followed by cranio-cervical flexion exercise (CCFE) (SR-CCFE) will result in a positive change in the shoulders and neck, showing a “downstream” effect. Objects: The purpose of this study was to investigate the immediate effects of SR-CCFE on craniovertebral angle (CVA), shoulder abduction range of motion (ROM), shoulder pain, and muscle activities of upper trapezius (UT), lower trapezius (LT), and serratus anterior (SA) and LT/UT and SA/UT muscle activity ratios during maximal shoulder abduction in subjects with FHP. Methods: In total, 19 subjects (7 males, 12 females) with FHP were recruited. The subject performed the fifth phase of CCFE immediately after receiving SR. CVA, shoulder abduction ROM, shoulder pain, muscle activities of UT, LT, and SA, and LT/UT and SA/UT muscle activity ratios during maximal shoulder abduction were measured immediately after SR-CCFE. A paired t-test and Wilcoxon signed-rank test were used to determine the significance of differences in scores between pre- and post-intervention in the same group. Results: The CVA (p<.001) and shoulder abduction ROM (p<.001) were increased significantly postversus pre-intervention. Shoulder pain was decreased significantly (p<.001), and LT (p<.05) and SA (p<.05) muscle activities were increased significantly post- versus pre-intervention. The LT/UT muscle activity ratio was increased significantly post- versus pre-intervention (p<.05). However, there was no significant change in UT muscle activity and SA/UT muscle activity ratio between pre- and post-intervention (p˃.05). Conclusion: SR-CCFE was an effective intervention to improve FHP and induce downstream effect from the neck to the trunk and shoulders in subjects with FHP.

Abstract

Background: For the treatment of forward head posture (FHP) and forward shoulder posture, methods for strengthening scapular retractors and deep cervical flexors and stretching pectoralis and upper cervical extensors are generally used. No study has yet assessed whether suboccipital release (SR) followed by cranio-cervical flexion exercise (CCFE) (SR-CCFE) will result in a positive change in the shoulders and neck, showing a “downstream” effect. Objects: The purpose of this study was to investigate the immediate effects of SR-CCFE on craniovertebral angle (CVA), shoulder abduction range of motion (ROM), shoulder pain, and muscle activities of upper trapezius (UT), lower trapezius (LT), and serratus anterior (SA) and LT/UT and SA/UT muscle activity ratios during maximal shoulder abduction in subjects with FHP. Methods: In total, 19 subjects (7 males, 12 females) with FHP were recruited. The subject performed the fifth phase of CCFE immediately after receiving SR. CVA, shoulder abduction ROM, shoulder pain, muscle activities of UT, LT, and SA, and LT/UT and SA/UT muscle activity ratios during maximal shoulder abduction were measured immediately after SR-CCFE. A paired t-test and Wilcoxon signed-rank test were used to determine the significance of differences in scores between pre- and post-intervention in the same group. Results: The CVA (p<.001) and shoulder abduction ROM (p<.001) were increased significantly postversus pre-intervention. Shoulder pain was decreased significantly (p<.001), and LT (p<.05) and SA (p<.05) muscle activities were increased significantly post- versus pre-intervention. The LT/UT muscle activity ratio was increased significantly post- versus pre-intervention (p<.05). However, there was no significant change in UT muscle activity and SA/UT muscle activity ratio between pre- and post-intervention (p˃.05). Conclusion: SR-CCFE was an effective intervention to improve FHP and induce downstream effect from the neck to the trunk and shoulders in subjects with FHP.

참고문헌 (32)

  1. Ann M J Cools, "Rehabilitation of scapular dyskinesis: from the office worker to the elite overhead athlete", British Journal of Sports Medicine, 48(8), pp.692~697 (2014), BMJ[DOI]
  2. Cram JR, "Introduction to Surface Electromyography", pp.65~74 (1998), Aspen Publishers
  3. Decker MJ, "Serratus anterior muscle activity during selected rehabilitation exercises", Am J Sports Med, 27(6), pp.784~791 (1999)
  4. Ekstrom RA, "Surface electromyographic analysis of exercises for the trapezius and serratus anterior muscles", J Orthop Sports Phys Ther, 33(5), pp.247~258 (2003)
  5. Falla D, "Effect of neck exercise on sitting posture in patients with chronic neck pain", Phys Ther, 87(4), pp.408~417 (2007)
  6. David M. Hallman, "Effects of Heart Rate Variability Biofeedback in Subjects with Stress-Related Chronic Neck Pain: A Pilot Study", Applied Psychophysiology and Biofeedback, 36(2), pp.71~80 (2011), Springer Nature[DOI]
  7. Harman K, "Effectiveness of an exercise program to improve forward head posture in normal adults: A randomized, controlled 10-week trial", J Man Manip Ther, 13(3), pp.163~176 (2005)
  8. Gillian A. Hawker, "Measures of adult pain: Visual Analog Scale for Pain (VAS Pain), Numeric Rating Scale for Pain (NRS Pain), McGill Pain Questionnaire (MPQ), Short-Form McGill Pain Questionnaire (SF-MPQ), Chronic Pain Grade Scale (CPGS), Short Form-36 Bodily Pain Scale (SF-36 BPS), and Measure of Intermittent and Constant Osteoarthritis Pain (ICOAP)", Arthritis Care & Research, 63(S11), pp.S240~S252 (2011), Wiley-Blackwell[DOI]
  9. Heintz MM, "Multimodal management of mechanical neck pain using a treatment based classification system", J Man Manip Ther, 16(4), pp.217~224 (2008)
  10. Alberto M. Heredia Rizo, "Immediate Effects of the Suboccipital Muscle Inhibition Technique in Craniocervical Posture and Greater Occipital Nerve Mechanosensitivity in Subjects With a History of Orthodontia Use: A Randomized Trial", Journal of Manipulative and Physiological Therapeutics, 35(6), pp.446~453 (2012), Elsevier BV[DOI]
  11. G.A. Jull, "The effect of therapeutic exercise on activation of the deep cervical flexor muscles in people with chronic neck pain", Manual Therapy, 14(6), pp.696~701 (2009), Elsevier BV[DOI]
  12. Jull G, "A randomized controlled trial of exercise and manipulative therapy for cervicogenic headache", Spine, 27(17), pp.1835~1843 (2002)
  13. Kebaetse M, "Thoracic position effect on shoulder range of motion, strength, and three-dimensional scapular kinematics", Arch Phys Med Rehabil, 80(8), pp.945~950 (1999)
  14. Kelly JD, "Identifying and managing scapular problems in overhead athletes", J Musculoskel Med, 28, pp.465~471 (2011)
  15. Kendall F, "Muscles: Testing and function with posture and pain", pp.330~337 (2005), Williams & Wilkins
  16. Ki-Hyun Kim, "The effects of horse-riding simulator exercise and Kendall exercise on the forward head posture", Journal of Physical Therapy Science, 27(4), pp.1125~1127 (2015), Society of Physical Therapy Science[DOI]
  17. Kolber MJ, "The reliability and concurrent validity of shoulder mobility measurements using a digital inclinometer and goniometer:A technical report", Int J Sports Phys Ther, 7(3), pp.306~313 (2012)
  18. Jeremy S Lewis, "Clinical measurement of the thoracic kyphosis. A study of the intra-rater reliability in subjects with and without shoulder pain", BMC Musculoskeletal Disorders, 11(1), pp.39~ (2010), Springer Nature[DOI]
  19. Lewis JS, "Subacromial impingement syndrome: The effect of changing posture on shoulder range of movement", J Orthop Sports Phys Ther, 35(2), pp.72~87 (2005)
  20. Enrique Lluch, "Immediate Effects of Active Versus Passive Scapular Correction on Pain and Pressure Pain Threshold in Patients With Chronic Neck Pain", Journal of Manipulative and Physiological Therapeutics, 37(9), pp.660~666 (2014), Elsevier BV[DOI]
  21. S. S. Lynch, "The effects of an exercise intervention on forward head and rounded shoulder postures in elite swimmers", British Journal of Sports Medicine, 44(5), pp.376~381 (2010), BMJ[DOI]
  22. Peterson DE, "Investigation of the validity and reliability of four objective techniques for measuring forward shoulder posture", J Orthop Sports Phys Ther, 25(1), pp.34~42 (1997)
  23. Portney L, "Foundations of Clinical Research:Applications to practice", pp.373~649 (2009), Pearson Prentice Hall
  24. June Quek, "Effects of thoracic kyphosis and forward head posture on cervical range of motion in older adults", Manual Therapy, 18(1), pp.65~71 (2013), Elsevier BV[DOI]
  25. Raine S, "Head and shoulder posture variations in 160 asymptomatic women and men", Arch Phys Med Rehabil, 78(11), pp.1215~1223 (1997)
  26. Roddey TS, "The effect of pectoralis muscle stretching on the resting position of the scapula in persons with varying degrees of forward head", rounded shoulder posture, 2002, pp.10(3), 124~128
  27. Selkowitz DM, "The effects of scapular taping on the surface electromyographic signal amplitude of shoulder girdle muscles during upper extremity elevation in individuals with suspected shoulder impingement syndrome", J Orthop Sports Phys Ther, 37(11), pp.694~702 (2007)
  28. Charles A. Thigpen, "Head and shoulder posture affect scapular mechanics and muscle activity in overhead tasks", Journal of Electromyography and Kinesiology, 20(4), pp.701~709 (2010), Elsevier BV[DOI]
  29. T’Jonck L, "Measurements of scapular position and rotation: A reliability study", Physiother Res Int, 1(3), pp.148~158 (1996)
  30. Wang WT, "Effectiveness of physical therapy for patients with neck pain: An individualized approach using a clinical decision-making algorithm", Am J Phys Med Rehabil, 82(3), pp.203~218 (2003)
  31. Yip CH, "The relationship between head posture and severity and disability of patients with neck pain", Man Ther, 13(2), pp.148~154 (2008)
  32. Yoo WG, "Effects of the height of ball-backrest on head and shoulder posture and trunk muscle activity in VDT workers", Ind Health, 46(3), pp.289~297 (2008)

관련 논문AI추천

Change of Head Position and Muscle Activities of Neck During Overhead Arm Lift Test in Subjects With Forward Head Posture김태호, 황병하한국전문물리치료학회 · 한국전문물리치료학회지2019 · 제26권 제2호Immediate Effects of Roller Massage for Posterior Neck Muscles on the Muscle Strength and Range of Motion for Cranio-Cervical Flexion in Subjects With Forward Head Posture권오윤, Jang-hun Jung, Seung-tak Kang한국전문물리치료학회 · 한국전문물리치료학회지2021 · 제28권 제2호Comparing the Effects of Manual and Self-exercise Therapy for Improving Forward Head Posture심경섭, 전혜선, Donghoon Kim한국전문물리치료학회 · 한국전문물리치료학회지2023 · 제30권 제3호Comparison of Muscle Thickness and Changing Ratio for Cervical Flexor Muscles During the Craniocervical Flexion Test Between Subjects With and Without Forward Head Posture권오윤, 황의재, Lee Jae-hyun한국전문물리치료학회 · 한국전문물리치료학회지2022 · 제29권 제3호관절가동술과 근력강화운동이 앞쪽머리자세 환자의 목기능과 근긴장도에 미치는 영향김진영, 송현승, 최정연대한정형도수물리치료학회 · 대한정형도수물리치료학회지2023 · 제29권 제3호Relationship Between Craniovertebral Angle and Upper Trapezius Muscle Stiffness and Tone in Office WorkersJung Sung-hoon, Kim Jun-hee, Kwon Oh-yun, Lee Yoon-ji한국전문물리치료학회 · 한국전문물리치료학회지2025 · 제32권 제1호

이 간행물의 다른 논문 (9건)