Forward head posture

Background
Postural deviations such as forward head posture (FHP) are associated with adverse health effects. The causes of these deviations are poorly understood. We hypothesized that anticipating target-directed movement could cause the head to get “ahead of” the body, interfering with optimal head/neck posture, and that the effect may be exacerbated by task difficulty and/or poor inhibitory control.

Method
We assessed posture in 45 healthy young adults standing quietly and when they anticipated walking to place a tray: in a simple condition and in conditions requiring that they bend low or balance an object on the tray. We defined FHP as neck angle relative to torso; we also measured head angle relative to neck and total neck length. We assessed inhibitory control using a Go/No-Go task, Stroop task, and Mindful Attention Awareness Scale (MAAS).

Results
FHP increased when participants anticipated movement, particularly for more difficult movements. Worse Stroop performance and lower MAAS scores correlated with higher FHP. False alarms on the Go/No-Go task correlated with a more extended head relative to the neck and with shortening of the neck when anticipating movement.

Conclusions
Maintaining neutral posture may require inhibition of an impulse to put the head forward of the body when anticipating target-directed movement.

Introduction: Forward Head Posture (FHP) is one of the most common faulty sagittal postures
of the craniocervical region in elderly adults. The sagittal alignment of the spine changes with
different body positions. This study aimed to compare head postural alignment between sitting
and standing positions in elder people with FHP.
Materials and Methods: The head posture was assessed in 32 participants including 16
old adults with FHP (Mean±SD age=67.9±3.8 years) and 16 normal matched individuals
(Mean±SD age=67.5±3.4 years). Side-view photographs were taken in standing and sitting
positions to determine the amount of the craniovertebral angle.
Results: The results of the paired t test indicated a significant difference between head postural
alignment in sitting and standing positions for normal (P<0.003) group. However, there is no
significant difference in sitting vs. standing in FHP group (P<0.09).
Conclusion: The assessment of head postural alignment in elder people using craniovertebral
angle in two different positions, sitting and standing, demonstrated no changes in the alignment
of head at FHP participants. It may be due to need for keeping the forward gaze.

This study was aimed at comparing the
effects of cervical stabilization exercises with thoracic
spine extension exercises and cervical stabilization
exercises with breathing exercises on head posture in
subjects with the forward head posture (FHP). FHP is a
poor habitual neck posture that is defined by the forward
translation of the cervical vertebrae and hyperextension of
the upper cervical vertebrae. Continuous FHP adds the load
to posterior cervical structures, for instance, ligament, and
transforms scapular kinetics and kinematics, and affects
the quality of life and activities of daily living. The study
included 30 adults with FHP, with 15 participants in each
group. The experimental group was asked to perform
cervical stabilization exercises with thoracic spine
extension exercises, and the control group was asked to
perform cervical stabilization exercises with breathing
exercises. After 4 weeks of exercise, the changes in head
posture (cranial rotation angle and craniovertebral angle)
were measured again. Craniovertebral angle and
craniovertebral angle were assessed using digital,
lateral-view photographs of the subjects in their usual
standing postures. The results showed that there was a
significant difference between experimental group and
control group before and after exercise (p < 0.05). In
between-group comparison, there were significant
differences noted in craniovertebral angle and cranial
rotation angle in the experimental group compared to the
control group (p < 0.05). Both two groups affect cranial
rotation angle, craniovertebral angle, and postural
alignment, but it is believed that cervical stabilization
exercises with thoracic spine extension exercises directly
affect the thoracic and cervical spines. As a result, cervical
stabilization exercises and thoracic spine extension
exercises are recommended to improve postural alignment.

Objective One of the most common faulty posture of cervical spine is forward head posture (FHP). According
to biomechanical changes in the muscles and ligaments of the neck which are rich source of
mechanoreceptors, in forward head posture there is the possibility for the proprioception to be impaired.
Assessment of neck repositioning angles can be an indicator to assess proprioception of this
region. The aim of this study was to investigate cervical proprioception in forward head posture subjects
in sagittal plane and compare it with normal subjects.
Materials & Methods This is a case-control study and subjects were selected by available sampling from
students of Iran University of Medical Sciences. Eighteen subjects with FHP (mean age 23.18 years) and
twenty two normal subjects (mean age 22.72 years) were participated in this study. Photography of sagittal
view was done in standing posture to determine the amount of FHP, as well as craniovertebral angle
(CVA) and the angle less than 49 degree was considered as FHP. Reposition error of target angle (50%
range of motion) and neutral angle in sagittal plane with close eyes in sitting posture was evaluated with
motion analysis system. The absolute and constant error of repositioning were analyzed by independent
t-test.
Results Absolute error did not show significant difference between two groups (P>0.05), but constant error
of neutral angle when return from forward flexion showed significant difference between two groups
(P<0.05). Also a significant correlation was found between body mass index (BMI) and CVA. This means
that increase in BMI could result in decrease of CVA (P<0.05).
Conclusions: Results of the present study indicated that subjects with FHP had more repositioning error
in some cervical movements related to the healthy individuals.

This research study examined the rapid changes in computer user behavior among Thai internet users, and analyzed differences in the computer health risk between desktop users and mobile device users. The emphasis is on “Text Neck” which has become a global epidemic affecting millions of people of all ages using various computer devices. The purpose of this study was to consider the incidence and relationship between health problems, and Thai Internet users’ behavior on computer and smart devices. The main research instrument was an internet-based survey which yielded 642 responses. The research findings reflected that the text neck health problem in Thailand is growing. This survey found that the smart phone device was the most popular computer application rather than desktop computers as almost two thirds of Thais always have their smart phones with them. The research isolated other behaviors of Thai computer users that contribute to health problems as the survey found that almost ...

This study aimed to investigate the effect of head and neck stabilization exercises on improving balance in older adults with forward head posture. Materials and Methods: Thirty elderly participants with forward head posture and Mean±SD age of 65.7±5.2 years were examined. The forward head posture was measured by plumb line and craniovertebral angle. Elderly balance was evaluated before and after 8 weeks of head and neck stabilization exercises with Timed Up and Go (TUG) and Functional Reach (FR) tests. The paired t-test was used to examine the changes that occurred after the intervention. Results: The results showed that head and neck stabilization exercises in the elderly significantly changed TUG test (8.3 s before the intervention, 7.8 s after the intervention; P=0.03) and FR test (23.4 cm before the intervention, 24.7 cm after the intervention; P=0.01) omitted. No significant statistical changes were observed in the amount of the craniovertebral angle after the intervention. Conclusion: Based on the study results, performing the head and neck stabilization exercises did not cause significant changes in the craniovertebral angle but improved the dynamic balance of the elderly.

This study aimed to investigate the effect of head and neck stabilization exercises on improving balance in older adults with forward head posture. Materials and Methods: Thirty elderly participants with forward head posture and Mean±SD age of 65.7±5.2 years were examined. The forward head posture was measured by plumb line and craniovertebral angle. Elderly balance was evaluated before and after 8 weeks of head and neck stabilization exercises with Timed Up and Go (TUG) and Functional Reach (FR) tests. The paired t-test was used to examine the changes that occurred after the intervention. Results: The results showed that head and neck stabilization exercises in the elderly significantly changed TUG test (8.3 s before the intervention, 7.8 s after the intervention; P=0.03) and FR test (23.4 cm before the intervention, 24.7 cm after the intervention; P=0.01) omitted. No significant statistical changes were observed in the amount of the craniovertebral angle after the intervention. Conclusion: Based on the study results, performing the head and neck stabilization exercises did not cause significant changes in the craniovertebral angle but improved the dynamic balance of the elderly.

Background: Technology is a crucial component of our daily lives, whether it is job-related or even personal usage and only few who can imagine life without it. There are many advantage with technology such as improving work productivity and efficacy, however using technology for extended period of time can place substantial amount of load to the neck musculature leading to musculoskeletal disorder. It is observed that the posture of human body precisely cervical spine tends to shift forward on using electronic device. Objective: The objective of our current study is to identify the prevalence of forward head and the associated factors among electronic gamers. Methods: A cross sectional study design was adopted with total of 160 participants (88 females and 72 males) with the age range between 18 to 40 (22.8 + 30) were recruited using predefined inclusion and exclusion criteria. Forward head posture angles were measured using Photogrammetry method and were analyzed using postural software, web plot digitizer software (WPD). Results: A total of 97 participants (60.63%) were discovered to have forward head posture. The results of Pearson correlation demonstrate there is no correlation exist between the device used for gaming and FHP, r (158) = 0.01, p = 0.97 and the breaks taken in between the gaming with FHP, r (158) = 0.08, p=0.31. However, there is moderate correlation exist between the duration of gaming and forward head posture r (158) =-0.73, p <0.01. These results suggest that individual who spend longer hours on their electronic gaming devices have a high risk of developing forward head posture due to the static loading that acts on the cervical spine. Conclusions: Correction and prevention of forward head is necessary in view of high incidence. Proper education and awareness on ill effects of prolonged usage of gaming devices may be beneficial in preventing FHP.

Introduction: Forward head posture (FHP) is a common postural deviation and chin tuck exercise has been traditionally prescribed to manage this condition. On the other hand, turtle is one of the common exercises in tai chi. Although, recently the physiotherapists are more interested in including tai chi in exercise therapy, there is no study comparing the effect of chin tuck and turtle exercise. Aim: The aim of this study was comparison of chin tuck and turtle exercise effects on FHP. Material and methods: 46 asymptomatic FHP subjects aged 22.45 ± 1.70 years were randomly assigned into two groups of chin tuck and turtle exercise. Cervical curve was measured before and after a 6-week intervention. The measures were compared by Mann-Whitney U test, paired sample T test and Wilcoxon. Results: 40 subjects completed the study. Within group analysis showed significant cervical curve increase. Interestingly, between group analysis showed equal cervical curve improvement. Conclusions: Both ...

be related to prolonged static posture in head, neck, and shoulder during daily activities and studying.
The purpose of this study was to investigate the relation between Forward head posture (FHP) and neck
pain in female and male students of different educational levels.
Materials and Methods 1017 students (511 girls, 506 boys) from the University of Tehran in undergraduate,
graduate and PhD level participated in this correlation study. Selection in departments have
been target, however sample, s selection have been random. The mean of age of girls and boys was
23.78±3.74, the weight was 63.24±12.1, and height 162.42±7.14 and boy’s age was 23.74±3.91, weight
57.23±8.87, and height 168.53±9.74.FHP was measured in students by questionnaire, visual analog scale
(VAS) and by using the Head Posture Spinal Curvature Instrument (HPSCI). Spearman correlation test
was administered to analyze the data using SPSS 18 software (P≤0.05).
Results Neck pain was significantly and negatively correlated with FHP in female PhD students (P=0.007),
while this relationship between undergraduate, graduate students and male PhD students was not significant
(P>0.05).
Conclusion Neck pain is associated with forward head posture in PhD students. Therefore, it is important
to address these faulty postures and correct them in treatment sessions. However, due to the progression
of student community to higher education level, it is more critical to be aware of the correct of
posture position in students.

The aim of this study was to evaluate the muscular activity timing during running in male children with forward head posture compared to healthy control ones. Methods 12 healthy male children with forward head posture (age: 11.7±1.4 years; height: 149.7±6.2 cm; Mass: 38.0±4.7 kg) and 16 healthy male children (age: 11.8±1.5 years; height: 148.2±6.6 cm; mass: 39.6±0.4 kg) were volunteered to participate in this study. The timing of muscular activity for erector spinae (cervical region), sternocleidomastoid, serratus anterior, upper and lower trapezius muscles of both right and left sides were evaluated during barefoot running. Muscular activity was recorded with a 16-chanels electromyography system. Independent sample t-test was used for statistical analysis. Results Finding did not demonstrate any significant differences in onset and offset of muscular activity during walking between both groups (P>0.05). The time duration of right erector spinae muscle in the healthy group was greater than that forward head group about 41 ms (P=0.024). Also, the time duration of left sternocleidomasteoid in the healthy group was longer than that in the forward head group by 64 ms (P=0.037). Conclusion In sum, these results could be used in rehabilitation protocols for children with forward head posture in clinical settings.

Objective Musculoskeletal disorders are the most common childhood problems. The aim of the present
study was to investigate the prevalence of head and upper extremity deformities in children with special
needs.
Materials & Methods The present research is a descriptive cross-sectional study with stratified sampling
method. Ten percent of students with mental retardation, hearing impairment and sight impairment in
the academic year of 2012-13 were selected for this study. There were 1194 persons in Tehran, 1526
people in the cities of the Tehran Province and 559 students in Alborz Province. In total, 3279 people
participated in the study. Demographic questionnaire and a plummet were used for data collection. Data
was reported using descriptive statistics.
Results The results of the study revealed that "dropped shoulder" in girls of Alborz province with visual
impairment with 100% had the highest rate and this abnormality in boys with visual impairment in the
Tehran had the least prevalence. In the deformities of the head, lateral head bending with 76.6% in girls
with visual impairment in Tehran, and forward head posture with 83.3% in boys with visual impairment
in cities of Tehran had the highest incidence in comparison with others.
Conclusion The prevalence of upper extremity deformities is high in students with special needs including
mental retardation, hearing impairment and sight impairment. It is necessary to diagnose these deformities
in time.