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van de Meent I, Koomen L, de Boer R, Le Clercq L, Janssen D, Boute M, Maat A, van Dellen E, Cahn W. Forward head posture associated with reduced cardiorespiratory fitness in psychotic disorders compared to autism spectrum disorder and healthy controls. Sci Rep 2024; 14:17143. [PMID: 39060286 PMCID: PMC11282316 DOI: 10.1038/s41598-024-67604-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Accepted: 07/12/2024] [Indexed: 07/28/2024] Open
Abstract
Individuals with psychotic disorders often lead sedentary lives, heightening the risk of developing forward head posture. Forward head posture affects upper cervical vertebrae, raising the likelihood of daily discomforts like skeletal misalignment, neck pain, and reduced cardiorespiratory fitness. Improving cardiorespiratory fitness in psychotic disorders is relevant, given its proven benefits in enhancing physical and mental health. This study investigates forward head posture by measuring craniovertebral angles in psychotic disorders and the relationship with reduced cardiorespiratory fitness. To determine whether forward head posture is specific to psychotic disorders, we also included individuals with autism spectrum disorder and healthy controls. Among 85 participants (32 psychotic disorders, 26 autism spectrum disorder, 27 healthy controls), photogrammetric quantification revealed a significantly lower mean craniocervical angle in psychotic disorders compared to autism spectrum disorder (p = < 0.02) and the healthy control group (p = < 0.01). Reduced craniovertebral angle is related to diminished cardiorespiratory fitness in psychosis (R2 = 0.45, p = < 0.01) but not in other control groups. This study found reduced craniovertebral angles, indicating forward head posture in psychotic disorders. Moreover, this relates to diminished cardiorespiratory fitness. Further research is needed to examine the underlying causes and to investigate whether this can be reversed through physical therapy.
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Affiliation(s)
- Ilona van de Meent
- Department of Psychiatry, Brain Center at the University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands.
- Graduate School of Life Sciences, Utrecht University, Utrecht, The Netherlands.
| | - Lisanne Koomen
- Department of Psychiatry, Brain Center at the University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
- Graduate School of Life Sciences, Utrecht University, Utrecht, The Netherlands
- Lister, Utrecht, The Netherlands
| | - Renske de Boer
- Human Movement Science, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Lonneke Le Clercq
- Human Movement Science, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Dieuwertje Janssen
- Department of Psychiatry, Brain Center at the University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
- Graduate School of Life Sciences, Utrecht University, Utrecht, The Netherlands
| | - Mikel Boute
- Department of Psychiatry, Brain Center at the University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
| | - Arija Maat
- Department of Psychiatry, Spaarne Gasthuis, Haarlem, The Netherlands
| | - Edwin van Dellen
- Department of Psychiatry, Brain Center at the University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
| | - Wiepke Cahn
- Department of Psychiatry, Brain Center at the University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
- Altrecht, Utrecht, The Netherlands
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Jung JY, Lee YB, Kang CK. Effect of Forward Head Posture on Resting State Brain Function. Healthcare (Basel) 2024; 12:1162. [PMID: 38921277 PMCID: PMC11203370 DOI: 10.3390/healthcare12121162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2024] [Revised: 06/03/2024] [Accepted: 06/06/2024] [Indexed: 06/27/2024] Open
Abstract
Forward head posture (FHP) is a common postural problem experienced by most people. However, its effect on brain activity is still unknown. Accordingly, we aimed to observe changes in brain waves at rest to determine the effect of FHP on the nervous systems. A total of 33 computer users (Male = 17; Female = 16; age = 22.18 ± 1.88) were examined in both FHP and neutral posture. For each session, brain waves were measured for 5 min, and then muscle mechanical properties and cranio-vertebral angle (CVA) were measured. Changes in brain waves between the neutral posture and FHP were prominent in gamma waves. A notable increase was confirmed in the frontal and parietal lobes. That is, eight channels in the frontal lobe and all channels in the parietal lobe showed a significant increase in FHP compared to neutral posture. Additionally, FHP changes were associated with a decrease in CVA (p < 0.001), an increase in levator scapulae tone (Right, p = 0.014; Left, p = 0.001), and an increase in right sternocleidomastoid stiffness (p = 0.002), and a decrease in platysma elasticity (Right, p = 0.039; Left, p = 0.017). The change in CVA was found to have a negative correlation with the gamma activity (P7, p = 0.044; P8, p = 0.004). Therefore, increased gamma wave activity in FHP appears to be related to CVA decrease due to external force that was applied to the nervous system and cervical spine.
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Affiliation(s)
- Ju-Yeon Jung
- Institute for Human Health and Science Convergence, Gachon University, Incheon 21565, Republic of Korea;
| | - Yeong-Bae Lee
- Neuroscience Research Institute, Gachon University, Incheon 21565, Republic of Korea
- Department of Neurology, Gil Medical Center, Gachon University College of Medicine, Incheon 21565, Republic of Korea
| | - Chang-Ki Kang
- Institute for Human Health and Science Convergence, Gachon University, Incheon 21565, Republic of Korea;
- Neuroscience Research Institute, Gachon University, Incheon 21565, Republic of Korea
- Department of Radiological Science, College of Medical Science, Gachon University, Incheon 21936, Republic of Korea
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Asadzadeh A, Salahzadeh Z, Samad-Soltani T, Rezaei-Hachesu P. An affordable and immersive virtual reality-based exercise therapy in forward head posture. PLoS One 2024; 19:e0297863. [PMID: 38446782 PMCID: PMC10917330 DOI: 10.1371/journal.pone.0297863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Accepted: 01/07/2024] [Indexed: 03/08/2024] Open
Abstract
Forward Head Posture (FHP) is one of the most commonly occurring musculoskeletal abnormalities. Despite exercise therapy being an effective approach for FHP treatment, it can be long, monotonous, and tedious. Virtual reality (VR) can be used as an innovative solution to address these challenges. We designed an affordable and immersive VR-based exercise therapy (VRET) system for FHP correction. The VRET contents (i.e., exercises and VR scenarios) were determined by physiotherapists and game designers at the focus group meetings. Hardware requirements include a VR box, smartphone, and sensors (i.e., a smartphone accelerometer and an affordable Inertial Measurement Unit (IMU)) to measure head motions and transfer them via Wi-Fi to the VRET system. The IMU was designed using the MPU6050, Arduino Nano, and ESP8266-01S. Gwet's AC1, Game Experience Questionnaires (GEQ), and System Usability Scale (SUS) were used to measure intra-rater reliability, user experience, and system usability, respectively. The determined exercises, including Capital Flexion-Extension and Chin Tuck, were designed in the form of a shooting game. A physiotherapist and twenty-one FHP individuals took part in evaluating the system. High precision was obtained for the designed IMU (i.e., pitch and roll < 0.1° and yaw < 1.3 °). Gwet's AC1 and SUS results showed very good intra-rater reliability (coefficient = 0.892) and excellent usability (score = 87.14), respectively. According to the mean scores of the GEQ, participants were confident about competence, immersion, flow, and positive affect components. The development of low-cost VRET systems for FHP correction is a step towards facilitating rehabilitation challenges by providing positive experiences for users as well as helping them perform therapeutic exercises correctly.
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Affiliation(s)
- Afsoon Asadzadeh
- Department of Health Information Technology, School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Zahra Salahzadeh
- Department of Physical Therapy, Faculty of Rehabilitation Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Taha Samad-Soltani
- Department of Health Information Technology, School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Peyman Rezaei-Hachesu
- Department of Health Information Technology, School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran
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Goo BW, Oh JH, Kim JS, Lee MY. Effects of cervical stabilization with visual feedback on craniovertebral angle and proprioception for the subjects with forward head posture. Medicine (Baltimore) 2024; 103:e36845. [PMID: 38215149 PMCID: PMC10783288 DOI: 10.1097/md.0000000000036845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Accepted: 12/12/2023] [Indexed: 01/14/2024] Open
Abstract
BACKGROUND This study aimed to identify the effect of cervical stabilization exercise with visual feedback on the craniovertebral angle and proprioception in subjects with forward head posture. METHODS Thirty healthy adults were recruited in the study. Participants were randomly assigned to the stabilization exercise with visual feedback (SE-VF) group (N = 15) or stabilization exercise group (N = 15). The SE-VF group performed cervical stabilization exercise while sitting on a chair without a backrest and checking their side profile in real-time via a monitor 3-m away. The stabilization exercise group performed the same cervical stabilization exercise as the SE-VF group but without visual feedback. Craniovertebral angle (CVA) was measured to quantify forward head posture, and the proprioception of the subjects was evaluated. RESULTS There was a significant interaction between group and time in CVA and proprioception (P < .05). Additionally, there was no significant difference pre-intervention between the groups (P > .05); however, there was a significant difference post-intervention (P < .05) in CVA and proprioception. CONCLUSION The findings of this study showed that the cervical stabilization exercise with visual feedback was effective for the proprioception of subjects. Moreover, the results suggest that visual feedback is effective in cervical stabilization exercise.
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Affiliation(s)
- Bon Wook Goo
- Rehabilitation Center, Yeungnam University Medical Center, Daegu, Republic of Korea
| | - Jin Hee Oh
- Department of Medical Science, Graduate School, Daegu Haany University, Gyeongsan, Republic of Korea
| | - Ju Sang Kim
- Department of Physical Therapy, Yeungnam University of College, Daegu, Republic of Korea
| | - Mi Young Lee
- Department of Physical Therapy, College of Biomedical Science, Daegu Haany University, Gyeongsan, Republic of Korea
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Miçooğulları M, Yüksel İ, Angın S. Efficacy of scapulothoracic exercises on proprioception and postural stability in cranio-cervico-mandibular malalignment: A randomized, double-blind, controlled trial. J Back Musculoskelet Rehabil 2024; 37:883-896. [PMID: 38427467 DOI: 10.3233/bmr-230323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/03/2024]
Abstract
BACKGROUND Cranio-cervico-mandibular (CCM) malalignment is associated with forward head posture (FHP) and temporomandibular joint (TMJ) disorders and affects masticatory muscles. OBJECTIVE This randomized, double-blind controlled trial aimed to compare the efficacy of scapula-thoracic (ST) exercises on temporomandibular and cervical joint position sense and postural stability in individuals with CCM malalignment. METHODS Fourty-nine participants with CCM malalignment were randomly assigned to the ST exercise group (STEG, n= 24) or the control group (CG, n= 25). STEG included progressive strengthening, proprioceptive, and stabilization exercises. All participants were assessed before treatment, at the end of the 8th week treatment period and at the 12th week post-treatment follow-up. Cranio-vertebral angle measurement, Fonseca's Questionnaire, Helkimo Clinical Dysfunction Index, TMJ position test, cervical joint position error test and postural stability assessment were used. RESULTS The TMJ and cervical joint position sense, total sway degree, area gap percentage, sway velocity and antero-posterior body sway results showed significant improvement in the STEG compared to the CG (p< 0.05), however medio-lateral body sway did not differ between groups (p> 0.05). CONCLUSIONS Postural stability, TMJ and cervical joint position sense appear to be affected in individuals with CCM malalignment. Our results showed that an exercise program including ST stabilization, proprioception and strengthening of the scapular muscles may be effective in the management of CCM malalignment and will allow clinicians to plan holistic treatment.
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Affiliation(s)
- Mehmet Miçooğulları
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Cyprus International University, Lefkoşa, Turkey
| | - İnci Yüksel
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Eastern Mediterranean University, Famagusta, Lefkoşa, Turkey
| | - Salih Angın
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Cyprus International University, Lefkoşa, Turkey
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Saad N, Moustafa IM, Ahbouch A, Alsaafin NM, Oakley PA, Harrison DE. Are Rotations and Translations of Head Posture Related to Gait and Jump Parameters? J Clin Med 2023; 12:6211. [PMID: 37834858 PMCID: PMC10573992 DOI: 10.3390/jcm12196211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2023] [Revised: 08/13/2023] [Accepted: 09/20/2023] [Indexed: 10/15/2023] Open
Abstract
This study assessed the relationship between head posture displacements and biomechanical parameters during gait and jumping. One hundred male and female students (20 ± 3 yrs) were assessed via the PostureScreen Mobile® app to quantify postural displacements of head rotations and translations including: (1) the cranio-vertebral angle (CVA) (°), (2) anterior head translation (AHT) (cm), (3) lateral head translation in the coronal plane (cm), and (4) lateral head side bending (°). Biomechanical parameters during gait and jumping were measured using the G-Walk sensor. The assessed gait spatiotemporal parameters were cadence (steps/min), speed (m/s), symmetry index, % left and right stride length (% height), and right and left propulsion index. The pelvic movement parameters were (1) tilt symmetry index, (2) tilt left and right range, (3) obliquity symmetry index, (4) obliquity left and right range, (5) rotation symmetry index, and (6) rotation left and right range. The jump parameters measured were (1) flight height (cm), (2) take off force (kN), (3) impact Force (kN), (4) take off speed (m/s), (5) peak speed (m/s), (6) average speed concentric phase (m/s), (7) maximum concentric power (kW), (8) average concentric power (kW) during the counter movement jump (CMJ), and (9) CMJ with arms thrust (CMJAT). At a significance level of p ≤ 0.001, moderate-to-high correlations (0.4 < r < 0.8) were found between CVA, AHT, lateral translation head, and all the gait and jump parameters. Weak correlations (0.2 < r < 0.4) were ascertained for lateral head bending and all the gait and jump parameters except for gait symmetry index and pelvic symmetry index, where moderate correlations were identified (0.4 < r < 0.6). The findings indicate moderate-to-high correlations between specific head posture displacements, such as CVA, lateral head translation and AHT with the various gait and jump parameters. These findings highlight the importance of considering head posture in the assessment and optimization of movement patterns during gait and jumping. Our findings contribute to the existing body of knowledge and may have implications for clinical practice and sports performance training. Further research is warranted to elucidate the underlying mechanisms and establish causality in these relationships, which could potentially lead to the development of targeted interventions for improving movement patterns and preventing injuries.
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Affiliation(s)
- Nabil Saad
- Department of Physiotherapy, College of Health Sciences, University of Sharjah, Sharjah 27272, United Arab Emirates (I.M.M.)
| | - Ibrahim M. Moustafa
- Department of Physiotherapy, College of Health Sciences, University of Sharjah, Sharjah 27272, United Arab Emirates (I.M.M.)
- Neuromusculoskeletal Rehabilitation Research Group, RIMHS–Research Institute of Medical and Health Sciences, University of Sharjah, Sharjah 27272, United Arab Emirates
| | - Amal Ahbouch
- Department of Physiotherapy, College of Health Sciences, University of Sharjah, Sharjah 27272, United Arab Emirates (I.M.M.)
| | - Nour Mustafa Alsaafin
- Department of Physiotherapy, College of Health Sciences, University of Sharjah, Sharjah 27272, United Arab Emirates (I.M.M.)
| | - Paul A. Oakley
- Kinesiology and Health Sciences, York University, Toronto, ON M3J 1P3, Canada
- Independent Researcher, Newmarket, ON L3Y 8Y8, Canada
| | - Deed E. Harrison
- CBP Nonprofit (a Spine Research Foundation), Eagle, ID 83616, USA
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Roman de Mettelinge T, Desimpelaere P, Cambier D. Cervical mobility and cervical proprioception in relation to fall risk among older adults: a prospective cohort study. Eur Geriatr Med 2023:10.1007/s41999-023-00785-y. [PMID: 37119446 DOI: 10.1007/s41999-023-00785-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2022] [Accepted: 04/11/2023] [Indexed: 05/01/2023]
Abstract
PURPOSE Age-related decreases in cervical mobility and proprioception have previously been demonstrated. Potential associations of these deteriorations with fall risk have not been investigated so far. This study aims to compare cervical mobility and proprioception between fallers and non-fallers and prospectively assess the contribution of these parameters in fall risk identification among healthy older adults. METHODS 95 community-dwelling older adults underwent a cervical screening. Active cervical range of motion (aCROM) was measured using a digital inclinometer and cervical proprioception was assessed by determining joint position error (JPE). Fear of falling was identified through the Iconographical Falls Efficacy Scale (iconFES). Falls were prospectively recorded during a 1-year follow-up period using monthly calendars. Univariate and multivariate logistic regression analyses were conducted to examine the association between these parameters and falls occurrence. RESULTS Baseline measurements revealed reduced cervical performance (i.e., smaller aCROM and larger JPE) among individuals who reported at least one fall during the following year ("fallers"). The multivariate logistic regression model contained eight independent variables (age, sex, walking aid, fall history, iconFES, aCROM F, aCROM E and JPE) and correctly classified 77.8% of cases. CONCLUSION Although the contribution of cervical parameters to fall risk identification seems to be rather small compared to well-known (though often unmodifiable) major risk factors, further research is needed to elucidate underlying mechanisms of cervical functions in relation to falls. Second, it would be interesting to develop a targeted fall preventive cervical exercise program and assess its effectiveness in terms of falls occurrence.
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Affiliation(s)
- Tine Roman de Mettelinge
- Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, Ghent University, Campus UZ Gent, Corneel Heymanslaan 10, 9000, Ghent, Belgium.
| | | | - Dirk Cambier
- Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, Ghent University, Campus UZ Gent, Corneel Heymanslaan 10, 9000, Ghent, Belgium
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Baer JL, Cohen RG. Does neck flexion improve performance? Effects on reaction time depend on whether responses are expected. SN APPLIED SCIENCES 2023. [DOI: 10.1007/s42452-023-05335-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/19/2023] Open
Abstract
AbstractThis research investigates the limitations of the apparent paradox in which neck flexion, which is associated with poor inhibition and neck pain, seems to facilitate performance in some tasks. We compared the effect of a flexed neck on performance in a reaction time and go-nogo task using a novel method of fixing neck posture. We hypothesize that using a flexed neck posture speeds response time for tasks with high prepotency (when participants are biased toward responding), but not for tasks with low prepotency (when participants are more likely to withhold a response). Previous findings demonstrated the effect of neck flexion on reaction time with a harness. In this study, participants complete both simple reaction time and go-nogo tasks with neck angles fixed in neutral or forward positions with tape. We found that simple reaction times were 10 ms faster in the forward neck position than in neutral; this facilitation was not seen in the go-nogo task. We conclude that using tape to induce a flexed neck posture facilitates reaction time during tasks that always require a response and does not affect reaction time on a task which may require withholding a response.
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