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Tsang SMH, Cheing GLY, Chan JWK. Severity of slouched posture during smartphone use is associated with the musculoskeletal discomfort, daily usage, and school year among adolescents. ERGONOMICS 2023; 66:1340-1353. [PMID: 36352815 DOI: 10.1080/00140139.2022.2146208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Accepted: 11/06/2022] [Indexed: 06/16/2023]
Abstract
Real-time measurement of the craniovertebral, thoracic kyphosis, and lumbar lordosis angles during natural and smartphone usage postures in sitting were analysed in a cohort of 560 adolescents using independent t-tests and Spearman's correlations between their reported musculoskeletal symptoms, daily device use and school year. Students with musculoskeletal symptoms (mean difference: 4.1-9.4°, p < .001) and in secondary schools (mean difference: 13.6-29.4°, p < .001) had a greater forward-head posture quantified by craniovertebral angle in both postures. Loss of lumbar lordosis was found in students spending ≥2 h/day on electronic devices (mean difference: 3.2°, p = .029) and those with musculoskeletal symptoms (mean difference: 5.4°, p = .001). Secondary school students exhibited a greater thoracic kyphosis when using smartphones (mean difference: 3.3°, p = .003). Findings suggest the urgent need for early and proactive intervention targeted to minimise the risk of developing musculoskeletal disorders related to intense device use for young adolescents.Practitioner Summary: Adolescents: (1) in higher school year had increased forward-head posture (FHP) and thoracic kyphosis; (2) with musculoskeletal symptoms had increased FHP and loss of lumbar lordosis, and; (3) with extended device use had a loss of lumbar lordosis. Early intervention targeting young adolescents promoting optimal posture and habit of device use is warranted.
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Affiliation(s)
- Sharon M H Tsang
- Department of Rehabilitation Science, The Hong Kong Polytechnic University, Hong Kong, China
| | - Gladys L Y Cheing
- Department of Rehabilitation Science, The Hong Kong Polytechnic University, Hong Kong, China
| | - Jess W K Chan
- Department of Rehabilitation Science, The Hong Kong Polytechnic University, Hong Kong, China
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2
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Arnone PA, Kraus SJ, Farmen D, Lightstone DF, Jaeger J, Theodossis C. Examining Clinical Opinion and Experience Regarding Utilization of Plain Radiography of the Spine: Evidence from Surveying the Chiropractic Profession. J Clin Med 2023; 12:jcm12062169. [PMID: 36983168 PMCID: PMC10054546 DOI: 10.3390/jcm12062169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 03/03/2023] [Accepted: 03/07/2023] [Indexed: 03/14/2023] Open
Abstract
Plain Radiography of the spine (PROTS) is utilized in many forms of healthcare including the chiropractic profession; however, the literature reflects conflicting opinions regarding utilization and value. Despite being an essential part of Evidence-Based Practice (EBP), few studies assess Doctors of Chiropractic (DCs) clinical opinions and experience regarding the utilization of (PROTS) in practice. In this study, DCs were surveyed regarding utilization of PROTS in practice. The survey was administered to an estimated 50,000 licensed DCs by email. A total of 4301 surveys were completed, of which 3641 were United States (US) DCs. The Clinician Opinion and Experience on Chiropractic Radiography (COECR) scale was designed to analyze survey responses. This valid and reliable scale demonstrated good internal consistency using confirmatory factor analysis and the Rasch model. Survey responses show that 73.3% of respondents utilize PROTS in practice and 26.7% refer patients out for PROTS. Survey responses show that, among US DCs, 91.9% indicate PROTS has value beyond identification of pathology, 86.7% indicate that PROTS is important regarding biomechanical analysis of the spine, 82.9% indicate that PROTS is vital to practice, 67.4% indicate that PROTS aids in measuring outcomes, 98.6% indicate the opinion that PROTS presents very low to no risk to patients, and 93.0% indicate that sharing clinical findings from PROTS studies with patients is beneficial to clinical outcomes. The results of the study indicated that based on clinical experience, the majority of DCs find PROTS to be vital to practice and valuable beyond the identification of red flags.
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Affiliation(s)
- Philip A. Arnone
- The Balanced Body Center, Matthews, NC 28105, USA
- Correspondence:
| | | | - Derek Farmen
- The Balanced Body Center, Matthews, NC 28105, USA
| | | | - Jason Jaeger
- Community Based Internship Program, Associate Faculty, Southern California University of Health Sciences, Whittier, CA 90604, USA
| | - Christine Theodossis
- Chair, Radiology Department, Sherman College of Chiropractic, Boiling Springs, SC 29316, USA
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Norton TC, Oakley PA, Harrison DE. Re-establishing the cervical lordosis after whiplash: a Chiropractic Biophysics ® spinal corrective care methods pre-auto injury and post-auto injury case report with follow-up. J Phys Ther Sci 2023; 35:270-275. [PMID: 36866005 PMCID: PMC9974326 DOI: 10.1589/jpts.35.270] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2022] [Accepted: 12/06/2022] [Indexed: 03/04/2023] Open
Abstract
[Purpose] To document the re-establishment of the cervical lordosis following radiographically verified altered sagittal plane alignment both prior to, and following a motor vehicle collision. [Participant and Methods] A 16-year-old male presented for a non-motor collision complaint of low back pain. Initial lateral cervical radiograph demonstrated cervical hypo-lordosis. The patient was treated with a 6-week plan (18 visits) utilizing Chiropractic BioPhysics® (CBP) methods to increase the cervical lordosis. Eight months later the patient presented with new complaints as a result of a motor collision. The cervical lordosis straightened. The patient received another round of similar treatment to improve the lordosis. There was also a 6.5-month follow-up. [Results] The initial round of treatment achieved a 21° improvement in cervical lordosis. The motor vehicle collision caused a loss of 15° of lordosis. The second round of treatment achieved a 12.5° improvement in lordosis that was demonstrated to be maintained at a 6.5-month follow-up. [Conclusions] This case illustrates how a whiplash event occurring during a motor vehicle collision subluxated the cervical spine. It was also shown that CBP methods reliably corrected the lordosis after two separate treatment programs using specialized methods. Beyond trauma, radiographic screening of specific cervical subluxation is recommended following all motor collisions.
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Affiliation(s)
| | - Paul A. Oakley
- Private Practice: 11A-1100 Gorham St., Newmarket, Ontario
L3Y8Y8, Canada,Corresponding author. Paul A. Oakley (E-mail: )
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4
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Suwaidi ASA, Moustafa IM, Kim M, Oakley PA, Harrison DE. A Comparison of Two Forward Head Posture Corrective Approaches in Elderly with Chronic Non-Specific Neck Pain: A Randomized Controlled Study. J Clin Med 2023; 12:jcm12020542. [PMID: 36675471 PMCID: PMC9861410 DOI: 10.3390/jcm12020542] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 12/18/2022] [Accepted: 01/07/2023] [Indexed: 01/12/2023] Open
Abstract
Forward head posture (FHP) is a common postural displacement that is significantly associated with neck pain, with higher risks of having neck pain in female and older populations. This study investigated the effect of two different forward head posture (FHP) interventions in elderly participants with poor posture and non-specific neck pain. Sixty-six elderly participants with a craniovertebral angle (CVA) < 50° were randomized into either a Chiropractic Biophyics® (CBP®) or a standardized exercise based FHP correction group (Standard Group). Both groups were treated for 18 sessions over a 6-week period. A 3-month post-treatment follow-up was also assessed with no further interventions. The CBP group received a mirror image® exercise and a Denneroll™ cervical traction orthotic (DCTO); the standard group performed a protocol of commonly used stretching and strengthening exercises for the neck. Both groups received 30 min of their respective interventions per session. The primary outcome was the CVA, with secondary outcomes including pain intensity, Berg balance score (BBS), head repositioning accuracy (HRA), and cervical range of motion (CROM). After 18 sessions (6 weeks later), the CBP group had statistically significant improvement in the CVA (p < 0.001), whereas the standard group did not. In contrast, both groups showed improved functional measurements on the BBS and HRA as well as improved pain intensity. However, at the 3-month follow-up (with no further treatment), there were statistically significant differences favoring the CBP group for all outcomes (p < 0.001). The differences in the between group outcomes at the 3-month follow-up indicated that the improved outcomes were maintained in the CBP group, while the standard group experienced regression of the initially improved outcomes at 6 weeks. It is suggested that the improvement in the postural CVA (in the CBP group but not in the standard group) is the driver of superior and maintained pain and functional outcomes.
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Affiliation(s)
- Aisha Salim Al Suwaidi
- Department of Physiotherapy, College of Health Sciences, University of Sharjah, Sharjah 27272, United Arab Emirates
| | - Ibrahim M. Moustafa
- Department of Physiotherapy, College of Health Sciences, University of Sharjah, Sharjah 27272, United Arab Emirates
- Neuromusculoskeletal Rehabilitation Research Group, Research Institute of Medical and Health Sciences, University of Sharjah, Sharjah 27272, United Arab Emirates
| | - Meeyoung Kim
- Department of Physiotherapy, College of Health Sciences, University of Sharjah, Sharjah 27272, United Arab Emirates
| | - Paul A. Oakley
- CBP Nonprofit (A Spine Research Foundation), Eagle, ID 83616, USA
- Private Practice, Newmarket, ON L3Y 8Y8, Canada
- Kinesiology and Health Sciences, York University, Toronto, ON M3J 1P3, Canada
| | - Deed E. Harrison
- CBP Nonprofit (A Spine Research Foundation), Eagle, ID 83616, USA
- Correspondence:
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Does Improvement towards a Normal Cervical Sagittal Configuration Aid in the Management of Lumbosacral Radiculopathy: A Randomized Controlled Trial. J Clin Med 2022; 11:jcm11195768. [PMID: 36233636 PMCID: PMC9572257 DOI: 10.3390/jcm11195768] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 09/24/2022] [Accepted: 09/24/2022] [Indexed: 12/04/2022] Open
Abstract
A randomized controlled study with a six-month follow-up was conducted to investigate the effects of sagittal head posture correction on 3D spinal posture parameters, back and leg pain, disability, and S1 nerve root function in patients with chronic discogenic lumbosacral radiculopathy (CDLR). Participants included 80 (35 female) patients between 40 and 55 years experiencing CDLR with a definite hypolordotic cervical spine and forward head posture (FHP) and were randomly assigned a comparative treatment control group and a study group. Both groups received TENS therapy and hot packs, additionally, the study group received the Denneroll cervical traction orthotic. Interventions were applied at a frequency of 3 x per week for 10 weeks and groups were followed for an additional 6-months. Radiographic measures included cervical lordosis (CL) from C2–C7 and FHP; postural measurements included: lumbar lordosis, thoracic kyphosis, trunk inclination, lateral deviation, trunk imbalance, surface rotation, and pelvic inclination. Leg and back pain scores, Oswestry Disability Index (ODI), and H-reflex latency and amplitude were measured. Statistically significant differences between the groups at 10 weeks were found: for all postural measures, CL (p = 0.001), AHT (p = 0.002), H-reflex amplitude (p = 0.007) and latency (p = 0.001). No significant difference for back pain (p = 0.2), leg pain (p = 0.1) and ODI (p = 0.6) at 10 weeks were identified. Only the study group’s improvements were maintained at the 6-month follow up while the control groups values regressed back to baseline. At the 6-month follow-up, it was identified in the study group that improved cervical lordosis and reduction of FHP were found to have a positive impact on 3D posture parameters, leg and back pain scores, ODI, and H-reflex latency and amplitude.
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Effect of Rounded and Hunched Shoulder Postures on Myotonometric Measurements of Upper Body Muscles in Sedentary Workers. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12073333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background: Shoulder pain is prominent among sedentary employees who make motions of the upper limbs on a regular basis. Rounded shoulder posture (RSP) and hunched shoulder posture (HSP) are the most common clinical postural misalignments. These causes the spine to bend and raise tension on the nerve roots, which has a negative impact on upper-extremity muscular strength and function. Therefore, this study was carried out to investigate the effect of RSP and HSP on the mechanical parameters of the upper body muscles in clinically asymptomatic sedentary workers. Methods: Twenty office workers with RSP, 20 with HSP, and 20 with normal shoulder posture (NSP) were matched for age, BMI, and type of job. Volunteers were split into groups based on photometric shoulder angle measurements. Mechanical properties such as muscle tone, stiffness, and elasticity of the upper trapezius, middle trapezius, posterior deltoid, and pectoralis major were assessed in sedentary postures. Results: The study revealed a significant decrease in muscle tone for the pectoralis major and a significant increase in muscle stiffness for the poster deltoid in both RSP and HSP as compared to NSP. Specifically, muscle tone decreased from 20.1 ± 4.0 to 12.4 ± 3.1 Hz (38.3%), (p ≤ 0.001) in RSP and from 20.1 ± 4.0 to 14.0 ± 4.8 Hz (30.3%), (p ≤ 0.001) in HSP. Muscle stiffness increased from 309.9 ± 70.7 to 348.15 ± 68.7 N/m (11%), (p ≤ 0.001) in RSP and from 309.9 ± 70.7 to 441.7 ± 45.9 N/m (29.8%), (p ≤ 0.001) in HSP. Conclusions: RSP and HSP have an impact on the tone, stiffness, and elasticity of upper body muscles in healthy asymptomatic sedentary workers. These postures, on a regular basis, may affect physical health and decrease workers’ productivity. In addition, it is recommended for sedentary workers to take regular breaks and attend training that could help improve their physical health.
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7
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Fortner MO, Woodham TJ, Oakley PA, Harrison DE. Is the cervical lordosis a key biomechanical biomarker in cervicogenic headache?: a Chiropractic Biophysics ® case report with follow-up. J Phys Ther Sci 2022; 34:167-171. [PMID: 35221522 PMCID: PMC8860691 DOI: 10.1589/jpts.34.167] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Accepted: 11/25/2021] [Indexed: 01/06/2023] Open
Abstract
[Purpose] To present the successful structural improvement in cervical lordosis in a
patient suffering from cervicogenic headache having cervical kyphosis. [Participant and
Methods] A 26 year old female presented with the primary complaint of headache.
Radiography demonstrated a cervical kyphosis. Chiropractic BioPhysics® methods
were used to restore the cervical spine alignment. Twenty-five treatments were given over
8 weeks. A 2.5 year follow-up was also reported. [Results] Radiography showed a dramatic
increase in cervical lordosis following initial treatment. The patient also reported
substantial reductions in headache frequency and severity as well as other bodily
improvements, reduced disability and improved quality of life. The long-term follow-up
showed a maintenance of lordosis correction and patient wellness. [Conclusion] A cervical
kyphosis was reversed back to a normal lordosis in 8 weeks and coincided with dramatic
resolution of cervicogenic headache in a young female. The cervical lordosis may be a key
biomechanical biomarker in cervicogenic headache.
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8
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Effect of Biofeedback Corrective Exercise on Reaction Time and Central Somatosensory Conduction Time in Patients With Forward Head Posture and Radiculopathy: A Randomized Controlled Study. J Chiropr Med 2022; 21:39-50. [DOI: 10.1016/j.jcm.2022.01.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 12/30/2021] [Accepted: 01/07/2022] [Indexed: 12/27/2022] Open
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9
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Effects of a combination of scapular stabilization and thoracic extension exercises for office workers with forward head posture on the craniovertebral angle, respiration, pain, and disability: A randomized-controlled trial. Turk J Phys Med Rehabil 2021; 67:291-299. [PMID: 34870115 PMCID: PMC8606989 DOI: 10.5606/tftrd.2021.6397] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2020] [Accepted: 06/23/2020] [Indexed: 11/27/2022] Open
Abstract
Objectives
This study aims to investigate how exercise programs not directly applied to the cervical spine affect office workers with forward head posture (FHP).
Patients and methods
Between March 2018 and June 2018, a total of 32 office workers with FHP (13 males, 19 females; mean age 36.63 years; range, 23 to 57 years) were randomized either to experimental (n=16) or control groups (n=16). Scapular stabilization and thoracic extension exercises were applied to the experimental group and cervical stabilization and stretching exercises to the control group. The results of the pre-intervention and after six weeks measurement of the craniovertebral angle (CVA), respiration, pain, and disability were compared and analyzed.
Results
For intra-group comparison, both groups showed significant differences (p<0.05) in CVA, forced expiratory volume at 1 sec (FEV1), Visual Analog Scale (VAS), and neck disability index at pre- and post-intervention, while only the experimental group showed a significant difference (p<0.05) in maximum inspiratory pressure, maximum expiratory pressure, and forced vital capacity. For inter-group comparison, a significant difference (p<0.05) between FEV1 and VAS was observed.
Conclusion
The combination of scapular stabilization and thoracic extension exercises, not directly applied to the cervical spine, has an effect on improving the posture, respiration, neck pain, and disability in office workers with FHP.
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10
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Kim J, Khil JH. Effects of Non-Contact Corrective Exercise Continuum for 12 Weeks on Postural Imbalance in Adults. THE ASIAN JOURNAL OF KINESIOLOGY 2021. [DOI: 10.15758/ajk.2021.23.4.29] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES This study was to examine the effect of the 12-week video-based non-contact corrective exercise continuum (CEC) program on the forward head posture, central asymmetry, varus and valgus knees for men and women with postural imbalance.METHODS Subjects were recruited openly by the Internet community and measured their posture with a 3D whole body scanner (Medicube WS-210, Korea), and then classified into exercise group (n=32, EG) and control group (n=32, CG). Total subjects were classified into forward head posture exercise group (n=8), central asymmetry exercise group (n=8), varus exercise group (n=8), valgus exercise group and each control group (n=8). For the non-contact home training, 12 weeks of 30 minutes/day, 3 times/week, corrective exercise continuum were conducted. The CEC program is an effective treatment to correct the anatomical alignment of the extremities as suggested by the National Academy of Sports Medicine.RESULTS As a result, the distance between the centers according to the forward head posture CEC program in EG, the angle of spinal inclination of the cervical and thoracic vertebrae, and central asymmetry were lowered (p<.05). Body shape distribution balance and shoulder tilt angle were lowered in EG according to the central asymmetry CEC program (p <.05). According to the varus CEC program in EG, the distance between the center of the knee, the tilt angle of the femur and tibia, and body shape distribution were lowered (p <.05). According to the valgus CEC program in EG, the distance between the center of the knee increased, and the tilt angle of the femur and tibia decreased (p<.05).CONCLUSIONS The effect of improving the anterior head posture, central asymmetry, varus and valgus knees of postural imbalance according to the CEC program was confirmed. It is thought that the CEC program can restore optimal neuromuscular control by restoring proper joint kinematics and restore posture and balance by reducing the observed muscle tension.
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11
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Oakley PA, Ehsani NN, Moustafa IM, Harrison DE. Restoring cervical lordosis by cervical extension traction methods in the treatment of cervical spine disorders: a systematic review of controlled trials. J Phys Ther Sci 2021; 33:784-794. [PMID: 34658525 PMCID: PMC8516614 DOI: 10.1589/jpts.33.784] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Accepted: 07/13/2021] [Indexed: 12/16/2022] Open
Abstract
[Purpose] To systematically review the literature on the use of cervical extension traction methods for increasing cervical lordosis in those with hypolordosis and cervical spine disorders. [Methods] Literature searches for controlled clinical trials were performed in Pubmed, PEDro, Cochrane, and ICL databases. Search terms included iterations related to the cervical spine, neck pain and disorders, and extension traction rehabilitation. [Results] Of 1,001 initially located articles, 9 met the inclusion/exclusion criteria. The trials demonstrated increases in radiographically measured lordosis of 12-18°, over 5-15 weeks, after 15-60 treatment sessions. Untreated controls/comparison groups not receiving extension traction showed no increase in cervical lordosis. Several trials demonstrated that both traction and comparison treatment groups experienced immediate pain relief. Traction treatment groups maintained their pain and disability improvements up to 1.5 years later. Comparative groups not receiving lordosis improvement experienced regression of symptoms towards pre-treatment values by 1 years' follow-up. [Conclusion] There are several high-quality controlled clinical trials substantiating that increasing cervical lordosis by extension traction as part of a spinal rehabilitation program reduces pain and disability and improves functional measures, and that these improvements are maintained long-term. Comparative groups who receive multimodal rehabilitation but not extension traction experience temporary relief that regresses after treatment cessation.
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Affiliation(s)
- Paul A. Oakley
- Innovative Spine & Wellness: Newmarket, ON, L3Y 8Y8
Canada
| | | | - Ibrahim M. Moustafa
- Department of Physiotherapy, College of Health Sciences,
University of Sharjah, UAE
- Basic Science Department, Faculty of Physical Therapy,
Cairo University, Egypt
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12
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Moustafa IM, Diab AA, Hegazy F, Harrison DE. Demonstration of central conduction time and neuroplastic changes after cervical lordosis rehabilitation in asymptomatic subjects: a randomized, placebo-controlled trial. Sci Rep 2021; 11:15379. [PMID: 34321539 PMCID: PMC8319301 DOI: 10.1038/s41598-021-94548-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Accepted: 07/13/2021] [Indexed: 12/14/2022] Open
Abstract
A randomized controlled study was conducted to evaluate the effect of rehabilitation of the cervical sagittal configuration on sensorimotor integration and central conduction time in an asymptomatic population. Eighty (32 female) participants with radiographic cervical hypolordosis and anterior head translation posture were randomly assigned to either a control or an experimental group. The experimental group received the Denneroll cervical traction while the control group received a placebo treatment. Interventions were applied 3 × per week for 10 weeks. Outcome measures included radiographic measured anterior head translation distance, cervical lordosis (posterior bodies of C2–C7), central somatosensory conduction time (latency) (N13–N20), and amplitudes of potentials for spinal N13, brainstem P14, parietal N20 and P27, and frontal N30. Outcomes were obtained at: baseline, after 10 weeks of intervention, and at 3 months follow up. After 10 weeks and 3-months, between-group analyses revealed statistically significant differences between the groups for the following measured variables: lordosis C2–C7, anterior head translation, amplitudes of spinal N13, brainstem P14, parietal N20 and P27, frontal N30 potentials (P < 0.001), and conduction time N13–N20 (P = 0.004). Significant correlation between the sagittal alignment and measured variables were found (P < 0.005). These findings indicate restoration of cervical sagittal alignment has a direct influence on the central conduction time in an asymptomatic population.
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Affiliation(s)
- Ibrahim M Moustafa
- Department of Physiotherapy, College of Health Sciences, University of Sharjah, Sharjah, UAE.,Basic Science Department, Faculty of Physical Therapy, Cairo University, Giza, Egypt
| | - Aliaa A Diab
- Basic Science Department, Faculty of Physical Therapy, Cairo University, Giza, Egypt
| | - Fatma Hegazy
- Department of Physiotherapy, College of Health Sciences, University of Sharjah, Sharjah, UAE
| | - Deed E Harrison
- CBP Nonprofit (A Spine Research Foundation), 950 E. Riverside Drive, Eagle, ID, USA.
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13
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Oakley PA, Betz JW, Harrison DE, Siskin LA, Hirsh DW. Radiophobia Overreaction: College of Chiropractors of British Columbia Revoke Full X-Ray Rights Based on Flawed Study and Radiation Fear-Mongering. Dose Response 2021; 19:15593258211033142. [PMID: 34421439 PMCID: PMC8375354 DOI: 10.1177/15593258211033142] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 06/17/2021] [Accepted: 06/22/2021] [Indexed: 01/11/2023] Open
Abstract
Fears over radiation have created irrational pressures to dissuade radiography use within chiropractic. Recently, the regulatory body for chiropractors practicing in British Columbia, Canada, the College of Chiropractors of British Columbia (CCBC), contracted Pierre Côté to review the clinical use of X-rays within the chiropractic profession. A "rapid review" was performed and published quickly and included only 9 papers, the most recent dating from 2005; they concluded, "Given the inherent risks of radiation, we recommend that chiropractors do not use radiographs for the routine and repeat evaluation of the structure and function of the spine." The CCBC then launched an immediate review of the use of X-rays by chiropractors in their jurisdiction. Member and public opinion were gathered but not presented to their members. On February 4, 2021, the College announced amendments to their Professional Conduct Handbook that revoked X-ray rights for routine/repeat assessment and management of patients with spine disorders. Here, we highlight current and historical evidence that substantiates that X-rays are not a public health threat. We also point out critical and insurmountable flaws in the single paper used to support irrational and unscientific policy that discriminates against chiropractors who practice certain forms of evidence-based X-ray-guided methods.
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Affiliation(s)
| | | | | | | | | | - International Chiropractors Association Rapid Response Research Review Subcommittee
- Private Practice, Newmarket, ON, Canada
- Private Practice, Boise, ID, USA
- CBP NonProfit, Inc, Eagle, ID, USA
- Private Practice, Green Brook, NJ, USA
- Private Practice, Laurel, MD, USA
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14
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Molaeifar S, Yazdani F, Yoosefinejad AK, Karimi MT. Correlation between craniovertebral angle in the sagittal plane and angles and indices measured in the frontal plane at the moment of inducing forward head posture. Work 2021; 68:1221-1227. [PMID: 33867381 DOI: 10.3233/wor-213451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Forward head posture (FHP) is the most common malposition in the head and neck area. With the growing use of digital devices, the prevalence of FHP may be expected to increase dramatically. Thus far, FHP has been evaluated only in the sagittal plane. OBJECTIVE The objective of this study was to measure angles and indices from anatomical landmarks in the frontal plane and determine the possible correlations between these variables and craniovertebral angle (CVA) as an index of FHP in the sagittal plane. METHODS Fifty eight healthy individuals (29 men, 29 women) between 18 and 40 years old participated in this cross-sectional study. Participants were evaluated with an 8-camera motion analysis system. After markers were placed on predetermined landmarks, the participants were asked to maintain their head and neck in the neutral position for 5 seconds. Then participants induced FHP by flexing and lowering their head. The correlation between CVA and a set of angles and indices was calculated at the moment of FHP induction. RESULTS A moderate correlation was observed between 3-D CVA and the angle formed between the sternum and both tragi for the whole sample and separately in both sexes. A moderate negative correlation was observed between 3-D CVA and height, weight, and BMI in women. A moderate negative correlation was observed between 3-D CVA and height, weight, BMI, and hours on digital devices in men. CONCLUSIONS Changes in CVA in the sagittal plane can be predicted from changes in the angle formed between the midpoint of the sternum and the left and right tragi in the frontal plane.
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Affiliation(s)
- Samira Molaeifar
- Physical Therapy Department, School of Rehabilitation, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Farzaneh Yazdani
- Physical Therapy Department, School of Rehabilitation, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Amin Kordi Yoosefinejad
- Physical Therapy Department, School of Rehabilitation, Shiraz University of Medical Sciences, Shiraz, Iran.,Rehabilitation Sciences Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad Taghi Karimi
- Rehabilitation Sciences Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.,Orthotics and Prosthesis Department, School of Rehabilitation, Shiraz University of Medical Sciences, Shiraz, Iran
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15
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Effect of 4 Weeks of Cervical Deep Muscle Flexion Exercise on Headache and Sleep Disorder in Patients with Tension Headache and Forward Head Posture. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18073410. [PMID: 33806089 PMCID: PMC8037445 DOI: 10.3390/ijerph18073410] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Revised: 03/22/2021] [Accepted: 03/23/2021] [Indexed: 11/19/2022]
Abstract
The purpose of this study was to investigate the effect of flexion exercise of the deep cervical muscles on headache and sleep disorders in patients with tension headaches and forward head posture. A total of 32 patients with tension headaches and forward head posture were randomly assigned to two groups: an experimental group (n = 16) and a control group (n = 16). The experimental group performed cervical deep muscle flexion exercises for 4 weeks, whereas the control group performed stretching exercises for the same period. The Henry Ford Hospital Headache Disability Inventory (HDI) was used for headache assessment, and the Korean version of the Pittsburgh Sleep Quality Index (PSQI-K) was used for sleep disorder assessment. The experimental group showed a significant reduction in both HDI and PSQI-K score after 4 weeks of intervention (p < 0.001), while no significant difference was found in the control group (p > 0.05). On comparing the experimental and control groups, we found a significant difference in changes in the HDI and PSQI-K between the groups (p < 0.05). The results indicate that flexion exercise of the deep cervical muscles in patients with tension headache and forward head posture will improve the quality of life and activities of daily life by mitigating headaches and sleep disorders.
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Fedorchuk CA, Lightstone DF, Oakley PA, Harrison DE. Correction of a double spondylolisthesis of the lumbar spine utilizing Chiropractic BioPhysics ® technique: a case report with 1 year follow-up. J Phys Ther Sci 2021; 33:89-93. [PMID: 33519081 PMCID: PMC7829569 DOI: 10.1589/jpts.33.89] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Accepted: 10/14/2020] [Indexed: 12/12/2022] Open
Abstract
[Purpose] To report on the reduction of a double lumbar spine spondylolisthesis by use
of Chiropractic BioPhysics® technique. [Participant and Methods] A 57 year-old
male presented with severe chronic low back pains and sciatica. After playing hockey for
50 years, he was unable to continue and was forced to retire. Lumbar radiography showed an
L3 retrolisthesis of −5.3 mm and an L4 anterolisthesis of 5.4 mm. Chiropractic BioPhysics
technique including mirror image lumbar spine drop-table adjustments, corrective exercises
and a unique pelvic extension traction was performed 50 times over 7-months. [Results] A
radiograph after 3-months showed full reduction of the L3 retrolisthesis. A radiograph
after 7-months showed full reduction of the L4 anterolisthesis. The patient reported full
resolution of chronic back pains and was able to return to play hockey; a 1.75 year
follow-up showed maintenance of the corrections and the patient remained injury-free while
returning to play hockey. [Conclusion] A customized treatment program including
Chiropractic BioPhysics lumbar spine traction, corrective exercises and drop-table spine
manipulation resolved chronic back pains and fully reduced an L3 and L4 retro- and
antero-listhesis, respectively. Further research may substantiate this treatment approach
for reducing translational displacements in the lumbar spine. Routine upright radiography
is required to diagnose spondylolisthesis.
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Clinical and radiological outcomes of kinesiotaping in patients with chronic neck pain: A double-blinded, randomized, placebo-controlled study. Turk J Phys Med Rehabil 2020; 66:459-467. [PMID: 33364567 PMCID: PMC7756830 DOI: 10.5606/tftrd.2020.5632] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2019] [Accepted: 08/24/2020] [Indexed: 01/21/2023] Open
Abstract
Objectives In this study, we aimed to evaluate the efficacy of kinesiotaping (KT) in patients with chronic non-specific neck pain (NSNP) in terms of pain, disability, cervical range of motion (ROM), and cervical lordosis. Patients and methods Between October 2013 and March 2014, a total of 50 patients (10 males, 40 females; mean age 35.1±9.9 years; range, 17 to 62 years) with chronic NSNP were randomized into the KT (n=25) or the sham KT intervention (n=25) groups. Both groups were additionally given a therapeutic exercise (TE) program. The Visual Analog Scale (VAS) and Neck Disability Index (NDI) scores and ROM measurements were recorded at baseline, at the end of treatment, and at one month. Lateral cervical digital radiographs were analyzed by the Cobb, posterior tangent and effective lordosis methods at baseline and at one month after the treatment. Results There was a statistically significant decrease in the VAS scores compared to baseline in the KT group. The NDI scores significantly decreased in both groups. The patients in the KT group experienced a significant increase in all planes of cervical ROM after the treatment. Cervical radiographs revealed a significant increase in the Cobb and posterior tangent angles only in the KT group. Conclusion Our study results suggest that KT significantly improves VAS, NDI scores, ROM and cervical lordosis angles. The combination of TE and KT is useful in reducing pain and disability and improving ROM and cervical lordosis loss in patients with chronic NSNP.
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Sung YH. Upper cervical spine dysfunction and dizziness. J Exerc Rehabil 2020; 16:385-391. [PMID: 33178639 PMCID: PMC7609854 DOI: 10.12965/jer.2040612.306] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Accepted: 09/04/2020] [Indexed: 12/12/2022] Open
Abstract
Although various causes of dizziness have been identified, many patients suffer from dizziness of unknown etiology and continue to visit hospitals to resolve their symptoms. Problems that occur in the ligaments or muscles of the upper cervical spine can cause confusion in proprioception. These changes can convey misinformation to the vestibular nucleus, resulting in abnormal reactions that can lead to cervicogenic dizziness (CGD). Though CGD remains controversial, it should be considered while diagnosing patients with dizziness. Understanding CGD can help create treatment strategies for them. This article suggested a relationship between the structure and function of the upper cervical spine and dizziness, and presented evaluations and treatments for the same.
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Affiliation(s)
- Yun-Hee Sung
- Department of Physical Therapy, College of Health Sciences, Kyungnam University, Changwon, Korea
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19
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Corso M, Cancelliere C, Mior S, Kumar V, Smith A, Côté P. The clinical utility of routine spinal radiographs by chiropractors: a rapid review of the literature. Chiropr Man Therap 2020; 28:33. [PMID: 32641135 PMCID: PMC7346665 DOI: 10.1186/s12998-020-00323-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Accepted: 05/24/2020] [Indexed: 02/08/2023] Open
Abstract
INTRODUCTION When indicated by signs or symptoms of potentially serious underlying pathology (red flags), chiropractors can use radiographs to inform their diagnosis. In the absence of red flags, the clinical utility of routine or repeat radiographs to assess the structure and function of the spine is controversial. OBJECTIVES To determine the diagnostic and therapeutic utility of routine or repeat radiographs (in the absence of red flags) of the cervical, thoracic or lumbar spine for the functional or structural evaluation of the spine. Investigate whether functional or structural findings on repeat radiographs are valid markers of clinically meaningful outcomes. The research objectives required that we determine the validity, diagnostic accuracy and reliability of radiographs for the structural and functional evaluation of the spine. EVIDENCE REVIEW We searched MEDLINE, CINAHL, and Index to Chiropractic Literature from inception to November 25, 2019. We used rapid review methodology recommended by the World Health Organization. Eligible studies (cross-sectional, case-control, cohort, randomized controlled trials, diagnostic and reliability) were critically appraised. Studies of acceptable quality were included in our synthesis. The lead author extracted data and a second reviewer independently validated the data extraction. We conducted a qualitative synthesis of the evidence. FINDINGS We identified 959 citations, screened 176 full text articles and critically appraised 23. No relevant studies assessed the clinical utility of routine or repeat radiographs (in the absence of red flags) of the cervical, thoracic or lumbar spine for the functional or structural evaluation of the spine. No studies investigated whether functional or structural findings on repeat radiographs are valid markers of clinically meaningful outcomes. Nine low risk of bias studies investigated the validity (n = 2) and reliability (n = 8) of routine or repeat radiographs. These studies provide no evidence of clinical utility. CONCLUSION We found no evidence that the use of routine or repeat radiographs to assess the function or structure of the spine, in the absence of red flags, improves clinical outcomes and benefits patients. Given the inherent risks of ionizing radiation, we recommend that chiropractors do not use radiographs for the routine and repeat evaluation of the structure and function of the spine.
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Affiliation(s)
- Melissa Corso
- Faculty of Health Sciences, Ontario Tech University and Centre for Disability Prevention and Rehabilitation, 2000 Simcoe St N, Oshawa, ON, L1G 0C5, Canada
| | - Carol Cancelliere
- Faculty of Health Sciences, Ontario Tech University and Centre for Disability Prevention and Rehabilitation, 2000 Simcoe St N, Oshawa, ON, L1G 0C5, Canada
| | - Silvano Mior
- Faculty of Health Sciences, Ontario Tech University and Centre for Disability Prevention and Rehabilitation, 2000 Simcoe St N, Oshawa, ON, L1G 0C5, Canada
- Canadian Memorial Chiropractic College, North York, Ontario, Canada
| | - Varsha Kumar
- Canadian Memorial Chiropractic College, North York, Ontario, Canada
| | - Ali Smith
- Canadian Memorial Chiropractic College, North York, Ontario, Canada
| | - Pierre Côté
- Faculty of Health Sciences, Ontario Tech University and Centre for Disability Prevention and Rehabilitation, 2000 Simcoe St N, Oshawa, ON, L1G 0C5, Canada.
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20
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Cho J, Lee E, Lee S. Upper cervical and upper thoracic spine mobilization versus deep cervical flexors exercise in individuals with forward head posture: A randomized clinical trial investigating their effectiveness. J Back Musculoskelet Rehabil 2019; 32:595-602. [PMID: 30584118 DOI: 10.3233/bmr-181228] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Although commonly utilized treatments, no study has directly compared the effectiveness of joint mobilization and stabilization exercise in individuals with forward head posture (FHP). OBJECTIVE This study aimed to investigate the effects of upper cervical and upper thoracic spine mobilization versus deep cervical flexors exercise (DCFE) in individuals with FHP. METHODS Thirty-one participants with FHP were randomized into the mobilization (n= 15) or exercise (n= 16) group. The treatment period was 4 weeks with follow-up assessment at 4 weeks and 6 weeks after the initial examination. Outcomes assessed included the craniovertebral angle (CVA), numeric pain rating scale (NPRS), respiratory function, and the global rating of change (GRC). RESULTS Participants in the mobilization group demonstrated significant improvements (p< 0.05) in CVA, NPRS, and respiratory function, as compared to those in the exercise group. In addition, 9 of 15 (60%) participants in the mobilization group, as compared to 4 of 16 participants (25%) in the exercise group, had a GRC score of +4 or higher. CONCLUSIONS The combination of upper cervical and upper thoracic spine mobilization indicated better overall short-term outcomes in CVA, NPRS, respiratory function, and GRC compared with DCFE in individuals with FHP.
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Affiliation(s)
- Juchul Cho
- Department of Physical Therapy, Graduate School of Sahmyook University, Seoul, Korea.,Department of Rehabilitation Medicine, Wellciti Hospital, Daejeon, Korea
| | - Eunsang Lee
- Department of Physical Therapy, Graduate School of Sahmyook University, Seoul, Korea
| | - Seungwon Lee
- Department of Physical Therapy, Sahmyook University, Seoul, Korea
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Kim EK, Kim SG. Forward head posture (FHP) angle and plantar pressure resulting from oscillatory stimulation training of the shoulder joint: A randomized controlled trial. J Back Musculoskelet Rehabil 2019; 32:37-42. [PMID: 30056409 DOI: 10.3233/bmr-160748] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Oscillatory stimulation provides strong sensory stimulation, which can activate muscle spindles, strengthening proprioceptive sense and, therefore, helping to strengthen the muscles involved in posture stability. OBJECTIVE This study aimed to investigate the difference in average distribution of plantar pressure resulting from changes in the forward head position (FHP) angle caused by controlling muscle activity in the neck and shoulders through Bodyblade. METHODS The subjects were divided into an experimental group (Bodyblade, n= 15) and a control group (general physiotherapy, n= 15). Eighteen sessions of exercise were implemented. Craniovertebral angle (CVA) and cranial rotation angle (CRA) were measured to evaluate the change of FHP. The Gaitview AFA-50 (Alfoots Co, Korea) was used to measure the plantar pressure distribution. RESULTS The experimental group showed a larger increase in CVA than the control group (p< 0.05). Only the experimental group showed a significant decrease in CRA (p< 0.05).Both the anterior pressure and posterior pressure showed a significant improvement only in the experimental group (p< 0.05). The experimental group showed a larger increase in anterior/posterior ratio than the control group (p< 0.05). CONCLUSIONS Bodyblade improves the angle of FHP, thus positively affecting the average ratio of plantar pressure.
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Affiliation(s)
- Eun-Kyung Kim
- Department of Physical Therapy, Gangdong University, Eumseong-gun, Chungcheongbuk-do 27600, Korea
| | - Seong-Gil Kim
- Department of Physical Therapy, Uiduk University, Gyeongju, Gyeongbuk 780-713, Korea
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Kim DH, Kim CJ, Son SM. Neck Pain in Adults with Forward Head Posture: Effects of Craniovertebral Angle and Cervical Range of Motion. Osong Public Health Res Perspect 2018; 9:309-313. [PMID: 30584494 PMCID: PMC6296804 DOI: 10.24171/j.phrp.2018.9.6.04] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Objectives The purpose of this study was to determine whether the cranial vertebral angle (CVA) and the range of motion (ROM) was different between participants with a forward head posture (FHP), with or without pain. Methods Forty-four participants who had FHP participated in this study. The FHP was assessed digitally by measuring a lateral view the CVA for each subject. A cervical ROM device measured the cervical ROM. The volunteers were allocated to either, with pain (n = 22), or without pain (n = 22) groups, and pain was evaluated using the Numeric Pain Rating Scale. Results The FHP in the pain group showed a significant difference in the CVA, and the cervical ROM in both flexion and extension, compared with those in the FHP without pain group (p < 0.05). Logistic regression analysis indicated that the occurrence of cervical area pain was higher amongst subjects who had a decreased CVA and flexion motion. Conclusion This study suggested that decreased CVA and cervical flexion range, were predictive factors for the occurrence of pain in the cervical region.
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Affiliation(s)
- Dae-Hyun Kim
- Department of Physical Therapy, Chonbuk National Hospital, Jeonju, Korea
| | - Chang-Ju Kim
- Department of Physical Therapy, College of Health Science, Cheongju University, Cheongju, Korea
| | - Sung-Min Son
- Department of Physical Therapy, College of Health Science, Cheongju University, Cheongju, Korea
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Fortner MO, Oakley PA, Harrison DE. Alleviation of chronic spine pain and headaches by reducing forward head posture and thoracic hyperkyphosis: a CBP ® case report. J Phys Ther Sci 2018; 30:1117-1123. [PMID: 30154612 PMCID: PMC6110208 DOI: 10.1589/jpts.30.1117] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2018] [Accepted: 05/15/2018] [Indexed: 12/14/2022] Open
Abstract
[Purpose] This case presents the reduction of both forward head posture and thoracic hyperkyphosis in a young male with chronic back pain and headaches by a comprehensive posture rehabilitation program as a part of Chiropractic BioPhysics® methods. [Participant and Methods] A 32 year old male presented with constant pain and headaches for seven years since he was involved in a work related injury. He had seen five different MDs, undergone multiple imaging tests, and received multiple prescriptions, thirteen steroid injections and was recommended for a spine surgery that he had denied. He was on long-term disability. Upon comprehensive posture and spine assessment, the patient had exaggerated forward head translation and thoracic hyperkyphosis. The patient was treated 36 times over 13-weeks with cervical and thoracic extension exercises, traction, and manipulation. [Results] After treatment the patient reported dramatic improvement in symptoms as indicated on valid disability questionnaires and substantial improvements in posture. [Conclusion] Posture-related pain and disability is not often addressed in allopathic medicine but substantial posture improvements are achievable in short time periods as this case illustrates. Poor postures in young patients should be corrected to avoid long-term consequences. Radiography as used in spinal rehabilitation is safe and reliable.
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Oakley PA, Jaeger JO, Brown JE, Polatis TA, Clarke JG, Whittler CD, Harrison DE. The CBP ® mirror image ® approach to reducing thoracic hyperkyphosis: a retrospective case series of 10 patients. J Phys Ther Sci 2018; 30:1039-1045. [PMID: 30154597 PMCID: PMC6110211 DOI: 10.1589/jpts.30.1039] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2018] [Accepted: 05/07/2018] [Indexed: 11/24/2022] Open
Abstract
[Purpose] To present a case series demonstrating the reduction of thoracic hyperkyphosis
by the Chiropractic BioPhysics® multimodal rehabilitation program.
[Participants and Methods] Ten randomly selected files and corresponding radiographs were
chosen from recent clinic archives of patients who were treated for thoracic
hyperkyphosis. All patients were treated by CBP mirror image® thoracic
extension traction and exercises, as well as spinal manipulative therapy. [Results]
Results demonstrated an average reduction in hyperkyphosis of 11.3° over an average of 25
treatments, over an average of 9 weeks. Patients also experienced a reduction in pain
levels and disability ratings. [Conclusion] Postural hyperkyphosis is a serious
progressive deformity that is related to a plethora of symptoms, syndromes, and early
death. Thoracic hyperkyphosis may be reduced/corrected by posture-specific, thoracic
extension protocols including mirror image extension traction and exercises, as well as
spinal manipulation as part of the CBP multi-modal rehabilitation program.
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Affiliation(s)
- Paul A Oakley
- Private Practice: 11A-1100 Gorham Street, Newmarket, ON, L3Y 8Y8, Canada
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25
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Fortner MO, Oakley PA, Harrison DE. Alleviation of posttraumatic dizziness by restoration of the cervical lordosis: a CBP ® case study with a one year follow-up. J Phys Ther Sci 2018; 30:730-733. [PMID: 29765191 PMCID: PMC5940483 DOI: 10.1589/jpts.30.730] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2017] [Accepted: 02/19/2018] [Indexed: 11/24/2022] Open
Abstract
[Purpose] To present the successful treatment of posttraumatic dizziness and neck pains
that were initiated in a patient following a whiplash event. [Subject and Methods] A
46 year old male suffered a whiplash event that initiated neck pain and dizziness
symptoms. The patient had many positive orthopedic findings and demonstrated a forward
head posture and cervical hypolordosis. The patient was treated by Chiropractic
BioPhysics® technique including cervical extension traction, extension
exercises and spinal manipulative therapy initially three times a week for 16-weeks, and
once a month thereafter. [Results] The patient had a resolution of daily dizziness and
neck pain with a concomitant reduction of forward head translation and increase in
cervical lordosis. The postural measures were further improved after one year of mostly
home-care. [Conclusion] The cervical spine alignment may be an important biomarker for
those with dizziness. The correction of cervical lordosis may be an essential requirement
for superior clinical outcomes for those with posttraumatic dizziness.
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26
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Dennis AK, Oakley PA, Weiner MT, VanVranken TA, Shapiro DA, Harrison DE. Alleviation of neck pain by the non-surgical rehabilitation of a pathologic cervical kyphosis to a normal lordosis: a CBP ® case report. J Phys Ther Sci 2018; 30:654-657. [PMID: 29706725 PMCID: PMC5909021 DOI: 10.1589/jpts.30.654] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2018] [Accepted: 01/29/2018] [Indexed: 11/24/2022] Open
Abstract
[Purpose] To present a case of the therapeutic reversal of a cervical kyphosis into a lordosis in a patient who presented with neck pain and headaches. [Subject and Methods] A 24-year-old male irritated his neck while dancing. Upon examination it was revealed he had an excessive, 45 mm forward head translation and a 15° cervical kyphosis from C3-C6. The patient was treated with Chiropractic BioPhysics® methods aimed at restoring the cervical lordosis by mirror image®, neck extension exercises, cervical extension traction, and spinal manipulative therapy. [Results] After two weeks of treatments the patient reported a complete resolution of neck pain. After 24 treatments over 10-weeks, a lateral radiograph demonstrated the restoration of a cervical lordosis and a complete reduction of forward head translation. [Conclusion] This case demonstrates that a cervical kyphosis may be reversed into a lordosis in as little as 10-weeks by specific care incorporating cervical extension protocols. This case also supports the biomechanical literature that suggests those with cervical kyphosis may be predisposed to spinal injury. We suggest that correcting even asymptomatic patients with obvious cervical spine deformity should be accomplished prior to future injury and/or degenerative changes.
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Oakley PA, Harrison DE. Radiophobia: 7 Reasons Why Radiography Used in Spine and Posture Rehabilitation Should Not Be Feared or Avoided. Dose Response 2018; 16:1559325818781445. [PMID: 30013456 PMCID: PMC6043928 DOI: 10.1177/1559325818781445] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2018] [Revised: 05/04/2018] [Accepted: 05/15/2018] [Indexed: 12/21/2022] Open
Abstract
Evidence-based contemporary spinal rehabilitation often requires radiography. Use of radiography (X-rays or computed tomography scans) should not be feared, avoided, or have their exposures lessened to decrease patient dose possibly jeopardizing image quality. This is because all fears of radiation exposures from medical diagnostic imaging are based on complete fabrication of health risks based on an outdated, invalid linear model that has simply been propagated for decades. We present 7 main arguments for continued use of radiography for routine use in spinal rehabilitation: (1) the linear no-threshold model for radiation risk estimates is invalid for low-dose exposures; (2) low-dose radiation enhances health via the body's adaptive response mechanisms (ie, radiation hormesis); (3) an X-ray with low-dose radiation only induces 1 one-millionth the amount of cellular damage as compared to breathing air for a day; (4) radiography is below inescapable natural annual background radiation levels; (5) radiophobia stems from unwarranted fears and false beliefs; (6) radiography use leads to better patient outcomes; (7) the risk to benefit ratio is always beneficial for routine radiography. Radiography is a safe imaging method for routine use in patient assessment, screening, diagnosis, and biomechanical analysis and for monitoring treatment progress in daily clinical practice.
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Fortner MO, Oakley PA, Harrison DE. Cervical extension traction as part of a multimodal rehabilitation program relieves whiplash-associated disorders in a patient having failed previous chiropractic treatment: a CBP ® case report. J Phys Ther Sci 2018; 30:266-270. [PMID: 29545691 PMCID: PMC5851360 DOI: 10.1589/jpts.30.266] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2017] [Accepted: 11/06/2017] [Indexed: 11/29/2022] Open
Abstract
[Purpose] To present the case of the non-surgical restoration of cervical lordosis in a
patient suffering from chronic whiplash syndrome including chronic neck pain and daily
headaches resulting from previous whiplash. [Subject and Methods] A 31 year old female
presented with a chief complaint of chronic neck pain and headaches for 12 years,
correlating temporally with a sustained whiplash. These symptoms were not significantly
relieved by previous chiropractic spinal manipulative therapy. The patient had cervical
hypolordosis and was treated with Chiropractic BioPhysics® protocol including
extension exercises, manual adjustments and cervical extension traction designed to
increase the cervical lordosis. [Results] The patient received 30 treatments over
approximately 5-months. Upon re-assessment, there was a significant increase in global
C2–C7 lordosis, corresponding with the reduction in neck pain and headaches. [Conclusion]
This case adds to the accumulating evidence that restoring lordosis may be key in treating
chronic whiplash syndrome. We suggest that patients presenting with neck pain and/or
headaches with cervical hypolordosis be treated with a program of care that involves
cervical extension traction methods to restore the normal cervical lordosis.
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Affiliation(s)
| | - Paul A Oakley
- Private Practice: 11A-1100 Gorham Street, Newmarket, Ontario L3Y8Y8, Canada
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Harrison DE, Oakley PA, Betz JW. Anterior head translation following cervical fusion-a probable cause of post-surgical pain and impairment: a CBP ® case report. J Phys Ther Sci 2018; 30:271-276. [PMID: 29545692 PMCID: PMC5851361 DOI: 10.1589/jpts.30.271] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2017] [Accepted: 11/07/2017] [Indexed: 11/24/2022] Open
Abstract
[Purpose] To present the case of the dramatic reduction in pain, disability, and
neurologic symptoms following the reduction of forward head translation and increased
cervical curvature in a patient suffering from post-surgical radiculopathy. [Subject and
Methods] A 52-year-old male mechanic presented with chronic neck pain, unilateral
paresthesia along the C5 and C6 dermatome distributions and diminished unilateral grip
strength for 12 years following a C5–C6 cervical discectomy and fusion. Outcome measures
included the neck disability index, the numerical pain rating scale, and the Zebris
cervical range of motion system. Radiographs and computerized posture analysis revealed
excessive forward head posture. Initial traditional ‘symptom-relief’ chiropractic
rehabilitation was provided, followed by CBP® structural rehabilitation of head
and neck posture with a 2.5 year follow-up. [Results] The initial traditional chiropractic
rehabilitation did not improve posture or disability scores. CBP methods resulted in
radiograph-verified postural alignment improvements corresponding with clinically
significant improvements in the patient’s neurologic condition, pain and disability
scores. These results were maintained at a 2.5 year follow-up with minimal treatment.
[Conclusion] Patients with post-surgical axial symptoms and/or radicular complaints should
be screened for altered cervical alignment and anterior head translation. Future studies
should attempt to duplicate these positive results in a trial with long-term
follow-up.
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Affiliation(s)
| | - Paul A Oakley
- Private Practice: 11A-1100 Gorham Street, Newmarket, Ontario L3Y8Y8, Canada
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Fortner MO, Oakley PA, Harrison DE. Non-surgical improvement of cervical lordosis is possible in advanced spinal osteoarthritis: a CBP ® case report. J Phys Ther Sci 2018; 30:108-112. [PMID: 29410577 PMCID: PMC5788786 DOI: 10.1589/jpts.30.108] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2017] [Accepted: 10/13/2017] [Indexed: 12/19/2022] Open
Abstract
[Purpose] To present a case of the non-surgical improvement in cervical kyphosis in a
patient with history of cervical spine trauma and advanced osteoarthritis. [Subject and
Methods] A 38 year old male presented with a chief complaint of chronic neck pain that was
not substantially relieved by recent previous traditional physiotherapy and chiropractic
manipulation. The cervical radiograph demonstrated a cervical hypolordosis of 5° as
measured by the Harrison posterior tangent method from C2–C7. There was a 15° kyphosis at
C4–C6 with advanced degenerative changes consistent with previous spine trauma. The
patient was treated by CBP® methods incorporating cervical extension traction,
extension exercises, and spinal manipulation for 30 sessions over an 18 week period.
[Results] After the treatment sessions, there was a substantial (27°) increase in global
C2–C7 lordosis, and 5° decrease in C4–C6 degenerative kyphosis corresponding to the
reduction in neck pain and disability, and an improvement in overall health status as
indicated on the SF-36 health questionnaire. [Conclusion] Although degenerative
spondylosis of the cervical spine will have physical limitations to non-surgical
correction, this case serves as an example that it is possible to reduce degenerative
kyphosis and increase global cervical lordosis corresponding to health improvements in
these patients.
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Betz JW, Oakley PA, Harrison DE. Relief of exertional dyspnea and spinal pains by increasing the thoracic kyphosis in straight back syndrome (thoracic hypo-kyphosis) using CBP ® methods: a case report with long-term follow-up. J Phys Ther Sci 2018; 30:185-189. [PMID: 29410595 PMCID: PMC5788804 DOI: 10.1589/jpts.30.185] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2017] [Accepted: 10/30/2017] [Indexed: 12/12/2022] Open
Abstract
[Purpose] To present the clinically significant improvement of straight back syndrome
(SBS) in a patient with spinal pain and exertional dyspnea. [Subject and Methods] A
19 year old presented with excessive thoracic hypokyphosis and other postural deviations.
A multimodal CBP® mirror image® protocol of corrective exercises,
traction procedures and spine/posture adjusting were given over an initial 12-week course
of intensive treatment followed by a 2.75 year follow-up with minimal supportive
treatment. [Results] The patient had significant postural improvements in all postural
measures and specifically a 14° increase in the thoracic kyphosis that was maintained at
long-term follow-up. The postural improvements were consistent with relief of exertional
dyspnea and pain, as well as increases in both antero-posterior thoracic diameter and the
ratio of antero-posterior to transthoracic diameter, measurements critical to the
wellbeing of patients with SBS. [Conclusion] Long-term follow-up confirmed stable
improvement in physiologic thoracic kyphosis in this patient. Nonsurgical correction in
thoracic hypokyphosis/SBS can be achieved by mirror image traction procedures configured
to flex the thoracic spine into hyperkyphosis as well as corrective exercise and
manipulation as a part of CBP technique protocols.
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Jaeger JO, Oakley PA, Moore RR, Ruggeroli EP, Harrison DE. Resolution of temporomandibular joint dysfunction (TMJD) by correcting a lateral head translation posture following previous failed traditional chiropractic therapy: a CBP ® case report. J Phys Ther Sci 2018; 30:103-107. [PMID: 29410576 PMCID: PMC5788785 DOI: 10.1589/jpts.30.103] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2017] [Accepted: 10/09/2017] [Indexed: 11/25/2022] Open
Abstract
[Purpose] To present the case of the resolution of right temporomandibular joint dysfunction (TMJD) following the correction of a right lateral head translation posture. [Subject and Methods] A 24 year old female reported facial pain and jaw clicking in the right TMJ. Radiography revealed a 19 mm right head (shift) translation posture. TMJ vibration analysis showed characteristic abnormalities for the right TMJ. The patient was treated with CBP® technique mirror image® left sided exercises, and traction methods as well as spinal manipulative therapy (SMT). [Results] After 36 treatments over a 12-week time period, a complete correction of the lateral head posture was achieved corresponding with a complete resolution of jaw pain and clicking. TMJ vibration analysis demonstrated normal right side TMJ characteristics following treatment. [Conclusion] Abnormal head/neck postures, such as lateral head translation, may be an unrealized source of TMJD and may be explained through the 'regional interdependence' model or by how seemingly unrelated anatomy may be associated with a primary complaint.
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Cho J, Lee E, Lee S. Upper thoracic spine mobilization and mobility exercise versus upper cervical spine mobilization and stabilization exercise in individuals with forward head posture: a randomized clinical trial. BMC Musculoskelet Disord 2017; 18:525. [PMID: 29233164 PMCID: PMC5727966 DOI: 10.1186/s12891-017-1889-2] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2017] [Accepted: 12/01/2017] [Indexed: 01/27/2023] Open
Abstract
Background Although upper cervical and upper thoracic spine mobilization plus therapeutic exercises are common interventions for the management of forward head posture (FHP), no study has directly compared the effectiveness of cervical spine mobilization and stabilization exercise with that of thoracic spine mobilization and mobility exercise in individuals with FHP. Methods Thirty-two participants with FHP were randomized into the cervical group or the thoracic group. The treatment period was 4 weeks, with follow-up assessment at 4 and 6 weeks after the initial examination. Outcome measures including the craniovertebral angle (CVA), cervical range of motion, numeric pain rating scale (NPRS), pressure pain threshold, neck disability index (NDI), and global rating of change (GRC) were collected. Data were examined with a two-way repeated-measures analysis of variance (group × time). Results Participants in the thoracic group demonstrated significant improvements (p < .05) in CVA, cervical extension, NPRS, and NDI at the 6-week follow-up compared with those in the cervical group. In addition, 11 of 15 (68.8%) participants in the thoracic group compared with 8 of 16 participants (50%) in the cervical group showed a GRC score of +4 or higher at the 4-week follow-up. Conclusions The combination of upper thoracic spine mobilization and mobility exercise demonstrated better overall short-term outcomes in CVA (standing position), cervical extension, NPRS, NDI, and GRC compared with upper cervical spine mobilization and stabilization exercise in individuals with FHP. Trial registration KCT0002307, April 11, 2017 (retrospectively registered).
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Affiliation(s)
- Juchul Cho
- Department of Physical Therapy, Graduate School of Sahmyook University, 815, Hwarang-ro, Nowon-gu, Seoul, South Korea
| | - Eunsang Lee
- Department of Physical Therapy, Graduate School of Sahmyook University, 815, Hwarang-ro, Nowon-gu, Seoul, South Korea
| | - Seungwon Lee
- Department of Physical Therapy, Sahmyook University, 815, Hwarang-ro, Nowon-gu, Seoul, South Korea.
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34
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Fryer G. Integrating osteopathic approaches based on biopsychosocial therapeutic mechanisms. Part 2: Clinical approach. INT J OSTEOPATH MED 2017. [DOI: 10.1016/j.ijosm.2017.05.001] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
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35
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Fryer G. Integrating osteopathic approaches based on biopsychosocial therapeutic mechanisms. Part 1: The mechanisms. INT J OSTEOPATH MED 2017. [DOI: 10.1016/j.ijosm.2017.05.002] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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36
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Wickstrom BM, Oakley PA, Harrison DE. Non-surgical relief of cervical radiculopathy through reduction of forward head posture and restoration of cervical lordosis: a case report. J Phys Ther Sci 2017; 29:1472-1474. [PMID: 28878485 PMCID: PMC5574331 DOI: 10.1589/jpts.29.1472] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2017] [Accepted: 05/09/2017] [Indexed: 12/15/2022] Open
Abstract
[Purpose] To present a case demonstrating the relief of cervical radiculopathy following the dramatic reduction of forward head posture and restoration of the cervical lordosis by use of a multi-modal rehabilitation program incorporating cervical extension traction. [Subject and Methods] A 31-year-old male patient presented with severe cervical radiculopathy and muscle weakness as well as neck pain. The patient had limited neck range of motion, and multiple positive orthopedic tests. Radiography revealed excessive forward head posture with a cervical kyphosis. [Results] The patient received a multi-modal rehabilitation protocol including mirror image extension exercises, cervical extension traction, and spinal manipulative therapy. After forty treatments over 17 weeks, the patient reported a complete resolution of radiculopathy and significant improvement in neck pain level. Post radiography demonstrated correction of the spine and posture alignment. The patient remained well and maintained corrected posture with limited treatment one year later. [Conclusion] Our case demonstrates the relief of cervical radiculopathy resulting from the non-surgical correction of forward head posture and cervical kyphosis.
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37
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Fedorchuk C, Lightstone DF, McRae C, Kaczor D. Correction of Grade 2 Spondylolisthesis Following a Non-Surgical Structural Spinal Rehabilitation Protocol Using Lumbar Traction: A Case Study and Selective Review of Literature. J Radiol Case Rep 2017; 11:13-26. [PMID: 29299090 DOI: 10.3941/jrcr.v11i5.2924] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Objective Discuss the use of non-surgical spinal rehabilitation protocol in the case of a 69-year-old female with a grade 2 spondylolisthesis. A selective literature review and discussion are provided. Clinical Features A 69-year-old female presented with moderate low back pain (7/10 pain) and severe leg cramping (7/10 pain). Initial lateral lumbar x-ray revealed a grade 2 spondylolisthesis at L4-L5 measuring 13.3 mm. Interventions and Outcomes The patient completed 60 sessions of Mirror Image® spinal exercises, adjustments, and traction over 45 weeks. Post-treatment lateral lumbar x-ray showed a decrease in translation of L4-L5 from 13.3 mm to 2.4 mm, within normal limits. Conclusions This case provides the first documented evidence of a non-surgical or chiropractic treatment, specifically Chiropractic BioPhysics®, protocols of lumbar spondylolisthesis where spinal alignment was corrected. Additional research is needed to investigate the clinical implications and treatment methods.
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Affiliation(s)
| | | | - Christi McRae
- Private Practice, St. Thomas, US Virgin Islands, USA
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38
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Wang K, Wang H, Deng Z, Li Z, Zhan H, Niu W. Cervical traction therapy with and without neck support: A finite element analysis. Musculoskelet Sci Pract 2017; 28:1-9. [PMID: 28171773 DOI: 10.1016/j.msksp.2017.01.005] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2016] [Revised: 01/02/2017] [Accepted: 01/08/2017] [Indexed: 12/19/2022]
Abstract
BACKGROUND Cervical traction is commonly used for treating neck pain. However, few studies have investigated the biomechanical impact such traction has on soft tissues. OBJECTIVES To analyze the biomechanics of cervical traction therapy in a supine position with and without neck support (NS and non-NS). METHODS A finite element model of the cervical spine was constructed to investigate the mechanism behind cervical traction therapy. An axial traction force of 100-N was loaded on the upper surface of C0 to simulate traction weight. Neck support traction was simulated by additionally constraining anterior-posterior motion of the surface of the C4 vertebral lamina. The average von Mises stress, tensile force and motions of related tissues were calculated and compared between the two conditions. Stress in the posterior annulus fibers under flexion was also recorded for comparison. RESULTS At the C4-C5 and C5-C6 levels, NS traction resulted in less of a decrease in the lordotic angle. At these levels, the highest average stress was distributed in the posterior annulus fibers with non-NS traction and both traction therapies produced greater stress on the posterior annulus fibers than physical flexion. The intradiscal pressure in all intervertebral discs between C4-T1 decreased during both traction therapies. CONCLUSION Neck support traction therapy produced less tension on the posterior annulus fibers and ligaments posterior to it at the C4-C5 and C5-C6 levels. In order to minimize the potential harm to soft tissue in clinical practice, it may be beneficial to use a neck support according to the targeted level.
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Affiliation(s)
- Kuan Wang
- Shi's Center of Orthopedics and Traumatology, Shuguang Hospital Affiliated to Shanghai University of TCM, Shanghai 201203, China; Institute of Traumatology, Shanghai Academy of TCM, Shanghai 201203, China
| | - Huihao Wang
- Shi's Center of Orthopedics and Traumatology, Shuguang Hospital Affiliated to Shanghai University of TCM, Shanghai 201203, China; Institute of Traumatology, Shanghai Academy of TCM, Shanghai 201203, China
| | - Zhen Deng
- Shi's Center of Orthopedics and Traumatology, Shuguang Hospital Affiliated to Shanghai University of TCM, Shanghai 201203, China; Institute of Traumatology, Shanghai Academy of TCM, Shanghai 201203, China
| | - Zhengyan Li
- Shi's Center of Orthopedics and Traumatology, Shuguang Hospital Affiliated to Shanghai University of TCM, Shanghai 201203, China; Institute of Traumatology, Shanghai Academy of TCM, Shanghai 201203, China
| | - Hongsheng Zhan
- Shi's Center of Orthopedics and Traumatology, Shuguang Hospital Affiliated to Shanghai University of TCM, Shanghai 201203, China; Institute of Traumatology, Shanghai Academy of TCM, Shanghai 201203, China.
| | - Wenxin Niu
- Department of Rehabilitation Sciences, Tongji University School of Medicine, Shanghai 200092, China; Shanghai Yangzhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Centre), Shanghai 201619, China.
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39
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Oh HJ, Song GB. Effects of neurofeedback training on the brain wave of adults with forward head posture. J Phys Ther Sci 2016; 28:2938-2941. [PMID: 27821966 PMCID: PMC5088157 DOI: 10.1589/jpts.28.2938] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2016] [Accepted: 07/07/2016] [Indexed: 11/24/2022] Open
Abstract
[Purpose] The purpose of the present study was to examine the effects of neurofeedback training on electroencephalogram changes in the cervical spine in adults with forward head posture through x-ray. [Subjects and Methods] The subjects of the study were 40 college students with forward head posture, randomly divided into a neurofeedback training group (NFTG, n=20) and a control group (CG, n=20). The neurofeedback training group performed six sessions of pottery and archery games, each for two minutes, three times per week for four weeks, while using the neurofeedback system. [Results] There were significant effects within and between groups in terms of the Delta wave, the Theta wave, the Alpha wave, the Beta wave, or the sensory motor rhythm. Especially, the Delta wave, Beta wave, and the sensory motor rhythm were showed significant effects between the groups. [Conclusion] It is thought that neurofeedback training, a training approach to self-regulate brain waves, enhances concentration and relaxation without stress, as well as an increase in attention, memory, and verbal cognitive performance. Therefore an effective intervention method to improve neck pain and daily activities.
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Affiliation(s)
- Hyun-Ju Oh
- Department of Physical Therapy, Taegu Science University,
Republic of Korea
| | - Gui-Bin Song
- Department of Physical Therapy Yeungnam University College, Republic of Korea
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40
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Oh HJ, Song GB. Effects of neurofeedback training on the cervical movement of adults with forward head posture. J Phys Ther Sci 2016; 28:2894-2897. [PMID: 27821957 PMCID: PMC5088148 DOI: 10.1589/jpts.28.2894] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2016] [Accepted: 07/07/2016] [Indexed: 11/25/2022] Open
Abstract
[Purpose] The purpose of the present study was to examine the effects of neurofeedback training on postural changes in the cervical spine and changes in the range of motion of the neck and in the Neck Disability Index in adults with forward head posture. [Subjects and Methods] The subjects of the study were 40 college students with forward head posture, randomly divided into a neurofeedback training group (NFTG, n=20) and a control group (CG, n=20). The neurofeedback training group received six sessions of pottery and archery games, each for two minutes, three times per week for four weeks, using the neurofeedback system. [Results] There were no significant effects within and between groups in terms of the absolute rotation angle, anterior weight bearing, and range of extension and flexion by x-ray imaging. There were significant effects in the neurofeedback training group pre- intervention and post-intervention in Neck Disability Index. There were significant effects between groups in Neck Disability Index. [Conclusion] It is thought that neurofeedback training, a training approach to self-regulate brain waves, enhances concentration and is therefore an effective intervention method to improve neck pain and daily activities.
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Affiliation(s)
- Hyun-Ju Oh
- Department of Physical Therapy, Taegu Science University,
Republic of Korea
| | - Gui-Bin Song
- Department of Physical Therapy, Yeungnam University
College, Republic of Korea
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41
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Kim EK, Kim JS. Correlation between rounded shoulder posture, neck disability indices, and degree of forward head posture. J Phys Ther Sci 2016; 28:2929-2932. [PMID: 27821964 PMCID: PMC5088155 DOI: 10.1589/jpts.28.2929] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2016] [Accepted: 07/07/2016] [Indexed: 11/24/2022] Open
Abstract
[Purpose] The present study aimed to examine the correlation between rounded shoulder posture, neck disability indices and the degree of forward head posture. [Subjects and Methods] Subjects aged 19-24 years were selected for this study, and the craniovertebral angle was used to measure the degree of forward head posture in the standing and seated positions. Vernier calipers were used to measure rounded shoulder posture in the supine position, and neck pain and functional disability were assessed using neck disability indices. [Results] Angle and neck disability indices in both standing and sitting posture positions exhibited a significant inverse relationship. However, no significant correlation was detected between the craniovertebral angle and rounded shoulder posture for the standing and sitting posture positions. [Conclusion] In conclusion, it was demonstrated in the present study that, depending on the degree of forward head posture, changes were detected in the neck disability indices. However, even an increase in the forward head tilt angle did not lead to rounded shoulder posture. Therefore, maintaining proper posture may prevent postural pain syndrome, functional disability, and postural deformity.
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Affiliation(s)
- Eun-Kyung Kim
- Department of Physical Therapy, Seonam University, Republic
of Korea
| | - Jin Seop Kim
- Department of Physical Therapy, Sunmoon University, Republic of Korea
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42
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Moustafa IM, Diab AA, Taha S, Harrison DE. Addition of a Sagittal Cervical Posture Corrective Orthotic Device to a Multimodal Rehabilitation Program Improves Short- and Long-Term Outcomes in Patients With Discogenic Cervical Radiculopathy. Arch Phys Med Rehabil 2016; 97:2034-2044. [PMID: 27576192 DOI: 10.1016/j.apmr.2016.07.022] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2016] [Revised: 07/19/2016] [Accepted: 07/19/2016] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To investigate the immediate and 1-year effects of a multimodal program, with cervical lordosis and anterior head translation (AHT) rehabilitation, on the intensity of pain, disability, and peripheral and central nervous system function in patients with discogenic cervical radiculopathy (CR). DESIGN A randomized controlled trial with 1-year and 10-week follow-up. SETTING University research laboratory. PARTICIPANTS Patients (N=60; 27 men) with chronic discogenic CR, a defined hypolordotic cervical spine, and AHT posture were randomly assigned to a control group (n=30; mean age, 43.9±6.2y) or an intervention group (n=30; mean age, 41.5±3.7y). INTERVENTIONS Both groups received the multimodal program; in addition, the intervention group received the Denneroll cervical traction device. MAIN OUTCOME MEASURES AHT distance, cervical lordosis, arm pain intensity, neck pain intensity, and disability (Neck Disability Index [NDI]), dermatomal somatosensory evoked potentials (DSSEPs), and central somatosensory conduction time (N13-N20). Measures were assessed at 3 time intervals: baseline, 10 weeks, and 1-year follow-up. RESULTS After 10 weeks of treatment, between-group analysis showed equal improvement in arm pain intensity (P=.40), neck pain intensity (P=.60), and latency of DSSEPs (P=.60) in both intervention and control groups. However, also at 10 weeks, there were significant differences between groups, favoring the intervention group for cervical lordosis (P<.0005), AHT distance (P<.0005), amplitude of DSSEPs (P<.0005), N13 to N20 conduction time (P<.0005), and NDI (P<.0005). Although at 1-year follow-up, between-group analysis identified a regression back to baseline values for the control group. Thus, all variables were significantly different, favoring the intervention group at 1-year follow-up: cervical lordosis (P<.0005), AHT distance (P<.0005), latency and amplitude of DSSEPs (P<.0005), N13 to N20 conduction time (P<.0005), intensity of neck and arm pain, and NDI (P<.0005). CONCLUSIONS The addition of the Denneroll cervical orthotic device to a multimodal program positively affected discogenic CR outcomes at long-term follow-up. We speculate that improved cervical lordosis and reduced AHT contributed to our findings.
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Affiliation(s)
- Ibrahim M Moustafa
- Basic Science Department, Faculty of Physical Therapy, Cairo University, Giza, Egypt.
| | - Aliaa A Diab
- Basic Science Department, Faculty of Physical Therapy, Cairo University, Giza, Egypt
| | - Shimaa Taha
- Basic Science Department, Faculty of Physical Therapy, Cairo University, Giza, Egypt
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43
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Kim JH, Kim JG, Do KS, Yim J. The effect of applying a head-weight device on cervical angle and pain of neck muscles. ACTA ACUST UNITED AC 2016. [DOI: 10.14474/ptrs.2016.5.2.101] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Jin-Hong Kim
- Department of Rehabilitation, Gachon University Gil Medical Center, Incheon, Republic of Korea
| | - Jong-Gun Kim
- Department of Rehabilitation, Deundeunhan Hospital, Ilsan, Republic of Korea
| | - Kwang-Sun Do
- Department of Rehabilitation, International St. Mary's Hospital, Incheon, Republic of Korea
| | - Jongeun Yim
- Department of Physical Therapy, College of Health and Welfare, Sahmyook University, Seoul, Republic of Korea
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44
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Kim TW, An DI, Lee HY, Jeong HY, Kim DH, Sung YH. Effects of elastic band exercise on subjects with rounded shoulder posture and forward head posture. J Phys Ther Sci 2016; 28:1733-7. [PMID: 27390405 PMCID: PMC4932046 DOI: 10.1589/jpts.28.1733] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2016] [Accepted: 02/22/2016] [Indexed: 11/24/2022] Open
Abstract
[Purpose] This study performed to investigate the effect of elastic band exercise program on the posture of subjects with rounded shoulder and forward head posture. [Subjects and Methods] The body length, forward shoulder angle, craniovertebral angle, and cranial rotation angle of participants (n=12) were measured before and after the exercise program. Furthermore, the thicknesses of the pectoralis major, rhomboid major, and upper trapezius were measured using an ultrasonographic imaging device. The exercises program was conducted with elastic bands, with 15 repetitions per set and 3 sets in total. [Results] The length of the pectoralis major, forward shoulder angle, and craniovertebral angle showed significant changes between before and after the exercise program, whereas the changes in the other measurements were not significant. The thickness of the upper trapezius showed a significant increase between before and after the elastic band exercise. [Conclusion] These findings suggest that the elastic band exercise program used in the study is effective for lengthening the pectoralis major and correcting rounded shoulder and forward head posture.
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Affiliation(s)
- Tae-Woon Kim
- Department of Physiology, College of Medicine, Kyung Hee University, Republic of Korea
| | - Da-In An
- Department of Physical Therapy, College of Natural Sciences, Kyungnam University, Republic of Korea
| | - Hye-Yun Lee
- Department of Physical Therapy, College of Natural Sciences, Kyungnam University, Republic of Korea
| | - Ho-Young Jeong
- Department of Physical Therapy, College of Natural Sciences, Kyungnam University, Republic of Korea
| | - Dong-Hyun Kim
- School of Sport Scinece, SungKyunKwan University, Republic of Korea
| | - Yun-Hee Sung
- Department of Physical Therapy, College of Natural Sciences, Kyungnam University, Republic of Korea
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45
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Lee JH. Effects of forward head posture on static and dynamic balance control. J Phys Ther Sci 2016; 28:274-7. [PMID: 26957773 PMCID: PMC4756019 DOI: 10.1589/jpts.28.274] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2015] [Accepted: 10/21/2015] [Indexed: 11/24/2022] Open
Abstract
[Purpose] To determine the effects of forward head posture on static and dynamic balance control. [Subjects and Methods] This study included 30 participants who were included into a forward head posture group (n = 14) and a control group (n = 16) according to their craniovertebral angles. Static balance control was assessed according to center of gravity sway velocity and total sway distance using an automatic balance calibration system. Dynamic balance control was assessed using the diagnosis mode of a body-tilt training and measurement system. [Results] Sway velocities on a hard surface with eyes open and closed and those on an unstable sponge surface with eyes closed were significantly higher in the forward head posture group than in the control group. Furthermore, on both the hard and sponge surfaces in the eyes open and closed conditions, total sway distances were significantly higher in the forward head posture group than in the control group. Results of dynamic balance control were not significantly different between groups. [Conclusion] Forward head posture has a greater effect on static balance control than on dynamic balance control.
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Affiliation(s)
- Joon-Hee Lee
- Department of Physical Therapy, Cheongju University, Republic of Korea
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46
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Kim JY, Kwag KI. Clinical effects of deep cervical flexor muscle activation in patients with chronic neck pain. J Phys Ther Sci 2016; 28:269-73. [PMID: 26957772 PMCID: PMC4756018 DOI: 10.1589/jpts.28.269] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2015] [Accepted: 10/21/2015] [Indexed: 11/24/2022] Open
Abstract
[Purpose] The purpose of this study was to investigate clinical effects of deep cervical flexor (DCF) muscles exercise on pain, Neck Disability Index (NDI), and neck and shoulder postures in patients with chronic neck pain. [Subjects and Methods] Twenty-eight patients with chronic neck pain were randomly assigned into either the general strengthening exercise (GSE) group or the DCF activation group as control and experimental groups, respectively. All exercises were performed three times per week over 4 weeks. NDI and numeric rating scale (NRS) score for pain were determined and radiological assessment of neck-shoulder postures (head tilt angle [HTA], neck flexion angle [NFA], and forward shoulder angle [FSA]) was performed before (baseline), 4 weeks after, and 8 weeks after exercise in order to directly compare the exercise effects between the groups. [Results] In the DCF group, the NDI, NRS score, and neck-shoulder postures (analyzed by uisng HTA, NFA, and FSA) were significantly improved. [Conclusion] DCF activation exercise was effective to alleviate pain, recover functions, and correct forward head posture in the patients with neck pain. Hence, it might be recommended in the rehabilitation of patients with chronic neck pain.
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Affiliation(s)
- Jin Young Kim
- Department of Occupational Therapy, Howon University, Republic of Korea
| | - Kwang Il Kwag
- Department of Sports Rehabilitation, We Fitness, Republic of Korea
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Shilton M, Branney J, de Vries BP, Breen AC. Does cervical lordosis change after spinal manipulation for non-specific neck pain? A prospective cohort study. Chiropr Man Therap 2015; 23:33. [PMID: 26644909 PMCID: PMC4671213 DOI: 10.1186/s12998-015-0078-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2015] [Accepted: 11/04/2015] [Indexed: 11/17/2022] Open
Abstract
Background The association between cervical lordosis (sagittal alignment) and neck pain is controversial. Further, it is unclear whether spinal manipulative therapy can change cervical lordosis. This study aimed to determine whether cervical lordosis changes after a course of spinal manipulation for non-specific neck pain. Methods Posterior tangents of C2 and C6 were drawn on the lateral cervical fluoroscopic images of 29 patients with subacute/chronic non-specific neck pain and 30 healthy volunteers matched for age and gender, recruited August 2011 to April 2013. The resultant angle was measured using ‘Image J’ digital geometric software. The intra-observer repeatability (measurement error and reliability) and intra-subject repeatability (minimum detectable change (MDC) over 4 weeks) were determined in healthy volunteers. A comparison of cervical lordosis was made between patients and healthy volunteers at baseline. Change in lordosis between baseline and 4-week follow-up was determined in patients receiving spinal manipulation. Results Intra-observer measurement error for cervical lordosis was acceptable (SEM 3.6°) and reliability was substantial ICC 0.98, 95 % CI 0.962–0991). The intra-subject MDC however, was large (13.5°). There was no significant difference between lordotic angles in patients and healthy volunteers (p = 0.16). The mean cervical lordotic increase over 4 weeks in patients was 2.1° (9.2) which was not significant (p = 0.12). Conclusions This study found no difference in cervical lordosis (sagittal alignment) between patients with mild non-specific neck pain and matched healthy volunteers. Furthermore, there was no significant change in cervical lordosis in patients after 4 weeks of cervical spinal manipulation.
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Affiliation(s)
- Michael Shilton
- Anglo-European College of Chiropractic, 13-15 Parkwood Road, Bournemouth, BH5 2DF UK
| | - Jonathan Branney
- Faculty of Health and Social Sciences, Bournemouth University, Bournemouth House, Bournemouth, BH1 3LH UK ; Institute of Musculoskeletal Research and Clinical Implementation, Anglo-European College of Chiropractic, 13-15 Parkwood Road, Bournemouth, BH5 2DF UK
| | - Bas Penning de Vries
- Anglo-European College of Chiropractic, 13-15 Parkwood Road, Bournemouth, BH5 2DF UK
| | - Alan C Breen
- Institute of Musculoskeletal Research and Clinical Implementation, Anglo-European College of Chiropractic, 13-15 Parkwood Road, Bournemouth, BH5 2DF UK
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Gong W. The effects of cervical joint manipulation, based on passive motion analysis, on cervical lordosis, forward head posture, and cervical ROM in university students with abnormal posture of the cervical spine. J Phys Ther Sci 2015; 27:1609-11. [PMID: 26157273 PMCID: PMC4483451 DOI: 10.1589/jpts.27.1609] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2015] [Accepted: 01/31/2015] [Indexed: 11/24/2022] Open
Abstract
[Purpose] The aim of this study was to determine the effect of cervical posture manipulation, based on passive motion analysis (MBPMA) and general mobilization, on cervical lordosis, forward head posture (FHP), and cervical ROM in university students with problems in cervical posture and range of motion (ROM). [Subjects] The Subjects were 40 university students in their 20s who displayed problems in cervical posture and ROM; they were divided into an MBPMA group (n=20) and a mobilization group (n=20). [Methods] Each group underwent MBPMA or mobilization three times a week for four weeks. The effects of MBPMA and mobilization on cervical lordosis, FHP, and cervical ROM were analyzed by radiography. [Results] MBPMA was effective in increasing the cervical lordosis, cervical extension ROM (CER), and ranges of flexion and extension motion (RFEM) and in decreasing FHP. Mobilization was effective in increasing CER and decreasing FHP. [Conclusion] MBPMA can be utilized as an effective method for decreasing FHP and improving cervical lordosis and cervical ROM.
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Affiliation(s)
- Wontae Gong
- Department of Physical Therapy, Korea Nazarene University, Republic of Korea
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Lee J, Lee Y, Kim H, Lee J. The Effects of Cervical Mobilization Combined with Thoracic Mobilization on Forward Head Posture of Neck Pain Patients. J Phys Ther Sci 2013. [DOI: 10.1589/jpts.25.7] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Affiliation(s)
- Jaehong Lee
- Department of Physical Therapy, Daegu Health College
| | - Younghwa Lee
- Center of Physical Therapy, Kimjun’s Orthopaedic Clinic
| | - Hansoo Kim
- Department of Occupational Therapy, Daegu Health College
| | - Jongho Lee
- Department of Sport Management, Namseoul University
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Diab AA, Moustafa IM. Lumbar lordosis rehabilitation for pain and lumbar segmental motion in chronic mechanical low back pain: a randomized trial. J Manipulative Physiol Ther 2012; 35:246-53. [PMID: 22632584 DOI: 10.1016/j.jmpt.2012.04.021] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2011] [Revised: 01/09/2012] [Accepted: 01/19/2012] [Indexed: 10/28/2022]
Abstract
OBJECTIVE The purpose of this study was to investigate the effects of lumbar extension traction with stretching and infrared radiation compared with stretching and infrared radiation alone on the lumbar curve, pain, and intervertebral movements of patients with chronic mechanical low back pain (CMLBP). METHODS This randomized clinical study with 3-month follow-up was completed at the Cairo University research laboratory. Eighty patients (age ranged from 40 to 50 years) with CMLBP and a hypolordotic lumbar spine were randomly assigned to traction or a comparison group. The comparison group (n = 40) received stretching exercises and infrared radiation, whereas the traction group (n = 40) received lumbar extension traction in addition to stretching exercises and infrared radiation. The absolute rotatory angle, intervertebral movements, and visual analog scale were measured for all patients at 3 intervals. RESULTS The results revealed a statistically significant difference between the groups at 2 follow-up time points compared with the baseline values for the translational and sagittal rotational movements of L3-L4, L4-L5, L5-S1, and L2-L3 (posttreatment) and absolute rotatory angle (P < .01). There were no statistically significant changes in pain (P = .1 and .3) and L1-L2 (P = .072 and .076) or L2-L3 (at follow-up; P = .3), and there was no significant difference between all the previous variables adjusted to the groups' baseline outcome interaction (P > .01). CONCLUSION Lumbar extension traction with stretching exercises and infrared radiation was superior to stretching exercises and infrared radiation alone for improving the sagittal lumbar curve, pain, and intervertebral movement in CMLBP.
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Affiliation(s)
- Aliaa A Diab
- Basic Science Department, Faculty of Physical Therapy, Cairo University, Cairo, Egypt
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