Changes in the Sagittal Cranio-Cervical Posture Following a 12-Week Intervention Using a Simple Spinal Traction Device

Effects of head alignment devices on working memory and postural support during computer work

The most common risk factor of computer workers is poor head and neck posture. Therefore, upright seated posture has been recommended repeatedly. However, maintaining an upright seated posture is challenging during computer work and induces various complaints, such as fatigue and discomfort, which can interfere working performance. Therefore, it is necessary to maintain an upright posture without complaints or intentional efforts during long-term computer work. Alignment devices are an appropriate maneuver to support postural control for maintaining head-neck orientation and reduce head weight. This study aimed to demonstrate the effects of workstations combined with alignment device on head-neck alignment, muscle properties, comfort and working memory ability in computer workers. Computer workers (n = 37) participated in a total of three sessions (upright computer (CPT_U), upright support computer (CPT_US), traction computer (CPT_T) workstations). The craniovertebral angle, muscles tone and stiffness, visual analog discomfort scale score, 2-back working memory performance, and electroencephalogram signals were measured. All three workstations had a substantial effect on maintaining head-neck alignment (p< 0.001), but only CPT_US showed significant improvement on psychological comfort (p = 0.04) and working memory performance (p = 0.024), which is consistent with an increase in delta power. CPT_U showed the increased beta 2 activity, discomfort, and false rates compared to CPT_US. CPT_T showed increased alpha and beta 2 activity and decreased delta activity, which are not conductive to working memory performance. In conclusion, CPT_US can effectively induce efficient neural oscillations without causing any discomfort by increasing delta and decreasing beta 2 activity for working memory tasks.

Changes in deep neck muscle length from the neutral to forward head posture. A cadaveric study using Thiel cadavers

Forward head posture (FHP) is one of the most common postural deviations. Deep neck muscle imbalance of individuals with FHP is of primary concern in clinical rehabilitation. However, there is scarce quantitative research on changes in deep neck muscle length with the head moving forward. This study aimed to investigate changes in deep neck muscle length with different severity levels of FHP. Six Thiel‐embalmed cadavers (four males and two females) were dissected, and 16 deep neck muscles in each cadaver were modeled by a MicroScribe 3D Digitizer in the neutral head posture, slight FHP, and severe FHP. The craniovertebral angle was used to evaluate the degrees of FHP. Quantitative length change of the deep neck muscles was analyzed using Rhinoceros 3D. In slight FHP significant changes in length occurred in four muscles: two shortened (upper semispinalis capitis, rectus capitis posterior minor) and two lengthened (longus capitis, splenius cervicis). In severe FHP all occipital extensors were significantly shortened (10.6 ± 6.4%), except for obliquus capitis superior, and all cervical extensors were significantly lengthened (4.8 ± 3.4%), while longus capitis (occipital flexor) and the superior oblique part of the longus colli (cervical flexor) were lengthened by 8.8 ± 3.8% and 4.2 ± 3.1%, respectively. No significant length change was observed for the axial rotator. This study presents an alternate anatomical insight into the clinical rehabilitation of FHP. Six muscles appear to be important in restoring optimal head posture, with improvements in FHP being related to interventions associated with the occipital and cervical extensors.

Effect of a Traction Exercise Neck Brace on Cervical Spondylopathy Radiculopathy: A Clinical Study and Finite Element Analysis

Traction of cervical spine is an effective method for the treatment of cervical spondylotic radiculopathy (CSR). In this study, a cervical tractor named traction exercise neck brace (TENB) was used to evaluate its effect on the patients with CSR. Forty CSR volunteers were recruited and randomly divided into two groups. One group was subjected to cervical muscle exercise with TENB under static traction condition. Another group was subjected to (JOBT) as controls. Symptoms of CSR were evaluated by the visual analogue scale (VAS) and neck disability index (NDI). Imaging characteristics were assessed by curvature of the cervical spine and size of the intervertebral foramen. A finite element (FE) analysis model of cervical spine was established by 3D reconstruction to simulate the TENB traction, which evaluates the biomechanical performance. Results showed that TENB significantly reduced scores of VAS and NDI in subjects, and this improved effect on symptoms of pain and radiculopathy is better than that of JOBT. TENB also improved the cervical curvature and enlarged intervertebral foramen at the C4-C6 level. Moreover, FE analysis found that simulated TENB traction increased the spacing of intervertebral foramen, intervertebral disc, and zygapophyseal and uncovertebral joints and changed the stress distribution on the facet joints and nucleus pulposus. This study demonstrates that TENB relieves the symptoms of CSR by adjusting structure of cervical vertebra and restoring its biomechanical performance, which may be a promising instrument in the treatment of CSR.

The Functional and Morphological Changes of the Cervical Intervertebral Disc after Applying Lordotic Curve Controlled Traction: A Double-Blind Randomized Controlled Study

The newly developed cervical lordotic curve-controlled traction (C-LCCT) appears to be an ideal method to improve the treatment outcome in patients with cervical intervertebral disc disease. The purpose of this study was to investigate the treatment outcomes of C-LCCT including the functional and morphological changes of the cervical intervertebral disc compared to traditional traction (TT) with a randomized controlled trial design. A total of 40 patients with cervical intervertebral disc disease at the C5/6 level confirmed by magnetic resonance imaging were recruited and assigned to either the C-LCCT group or the TT group. The comprehensive health status changes of the patients were recorded using pain and functional scores (Visual Analogue Scale, Oswestry Disability Index) and morphological changes (cervical lordosis, cervical central canal area) before and after the traction treatment. Both groups showed a significant improvement in pain scores after traction (p < 0.05). The functional score and morphological changes improved significantly after treatment in the C-LCCT group. However, there was no significant improvement in the TT group (p < 0.05). The C-LCCT showed significant pain, functional, and morphological improvement compared to TT. C-LCCT could be effective in improving the treatment outcomes of the traction technique in patients with cervical intervertebral disc disease.