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The comparison of repositioning errors in cervical movement
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[Purpose] The purpose of this study was to compare reposition errors in subjects with upper crossed syndrome to examine the effects of upper crossed syndrome on position senses. [Subjects and Methods] A sample population of 60 subjects was randomly divided into three groups of 20: a normal group, a mild group, a moderate group. A cervical range of...
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... Healthy girls were in a more favorable situation in proprioception variables of 45-and 80-degrees of shoulder external rotation in both right and left limbs than those with upper cross syndrome. With this respect, Gu et al. (2016) approved that as postural disharmony becomes more severe in upper cross syndrome cases, cervical spine proprioception decreases [48]. Shaghayeghfard et al. (2015) investigated the proprioception of neck in individuals with forward head and compared it with healthy ones, and their results expressed that those individuals with forward head have more errors in reconstructing some neck movements than healthy ones [49]. ...
... Healthy girls were in a more favorable situation in proprioception variables of 45-and 80-degrees of shoulder external rotation in both right and left limbs than those with upper cross syndrome. With this respect, Gu et al. (2016) approved that as postural disharmony becomes more severe in upper cross syndrome cases, cervical spine proprioception decreases [48]. Shaghayeghfard et al. (2015) investigated the proprioception of neck in individuals with forward head and compared it with healthy ones, and their results expressed that those individuals with forward head have more errors in reconstructing some neck movements than healthy ones [49]. ...
Introduction.
Upper cross syndrome is one of the most common disorders of the upper part of body, often associated with abnormalities of forward head, forward shoulders, elevated and protracted of scapula, and increased thoracic kyphosis. Conducting research on upper cross syndrome, especially in girls, is of highly significant, considering this issue and lack of examination of complications and consequences of this syndrome; therefore, this study aims to compare the balance and proprioception of the shoulder joint in girls with and without upper cross syndrome.
Method The statistical population included two groups of 10-12-year-old female students, i.e., healthy and those with upper cross syndrome in the city of Khalkhal in Iran in 2022–2023. A total of 60 girl children were included in this study. The subjects were screened using a checker board and after quantitative evaluations of posture, they were assigned into two groups: healthy group (No. 30) and the one suffering from upper cross syndrome (No. 30). Forward head and forward shoulder angle were assessed using photography and kinovea software, kyphosis angle using Goniometer-pro app, static and dynamic balance using BESS and Y tests, also proprioception at angles of 45- and 80-degrees external rotation of the shoulder joint through photography and kinovea software. Data were analyzed through independent t-test in SPSS software version 26 at the significance level of 0.05.
Results Healthy girls were in a better position in all variables of static balance (1.14 95% CI: [0.96, 1.70], p = 0.001), dynamic balance (0.81, 95% CI: [0.73,1.24], p = 0.001), proprioception of external rotation of shoulder joint at 45- (0.78, 95% CI: [0.64, 1.14], p = 0.001) and 80-degrees (0.89, 95% CI: [0.59, 1.34], p = 0.001) angles than those with upper cross syndrome.
Conclusion It can be concluded that upper cross syndrome causes a decrease in balance and proprioception of the shoulder joint in female students; therefore, along with correcting the abnormalities, special attention should be paid to strengthening and improving these components. It is recommended for rehabilitation professionals to apply exercise training programs to improve the balance and proprioception and correct of the upper cross syndrome: that the strengthening of these components prevents musculoskeletal disorders.
Implications for clinical practice
• It is recommended for rehabilitation professionals to apply exercise training programs to improve the balance and proprioception of individual with upper cross syndrome.
• It is recommended for rehabilitation professionals to apply exercise training programs to correct of the upper cross syndrome in order to prevents musculoskeletal disorders.
... Ofis çalışanlarda başın protraksiyona doğru yönelimi ile ilgili çalışmalar bu durumun görülme oranının yüksek olduğunu, yaş ve tecrübe yılı ile ilişkili olduğunu göstermiştir (Stîncel, Niţă, & Oraviţan, 2021). Çalışanlarda var olan veya zamanla gelişebilen postüral hatalar çalışanlarda pozisyon hissinin azalmasına neden olabilmektedir (Gu, Hwangbo, & Lee, 2016;Lee, Lee, & Yong, 2014). Çalışanların ergonomik bilgi düzeyi yüksek bile olsa eğitim sonrası ergonomik farkındalığın arttığı ve bilginin davranışa yansımasının kolaylaştığı bilinmektedir (Öztürk, 2023). ...
Bilgisayar başı çalışanlar ergonomik düzenleme ile daha ağrısız ve risksiz bir çalışma hayatına kavuşabilir. Ergonomik değerlendirme ile kişilerin yanlış alışkanlıklarının farkına varması sağlanabilir. Ergonomik değerlendirme ve düzenlemenin çevrim içi hale gelmesi ergonomi uzmanı veya sağlık personeline ulaşımı kolaylaştırıp sağlıklı yaşam önündeki bariyerleri azaltabilir. Çevrim içi değerlendirme yöntemlerinin giderek standardize edilmeye çalışıldığı ve yanıltıcı olabileceğinin yanı
sıra değerlendirmelerin güvenilirliğinin ve çalışanların çevrim içi ergonomik müdahaleye uyumlarının yüksek olduğunu gösteren çalışmalar da bulunmaktadır. Bu nedenle tele-ergonomi yaklaşımları da tele sağlık şemsiyesinin altında uygulanabilir ve ulaşılabilirlik, pratiklik ve maliyet anlamında sürdürülebilir bir yöntem önerisi olarak gelişimini sürdürmektedir.
... To analyze at least 15 participants and thus obtain a good estimate of the mean effect, the participants were divided into two groups according to their median values. This value was close to the 2.5 cm value accepted in another study [35]. The slight FHP is accepted to be lower than 2.8 cm, and the severe FHP is greater than 2.8 cm. ...
Based on the pressure distributions in the head, neck, and upper body and the spine support values, this study aims to recommend the most suitable pillow for those with forward head posture (FHP) according to different sleeping positions. This descriptive cross-sectional study recruited thirty healthy 18-to 55-year-old men and women with body mass indexes of less than 30 kg/m 2. Participants tried five different pillows (viscose, fiber, cotton, goose feather, and wool) on a medium-firm hybrid mattress at room temperature with a humidity of 45-55%. Participants tried the pillows first in the supine position, then side-lying, and finally in the prone position. A pressure-mapping system was utilized to measure the pressure distributions of the head and shoulder areas in millimeters of mercury (mmHg) and the amount of support provided by the pillow to these regions in square centimeters (cm 2). When the comfort and support parameters of different pillow materials were compared among all participants, for the supine position, Pillow B and Pillow E provided higher head comfort (p < 0.001), while Pillow A and Pillow E provided higher shoulder support (p = 0.044). In the side-lying position, Pillow B provided higher head comfort (p < 0.001) and Pillow C (p = 0.003) higher shoulder comfort. In the prone position, Pillow B and Pillow E provided higher head comfort (p < 0.001), while Pillow E also provided higher shoulder support (p = 0.002). This study showed pillow materials affect the spine comfort and support of the participants , and these values may vary according to different spinal alignments, such as FHP. According to the preferred sleeping position, the pillow material that supports the spine and its comfort and support values may also change.
... Upper Cross Syndrome affects the body posture and mechanics of cervical spine and shoulder girdle resulting in upper quarter and neck pain [5,6]. A study has shown postural changes in shoulder girdle related to UCS where people with UCS had more scapular anterior tilting and internal rotation of shoulder joint compared to people who are not affected by UCS. ...
... In this sense, most of the cases of acute neck pain will be resolved with or without treatment, while 50% of these cases will continue suffering from neck pain, affecting their quality of life [10] and function. Sedentary life, spent sitting in front of screens for hours with static positions of the head and shoulders, as workers or students do, produces muscular stress and imbalance and has been described as a cause of chronic neck pain [11][12][13][14]. In a recent study analyzing musculoskeletal rehabilitation needs while taking into account the proportion of prevalent cases and the years lived with disability, neck pain ranked 5th after lower back pain, fractures, osteoarthritis, and other injuries as the condition with the greatest need for musculoskeletal rehabilitation worldwide in the last 3 decades [15]. ...
... of 16 Life 2023,13,48 ...
Chronic neck pain is among the most common types of musculoskeletal pain. Manual therapy has been shown to have positive effects on this type of pain, but there are not yet many predictive models for determining how best to apply manual therapy to the different subtypes of neck pain. The aim of this study is to develop a predictive learning approach to determine which basal outcome could give a prognostic value (Global Rating of Change, GRoC scale) for Mulligan's mobilization technique and to identify the most important predictive factors for recovery in chronic neck pain subjects in four key areas: the number of treatments, time of treatment, reduction of pain, and range of motion (ROM) increase. A prospective cohort dataset of 80 participants with chronic neck pain diagnosed by their family doctor was analyzed. Logistic regression and machine learning modeling techniques (Generalized Boosted Models, Support Vector Machine, kernel, classification and decision trees, random forest and neural networks) were each used to form a prognostic model for each of the nine outcomes obtained before and after intervention: disability-neck disability index (NDI), patient satisfaction (GRoC), quality of life (12-Item Short Form Survey, SF-12), State-Trait Anxiety Inventory (STAI), Beck Depression Inventory (BDI II), pain catastrophizing scale (ECD), kinesiophobia-Tampa scale of kinesiophobia (TSK-11), Pain Intensity Visual Analogue Scale (VAS), and cervical ROM. Pain descriptions from the subjects and pain body diagrams guided the physical examination. The most important predictive factors for recovery in chronic neck pain patients indicated that the more anxiety and the lower the ROM of lateroflexion, the higher the probability of success with the Mulligan concept treatment.
Keywords: chronic neck pain; musculoskeletal manipulations; machine learning; Mulligan concept; manual therapy; chronic pain
... Patterns to uphold correct posture are regarded as necessary in relation to cervical spine postures. Thus, avoiding damage and pain [21]. Pain reduction was substantially responsible for changes in trigger point status from active to latent or resolved period. ...
Background:
In today's world, the upper cross syndrome is growing more common and becoming very prevalent among dental undergraduate practitioners. One of the most important conditions for which dentists seek physiotherapy treatment is neck pain. It is characterized by overactive pectoralis and trapezius muscles. It is frequently linked to poor posture in dental students' daily life, causing them to miss their work.
Objectives:
The first objective of our study was to find the efficacy of myofascial rollers and post-isometric relaxation technique along with conventional therapy for pain relief and correction of postural deviation in undergraduate dental students. And, the second objective of the study was to compare the effect of myofascial rollers and post-isometric relaxation techniques in upper cross syndrome.
Methods:
The study was conducted with pre-test and post-test methods. The study consisted of 80 participants who were included based on our inclusion and exclusion criteria. The study sample was randomly assigned into two groups. Each group consisted of a total of 40 participants. Group A was treated using myofascial rollers and hot packs, and Group B was treated using the post-isometric relaxation technique and hot packs. Patients were asked to mark their intensity of pain on the Numerical Pain Rating Scale and an assessment of postural deviations (in mm) was noted through a plumb line in the posture grid. Posture assessment was done in lateral view. The protocol covered four weeks of treatment based on the defined protocol. Finally, the t-square test and Chi-square test were used to compare the difference in the result. Also, the level of significance was kept at <0.05.
Result:
Statistical analysis was done using descriptive and inferential statistics using student paired, unpaired, and chi-square test. IBM SPSS Statistics for Windows, Version 27.0 (Released 2020; IBM Corp., Armonk, New York, United States) was used. The Numerical Pain Rating Scale showed mean deviations of (4.15±1.29) for Group A and (3.30±1.01) for Group B. Plumb line assessment showed mean deviations of (9.09±4.31) for Group A and (6.33±2.36) for Group B. Also, Numerical Pain Rating Scale showed (t=3.26, p=0.002) and Plumb line deviation showed (t=3.57, p=0.001).
Conclusion:
Through our study, we conclude that statistically no significant differences were found in pre-intervention and post-intervention, but myofascial rollers gave better results as compared to the post-isometric relaxation technique in alleviating pain and correcting postural deviation.
... UCS symptoms may alter muscle activation patterns, which can be considered one of the most potent stimuli to central motor programming (Madeleine et al. 1999;Brandt et al. 2014;Gu et al. 2016). Furthermore, muscle activation alterations were observed in office workers suffering frequent pain in the shoulder and neck and poor postural stability, respectively Andersen et al. 2011;Sterling 2011). ...
Objective
To evaluate the effects of online-supervised versus workplace corrective exercises on neck–shoulder pain (NSP), sick leave, posture, workability, and muscular activity among office workers with the upper crossed syndrome (UCS).
Methods
We performed a parallel-group randomized control trial at Shahid Beheshti University, Tehran, Iran, assigning 36 office workers to online-supervised, workplace, and control groups (mean (SD) age 38.91 ± 3.87, 38.58 ± 7.34, 37.00 ± 8.12). Inclusion criteria were alignment alteration (forward head (≥ 45°), rounding shoulder (≥ 52°), rounding back (≥ 42°), and pain intensity ≥ 3 in neck and shoulder. The two intervention groups performed 8-week exercise program, while the control group continued usual activities. Primary (NSP and sick leave) and secondary outcomes [postural angles, workability, and muscular activity were measured by VAS, outcome evaluation questionnaire (OEQ), photogrammetry, workability index, and EMG, respectively, at the baseline and an 8-week follow-up].
Results
ANCOVA results revealed improvements for the online-supervised group versus control for NSP (P = 0.007), postural angles (P = 0.000, P = 0.001, P = 0.005), workability (P = 0.048, P = 0.042), and upper trapezius activation (P = 0.024, P = 0.016), respectively. Using paired t tests, both intervention groups improved from baseline to follow-up for NSP (P = 0.000, P = 0.002), forward head posture (P = 0.000, P = 0.000), round shoulders (P = 0.001, P = 0.031), and round back (P = 0.034, P = 0.008), respectively. Related parameters of workability (P = 0.041, P = 0.038), upper trapezius (P = 0.005, P = 0.005, P = 0.022), and serratus anterior (P = 0.020, P = 0.015) changed only in the online-supervised group.
Conclusion
Online-supervised corrective exercise seems to improve a range of parameters related to work performance. These findings are highly applicable in light of the ongoing COVID pandemic; many workers have to work from home.
... Neck or shoulder pain symptoms appear to intensify since office workers with UCS generally sit with curved postures, take prolonged constant muscle activity, and perform repetitive job tasks [18,19]. Pain is considered as the strongest stimulus to central motor programming, which can alter electromyography (EMG) patterns in functional tasks since it has an inhibitory effect on muscle activation [20]. ...
Background and objective
Musculoskeletal disorders (MSDs) including upper crossed syndrome (UCS) are considered as the leading cause of work-related issues worldwide among office workers. Therefore, the present study aims to evaluate the effect of workplace-based versus online-supervised home-based corrective exercises among office workers with UCS.
Methods and design
To this end, 45 subjects within the age range of 30–45 years are randomly assigned to three groups in the present parallel-group, randomized control trial using a pretest-posttest design. These groups include the subjects who receive online-supervised exercise and workplace exercise containing three sessions of intervention for 8 weeks and the control group receives no intervention while performing routine activities. The primary outcome variables are neck-shoulder pain (NSP) and consequent sick leave due to NSP, followed by alignment, workability, and the surface electromyography of upper, middle, and lower trapezius (UT, MT, and LT), sternocleidomastoid (SCM), and serratus anterior (SA) as the secondary variables.
Discussion
The present study seeks to assess the effect of workplace versus online-supervised corrective exercise interventions among 45 office workers suffering from UCS. It is expected to improve and reduce the related symptoms including postural malalignment and imbalance muscles after 8 weeks of corrective exercises. If effective, the findings may lead to adherence and work performance among the office workers, and individuals subjected to UCS can use the benefits of an online-supervised intervention. In addition, the findings may be useful in different workplaces as the evidence for employers to benefit from the reduction in the related costs and side effects of work-related neck/shoulder disorders including work disability, productivity loss, time expense, social insurance, work absenteeism, and treatment costs. Finally, clinicians and corrective exercise therapists can consider it as a clinical based-evidence intervention for their further actions.
Trial registration
Iranian Registry of Clinical Trials IRCT20200729048249N1. Registered on 5 October 2020 ( https://en.irct.ir/user/trial/49992/view )
... UCS may have certain complications, including cervicogenic headache, pseudoangina pectoris, impingement syndrome, degeneration of hard and soft tissues in the body, and shoulder instability (8,12,13). In addition, Gu and colleagues (2016) reported that joint position sense would decrease according to the degree of UCS (14). Moreover, in a recent study, Kirthika and colleagues (2018) showed that the maximum voluntary ventilation is lower in recreational male athletes with UCS compared to healthy ones (15). ...
Background: Upper crossed syndrome (UCS) is believed to be a prevalent deformity among female beauticians. This study designed to investigate the effect of 12 weeks of corrective exercises on the postural angles, namely, forward shoulder, forward head, and kyphosis of female beauticians with UCS. Methods: In this clinical trial study, 40 females were selected through purposive sampling. This study was conducted in Tehran between September 2020 and March 2021. Photogrammetric method was employed to measure forward head and forward shoulder angles. Thoracic kyphosis angle was measured using flexible ruler. The participants were assigned to two groups employing simple randomization. The intervention group carried out corrective exercises for 12 weeks. Paired-sample t-test and analysis of covariance (ANCOVA), at the significance level of P<0.05, were used for data analysis. The clinical trial registration number of this study is IRCT20180626040244N2. Results: The within group comparisons revealed significant changes in all of the postural variables (P=0.001), including forward head, forward shoulder, and thoracic kyphosis of the intervention group. The between group comparisons indicated that a 12-week corrective exercise program significantly decreased forward head (P=0.001) and shoulder (P=0.001), and thoracic kyphosis (P=0.001) angles. Conclusion: The substantial reduction in forward shoulder, forward head, and thoracic kyphosis angles after corrective exercises indicated the effectiveness of these exercises in correcting the postural abnormalities in the beautician females.
... Another source of effectiveness in this work was the proprioception exercises. Decreased proprioception has been identified as another side effect of postural deformities [3,43]. Thus, the proprioception exercises implemented in this work can give rise to significant improvement in deformity correction as such activities may enhance the response of the central nervous system to afferents for the reorganization and coordination of muscles. ...
Background: The lifestyle and long-term use of communication technologies have led to the prevalence of neck pain and concurrent forward head posture (FHP), Rounded shoulder posture (RSP), and hyperkyphosis (HK) deformities. The present study aimed to determine the effects of the eight-week water–based corrective exercises on FHP, RSP, HK deformities, and neck pain.
Methods: After screening the 200 students, 30 students with FHP, RSP and HK were selected. They were assigned randomly to experimental (n=14) and control (n=16) groups. Imaging from lateral view and AutoCAD software were used to evaluate the FHP and RSP angles and HK was measured by flexible ruler. Moreover, Visual Analog Scale (VAS) was used to assess shoulder, and neck pain. These variables were assessed before and after 8-week intervention period.
Results: statistical analysis indicated a significant group by time interaction in the FHP (P=0.001), RSP (P=0.001), HK (P=0.001) angels and in terms of the pain (P=0.001) which indicated a decrease in kyphosis and forward head angels, and Rounded shoulder displacement. But no significant decrease was observed in control group measures (all P>0.05).
Conclusions: Based on the results, probably performing 8-week corrective exercises in the water environment could have more effect on FHP, RSP, HK angels decreasing and neck and shoulder pain reduction. This corrective exercises protocol can be suggested to professionals in order to correct these concurrent malalignments.
Trial registration: The protocols were also registered in the Iranian Registry of Clinical Trials (Registration no.: IRCT20170615034554N2). https://www.irct.ir/trial/26381. 2018-05-07.