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Effects of forward head posture on forced vital capacity and respiratory muscles activity

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Jintae Han
Jintae Han
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Soojin Park
Soojin Park
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Youngju Kim
Youngju Kim
Youngju Kim
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Yeonsung Choi
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Abstract and Figures

[Purpose] This study investigated the effects of forward head posture on forced vital capacity and deep breathing. [Subjects] Twenty-six subjects, divided into the two groups (normal and forward head posture groups), participated in this study. [Methods] Forced vital capacity and forced expiratory volume in 1 second were measured using respiratory function instrumentation that met the American Thoracic Society’s recommendation for diagnostic spirometry. Accessory respiratory muscle activity during deep breathing was measured by electromyography. A Mann-Whitney test was used to compare the measure variables between the normal and forward head posture group. [Results] Forced vital capacity and forced expiratory volume in 1 second were significantly lower in the forward head posture group than in the normal group. Accessory respiratory muscle activity was also lower in the forward head posture group than in the normal group. In particular, the sternocleidomastoid and pectoralis major activity of the forward head posture group was significantly lower than that of normal group. Activities of the other muscles were generally decreased with forward head posture, but were not significantly different between the two groups. [Conclusion] These results indicate that forward head posture could reduce vital capacity, possibly because of weakness or disharmony of the accessory respiratory muscles.
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Eects of forward head posture on forced vital
capacity and respiratory muscles activity
Jintae Han, PT, PhD
1)
, SooJin Park, PT, PhD
1)*
, YoungJu kim
2)
, YeonSung CHoi
1)
,
HYeon nam LYu
1)
1)
Department of Physical Therapy, College of Science, Kyungsung University: 309 Suyeong-ro,
Nam-gu, Busan 608-736, Republic of Korea
2)
Department of Physical Therapy, Graduate School of Clinical Pharmacy and Health, Kyungsung
University, Republic of Korea
Abstract. [Purpose] This study investigated the effects of forward head posture on forced vital capacity and deep
breathing. [Subjects] Twenty-six subjects, divided into the two groups (normal and forward head posture groups),
participated in this study. [Methods] Forced vital capacity and forced expiratory volume in 1 second were measured
using respiratory function instrumentation that met the American Thoracic Society’s recommendation for diagnos-
tic spirometry. Accessory respiratory muscle activity during deep breathing was measured by electromyography.
A Mann-Whitney test was used to compare the measure variables between the normal and forward head posture
group. [Results] Forced vital capacity and forced expiratory volume in 1 second were signicantly lower in the
forward head posture group than in the normal group. Accessory respiratory muscle activity was also lower in the
forward head posture group than in the normal group. In particular, the sternocleidomastoid and pectoralis major
activity of the forward head posture group was signicantly lower than that of normal group. Activities of the other
muscles were generally decreased with forward head posture, but were not signicantly different between the two
groups. [Conclusion] These results indicate that forward head posture could reduce vital capacity, possibly because
of weakness or disharmony of the accessory respiratory muscles.
Key words: Forward head posture, Forced vital capacity, Breathing muscle activity
(This article was submitted Aug. 28, 2015, and was accepted Oct. 14, 2015)
INTRODUCTION
In recent times in some occupations work in static sedentary postures for long hours in order to perform the tasks required
of them. This can cause continuous muscle contraction in the neck and shoulders, which subsequently leads most people to
adopt a forward head posture (FHP) in which their chins stick out
1)
.
When FHP is maintained for prolonged periods the neck exors and the erector spinae (ES) muscles in the upper thoracic
region are weakened due to their lengthening, and the scapula is elevated due to tension in the levator scapula, sternocleido-
mastoid (SCM), splenius muscles, and the suboccipitalis, which also causes tension in the upper trapezius (UT)
2)
. Therefore,
because of an imbalance in the muscles, such as the shortening or lengthening, or straining or loosening of the muscles
around the neck, a rounded shoulder posture is exhibited, in which the upper thoracic region is slightly bent while in a sitting
posture
3)
, and chronic neck pain results due to mechanical stress
1)
. These changes in muscle activity result from changes in
motor strategies to minimize the activities of muscles that are sensing pain and to compensate for these suppressed muscles
4)
.
In addition, FHP is known to have a large inuence on respiratory function by weakening the respiratory muscles
5, 6)
.
The SCM, scalene muscles, UT, pectoralis major (PM), and thoracolumbar ES muscles are important accessory respiratory
muscles involved in inspiration
7, 8)
and prolonged FHP weakens these muscles, thereby decreasing their respiratory function
7)
.
J. Phys. Ther. Sci. 28: 128–131, 2016
*Corresponding author. Soojin Park (E-mail: rememversj@hanmail.net)
©2016 The Society of Physical Therapy Science. Published by IPEC Inc.
This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial No Derivatives (by-nc-nd)
License <http://creativecommons.org/licenses/by-nc-nd/3.0/>.
Original Article
The Journal of Physical Therapy Science The Journal of Physical Therapy Science
129
Because of this, patients with FHP accompanied by chronic neck pain have been shown to have less respiratory muscle
strength than normal individuals
9)
and their accessory respiratory muscles are shortened, which largely affects their respira-
tory function
10)
. In addition, a study reported that FHP changes the alignment of the thoracic spine and rib cage due to a
slightly bent posture, thereby causing respiratory dysfunction
5)
.
However, most previous studies on this topic were conducted on patients with neck pain or on patients with neck pain
accompanied by FHP, whereas the number of studies that have identied the specic effects of just FHP on respiration is
limited. Therefore, this study measured the forced vital capacity (FVC) and the forced expiratory volume in 1 second (FEV1)
in healthy normal adults and healthy adults with FHP to determine the effects of FHP on respiratory dysfunction. In addition,
the present study attempted to determine the relationship between FHP and accessory respiratory muscle activity by measur-
ing the activity of the SCM, UT, PM, and thoracolumbar ES muscles during deep breathing.
SUBJECTS AND METHODS
Twenty-six subjects (14 males, 12 females) participated in this study. They were divided into the two groups: normal group
and FHP group. Because lung capacity and muscle activity differ between the genders
11)
, results between the normal and FHP
groups were compared separately for males and females. Before participation in this study, all subjects signed an informed
consent document that was approved by the Institute Research Board of Kyungsung University. FVC, FEV1, and accessory
respiratory muscle activity during deep breathing were measured for each group. To measure FVC and FEV1, the subjects are
asked to perform a rapid full inspiration through the mouthpiece and then, without hesitation, perform a full expiration with
maximum force, followed by another rapid maximum inspiration. FVC and FEV1 were measured using pulmonary function
equipment (Spiropalm, Cosmed, Italy) that met the American Thoracic Society’s recommendation for diagnostic spirometry.
An electromyography unit (Telemyo direct transmission system, Noraxon, USA) was used to measure the activity of
the following accessory respiratory muscles during deep breathing: SCM, UT, PM, and ES muscles. Data are expressed
as percentages of the reference voluntary contraction (% RVC). Muscle activity was measured during the inspiration and
expiration phases.
A Mann-Whitney test was used to compare the FVC, FEV1, and breathing muscle activity between the normal and FHP
group. SPSS software (version 21.0; SPSS, Chicago, IL, USA) was used to generate the statistics, and p-values less than 0.05
were considered statistically signicant.
RESULTS
The characteristics of the subjects are shown in Table 1. The craniovertebral angle was signicantly different between
normal and FHP subjects in both males and females (p < 0.05 for both genders). FVC and FEV1 of the FHP group were
both signicantly lower than they were in the normal group, in both males and females (p < 0.05 for both genders) (Table 2).
Activity of the SCM and PM in the FHP group was signicantly lower than that of the normal group in males (p < 0.05).
Table 1. Subject characteristics (mean±SD)
Var iable
Group
Male (n=14) Female (n=12)
Normal (n=7) FHP (n=7) Normal (n=5) FHP (n=7)
Age (years) 23.3±2.2 24.2±3.6 22.8±0.3 23.2±2.8
Height (cm) 174.6±8.5 176.7±8.9 161.4±4.2 162.9±5.4
Weight (kg) 70.1±8.2 72.6±5.5 54.3±5.6 53.9±4.6
CVA (°) 53.1±2.3 40.9±4.0 55.4±2.1 43.1±2.5
SD: standard deviation, FHP: forward head posture, CVA: craniovertebral angle
Table 2. Comparisons of FVC and FEV1 between normal and FHP subjects (mean ± SD)
Var iable
Group
Male (n=14) Female (n=12)
Normal (n=7) FHP (n=7) Normal (n=5) FHP (n=7)
FVC 4.6±0.4 3.9±0.3* 3.2±0.2 2.7±0.4*
FEV1 4.5±0.4 3.6±0.4* 3.2±0.4 2.5±0.4*
*p < 0.05. SD: standard deviation, FHP: forward head posture, FVC: forced vital capacity, FEV1: forced expiratory
volume at 1 second
J. Phys. Ther. Sci. Vol. 28, No. 1, 2016
130
Activity of the UT and ES in the FHP group was generally lower than that of the normal group in men but the difference was
not signicant (p > 0.05) (Table 3). Activity of the SCM, PM, and UT in the FHP group was signicantly lower than that of
the normal group in women (p < 0.05). The activity of the ES in FHP group was generally lower than that of the normal group
in women but the difference was not signicant (p > 0.05) (Table 3).
DISCUSSION
The present study measured FVC and FEV1, as well as the muscular activity in the SCM, UT, PM, and ES muscles during
inspiration to identify the effects of FHP on vital capacity and the activity of the accessory respiratory muscles. The FHP
group showed statistically signicantly lower FVC and FEV1 levels than the normal group. In terms of the activity of the
accessory respiratory muscles, the FHP group also exhibited statistically signicant decreases in the activation of the SCM,
UT, and PM relative to muscle activation in the normal group. While the FHP group did not show a signicant decrease in
the ES muscle’s activity, its activity in this group was generally lower than in the normal group.
FHP causes shortening and weakening of the accessory respiratory muscles, thereby decreasing the ratio of FEV1 to
FVC
10)
. Kapreli et al. reported that an increase in FHP resulted in a corresponding increase in respiratory dysfunction
6)
.
In addition, even among the subjects without neck pain, an increase in FHP led to a corresponding statistically signicant
decrease in vital capacity
3)
.
Dimitriadis et al. reported that maximal inspiratory and expiratory pressure showed statistically signicant decreases
for complex reasons, such as weaknesses of the SCM, scalene muscles, and the trapezius, which are accessory respiratory
muscles, and a reduction in kinetic control of the cervical area
9)
. In addition, Wirth et al. reported that weaknesses of the
neck muscles and accessory respiratory muscles in patients with neck pain resulted in a decline in thoracic mobility, thereby
decreasing maximal voluntary ventilation, maximal inspiratory pressure, and maximal expiratory pressure, and that these
effects were closely related to FHP
12)
. However, some studies reported that an increase in FHP resulted in a corresponding
increase in maximal expiratory pressure
6, 9)
. This result may be explained as follows: while FHP represents an abnormal
posture, this posture can increase the trunk’s internal pressure during expiration and therefore may increase dynamic mecha-
nisms. In the present study, the observed decrease in FEV1 may have been due to increased kyphosis in the upper thoracic
region, which is characterized by FHP, causing a reduction in the volume of the thoracic cage. This would not only reduce
the expiratory reserve volume, but also create resistance to the exhalation.
In general, respiration is an activity inuenced by complex biomechanical factors and the stability of the cervical and
thoracic regions of the spine is of great importance to smooth respiratory function
5)
. However, FHP causes the shortening and
weakening of the SCM, scalene muscles, trapezius, and ES muscles
7)
, and therefore, reduces the endurance and propriocep-
tion of these muscles
5)
. In addition, FHP increases muscle tension around the thoracic spine, thereby restricting the range of
motion in the upper thoracic spine
3)
.
The present study compared normal adults without neck pain based on the presence or absence of FHP. The results were
similar to those of a number of previous studies on patients with FHP and neck pain, as well as those of the previous studies
on normal adults with FHP but without neck pain
3)
. The results presented here may be important in conrming that FHP
without neck pain can still inuence respiration. Therefore, when treating patients with FHP or lung dysfunction, improve-
ments in respiratory function through the correction of posture and the strengthening of weakened accessory respiratory
muscles may be clinically important.
ACKNOWLEDGEMENT
This work was supported by the Brain Busan 21 Project in 2015.
Table 3. Comparisons of respiratory muscle activity between normal and FHP subjects (mean ± SD)
Var iable
Group
Male (n=14) Female (n=12)
Normal (n=7) FHP (n=7) Normal (n=5) FHP (n=7)
SCM 816.6±350.0 353.3±192.0* 1,243.6±762.2 514.2±123.0*
UT 273.2 ±114.3 177.5±39.7 596.6±350.6 244.8±103.0*
PM 274.8±95.7 183.6±39.4* 290.8±68.2 200.3±67.9*
ES 197.1±71.3 184.2±37.4 229.0±82.5 171.1±53.9
*p < 0.05. SD: standard deviation, FHP: forward head posture, SCM: sternocleidomastoid, UT: upper trapezius, PM:
pectoralis major, ES: erector spinae
131
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  • Jan 2025
Introduction: Breathing and postural control is reported to be both neuromuscularly and mechanically interdependent. To date, the effects of voluntary abdominal and thoracic breathing (VAB and VTB) on the EMG activity of muscles involved in both respiratory and postural functions, as well as gait biomechanics related to these breathing patterns, have not been investigated in young, healthy adults. The aim of the study was to evaluate the EMG responses of neck and trunk muscles, as well as the kinematic, stability, and kinetic parameters of gait induced by VAB and VTB compared to involuntary breathing (INB). Methods: Twenty-four healthy, physically active participants (12 men and 12 females) were required to complete three two-minute walking sessions on an instrumented treadmill (e.g. devices with capacitive sensors embedded beneath the running belt) at 5.0 km h􀀀 1, first with INB and then alternatively with VAB and VTB. A respiratory inductive plethysmography unit was used to provide real-time visual feedback of the breathing pattern performed by each participant. The EMG activity of the sternocleidomastoid (SCM), upper trapezius (UT), thoracic and lumbar erector spinae (TES and LES), as well as spatiotemporal (step width, stride length, stride time, stance phase, swing phase, and cadence), stability (anteroposterior and mediolateral center of pressure trajectory), and dynamic gait parameters (vertical ground reaction forces, vGRF) were recorded during each testing condition. Results: Our findings revealed that both voluntary breathing patterns significantly affected the EMG activity of the SCM (p < 0.01) and UT (p < 0.05), with the activity between these muscles, as expressed by the SCM:UT ratio, being more balanced during VAB (0.94) and VTB (1.05) compared to INB (0.73). Additionally, VAB walking led to a narrower step width (p < 0.01) and reduced vGRF over the forefoot (p < 0.01) compared to INB walking. Neither VAB nor VTB influenced the activation levels of the LES and TES, nor did they affect other spatiotemporal, stability, or dynamic gait parameters (p > 0.05). Conclusions: Our findings suggest that certain gait parameters (e.g. step width, forefoot vGRFs) are primarily influenced by VAB compared to INB, likely due to the more balanced activation of the SCM and UT muscles. This balanced activation may enhance
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Correlação entre função pulmonar, postura e composição corporal em pacientes com asma
Article
Full-text available
  • Sep 2013
Aim Asthma may result in postural disorders due to increased activity of accessory respiratory muscles and hyperinflation. Our primary objective was to assess the correlation between pulmonary function and posture in adult patients with asthma. Secondarily, we aimed to study the correlation between body composition and body posture in this group of patients. Method This was a cross-sectional study including 34 patients with asthma who were subjected to postural assessment (photogrammetry), pulmonary function testing (spirometry, whole-body plethysmography, diffusing capacity for carbon monoxide, and respiratory muscle strength), and body composition estimation by means of bioelectrical impedance. Results Most patients were female (70.6%) with a median age of 32.5 years (range: 23-42 years old). We found a significant correlation between horizontal alignment of head (anterior view) and the ratio of forced expiratory volume in 1 second to forced vital capacity (FEV1/FVC; Ͽ = ⿿0,37; P = .03), total lung capacity (TLC; Ͽ = 0,42; P = .01), and residual volume (RV; Ͽ = 0,45; P < .001). Bronchial obstruction and respiratory muscle strength variables also correlated with postural assessment measures on the right and left lateral views. Both body mass index and the percentage of fat mass correlated with horizontal alignment of head, horizontal alignment of the pelvis, and the frontal angle of the lower limbs. Conclusion Adult patients with asthma exhibit specific postural disorders that correlate with pulmonary function and body composition. The assessment of postural variables may provide a better pulmonary rehabilitation approach for these patients.
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Respiratory weakness in patients with chronic neck pain
Article
Full-text available
  • Nov 2012
Respiratory muscle strength is one parameter that is currently proposed to be affected in patients with chronic neck pain. This study was aimed at examining whether patients with chronic neck pain have reduced respiratory strength and with which neck pain problems their respiratory strength is associated. In this controlled cross-sectional study, 45 patients with chronic neck pain and 45 healthy well-matched controls were recruited. Respiratory muscle strength was assessed through maximal mouth pressures. The subjects were additionally assessed for their pain intensity and disability, neck muscle strength, endurance of deep neck flexors, neck range of movement, forward head posture and psychological states. Paired t-tests showed that patients with chronic neck pain have reduced Maximal Inspiratory (MIP) (r = 0.35) and Maximal Expiratory Pressures (MEP) (r = 0.39) (P < 0.05). Neck muscle strength (r > 0.5), kinesiophobia (r < -0.3) and catastrophizing (r < -0.3) were significantly associated with maximal mouth pressures (P < 0.05), whereas MEP was additionally negatively correlated with neck pain and disability (r < -0.3, P < 0.05). Neck muscle strength was the only predictor that remained as significant into the prediction models of MIP and MEP. It can be concluded that patients with chronic neck pain present weakness of their respiratory muscles. This weakness seems to be a result of the impaired global and local muscle system of neck pain patients, and psychological states also appear to have an additional contribution. Clinicians are advised to consider the respiratory system of patients with chronic neck pain during their usual assessment and appropriately address their treatment.
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The physical factors affecting on FVC, ERV, and MVV of Korean adults in their 20s
Article
  • Apr 2013
[Purpose] The aim of this study was to research the physical factors affecting vital capacity (FVC, ERV, MVV) of adults in their 20s. [Methods] Ninety-seven healthy adults without neurological and muscular disorders participated in this study. The physical factors were defined by gender, body mass index (BMI), smoking history, and postures. A Spiropalm (A-M systems, Sequim, WA, USA) was used to measure respiratory function (FVC, ERV, and MVV). Multiple regressions were used to research the physical factors affecting vital capacity (FVC, ERV, and MVV). [Results] The important physical factors found to be significantly associated with FVC, ERV, and MVV were gender and weight (R2 =0.756), smoking history (R2 =0.179), and gender (R2 =0.427), respectively. [Conclusion] This study indicated that gender and weight are important physical factors for vital capacity in Korean adults in their 20s.
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Correlations between Cervical Lordosis, Vital Capacity, T-spine ROM and Equilibrium
Article
  • Feb 2011
[Purpose] This study used radiometry to examine the effects of cervical lordosis and forward head posture (FHP) angles on vital capacity, equilibrium and ROM of the thoracic spine, and to explore the correlations between each of these factors.[Subjects]The subjects of this study were 36 college students in their twenties (male=16, female=20). [Subjects and Methods]Cervical lordosis angles and FHPs were analyzed with lateral view radiographs. Measures were taken of vital capacity, equilibrium and the range of motion of the thoracic spine and the results were analyzed. [Results]As the absolute rotation angle (ARA) decreased, the anterior weight-bearing angle (AWB) increased while vital capacity (VC) decreased. The results of this study indicate that as the range of motion of the thoracic spine from neutral to flexion increases, the ROM from neutral to extension also increases, and as the ROM from neutral to extension increases, the angle from flexion to extension also increases. [Conclusion]As faulty head and neck postures of subjects affected not only the dynamic stress of their neck but also their vital lung capacity, it is recommended that ARA and AWB angles should be considered when aligning posture in the treatment of impaired vital capacity.
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Correlations between Craniovertebral Angle(CVA) and Cardiorespiratory Function in Young Adults
Article
  • Feb 2014
PURPOSE: The purpose of this study was to investigate the correlation between craniovertebral angle (CVA) and cardiorespiratory function ( and ) in young adults. METHODS: For this study, the students of D college were questioned and 50 members of D college were participated in our research.. Side-view pictures of each subject were taken in standing positions, in order to assess forward head posture (FHP) by measuring the craniovertebral angle. The craniovertebral angle was measured as the angle between a horizontal line at C7 and a line from the tragus of the ear to the spinous process of C7. And and were measured by Quark CPET (cosmed co, USA) while the subjects were performed the treadmill running task of a intensity to set with respiratory mask. Subjucts were Then Pearson's correlation coefficient was calculated to estimate the relationship between craniovertebral and cardiorespiratory function ( and ) using SPSS for window. RESULTS: There was a significant positive correlation between craniovertebral angle and during treadmill running task (r=0.528, p
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Respiratory dysfunction in patients with chronic neck pain - Influence of thoracic spine and chest mobility
Article
  • Apr 2014
  • MANUAL THER
Patients with chronic neck pain exhibit various musculoskeletal deficits and respiratory dysfunction. As there is a link between thoracic and cervical spine motion, the aim of this study was to investigate the relationship between thoracic spine and chest mobility with respiratory function and neck disability. Nineteen patients with chronic neck pain (7 male, 46.6 ± 10.5 years) and 19 healthy subjects (7 male, 46.5 ± 9.9 years) participated. Spirometry was conducted to determine maximal voluntary ventilation (MVV), maximal inspiratory (Pimax) and maximal expiratory pressure (Pemax). Thoracic spine mobility was measured using the Spinal Mouse(®). Chest expansion was assessed by subtracting chest circumference during maximal inspiration and expiration. Neck function was investigated by examining range of motion, forward head posture, neck flexor muscle synergy endurance and self-assessment (Neck disability index (NDI)). Correlation analyses and multiple linear regression analyses were conducted using MVV, Pimax and Pemax as independent variables. Thoracic spine mobility during flexion and chest expansion correlated significantly to MVV (r = 0.45 and 0.42), all neck motions (r between 0.39 and 0.59) and neck muscle endurance (rS = 0.36). Pemax and Pimax were related to NDI (r = -0.58 and -0.46). In the regression models, chest expansion was the only significant predictor for MVV, and Pemax was determined by neck muscle endurance. These results suggest that chronic neck pain patients should improve the endurance of the neck flexor muscles and thoracic spine and chest mobility. Additionally, these patients might benefit from respiratory muscle endurance training, possibly by increasing chest mobility and Pemax.
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Correlation between pulmonary function, posture, and body composition in patients with asthma
Article
  • Jun 2013
Aim: Asthma may result in postural disorders due to increased activity of accessory respiratory muscles and hyperinflation. Our primary objective was to assess the correlation between pulmonary function and posture in adult patients with asthma. Secondarily, we aimed to study the correlation between body composition and body posture in this group of patients. Method: This was a cross-sectional study including 34 patients with asthma who were subjected to postural assessment (photogrammetry), pulmonary function testing (spirometry, whole-body plethysmography, diffusing capacity for carbon monoxide, and respiratory muscle strength), and body composition estimation by means of bioelectrical impedance. Results: Most patients were female (70.6%) with a median age of 32.5 years (range: 23-42 years old). We found a significant correlation between horizontal alignment of head (anterior view) and the ratio of forced expiratory volume in 1 second to forced vital capacity (FEV1/FVC; ρ=-0,37; P=.03), total lung capacity (TLC; ρ=0,42; P=.01), and residual volume (RV; ρ=0,45; P<.001). Bronchial obstruction and respiratory muscle strength variables also correlated with postural assessment measures on the right and left lateral views. Both body mass index and the percentage of fat mass correlated with horizontal alignment of head, horizontal alignment of the pelvis, and the frontal angle of the lower limbs. Conclusion: Adult patients with asthma exhibit specific postural disorders that correlate with pulmonary function and body composition. The assessment of postural variables may provide a better pulmonary rehabilitation approach for these patients.
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Respiratory Dysfunction in Chronic Neck Pain Patients. A Pilot Study
Article
  • Mar 2009
  • CEPHALALGIA
The aim of this pilot study was to add weight to a hypothesis according to which patients presenting with chronic neck pain could have a predisposition towards respiratory dysfunction. Twelve patients with chronic neck pain and 12 matched controls participated in this study. Spirometric values, maximal static pressures, forward head posture and functional tests were examined in all subjects. According to the results, chronic neck patients presented with a statistically significant decreased maximal voluntary ventilation (P = 0.042) and respiratory muscle strength (Pimax and Pemax), (P = 0.001 and P = 0.002, respectively). Furthermore, the current study demonstrated a strong association between an increased forward head posture and decreased respiratory muscle strength in neck pateits. The connection of neck pain and respiratory function could be an important consideration in relation to patient assessment, rehabilitation and consumption of pharmacological agents.
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A Study on the Prevalence of and Risk Factors for Neck Pain Among University Academic Staff in Hong Kong
Article
  • Jul 2002
The 1-year prevalence of neck pain and possible risk factors among university academic staff were investigated. Self-administered questionnaires were distributed to all the full-time academic staff in one of the universities in Hong Kong. The 1-year prevalence of neck pain was investigated. The relationship between individual factors, job nature, psychosocial factors, and neck pain were also analyzed. The 1-year prevalence of neck pain among after being an academic staff was 46.7%. A significant association was found between gender and neck pain (p = 0.02). The percentage of female academic staff with neck pain (62%) was higher than that in male staff (38%). This matched the results of other studies, which demonstrated that neck pain was more prevalent in women. There was a significant association between head posture during computer processing and neck pain (p = 0.02). Among those with neck pain during computer processing, 60.5% had a forward head posture. However, a low correlation between psychosocial factors and neck pain was demonstrated (r = 0.343). Academic staff in tertiary institutions could be considered as a high-risk group of job-related neck pain.
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Respiratory effects of the scalene and sternomastoid muscles in humans
Article
  • Apr 2003
Previous studies have shown that in normal humans the change in airway opening pressure (DeltaPao) produced by all the parasternal and external intercostal muscles during a maximal contraction is approximately -18 cmH(2)O. This value is substantially less negative than DeltaPao values recorded during maximal static inspiratory efforts in subjects with complete diaphragmatic paralysis. In the present study, therefore, the respiratory effects of the two prominent inspiratory muscles of the neck, the sternomastoids and the scalenes, were evaluated by application of the Maxwell reciprocity theorem. Seven healthy subjects were placed in a computed tomographic scanner to determine the fractional changes in muscle length during inflation from functional residual capacity to total lung capacity and the masses of the muscles. Inflation induced greater shortening of the scalenes than the sternomastoids in every subject. The inspiratory mechanical advantage of the scalenes thus averaged (mean +/- SE) 3.4 +/- 0.4%/l, whereas that of the sternomastoids was 2.0 +/- 0.3%/l (P < 0.001). However, sternomastoid muscle mass was much larger than scalene muscle mass. As a result, DeltaPao generated by a maximal contraction of either muscle would be 3-4 cmH(2)O, which is about the same as DeltaPao generated by the parasternal intercostals in all interspaces.
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