Relationship between Forward Head and Thoracic Hyper-Kyphosis Posture and Pulmonary Function, Spinal Deformities, Neck, and Shoulder Muscle Strength and Range of Motion: A Cross-Sectional Study

Document Type : Case Report

Authors

1 MSc. Student, Sport Injuries and Corrective Exercises Department, Sport Sciences Faculty, Razi University, Kermanshah, Iran

2 Assistant Professor, Sport Injuries and Corrective Exercises Department, Sport Sciences Faculty, Razi University, Kermanshah, Iran.

Abstract

Backgrounds and Aims: It is unclear how thoracic hyper-kyphosis (THK) and forward head posture deformities (FHP) relate to physical function. The purpose of the current research was to study the relationship between forward head posture (FHP) and thoracic hyper-kyphosis (THK) and pulmonary function, spinal deformities, neck, and shoulder muscle strength and range of motion (ROM).
Materials and Methods: In the present descriptive correlational study, after screening 80 patients via flexible ruler and posture assessment tools, 40 individuals who had inclusion criteria were recruited. Study variables were measured using an evaluator. We used Photography and Image J software to evaluate FHP, Spinal mouse to evaluate spine deformities, Spirometry to evaluate pulmonary volumes, PT-Scan to evaluate postural sways, Pull-Push-Dynamometer to evaluate muscles strength, and the Babble Baseline Inclinometer was used to assess neck and shoulder ROM. Pearson’s r was run to assess the relationship among variables.
Results: The results showed that FHP had a negative correlation with trunk extension (P=0.029), neck flexion (P=0.010), and shoulder adduction (P=0.018) ROM, positive correlation with shoulder flexors (P=0.010) and abductors (P=0.010) strength as well as negative correlation with FEV1/FVC (P=0.004) and FEV1 (P=0.024). THK posture, also, had a negative correlation with trunk flexion (P=011), neck flexion (P=0.009), and shoulder adduction (P=0.049) ROM, but its had a positive correlation with lumbar lordosis (P=0.004).
Conclusion: Based on our results, THK was associated with neck and trunk flexion, shoulder adduction ROM, and lumbar lordosis. Also, FHP was associated with trunk extension, neck flexion and shoulder adduction ROM, shoulder flexor and abductors strength, and pulmonary function.
 

Keywords

Main Subjects

References

  1. Andersen JH, Kaergaard A, Frost P, Thomsen JF, Bonde JP, Fallentin N, et al. Physical, psychosocial, and individual risk factors for neck/shoulder pain with pressure tenderness in the muscles among workers performing monotonous, repetitive work. Spine.2002; (6):27; 7-660.##
  2. Sahrmann S. Movement system impairment syndromes of the extremities, cervical and thoracic spines-e-book: Elsevier Health Sciences. 2010. ##
  3. Nitzschke E, Hildenbrand M. Epidemiology of kyphosis in school children. Zeitschrift fur Orthopadie und ihre Grenzgebiete. 1990;128(5):477-81. ##
  4. Miyakoshi N, Itoi E, Kobayashi M, Kodama H. Impact of postural deformities and spinal mobility on quality of life in postmenopausal osteoporosis. Osteoporosis International. 2003;14(12):1007-12. ##
  5. Vaughn DW, Brown EW. The influence of an in-home based therapeutic exercise program on thoracic kyphosis angles. Journal of Back and Musculoskeletal Rehabilitation. 2007; 20(4):155-65. ##
  6. Peters S. Electrocardiography changes in scoliosis and kyphosis deformities of the thorax. Zeitschrift fur Orthopadie und ihre Grenzgebiete. 1987; 125(1):14-8. ##
  7. Drennan JC. The role of muscles in the development of human lumbar kyphosis. Developmental Medicine & Child Neurology. 1970; 12:33-8. ##
  8. Taheri-Tizabi A, Mahdavinejad R, Azizi A, Jafarnejadgero T, Sanjari M. Investigation of sagittal curves of spinal column and establishing the norm of thoracic kyphosis and lumbar lordosis. Word J Sport Sci. 2012;6(1):80-3. ##
  9. Peterson-Kendall F, Kendall-McCreary E, Geise-Provance P, McIntyre-Rodgers M, Romani W. Muscles testing and function with posture and pain. Lippincott Williams & Wilkins, Philadelphia. 2005. ##
  10. Hertling D, Kessler RM. Management of common musculoskeletal disorders: physical therapy principles and methods: Lippincott Williams & Wilkin. 2006; 7(2):66-72. ##
  11. Sherekar S, Yadav Y, Basoor A, Baghel A, Adam N. Clinical implications of alignment of upper and lower cervical spine. Neurology India. 2006; 54(3):264. ##
  12. Sawdon-Bea J. Effects of a 10-week exercise intervention on thoracic kyphosis, pulmonary function, endurance, back extensor strength, and quality of life in women with osteoporosis (Doctoral dissertation, Texas Woman's University). ##
  13. Lee JH. Effects of forward head posture on static and dynamic balance control. Journal of physical therapy science. 2016;28(1):274-7. ##
  14. Singla D, Veqar Z. Association between forward head, rounded shoulders, and increased thoracic kyphosis: a review of the literature. Journal of chiropractic medicine. 2017;16(3):220-9. ##
  15. Marefat R, Saberi M, Abdolmajid A, Zoodranj M. A survey on collaboration rate of authors in presenting scientific papers in Koomesh journal during 1999-2010. Koomesh. 2012;13(3):279-86. [In Persian] ##
  16. Feng Q, Wang M, Zhang Y, Zhou Y. The effect of a corrective functional exercise program on postural thoracic kyphosis in teenagers: a randomized controlled trial. Clinical rehabilitation. 2018;32(1):48-56. ##
  17. Shih HS, Chen SS, Cheng SC, Chang HW, Wu PR, Yang JS, Lee YS, Tsou JY. Effects of Kinesio taping and exercise on forward head posture. Journal of back and musculoskeletal rehabilitation. 2017;30(4):725-33. ##
  18. Van Niekerk SM, Louw Q, Vaughan C, Grimmer-Somers K, Schreve K. Photographic measurement of upper-body sitting posture of high school students: a reliability and validity study. BMC musculoskeletal disorders. 2008 Dec;9(1):113. ##
  19. Krause DA, Hansen KA, Hastreiter MJ, Kuhn TN, Peichel ML, Hollman JH. A Comparison of Various Cervical Muscle Strength Testing Methods Using a Handheld Dynamometer. Sports health. 2019;11(1):59-63. ##
  20. Cejudo A, Sánchez-Castillo S, de Baranda PS, Gámez JC, Santonja-Medina F. Low Range of Shoulders Horizontal Abduction Predisposes for Shoulder Pain in Competitive Young Swimmers. Frontiers in psychology. 2019;10. ##
  21. Ullucci PA, Tudini F, Moran MF. Reliability of smartphone inclinometry to measure upper cervical range of motion. Journal of sport rehabilitation. 2019;28(1). doi:10.3906/sag-1812-55. ##
  22. Fadaee E, Seidi F, Rajabi R. The validity and reliability of spinal mouse device in measuring angle values of thoracic kyphosis and lumbar lordosis. J Shahrekord Univ Med Sci. 2017; 19(1): 137-147. [In Persian] ##
  23. Masaki M, Ikezoe T, Yanase K, Ji X, Umehara J, Aoyama J, Minami S, Fukumoto Y, Watanabe Y, Kimura M, Ichihashi N. Association of Pain History and Current Pain With Sagittal Spinal Alignment and Muscle Stiffness and Muscle Mass of the Back Muscles in Middle-aged and Elderly Women. Clinical spine surgery. 2019;32(7):E346-52. ##
  24. Kim M, Lee JC and Yoo K. The effects of shoulder stabilization exercises and pectoralis minor stretching on balance and maximal shoulder muscle strength of healthy young adults with round shoulder posture. The Journal of Physical Therapy Science. 2018; 30(3):373–380. ##
  25. Luque-Suarez A, Martinez-Calderon J, Falla D. Role of kinesiophobia on pain, disability and quality of life in people suffering from chronic musculoskeletal pain: a systematic review. Br J Sports Med 2019;53:554-9. ##
  26. Choi EH, Hur JK, Yang JI, Park DS. The effect of thoracic exercise program on thoracic pain, kyphosis, and spinal mobility. Archives of physical medicine and rehabilitation. 2005;86(9):e23. ##
  27. Sangtarash F, Manshadi FD, Sadeghi A. The relationship of thoracic kyphosis to gait performance and quality of life in women with osteoporosis. Osteoporosis International. 2015;26(8):2203-8. ##
  28. Arshadi R, Rajabi R, Alizadeh MH. The relationship between spine mobility with kyphosis and lordosis, Sport Science Research 2007,15. pp123-132. [In Persian] ##
  29. Ahmadi H, Yalfani A, Gandomi F. The effect of eight-week comprehensive corrective exercises carried out in water on pain, neck flexors endurance and upper extremity range of motion in patient with upper crossed syndrome. J Shahid Sadoughi Uni Med Sci 2019; 27(3): 1381-94. [In Persian] ##
  30. Shin YJ, Kim WH, Kim SG. Correlations among visual analogue scale, neck disability index, shoulder joint range of motion, and muscle strength in young women with forward head posture. Journal of exercise rehabilitation. 2017;13(4):413. ##
  31. Quek J, Pua YH, Clark RA, Bryant AL. Effects of thoracic kyphosis and forward head posture on cervical range of motion in older adults. Manual therapy. 2013;18(1):65-71. ##
  32. Gong W, Kim C, Lee Y. Correlations between cervical lordosis, forward head posture, cervical ROM and the strength and endurance of the deep neck flexor muscles in college students. Journal of Physical Therapy Science. 2012;24(3):275-7. ##
  33. Kim MS, Cha YJ, Choi JD. Correlation between forward head posture, respiratory functions, and respiratory accessory muscles in young adults. Journal of back and musculoskeletal rehabilitation. 2017 Jan 1;30(4):711-5. ##
  34. Lorbergs AL, O’Connor GT, Zhou Y, Travison TG, Kiel DP, Cupples LA, Rosen H, Samelson EJ. Severity of kyphosis and decline in lung function: The Framingham study. Journals of Gerontology Series A: Biomedical Sciences and Medical Sciences. 2017;72(5):689-94. ##
  35. Lee YM, Gong WT, Kim BK: Correlation between cervical lordosis, vital capacity, T-spine ROM and equilibrium. J Phys Ther Sci, 2011, 23: 103–105. ##
  36. Koseki T, Kakizaki F, Hayashi S, Nishida N, Itoh M. Effect of forward head posture on thoracic shape and respiratory function. Journal of physical therapy science. 2019;31(1):63-8. ##
  37. Han J, Park S, Kim Y, Choi Y, Lyu H. Effects of forward head posture on forced vital capacity and respiratory muscles activity. Journal of physical therapy science. 2016;28(1):128-31. ##
  38. Bae W, Lee K, Park S, Baek Y. Effect of the changes in forward head posture and neutral head posture on respiratory. Journal of The Korean Society of Integrative Medicine. 2017;5(1):67-74. ##
  39. Chow SB, Moffat M. Relationship of thoracic kyphosis to functional reach and lower-extremity joint range of motion and muscle length in women with osteoporosis or osteopenia: a pilot study. Top Geriatr Rehabil. 2004; 20(4):297–306. ##
  40. Fouladi M, Ahmadi A, Maroufi N, Sarrafzadeh J, Esmaeelnezhad M. Comparison of Thoracic Kyphosis and Lumbar Lordosis in Healthy Individuals and Patients with Forward Head Posture. J Rehab Med. 2018; 7(1): 216-224. [In Persian] ##
The Scientific Journal of Rehabilitation Medicine
Volume 9, Issue 4
January 2021
Pages 216-227

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History

  • Receive Date: 24 March 2020
  • Revise Date: 13 April 2020
  • Accept Date: 19 April 2020
  • First Publish Date: 21 December 2020

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