1
|
Abu-Taleb W, Yamany AA, Aneis YM, Abu El Kasem ST. Effect of adding global postural reeducation to kendall exercises for treating asymptomatic forward head posture: A single-blinded randomized controlled trial. J Bodyw Mov Ther 2025; 42:938-947. [PMID: 40325777 DOI: 10.1016/j.jbmt.2025.01.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2024] [Revised: 01/02/2025] [Accepted: 01/22/2025] [Indexed: 05/07/2025]
Abstract
INTRODUCTION Forward head posture (FHP) is a common postural malalignment in young population that is associated with limitation of mobility and functional disability. Kendall exercises are one of the commonly used postural correction techniques to treat FHP. Global postural reeducation (GPR) is a postural correction exercise commonly used for musculoskeletal disorders. The current study aimed to investigate the combined effect of GPR and Kendall Exercises in the treatment of FHP. METHODS A single-blinded parallel-groups randomized controlled trial was conducted. Forty-three participants aged 18-30 years were recruited with FHP marked by a craniovertebral angle (CVA) less than 50°. Participants were randomly allocated into two groups: group A (GrA) received GPR plus Kendall Exercises, and group B (GrB) received Kendall Exercises only. Variables were measured before and immediately after 12 sessions of treatment including CVA, gaze angle (GA), shoulder angle (SA), cervical range of motion (CROM), neck disability index (NDI), chest expansion, and spinal mobility. RESULTS Between groups analysis revealed no statistically significant difference between either treatment in CVA, CROM, and NDI. There was a statistically significant improvement of chest expansion and spinal mobility in favor to GrA. Within-group analysis revealed that both interventions were statistically significant in improving CVA, CROM, and NDI (P < 0.05). Both treatments showed no statistical difference in GA and SA. CONCLUSIONS The added effect GPR technique to Kendall exercises significantly improved craniovertebral angle, cervical mobility and functional disability, chest expansion, and spinal mobility in people with FHP.
Collapse
Affiliation(s)
- Walaa Abu-Taleb
- Physiotherapy, School of Human Sciences, London Metropolitan University, London, UK; Department of Basic Science, Faculty of Physical Therapy, Cairo University, Giza, Egypt.
| | | | - Yasser M Aneis
- Department of Basic Science, Faculty of Physical Therapy, Cairo University, Giza, Egypt; Department of Physical Therapy, Oman College of Health Sciences, Sultanate of Oman.
| | - Shimaa T Abu El Kasem
- Department of Basic Science, Faculty of Physical Therapy, Cairo University, Giza, Egypt; Department of Basic Science, Faculty of Physical Therapy, Galala University, Suez, Egypt.
| |
Collapse
|
2
|
Ozturk N, Unver F. The effects of pilates on posture and physical fitness parameters in 5–6 years old children: A non-randomized controlled study. J Bodyw Mov Ther 2022; 31:153-158. [DOI: 10.1016/j.jbmt.2022.03.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 01/30/2022] [Accepted: 03/17/2022] [Indexed: 11/25/2022]
|
3
|
A 10-Week Program of Combined Hippotherapy and Scroth's Exercises Improves Balance and Postural Asymmetries in Adolescence Idiopathic Scoliosis: A Randomized Controlled Study. CHILDREN (BASEL, SWITZERLAND) 2021; 9:children9010023. [PMID: 35053648 PMCID: PMC8774272 DOI: 10.3390/children9010023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 11/24/2021] [Accepted: 12/07/2021] [Indexed: 01/12/2023]
Abstract
Introduction: The most frequent type of spine abnormality throughout adolescence was adolescent idiopathic scoliosis (AIS). Hippotherapy improved posture, balance and gait of different musculoskeletal conditions. Therefore, this study aims to see how hippotherapy combined with Schroth exercises affected postural asymmetry and dynamic balance in AIS compared to traditional physiotherapy (Schroth exercises) alone. Materials and methods: In this randomized controlled trial, fifty-two patients with AIS (10–18 years, 37 girls and 15 boys) participated. They were arbitrarily allocated into two groups: experimental (19 female/8 male; aged 14.74 ± 1.79 years; Cobb angle 18.59 ± 2.66 degrees) and control (18 female/7 male; aged 15.04 ± 1.81 years; Cobb angle 19.32 ± 2.69 degrees) groups. Both groups received Schroth exercises for 10 weeks, three days/week. The experimental group additionally received hippotherapy training. Pre-treatment and post-treatment assessment for the scoliotic, kyphotic angle, pelvic obliquity, pelvic torsion and vertical spinal rotation and the anteroposterior, mediolateral and overall stability indices were assessed using the formetric system 4D and Biodex Balance System, respectively. Results: After intervention, both groups illustrated significant improvements in all examined variables (p < 0.05). The experimental group illustrated significant improvements in scoliotic angle, kyphotic angle, pelvic obliquity, pelvic torsion and vertical spinal rotation and the stability indices compared to the control group (p < 0.05). Conclusion: In adolescence idiopathic scoliosis, hippotherapy training combined with Schroth exercises improves posture asymmetry and balancing ability more effectively than Schroth exercises alone.
Collapse
|
4
|
Bayattork M, Sköld MB, Sundstrup E, Andersen LL. Exercise interventions to improve postural malalignments in head, neck, and trunk among adolescents, adults, and older people: systematic review of randomized controlled trials. J Exerc Rehabil 2020; 16:36-48. [PMID: 32161733 PMCID: PMC7056483 DOI: 10.12965/jer.2040034.017] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Accepted: 02/05/2020] [Indexed: 12/12/2022] Open
Abstract
Despite the widespread use of postural correction in exercise interventions, limited experimental evidence exists for its effectiveness. The present study aimed to systematically review the literature on the efficacy of exercise interventions in improving postural malalignment in head, neck, and trunk. A systematic review was performed by screening four scientific databases (MEDLINE, Web of Science, EBSCO, and Cochrane database) for published randomized controlled trials (RCTs) in English from 1996–2019. The review followed the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement guidelines. Two researchers independently performed study screening, extracting data and assessing the risk of bias for each included study using the Cochrane Collaboration tool for evaluating the risk of bias. A total of 22 RCTs comprising 1,209 participants were identified for inclusion in the review. There was a high risk of bias across most of the included studies (12 studies). Only two studies were classified as low risk of bias, and eight studies were classified as moderate risk of bias. The intervention duration ranged from 2 to 13 weeks, frequency from 2 to 4 days per week, and duration of each session between 15 to 60 min. The insufficiency and quality of included studies did not allow an integrated assessment of the efficacy of exercise interventions on postural malalignments; however, the positive effects noticed in most of the studies indicate some advantages but underscores the necessity of adequately designed RCTs in this field.
Collapse
Affiliation(s)
- Mohammad Bayattork
- Department of Sport Sciences and Physical Education, Faculty of Humanities Science, University of Hormozgan, Bandar Abbas, Iran.,National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Margrethe Bordado Sköld
- National Research Centre for the Working Environment, Copenhagen, Denmark.,Department of Occupational and Social Medicine, Holbæk University Hospital, Holbæk, Denmark
| | - Emil Sundstrup
- National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Lars Louis Andersen
- National Research Centre for the Working Environment, Copenhagen, Denmark.,Sport Sciences, Department of Health Science and Technology, Aalborg University, Aalborg, Denmark
| |
Collapse
|
5
|
Short- and Mid-Term Improvement of Postural Balance after a Neurorehabilitation Program via Hippotherapy in Patients with Sensorimotor Impairment after Cerebral Palsy: A Preliminary Kinetic Approach. Brain Sci 2019; 9:brainsci9100261. [PMID: 31569505 PMCID: PMC6826615 DOI: 10.3390/brainsci9100261] [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: 07/24/2019] [Revised: 09/24/2019] [Accepted: 09/28/2019] [Indexed: 11/16/2022] Open
Abstract
There is still a lack of studies focused on trunk neurorehabilitation. Accordingly, it is unclear which therapeutic modalities are the most effective in improving static/dynamic balance after brain damage. We designed a pilot study on hippotherapy to assess its short- and mid-term effect on dynamic postural balance in patients with moderate-to-severe sensorimotor impairment secondary to cerebral palsy. Five patients aged 15.4 ± 6.1 years old were recruited. All of them had moderate-to-severe alterations of the muscle tone with associated postural balance impairment. Standing and walking were also impaired. Ten minutes horse riding simulator followed by twenty minutes hippotherapy session were conducted during five session days separated by one week each. We analyzed the displacement of the Center of Pressure (COP) on the sitting surface of the simulator’s saddle by means of a customized pressure pad. We measured the general behavior of the COP displacement as well as the postural adjustments when pace changed from walk to trot to walk during the sessions and among sessions. Statistical analysis revealed an improved postural control both by the end of the session and from session 1 to session 5. These results suggest that hippotherapy might support regularization of postural control in a long-term neurorehabilitation context.
Collapse
|
6
|
Iona T, Scarfone R, Palumbo A, Iocco M, Ammendolia A. Is cardio-fitness multi-planar exercise really useful to train? GAZZETTA MEDICA ITALIANA ARCHIVIO PER LE SCIENZE MEDICHE 2019. [DOI: 10.23736/s0393-3660.18.03822-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
|
7
|
Moon JH, Jung JH, Hahm SC, Oh HK, Jung KS, Cho HY. Effects of lumbar lordosis assistive support on craniovertebral angle and mechanical properties of the upper trapezius muscle in subjects with forward head posture. J Phys Ther Sci 2018; 30:457-460. [PMID: 29581671 PMCID: PMC5857458 DOI: 10.1589/jpts.30.457] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2017] [Accepted: 12/22/2017] [Indexed: 11/24/2022] Open
Abstract
[Purpose] The aim of this study was to investigate the effect of lumbar lordosis
assistive support (LLAS) on craniovertebral angle (CVA) and mechanical properties of the
upper trapezius (UT) muscle in subjects with forward head posture (FHP). [Subjects and
Methods] This study recruited 20 subjects with FHP. CVA and muscle tone, viscoelasticity,
and stiffness of the UT were measured using Myoton in all subjects in a sitting position
with LLAS and in a neutral sitting position. The order of measurements was randomized and
the mean values were calculated twice. [Results] The sitting position with LLAS showed a
significantly greater improvement than the neutral sitting position with regard to CVA and
muscle tone, viscoelasticity, and stiffness of the UT. [Conclusion] We suggest that the
sitting position using LLAS induces the maintenance of normal neck posture and a reduction
in the muscle tone of the UT in the subjects with FHP.
Collapse
Affiliation(s)
- Jong-Hoon Moon
- Department of Occupational Therapy, Graduate School, Gachon University, Republic of Korea
| | - Jin-Hwa Jung
- Department of Occupational Therapy, Semyung University: 65 Semyung-ro, Jecheon-si, Chungbuk 390-711, Republic of Korea
| | - Suk-Chan Hahm
- Department of Rehabilitation Standard and Policy, National Rehabilitation Research Institute, National Rehabilitation Center, Republic of Korea
| | | | - Kyoung-Sim Jung
- Department of Occupational Therapy, Semyung University: 65 Semyung-ro, Jecheon-si, Chungbuk 390-711, Republic of Korea
| | - Hwi-Young Cho
- Department of Physical Therapy, Gachon University: 191 Hambangmoe-ro, Yeonsu-gu, Incheon 406-799, Republic of Korea
| |
Collapse
|
8
|
Lee DY, Nam CW, Sung YB, Kim K, Lee HY. Changes in rounded shoulder posture and forward head posture according to exercise methods. J Phys Ther Sci 2017; 29:1824-1827. [PMID: 29184298 PMCID: PMC5684019 DOI: 10.1589/jpts.29.1824] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2017] [Accepted: 07/18/2017] [Indexed: 11/24/2022] Open
Abstract
[Purpose] This study aimed to determine the effect of forward head posture-improving exercises on rounded shoulder posture when employing the self-stretch exercise, the McKenzie exercise, and the Kendall exercise as intervention methods based on previous studies that reported negative effects of unbalanced posture and musculoskeletal problems on forward head posture and rounded shoulder posture. [Subjects and Methods] The selected 28 subjects were randomly assigned into the McKenzie exercise group (n=9), the self-stretch exercise group (n=10), and the Kendall exercise group (n=9). To compare the forward head posture, the craniovertebral angle was used. To measure the rounded shoulder posture, the scapular index was used. [Results] There were significant differences in the craniovertebral angle and scapular index within the groups and no significant differences between the groups. [Conclusion] The result of this study showed that all interventions increased the craniovertebral angle and the scapular index, which revealed that the applied exercises had a positive effect on forward head posture and rounded shoulder posture.
Collapse
Affiliation(s)
- Do Youn Lee
- Department of Physical Therapy, College of Rehabilitation Science, Daegu University, Republic of Korea
| | - Chan Woo Nam
- Department of Physical Therapy, College of Rehabilitation Science, Daegu University, Republic of Korea
| | - Youn Bum Sung
- Department of Physical Therapy, College of Rehabilitation Science, Daegu University, Republic of Korea
| | - Kyoung Kim
- Department of Physical Therapy, College of Rehabilitation Science, Daegu University, Republic of Korea
| | - Hae Yong Lee
- Department of Physical Therapy, Youngsan University: 288 Joonam-ro, Yangsan, Gyeongsangnam-do, Republic of Korea
| |
Collapse
|
9
|
Kim BB, Lee JH, Jeong HJ, Cynn HS. Effects of suboccipital release with craniocervical flexion exercise on craniocervical alignment and extrinsic cervical muscle activity in subjects with forward head posture. J Electromyogr Kinesiol 2016; 30:31-7. [DOI: 10.1016/j.jelekin.2016.05.007] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2016] [Revised: 05/20/2016] [Accepted: 05/21/2016] [Indexed: 11/28/2022] Open
|
10
|
Lim JH, Cho WS, Lee SJ, Park CB, Park JS. Effects of mechanical horseback riding velocity on spinal alignment in young adults. J Phys Ther Sci 2016; 28:1836-9. [PMID: 27390428 PMCID: PMC4932069 DOI: 10.1589/jpts.28.1836] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2016] [Accepted: 03/12/2016] [Indexed: 11/29/2022] Open
Abstract
[Purpose] This study aimed to determine if the velocity of mechanical horseback-riding
training can improve spinal alignment in young adults. [Subjects and Methods] Thirty-six
subjects were enrolled in this study. The subjects were randomly allocated into high-,
moderate-, and low-velocity mechanical horseback-riding training groups. All participants
completed one 20-minute session per day, 3 days per week, for 6 weeks. The evaluation was
performed before and 6 weeks after the training intervention. The spinal alignment was
measured by a Formetric III device. The measurement items were kyphotic angle, lordotic
angle, trunk inclination, pelvic torsion, pelvic rotation, and lateral deviation. The data
were analyzed using analysis of covariance to determine the statistical significance.
[Results] The kyphotic angle and trunk inclination were significantly different among the
groups. The kyphotic angles of the high- and moderate-velocity groups were significantly
lower than that of the low-velocity group after the intervention. The trunk inclination of
the high-velocity group was significantly lower than that of the low-velocity group after
intervention. [Conclusion] Higher-velocity mechanical horseback-riding training is more
effective than lower-velocity mechanical horseback-riding training for improving spinal
alignment.
Collapse
Affiliation(s)
- Jae-Heon Lim
- Department of Physical Therapy, Seonam University, Republic of Korea
| | - Woon-Su Cho
- Department of Physical Therapy, Nambu University, Republic of Korea
| | - Seong-Jin Lee
- Department of Rehabilitation Health Management, Songwon University, Republic of Korea
| | - Chi-Bok Park
- Department of Physical Therapy, Graduate School of Dongshin University, Republic of Korea
| | - Jang-Sung Park
- Department of Physical Therapy, Seonam University, Republic of Korea
| |
Collapse
|
11
|
Oh SH, Yoo KT. The effects of stabilization exercises using a sling and stretching on the range of motion and cervical alignment of straight neck patients. J Phys Ther Sci 2016; 28:372-7. [PMID: 27065521 PMCID: PMC4792976 DOI: 10.1589/jpts.28.372] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2015] [Accepted: 10/30/2015] [Indexed: 11/24/2022] Open
Abstract
[Purpose] The purpose of this study was to assess how stretching exercise training and sling exercise training for stabilization influences the cervical spine angles and cervical range of motion of straight neck patients. [Subjects and Methods] Twenty straight neck patients were selected as subjects and they were randomly divided into two groups, the stretching and sling stabilization exercise groups which 60 minutes of exercise three times a week for 6weeks. All the subjects in each of the two respective study groups received an X-ray and had their cervical range of motion measured, both before and after the exercise. [Results] When differences in the cervical spine angle between the pre- and the post-test were checked, it was found that only the stretching exercise group showed statistically significant decreases in the craniovertebral angle and the cranial rotation angle. When differences in the range of motion between pre- and post-test were checked, the sling stabilization exercise group showed a significant change in flexion, right rotation, left lateral bending, right lateral bending, and the stretching exercise group showed a significant change in left rotation, left lateral bending, and right lateral bending. [Conclusion] These results indicate that both types of exercises are effective at improving the cervical range of motion of straight neck patients, and that the stretching exercise was more effective than the sling stabilization exercise at improving cervical spine angles.
Collapse
Affiliation(s)
- Seung-Hyean Oh
- Department of Physical Therapy, Gangnam Balance Clinic, Republic of Korea
| | - Kyung-Tae Yoo
- Department of Physical Therapy, Namseoul University, Republic of Korea
| |
Collapse
|