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Phys. Ther. Korea 2024; 31(2): 159-166

Published online August 20, 2024

https://doi.org/10.12674/ptk.2024.31.2.159

© Korean Research Society of Physical Therapy

Effect of Forward Head Posture on Erector Spinae Muscle Activity

FEIFEI LI1 , BPT, Yoongyeom Choi1 , PT, BPT, Ilyoung Moon2 , PT, PhD, Chung-hwi Yi3 , PT, PhD

1Department of Physical Therapy, The Graduate School, Yonsei University, 2Wonju Severance Christian Hospital, 3Department of Physical Therapy, College of Software and Digital Healthcare Convergence, Yonsei University, Wonju, Korea

Correspondence to: Chung-hwi Yi
E-mail: pteagle@yonsei.ac.kr
https://orcid.org/0000-0003-2554-8083

Received: July 25, 2024; Revised: August 1, 2024; Accepted: August 1, 2024

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background: For instance, forward head posture (FHP), characterized by the forward movement of the head relative to the spine, places significant stress on the neck and upper back muscles, disrupting the biomechanical balance of the body.
Objects: The objective of this study was to probe the biomechanical effects of FHP on musculoskeletal health through a relative analysis of 26 adults diagnosed with FHP and 26 healthy controls.
Methods: In this study, we evaluated the biomechanical impacts of FHP. Participants adjusted their head positions and underwent muscle strength tests, including electromyography assessments and the Biering-Sørensen test for trunk muscle endurance. Data analysis was conducted using Kinovea (Kinovea) and IBM SPSS software ver. 26.0 (IBM Co.) to compare muscle activities between groups with normal and FHPs.
Results: The study shows that individuals with FHP have significantly lower muscle activity, endurance, and spinal extension in the erector spinae compared to those without, highlighting the detrimental effects of FHP on these muscles.
Conclusion: This study underscores the impact of FHP on erector spinae function and emphasizes the need for posture correction to enhance musculoskeletal health and guide future research on intervention strategies.

Keywords: Biomechanical phenomena, Mechanical stress, Posture

Article

Original Article

Phys. Ther. Korea 2024; 31(2): 159-166

Published online August 20, 2024 https://doi.org/10.12674/ptk.2024.31.2.159

Copyright © Korean Research Society of Physical Therapy.

Effect of Forward Head Posture on Erector Spinae Muscle Activity

FEIFEI LI1 , BPT, Yoongyeom Choi1 , PT, BPT, Ilyoung Moon2 , PT, PhD, Chung-hwi Yi3 , PT, PhD

1Department of Physical Therapy, The Graduate School, Yonsei University, 2Wonju Severance Christian Hospital, 3Department of Physical Therapy, College of Software and Digital Healthcare Convergence, Yonsei University, Wonju, Korea

Correspondence to:Chung-hwi Yi
E-mail: pteagle@yonsei.ac.kr
https://orcid.org/0000-0003-2554-8083

Received: July 25, 2024; Revised: August 1, 2024; Accepted: August 1, 2024

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background: For instance, forward head posture (FHP), characterized by the forward movement of the head relative to the spine, places significant stress on the neck and upper back muscles, disrupting the biomechanical balance of the body.
Objects: The objective of this study was to probe the biomechanical effects of FHP on musculoskeletal health through a relative analysis of 26 adults diagnosed with FHP and 26 healthy controls.
Methods: In this study, we evaluated the biomechanical impacts of FHP. Participants adjusted their head positions and underwent muscle strength tests, including electromyography assessments and the Biering-Sørensen test for trunk muscle endurance. Data analysis was conducted using Kinovea (Kinovea) and IBM SPSS software ver. 26.0 (IBM Co.) to compare muscle activities between groups with normal and FHPs.
Results: The study shows that individuals with FHP have significantly lower muscle activity, endurance, and spinal extension in the erector spinae compared to those without, highlighting the detrimental effects of FHP on these muscles.
Conclusion: This study underscores the impact of FHP on erector spinae function and emphasizes the need for posture correction to enhance musculoskeletal health and guide future research on intervention strategies.

Keywords: Biomechanical phenomena, Mechanical stress, Posture

Fig 1.

Figure 1.Electrode placement for the T12, L3 paraspinal site.
Physical Therapy Korea 2024; 31: 159-166https://doi.org/10.12674/ptk.2024.31.2.159

Fig 2.

Figure 2.Biering-Sørensen test.
Physical Therapy Korea 2024; 31: 159-166https://doi.org/10.12674/ptk.2024.31.2.159

Fig 3.

Figure 3.Correlation between CVA and spine extension ROM of the FHP study group. CVA, craniovertebral angle; ROM, range of motion; FHP, forward head posture.
Physical Therapy Korea 2024; 31: 159-166https://doi.org/10.12674/ptk.2024.31.2.159

Fig 4.

Figure 4.Correlation between CVA and spine extension ROM of the non-FHP study group. CVA, craniovertebral angle; ROM, range of motion; FHP, forward head posture.
Physical Therapy Korea 2024; 31: 159-166https://doi.org/10.12674/ptk.2024.31.2.159

Table 1 . Descriptive statistics for age, weight, and height of the study group.

VariableFHPNon-FHPTotal
Age (y)22.26 ± 2.0824.53 ± 2.3123.40 ± 2.46
Weight (kg)68.65 ± 16.1868.60 ± 19.4168.63 ± 17.69
Height (cm)170.07 ± 8.46171.80 ± 9.20170.94 ± 8.79

Values are presented as mean ± standard deviation. FHP, forward head posture..


Table 2 . Descriptive statistics of the CVA and spine extension ROM of the non-FHP study group.

VariableMean ± SDMaximumMinimum
CVA (°)51.35 ± 1.1553.750.1
Spine extension ROM (°)43.50 ± 7.1960.034.0

SD, standard deviation; CVA, craniovertebral angle; ROM, range of motion; FHP, forward head posture..


Table 3 . Descriptive statistics of the CVA and spine extension ROM of the FHP study group.

VariableMean ± SDMaximumMinimum
CVA (°)37.09 ± 4.1245.827.6
Spine extension ROM (°)20.11 ± 7.0333.07.0

SD, standard deviation; CVA, craniovertebral angle; ROM, range of motion; FHP, forward head posture..


Table 4 . Endurance time in the FHP group and non-FHP group.

VariableMean ± SDMaximumMinimum
Non-FHP endurance time (s)92.00 ± 34.6645.8052.25
FHP endurance time (s)31.45 ± 12.40205.209.09

SD, standard deviation; FHP, forward head posture..


Table 5 . Maximum voluntary isometric contraction.

Muscle nameGroupp-value95% CI

FHPNon-FHP
Thoracic ES LTuV131.24 ± 42.75266.90 ± 56.65< 0.001*–163.61 to –107.70
Thoracic ES RTuV92.69 ± 41.04205.82 ± 65.25< 0.001*–143.49 to –82.76
Lumbar ES LTuV91.59 ± 29.33221.07 ± 202.970.002–210.25 to –48.80
Lumbar ES RTuV86.77 ± 34.72189.50 ± 60.25< 0.001*–130.12 to –75.33

CI, confidence interval; FHP, forward head posture; Thoracic ES LTuV, thoracic erector spinae on the left side; Thoracic ES RTuV, thoracic erector spinae on the right side; Lumbar ES LTuV, lumbar erector spinae on the left side; Lumbar ES RTuV, lumbar erector spinae on the right side. *p < 0.001..


Table 6 . Endurances.

Muscle nameGroupp-value95% CI

FHPNon-FHP
Thoracic ES LTuV (s)56.68 ± 14.88129.19 ± 41.61< 0.001**55.09 to –89.91
Thoracic ES RTuV (s)52.48 ± 16.83144.79 ± 30.410.004*30.85 to 153.76
Lumbar ES LTuV (s)54.42 ± 19.17104.90 ± 24.20< 0.001**38.31 to 62.63
Lumbar ES RTuV (s)52.30 ± 17.25106.29 ± 30.21< 0.001**40.28 to 67.69

CI, confidence interval; FHP, forward head posture; Thoracic ES LTuV, thoracic erector spinae on the left side; Thoracic ES RTuV, thoracic erector spinae on the right side; Lumbar ES LTuV, lumbar erector spinae on the left side; Lumbar ES RTuV, lumbar erector spinae on the right side. *p < 0.01, **p < 0.001..