Effect of two different manual therapy techniques for treatment of forward head posture: A comparative study
Abstract
Background: Forward head posture (FHP) is a misalignment of the head on trunk that makes the external moment longer by shifting the gravitational center in front of the load bearing axis causing stress on the suboccipital muscles with functional movement limitations and formation of myofascial trigger points (MTrPs). Objectives: To compare between suboccipital muscle inhibition technique (SMIT) and progressive pressure release technique (PPRT) on craniovertebral angle (CVA) and neck range of motion (ROM) in individuals with FHP and active suboccipital MTrPs. Methods: Forty-five subjects were randomly assigned in three groups. Group A was given postural correction exercise, group B received SMIT and postural correction exercise, and group C received suboccipital PPRT and postural correction exercise. Results: Statistical significance was found within and between groups in respect to ROM in all directions (P < 0.05) except for right and left side bending between groups A and B, which was P = 0.54 and P = 0.67, respectively. CVA had shown significant results for within and between groups (P < 0.05) except for group A versus group B (P = 0.41). Conclusion: Both techniques work to increase CVA and improve ROM in individuals with FHP. However, suboccipital PPRT has shown to be more effective.
Downloads
References
Aggarwal, A., Nair, A., Palekar, T. J., & Bhamare, D. (2022). Effect of suboccipital release technique in forward head posture: A comparative study. Medical Journal of Dr. DY Patil Vidyapeeth, 15(4), 534-537.
Antolinos-Campillo, P. J., Oliva-Pascual-Vaca, A., Rodríguez-Blanco, C., Heredia-Rizo, A. M., Espí-López, G. V., & Ricard, F. (2014). Short-term changes in median nerve neural tension after a suboccipital muscle inhibition technique in subjects with cervical whiplash: a randomised controlled trial. Physiotherapy, 100(3), 249-255.
Aparicio, É. Q., Quirante, L. B., Blanco, C. R., & Sendín, F. A. (2009). Immediate effects of the suboccipital muscle inhibition technique in subjects with short hamstring syndrome. Journal of Manipulative and Physiological Therapeutics, 32(4), 262-269.
Ceballos-Laita, L., Jiménez-del-Barrio, S., Marín-Zurdo, J., Moreno-Calvo, A., Marín-Boné, J., Albarova-Corral, M. I., & Estébanez-de-Miguel, E. (2022). Comparison of dry needling and self-stretching in muscle extensibility, pain, stiffness, and physical function in hip osteoarthritis: A randomized controlled trial. Complementary Therapies in Clinical Practice, 49, 101667.
Contractor, E. S., Shah, S., & Dave, P. (2019). To study the immediate effect of suboccipital muscle energy technique on craniovertebral angle and cranio-horizontal angle on subjects with forward head posture. International Journal of Health Sciences and Research, 9(3), 83-87.
Donatelli, R. A., & Wooden, M. J. (2009). Orthopaedic physical therapy. Elsevier health sciences.
Fletcher, J. P., & Bandy, W. D. (2008). Intrarater reliability of CROM measurement of cervical spine active range of motion in persons with and without neck pain. Journal of Orthopaedic & Sports Physical Therapy, 38(10), 640-645.
Fryer, G., & Hodgson, L. (2005). The effect of manual pressure release on myofascial trigger points in the upper trapezius muscle. Journal of Bodywork and movement therapies, 9(4), 248-255.
Gerwin, R. D., Shannon, S., Hong, C. Z., Hubbard, D., & Gevirtz, R. (1997). Interrater reliability in myofascial trigger point examination. Pain, 69(1-2), 65-73.
Hanten, W. P., Olson, S. L., Butts, N. L., & Nowicki, A. L. (2000). Effectiveness of a home program of ischemic pressure followed by sustained stretch for treatment of myofascial trigger points. Physical therapy, 80(10), 997-1003.
Harman, K., Hubley-Kozey, C. L., & Butler, H. (2005). Effectiveness of an exercise program to improve forward head posture in normal adults: a randomized, controlled 10-week trial. Journal of Manual & Manipulative Therapy, 13(3), 163-176.
Harman, K., Hubley-Kozey, C. L., & Butler, H. (2005). Effectiveness of an exercise program to improve forward head posture in normal adults: a randomized, controlled 10-week trial. Journal of Manual & Manipulative Therapy, 13(3), 163-176.
Heintz, M. M., & Hegedus, E. J. (2008). Multimodal management of mechanical neck pain using a treatment based classification system. Journal of Manual & Manipulative Therapy, 16(4), 217-224.
Hou, C. R., Tsai, L. C., Cheng, K. F., Chung, K. C., & Hong, C. Z. (2002). Immediate effects of various physical therapeutic modalities on cervical myofascial pain and trigger-point sensitivity. Archives of physical medicine and rehabilitation, 83(10), 1406-1414.
Hou, C. R., Tsai, L. C., Cheng, K. F., Chung, K. C., & Hong, C. Z. (2002). Immediate effects of various physical therapeutic modalities on cervical myofascial pain and trigger-point sensitivity. Archives of physical medicine and rehabilitation, 83(10), 1406-1414.
Im, B., Kim, Y., Chung, Y., & Hwang, S. (2015). Effects of scapular stabilization exercise on neck posture and muscle activation in individuals with neck pain and forward head posture. Journal of physical therapy science, 28(3), 951-955.
Jeong, E. D., Kim, C. Y., Kim, S. M., Lee, S. J., & Kim, H. D. (2018). Short-term effects of the suboccipital muscle inhibition technique and cranio-cervical flexion exercise on hamstring flexibility, cranio-vertebral angle, and range of motion of the cervical spine in subjects with neck pain: A randomized controlled trial. Journal of Back and Musculoskeletal Rehabilitation, 31(6), 1025-1034.
Kendall, F. P., McCreary, E. K., & Provance, P. G. (1993). Tests for length of hip flexor muscles. Muscles: Testing and Function. 4th ed. Baltimore, MD: Williams & Wilkins, 27-68.
Kim, B. B., Lee, J. H., Jeong, H. J., & Cynn, H. S. (2016). Effects of suboccipital release with craniocervical flexion exercise on craniocervical alignment and extrinsic cervical muscle activity in subjects with forward head posture. Journal of Electromyography and Kinesiology, 30, 31-37.
Kim, D. H., Kim, C. J., & Son, S. M. (2018). Neck pain in adults with forward head posture: effects of craniovertebral angle and cervical range of motion. Osong public health and research perspectives, 9(6), 309.
Kong, Y. S., Kim, Y. M., & Shim, J. M. (2017). The effect of modified cervical exercise on smartphone users with forward head posture. Journal of physical therapy science, 29(2), 328-331.
Kwan, C. S., Worrilow, C. C., Kovelman, I., & Kuklinski, J. M. (2012). Using suboccipital release to control singultus: a unique, safe, and effective treatment. The American journal of emergency medicine, 30(3), 514.e5-7.
Lee, N. G., & You, J. H. (2007). Effects of trigger point pressure release on pain modulation and associated movement impairments in a patient with severe acute myofascial pain syndrome: a case report. The Pain Clinic, 19(2), 83-87.
Mamania, J. A., Anap, D. B., & Tanksale, D. (2017). Validity and Reliability of'on Protractor'smartphone Application for Measurement of Craniovertebral and Cranio-Horizontal Angle. International journal of physiotherapy, 4(4), 207-211.
Molaeifar, S., Yazdani, F., Yoosefinejad, A. K., & Karimi, M. T. (2021). Correlation between craniovertebral angle in the sagittal plane and angles and indices measured in the frontal plane at the moment of inducing forward head posture. Work, 68(4), 1221-1227.
Mylonas, K., Angelopoulos, P., Billis, E., Tsepis, E., Tsekoura, M., & Fousekis, K. (2021). The effects of therapeutic exercise in improving forward head posture and functionality in patients with neck pain A literature update. Archives of Hellenic Medicine/Arheia Ellenikes Iatrikes, 38(5), 612-617.
Oliveira-Campelo, N. M., Rubens-Rebelatto, J., MartÍn-Vallejo, F. J., Alburquerque-SendÍn, F., & Fernández-de-las-Peñas, C. (2010). The immediate effects of atlanto-occipital joint manipulation and suboccipital muscle inhibition technique on active mouth opening and pressure pain sensitivity over latent myofascial trigger points in the masticatory muscles. Journal of orthopaedic & sports physical therapy, 40(5), 310-317.
Ramalingam, V., & Subramaniam, A. (2019). Prevalence and associated risk factors of forward head posture among university students. Indian Journal of Public Health Research & Development, 10(7), 775-780.
Ramezani, E., & Arab, A. M. (2017). The effect of suboccipital myofascial release technique on cervical muscle strength of patients with cervicogenic headache. Physical Treatments-Specific Physical Therapy Journal, 7(1), 19-28.
Ramieri, A., Costanzo, G., & Miscusi, M. (2022). Functional Anatomy and Biomechanics of the Cervical Spine. In: Menchetti, P.P.M. (eds) Cervical Spine. Springer, Cham.
Rizo, A. M. H., Pascual-Vaca, Á. O., Cabello, M. A., Blanco, C. R., Pozo, F. P., & Carrasco, A. L. (2012). Immediate effects of the suboccipital muscle inhibition technique in craniocervical posture and greater occipital nerve mechanosensitivity in subjects with a history of orthodontia use: a randomized trial. Journal of manipulative and physiological therapeutics, 35(6), 446-453.
Ruivo, R. M., Pezarat-Correia, P., & Carita, A. I. (2017). Effects of a resistance and stretching training program on forward head and protracted shoulder posture in adolescents. Journal of manipulative and physiological therapeutics, 40(1), 1-10.
Sedighi, A., Ansari, N. N., & Naghdi, S. (2017). Comparison of acute effects of superficial and deep dry needling into trigger points of suboccipital and upper trapezius muscles in patients with cervicogenic headache. Journal of bodywork and movement therapies, 21(4), 810-814.
Seidi, F. (2014). The effect of a 12-week corrective exercises program on Forward head and shoulder deformities. Studies in Sport Medicine, 5(14), 31-44.
Sheikhhoseini, R., Shahrbanian, S., Sayyadi, P., & O’Sullivan, K. (2018). Effectiveness of therapeutic exercise on forward head posture: a systematic review and meta-analysis. Journal of manipulative and physiological therapeutics, 41(6), 530-539.
Simons, D. G. (2002). Understanding effective treatments of myofascial trigger points. Journal of Bodywork and movement therapies, 6(2), 81-88.
Simons, D. G., Travell, J., & Simons, L. S. (1999). Myofascial pain and dysfunction: the trigger point manual volume 1 (2nd edition). Book review. Acupuncture in Medicine, 17(1), 72.
Takla, M. K., Atwa, O. A., & El-Latif, N. A. (2017). Progressive pressure release versus dry needling on cervical latent trigger points. Bulletin of Faculty of Physical Therapy, 22(1), 15-22.
Travell, J. G., & Simons, D. G. (1992). Myofascial pain and dysfunction: the trigger point manual (Vol. 2). Lippincott Williams & Wilkins.
Vernon, H., & Schneider, M. (2009). Chiropractic management of myofascial trigger points and myofascial pain syndrome: a systematic review of the literature. Journal of manipulative and physiological therapeutics, 32(1), 14-24.
Yip, C. H. T., Chiu, T. T. W., & Poon, A. T. K. (2008). The relationship between head posture and severity and disability of patients with neck pain. Manual therapy, 13(2), 148-154.
The works and papers that are published in this Journal are subject to the following terms:
1. The Publication Service of the University of Murcia (the publisher) has the Publication Rights (Copyright) to the published papers and works, and favors and permits the reusing of the same under the license indicated in point 2.
© Servicio de Publicaciones, Universidad de Murcia, 2013
2. The papers and works are to be published in the digital edition of the Journal under the license Creative Commons Reconocimiento-No Comercial-Sin Obra Derivada 3.0 España (legal text). The copying, using, spreading, transmitting and publicly displaying of the papers, works or publication are permitted as long as: i) the authors and original sources (Journal, publisher and URL of the publication) are quoted; ii) it is not used for commercial benefit; iii) the existence and specifications of this users license are mentioned.
3. Conditions of Self-Archiving. It is permitted and encouraged that the authors spread electronically the pre-print (before printing) and/or post-print (the revised, evaluated and accepted) versions of their papers or works before their publication since this favors their circulation and early diffusion and therefore can help increase their citation and quotation, and also there reach through the academic community.
The works and papers that are published in this Journal are subject to the following terms:
1. The Publication Service of the University of Murcia (the publisher) has the Publication Rights (Copyright) to the published papers and works, and favors and permits the reusing of the same under the license indicated in point 2.
© Servicio de Publicaciones, Universidad de Murcia, 2013
2. The papers and works are to be published in the digital edition of the Journal under the license Creative Commons Reconocimiento-No Comercial-Sin Obra Derivada 3.0 España (legal text). The copying, using, spreading, transmitting and publicly displaying of the papers, works or publication are permitted as long as: i) the authors and original sources (Journal, publisher and URL of the publication) are quoted; ii) it is not used for commercial benefit; iii) the existence and specifications of this users license are mentioned.
3. Conditions of Self-Archiving. It is permitted and encouraged that the authors spread electronically the pre-print (before printing) and/or post-print (the revised, evaluated and accepted) versions of their papers or works before their publication since this favors their circulation and early diffusion and therefore can help increase their citation and quotation, and also there reach through the academic community.