Immediate effect of forward head rounded shoulder posture corrective orthosis on craniovertebral and protraction-retraction angles

authors:

avatar Reza Hamzelouie , avatar Alireza Khaghani , * , avatar Fatemeh Azadinia

Koomesh: Vol.23, issue 3; 365-371
published online: June 02, 2021
article type: Research Article
received: May 01, 2020
accepted: November 02, 2020

how to cite: Hamzelouie R, Khaghani A, Azadinia F. Immediate effect of forward head rounded shoulder posture corrective orthosis on craniovertebral and protraction-retraction angles. koomesh. 2021;23(3):e149955. 

Abstract

Introduction: Forward head posture, which occurs often in conjunction with increased curvature in the upper body and rounded shoulder, is one of the most common postural deviations. Over time, this poor posture can contribute to the development of neck pain and shoulder dysfunction. Therefore, the purpose of this study is to design and develop a forward head rounded shoulder posture corrective orthosis (FHRSO) and its immediate effect on craniovertebral and protraction-retraction angles in people with postural deviations in the upper body. Materials and Methods: Thirty men aged between 18 and 60 years with a forward head posture disorder (craniovertebral angle less than 42.5 degrees) participated in this study. Correspondingly, the immediate effect of the newly designed orthosis, namely FHRSO was investigated via measuring two variables, craniovertebral and protraction-retraction angles in the standing position by taking lateral view photographs. Results: Both craniovertebral and protraction-retraction angles were significantly increased following the FHRSO wearing in comparison with no orthosis condition (P

References

  • 1.

    [1] Kendall FP, Kendall H, Boynton DA. Posture and pain. Baltimore: Williams and Wilkins; 1952.

  • 2.

    [2] Eitivipart AC, Viriyarojanakul S, Redhead L. Musculoskeletal disorder and pain associated with smartphone use: A systematic review of biomechanical evidence. Hong Kong Physiother J 2018; 38: 77-90.

  • 3.

    https://doi.org/10.1142/S1013702518300010.

  • 4.

    PMid:30930581 PMCid:PMC6405356.

  • 5.

    [3] Griegel-Morris P, Larson K, Mueller-Klaus K, Oatis CA. Incidence of common postural abnormalities in the cervical, shoulder, and thoracic regions and their association with pain in two age groups of healthy subjects. Phys Ther 1992; 72: 425-431.

  • 6.

    https://doi.org/10.1093/ptj/72.6.425.

  • 7.

    PMid:1589462.

  • 8.

    [4] Watson DH, Trott PH. Cervical headache: an investigation of natural head posture and upper cervical flexor muscle performance. Cephalalgia 1993; 13: 272-284.

  • 9.

    [5] Janda V. Some aspects of extracranial causes of facial pain. The Journal of Prosthetic Dentistry 1986.

  • 10.

    56: 484-487.

  • 11.

    [6] Sahrmann S. Movement impairment syndromes of the shoulder girdle. In: Sahrmann S, editor. Diagnosis and treatment of movement impairment syndromes. St Louis: Mosby; 2001; 193-245.

  • 12.

    [7] Lee Y, Gong W, Jeon J. Correlations between forward head posture, range of motion of cervicospinal Area, resting state, and concentrations of the brain. J Phys Ther Sci 2011; 23: 481-484.

  • 13.

    https://doi.org/10.1589/jpts.23.481.

  • 14.

    [8] Norkin CC, Levangie PK. Joint structure & function: a Comprehensive analysis. 1992: F A Davis Philadelphia.

  • 15.

    [9] Lynch SS, Thigpen CA, Mihalik JP, Prentice WE, Padua D. The effects of an exercise intervention on forward head and rounded shoulder postures in elite swimmers. Br J Sports Med 2010; 44: 376-381.

  • 16.

    https://doi.org/10.1136/bjsm.2009.066837.

  • 17.

    PMid:20371564.

  • 18.

    [10] Bae WS, Lee HO, Shin JW, Lee KC. The effect of middle and lower trapezius strength exercises and levator scapulaeand upper trapezius stretching exercises in upper crossed syndrome. J Phys Ther Sci 2016; 28: 1636-1639.

  • 19.

    https://doi.org/10.1589/jpts.28.1636.

  • 20.

    PMid:27313388 PMCid:PMC4905927.

  • 21.

    [11] Kim TW, An DI, Lee HY, Jeong HY, Kim DH, Sung YH. Effects of elastic band exercise on subjects with rounded shoulder posture and forward head posture. J Phys Ther Sci 2016; 28: 1733-1737.

  • 22.

    https://doi.org/10.1589/jpts.28.1733.

  • 23.

    PMid:27390405 PMCid:PMC4932046.

  • 24.

    [12] Hinman MR. Comparison of thoracic kyphosis and postural stiffness in younger and older women. Spine J 2004; 4: 413-417.

  • 25.

    https://doi.org/10.1016/j.spinee.2004.01.002.

  • 26.

    PMid:15246302.

  • 27.

    [13] Cole AK, McGrath ML, Harrington SE, Padua DA, Rucinski TJ, Prentice WE. Scapular bracing and alteration of posture and muscle activity in overhead athletes with poor posture. J Athl Train 2013; 48: 12-24.

  • 28.

    https://doi.org/10.4085/1062-6050-48.1.13.

  • 29.

    PMid:23672321 PMCid:PMC3554027.

  • 30.

    [14] Manor J, Hibberd E, Petschauer M, Myers J. Acute effects of posture shirts on rounded-shoulder and forward-head posture in college students. J Sport Rehabil 2016; 25: 309-314.

  • 31.

    https://doi.org/10.1123/jsr.2014-0304.

  • 32.

    PMid:27705072.

  • 33.

    [15] Hosseinabadi M, Kamyab M, Azadinia F, Sarrafzadeh J. Effect of a Spinomed orthosis on balance performance, spinal alignment, joint position sense and back muscle endurance in elderly people with hyperkyphotic posture: A randomized controlled trial. Prosthet Orthot Int 2020; 44: 234-244.

  • 34.

    https://doi.org/10.1177/0309364620923816.

  • 35.

    PMid:32507057.

  • 36.

    [16] Gurudut P, Gauns SV. Effect of kinesio taping on neck flexors and Craniovertebral Angle in Subjects with forward head posture: A randomized controlled trial. Int J Physiother Res 2016; 4: 1728-1735.

  • 37.

    https://doi.org/10.16965/ijpr.2016.176.

  • 38.

    [17] Raine S, Twomey LT. Head and shoulder posture variations in 160 asymptomatic women and men. Arch Phys Med Rehabil 1997; 78: 1215-1223.

  • 39.

    https://doi.org/10.1016/S0003-9993(97)90335-X.

  • 40.

    [18] Yoon TL, Cynn HS, Choi SA, Lee JH, Chio BS. Effect of the craniocervical brace on craniocervical angle, thoracic kyphosis angle, and trunk extensor muscle activity during typing in subjects with forward head posture. Work 2016; 55: 163-169.

  • 41.

    https://doi.org/10.3233/WOR-162378.

  • 42.

    PMid:27612059.

  • 43.

    [19] Falla D, Jull G, Russell T, Vicenzino B, Hodges P. Effect of neck exercise on sitting posture in patients with chronic neck pain. Phys Ther 2007; 87: 408-417.

  • 44.

    https://doi.org/10.2522/ptj.20060009.

  • 45.

    PMid:17341512.

  • 46.

    [20] Yip CH, Chiu TT, Poon AT. The relationship between head posture and severity and disability of patients with neck pain. Manual Ther 2008; 13: 148-154.

  • 47.

    https://doi.org/10.1016/j.math.2006.11.002.

  • 48.

    PMid:17368075.

  • 49.

    [21] Cuccia AM, Carola C. The measurement of craniocervical posture: A simple method to evaluate head position. Int J Pediatr Otorhinolaryngol 2009; 73: 1732-1736.

  • 50.

    https://doi.org/10.1016/j.ijporl.2009.09.011.

  • 51.

    PMid:19786307.

  • 52.

    [22] Salahzadeh Z, Maroufi N, Ahmadi A, Behtash H, Razmjoo A, Gohari M, Parnianpour M. Assessment of forward head posture in females: observational and photogrammetry methods. J Back Musculoskelet Rehabil 2014; 27: 131-139.

  • 53.

    https://doi.org/10.3233/BMR-130426.

  • 54.

    PMid:23963268.

  • 55.

    [23] Sun A, Yeo HG, Kim TU, Hyun JK, Kim JY. Radiologic assessment of forward head posture and its relation to myofascial pain syndrome. Ann Rehabil Med 2014; 38: 821-826.

  • 56.

    https://doi.org/10.5535/arm.2014.38.6.821.

  • 57.

    PMid:25566482 PMCid:PMC4280379.

  • 58.

    [24] Ruivo RM, Pezarat-Correia P, Carita AI. Cervical and shoulder postural assessment of adolescents between 15 and 17 years old and association with upper quadrant pain. Braz J Phys Ther 2014; 18: 364-371.

  • 59.

    https://doi.org/10.1590/bjpt-rbf.2014.0027.

  • 60.

    PMid:25054381 PMCid:PMC4183261.

  • 61.

    [25] Wong CK, Coleman D, diPersia V, Song J, Wright D. The effects of manual treatment on rounded-shoulder posture, and associated muscle strength. J Bodyw Mov Ther 2010; 14: 326-333.

  • 62.

    https://doi.org/10.1016/j.jbmt.2009.05.001.

  • 63.

    PMid:20850039.

  • 64.

    [26] Booth FW. Effect of limb immobilization on skeletal muscle. J Appl Physiol Respir Environ Exerc Physiol 1982; 52: 1113-1118.

  • 65.

    https://doi.org/10.1152/jappl.1982.52.5.1113.

  • 66.

    PMid:7047468.

  • 67.

    [27] Raine S, Twomey LT. Head and shoulder posture variations in 160 asymptomaticwomen and men. Arch Phys Med Rehabil 1997; 78: 1215-1223.

  • 68.

    https://doi.org/10.1016/S0003-9993(97)90335-X.

  • 69.

    [28] Chansirinukor W, Wilson D, Grimmer K, Dansie B. Effects of backpacks on students: Measurement of cervical and shoulder posture. Aust J Physiother 2001; 47: 110-116.

  • 70.

    https://doi.org/10.1016/S0004-9514(14)60302-0.

  • 71.

    [29] Thigpen CA, Padua DA, Michener LA, Guskiewicz K, Giuliani C, Keener JD, Stergiou N. Head and shoulder posture affect scapular mechanics and muscle activity in overhead tasks. J Electromyogr Kinesiol 2010; 20: 701-709.

  • 72.

    https://doi.org/10.1016/j.jelekin.2009.12.003.

  • 73.

    PMid:20097090.

  • 74.

    [30] Shaghayegh fard B, Ahmadi A, Maroufi N, Sarrafzadeh J. Evaluation of forward head posture in sitting and standing positions. Eur Spine J 2016; 25: 3577-3582.

  • 75.

    https://doi.org/10.1007/s00586-015-4254-x.

  • 76.

    PMid:26476717.

  • 77.

    [31] Dimitriadis Z, Podogyros G, Polyviou D, Tasopoulos I, Passa K. The reliability of lateral photography for the assessment of the forward head posture through four different angle-based analysis methods in healthy individuals. Musculoskeletal Care 2015; 13: 179-186.

  • 78.

    https://doi.org/10.1002/msc.1095.

  • 79.

    PMid:25640070.

  • 80.

    [32] Fon GJ, Pitt MJ, Thies Jr AC. Thoracic kyphosis: Range in normal subjects. Am J Roentgenol 1980; 134: 979-983.

  • 81.

    https://doi.org/10.2214/ajr.134.5.979.

  • 82.

    PMid:6768276.

  • 83.

    [33] Fazli F, Farahmand B, Azadinia F, Amiri A. The effect of ergonomic latex pillow on head and neck posture and muscle endurance in patients with cervical spondylosis: a randomized controlled trial. J Chiropr Med 2019; 18: 155-162.

  • 84.

    https://doi.org/10.1016/j.jcm.2019.02.003.

  • 85.

    PMid:32874156 PMCid:PMC7452254.

  • 86.

    [34] Ghorbani F, Kamyab M, Azadinia F, Hajiaghaei B. Open-design collar vs. Conventional Philadelphia collar regarding user satisfaction and cervical range of motion in asymptomatic adults. Am J Phys Med Rehabil 2016; 95: 291-299.

  • 87.

    https://doi.org/10.1097/PHM.0000000000000374.

  • 88.

    PMid:26390392.

  • 89.

    [35] Sharpe KP, Rao S, Ziogas A. Evaluation of the effectiveness of the Minerva cervicothoracic orthosis. Spine 1995; 20: 1475-1479.

  • 90.

    https://doi.org/10.1097/00007632-199507000-00006.

  • 91.

    PMid:8623066.

  • 92.

    [36] Harman K, Hubley-Kozey CL, Butler H. Effectiveness of an exercise program to improve forward head posture in normal adults: a randomized, controlled 10-week trial. J Manual Manip Ther 2005; 13: 163-176.

  • 93.

    https://doi.org/10.1179/106698105790824888.

  • 94.

    [37] Lee JH, Cynn HS, Yoon TL, Ko CH, Choi WJ, Choi SA, Choi BS. The effect of scapular posterior tilt exercise, pectoralis minor stretching, and shoulder brace on scapular alignment and muscles activity in subjects with round-shoulder posture. J Electromyogr Kinesiol 2015; 25: 107-114.

  • 95.

    https://doi.org/10.1016/j.jelekin.2014.10.010.

  • 96.

    PMid:25467545.

  • 97.

    [38] Youssef AS, Xia N, Emara ST, Moustafa IM, Huang X. Addition of a new three-dimensional adjustable cervical thoracic orthosis to a multi-modal program in the treatment of nonspecific neck pain: study protocol for a randomised pilot trial. Trials 2019; 20: 248.

  • 98.

    https://doi.org/10.1186/s13063-019-3337-0.

  • 99.

    PMid:31036033 PMCid:PMC6489278.

  • 100.

    [39] Schuldt K, Ekholm J, Harms-Ringdahl K, Ne'meth G, Arborelius UP. Effects of changes in sitting work posture on static neck and shoulder muscle activity. Ergonomics 1986; 29: 1525-1537.

  • 101.

    https://doi.org/10.1080/00140138608967266.

  • 102.

    PMid:3816746.

  • 103.

    [40] Kotwicki T, Cheneau J. Biomechanical action of a corrective brace on thoracic idiopathic scoliosis: Cheneau 2000 orthosis. Disabil Rehabil Assist Technol 2008; 3: 146-153.

  • 104.

    https://doi.org/10.1080/17483100801905744.

  • 105.

    PMid:18465398.

  • 106.

    [41] Vasavada AN, Li S, Delp SL. Influence of muscle morphometry and moment arms on the moment-generating capacity of human neck muscles. Spine 1998; 23: 412-422.

  • 107.

    https://doi.org/10.1097/00007632-199802150-00002.

  • 108.

    PMid:9516695.

  • 109.

    [42] Vasavada AN, Nevins DD, Monda SM, Hughes E, Lin DC. Gravitational demand on the neck musculature during tablet computer use. Ergonomics 2015; 58: 990-1004.

  • 110.

    https://doi.org/10.1080/00140139.2015.1005166.

  • 111.

    PMid:25643042.

  • 112.

    [43] Quinzi F, Scalia M, Giombini A, Cagno AD, Pigozzi F, Casasco M, Macaluso A. The effect of an orthotic device for balancing neck muscles during daily office tasks. Human Factors 2019; 61: 722-735.

  • 113.

    https://doi.org/10.1177/0018720818814957.

  • 114.

    PMid:30608175.

  • 115.

    [1] Kendall FP, Kendall H, Boynton DA. Posture and pain. Baltimore: Williams and Wilkins; 1952.

  • 116.

    [2] Eitivipart AC, Viriyarojanakul S, Redhead L. Musculoskeletal disorder and pain associated with smartphone use: A systematic review of biomechanical evidence. Hong Kong Physiother J 2018; 38: 77-90.

  • 117.

    https://doi.org/10.1142/S1013702518300010.

  • 118.

    PMid:30930581 PMCid:PMC6405356.

  • 119.

    [3] Griegel-Morris P, Larson K, Mueller-Klaus K, Oatis CA. Incidence of common postural abnormalities in the cervical, shoulder, and thoracic regions and their association with pain in two age groups of healthy subjects. Phys Ther 1992; 72: 425-431.

  • 120.

    https://doi.org/10.1093/ptj/72.6.425.

  • 121.

    PMid:1589462.

  • 122.

    [4] Watson DH, Trott PH. Cervical headache: an investigation of natural head posture and upper cervical flexor muscle performance. Cephalalgia 1993; 13: 272-284.

  • 123.

    [5] Janda V. Some aspects of extracranial causes of facial pain. The Journal of Prosthetic Dentistry 1986.

  • 124.

    56: 484-487.

  • 125.

    [6] Sahrmann S. Movement impairment syndromes of the shoulder girdle. In: Sahrmann S, editor. Diagnosis and treatment of movement impairment syndromes. St Louis: Mosby; 2001; 193-245.

  • 126.

    [7] Lee Y, Gong W, Jeon J. Correlations between forward head posture, range of motion of cervicospinal Area, resting state, and concentrations of the brain. J Phys Ther Sci 2011; 23: 481-484.

  • 127.

    https://doi.org/10.1589/jpts.23.481.

  • 128.

    [8] Norkin CC, Levangie PK. Joint structure & function: a Comprehensive analysis. 1992: F A Davis Philadelphia.

  • 129.

    [9] Lynch SS, Thigpen CA, Mihalik JP, Prentice WE, Padua D. The effects of an exercise intervention on forward head and rounded shoulder postures in elite swimmers. Br J Sports Med 2010; 44: 376-381.

  • 130.

    https://doi.org/10.1136/bjsm.2009.066837.

  • 131.

    PMid:20371564.

  • 132.

    [10] Bae WS, Lee HO, Shin JW, Lee KC. The effect of middle and lower trapezius strength exercises and levator scapulaeand upper trapezius stretching exercises in upper crossed syndrome. J Phys Ther Sci 2016; 28: 1636-1639.

  • 133.

    https://doi.org/10.1589/jpts.28.1636.

  • 134.

    PMid:27313388 PMCid:PMC4905927.

  • 135.

    [11] Kim TW, An DI, Lee HY, Jeong HY, Kim DH, Sung YH. Effects of elastic band exercise on subjects with rounded shoulder posture and forward head posture. J Phys Ther Sci 2016; 28: 1733-1737.

  • 136.

    https://doi.org/10.1589/jpts.28.1733.

  • 137.

    PMid:27390405 PMCid:PMC4932046.

  • 138.

    [12] Hinman MR. Comparison of thoracic kyphosis and postural stiffness in younger and older women. Spine J 2004; 4: 413-417.

  • 139.

    https://doi.org/10.1016/j.spinee.2004.01.002.

  • 140.

    PMid:15246302.

  • 141.

    [13] Cole AK, McGrath ML, Harrington SE, Padua DA, Rucinski TJ, Prentice WE. Scapular bracing and alteration of posture and muscle activity in overhead athletes with poor posture. J Athl Train 2013; 48: 12-24.

  • 142.

    https://doi.org/10.4085/1062-6050-48.1.13.

  • 143.

    PMid:23672321 PMCid:PMC3554027.

  • 144.

    [14] Manor J, Hibberd E, Petschauer M, Myers J. Acute effects of posture shirts on rounded-shoulder and forward-head posture in college students. J Sport Rehabil 2016; 25: 309-314.

  • 145.

    https://doi.org/10.1123/jsr.2014-0304.

  • 146.

    PMid:27705072.

  • 147.

    [15] Hosseinabadi M, Kamyab M, Azadinia F, Sarrafzadeh J. Effect of a Spinomed orthosis on balance performance, spinal alignment, joint position sense and back muscle endurance in elderly people with hyperkyphotic posture: A randomized controlled trial. Prosthet Orthot Int 2020; 44: 234-244.

  • 148.

    https://doi.org/10.1177/0309364620923816.

  • 149.

    PMid:32507057.

  • 150.

    [16] Gurudut P, Gauns SV. Effect of kinesio taping on neck flexors and Craniovertebral Angle in Subjects with forward head posture: A randomized controlled trial. Int J Physiother Res 2016; 4: 1728-1735.

  • 151.

    https://doi.org/10.16965/ijpr.2016.176.

  • 152.

    [17] Raine S, Twomey LT. Head and shoulder posture variations in 160 asymptomatic women and men. Arch Phys Med Rehabil 1997; 78: 1215-1223.

  • 153.

    https://doi.org/10.1016/S0003-9993(97)90335-X.

  • 154.

    [18] Yoon TL, Cynn HS, Choi SA, Lee JH, Chio BS. Effect of the craniocervical brace on craniocervical angle, thoracic kyphosis angle, and trunk extensor muscle activity during typing in subjects with forward head posture. Work 2016; 55: 163-169.

  • 155.

    https://doi.org/10.3233/WOR-162378.

  • 156.

    PMid:27612059.

  • 157.

    [19] Falla D, Jull G, Russell T, Vicenzino B, Hodges P. Effect of neck exercise on sitting posture in patients with chronic neck pain. Phys Ther 2007; 87: 408-417.

  • 158.

    https://doi.org/10.2522/ptj.20060009.

  • 159.

    PMid:17341512.

  • 160.

    [20] Yip CH, Chiu TT, Poon AT. The relationship between head posture and severity and disability of patients with neck pain. Manual Ther 2008; 13: 148-154.

  • 161.

    https://doi.org/10.1016/j.math.2006.11.002.

  • 162.

    PMid:17368075.

  • 163.

    [21] Cuccia AM, Carola C. The measurement of craniocervical posture: A simple method to evaluate head position. Int J Pediatr Otorhinolaryngol 2009; 73: 1732-1736.

  • 164.

    https://doi.org/10.1016/j.ijporl.2009.09.011.

  • 165.

    PMid:19786307.

  • 166.

    [22] Salahzadeh Z, Maroufi N, Ahmadi A, Behtash H, Razmjoo A, Gohari M, Parnianpour M. Assessment of forward head posture in females: observational and photogrammetry methods. J Back Musculoskelet Rehabil 2014; 27: 131-139.

  • 167.

    https://doi.org/10.3233/BMR-130426.

  • 168.

    PMid:23963268.

  • 169.

    [23] Sun A, Yeo HG, Kim TU, Hyun JK, Kim JY. Radiologic assessment of forward head posture and its relation to myofascial pain syndrome. Ann Rehabil Med 2014; 38: 821-826.

  • 170.

    https://doi.org/10.5535/arm.2014.38.6.821.

  • 171.

    PMid:25566482 PMCid:PMC4280379.

  • 172.

    [24] Ruivo RM, Pezarat-Correia P, Carita AI. Cervical and shoulder postural assessment of adolescents between 15 and 17 years old and association with upper quadrant pain. Braz J Phys Ther 2014; 18: 364-371.

  • 173.

    https://doi.org/10.1590/bjpt-rbf.2014.0027.

  • 174.

    PMid:25054381 PMCid:PMC4183261.

  • 175.

    [25] Wong CK, Coleman D, diPersia V, Song J, Wright D. The effects of manual treatment on rounded-shoulder posture, and associated muscle strength. J Bodyw Mov Ther 2010; 14: 326-333.

  • 176.

    https://doi.org/10.1016/j.jbmt.2009.05.001.

  • 177.

    PMid:20850039.

  • 178.

    [26] Booth FW. Effect of limb immobilization on skeletal muscle. J Appl Physiol Respir Environ Exerc Physiol 1982; 52: 1113-1118.

  • 179.

    https://doi.org/10.1152/jappl.1982.52.5.1113.

  • 180.

    PMid:7047468.

  • 181.

    [27] Raine S, Twomey LT. Head and shoulder posture variations in 160 asymptomaticwomen and men. Arch Phys Med Rehabil 1997; 78: 1215-1223.

  • 182.

    https://doi.org/10.1016/S0003-9993(97)90335-X.

  • 183.

    [28] Chansirinukor W, Wilson D, Grimmer K, Dansie B. Effects of backpacks on students: Measurement of cervical and shoulder posture. Aust J Physiother 2001; 47: 110-116.

  • 184.

    https://doi.org/10.1016/S0004-9514(14)60302-0.

  • 185.

    [29] Thigpen CA, Padua DA, Michener LA, Guskiewicz K, Giuliani C, Keener JD, Stergiou N. Head and shoulder posture affect scapular mechanics and muscle activity in overhead tasks. J Electromyogr Kinesiol 2010; 20: 701-709.

  • 186.

    https://doi.org/10.1016/j.jelekin.2009.12.003.

  • 187.

    PMid:20097090.

  • 188.

    [30] Shaghayegh fard B, Ahmadi A, Maroufi N, Sarrafzadeh J. Evaluation of forward head posture in sitting and standing positions. Eur Spine J 2016; 25: 3577-3582.

  • 189.

    https://doi.org/10.1007/s00586-015-4254-x.

  • 190.

    PMid:26476717.

  • 191.

    [31] Dimitriadis Z, Podogyros G, Polyviou D, Tasopoulos I, Passa K. The reliability of lateral photography for the assessment of the forward head posture through four different angle-based analysis methods in healthy individuals. Musculoskeletal Care 2015; 13: 179-186.

  • 192.

    https://doi.org/10.1002/msc.1095.

  • 193.

    PMid:25640070.

  • 194.

    [32] Fon GJ, Pitt MJ, Thies Jr AC. Thoracic kyphosis: Range in normal subjects. Am J Roentgenol 1980; 134: 979-983.

  • 195.

    https://doi.org/10.2214/ajr.134.5.979.

  • 196.

    PMid:6768276.

  • 197.

    [33] Fazli F, Farahmand B, Azadinia F, Amiri A. The effect of ergonomic latex pillow on head and neck posture and muscle endurance in patients with cervical spondylosis: a randomized controlled trial. J Chiropr Med 2019; 18: 155-162.

  • 198.

    https://doi.org/10.1016/j.jcm.2019.02.003.

  • 199.

    PMid:32874156 PMCid:PMC7452254.

  • 200.

    [34] Ghorbani F, Kamyab M, Azadinia F, Hajiaghaei B. Open-design collar vs. Conventional Philadelphia collar regarding user satisfaction and cervical range of motion in asymptomatic adults. Am J Phys Med Rehabil 2016; 95: 291-299.

  • 201.

    https://doi.org/10.1097/PHM.0000000000000374.

  • 202.

    PMid:26390392.

  • 203.

    [35] Sharpe KP, Rao S, Ziogas A. Evaluation of the effectiveness of the Minerva cervicothoracic orthosis. Spine 1995; 20: 1475-1479.

  • 204.

    https://doi.org/10.1097/00007632-199507000-00006.

  • 205.

    PMid:8623066.

  • 206.

    [36] Harman K, Hubley-Kozey CL, Butler H. Effectiveness of an exercise program to improve forward head posture in normal adults: a randomized, controlled 10-week trial. J Manual Manip Ther 2005; 13: 163-176.

  • 207.

    https://doi.org/10.1179/106698105790824888.

  • 208.

    [37] Lee JH, Cynn HS, Yoon TL, Ko CH, Choi WJ, Choi SA, Choi BS. The effect of scapular posterior tilt exercise, pectoralis minor stretching, and shoulder brace on scapular alignment and muscles activity in subjects with round-shoulder posture. J Electromyogr Kinesiol 2015; 25: 107-114.

  • 209.

    https://doi.org/10.1016/j.jelekin.2014.10.010.

  • 210.

    PMid:25467545.

  • 211.

    [38] Youssef AS, Xia N, Emara ST, Moustafa IM, Huang X. Addition of a new three-dimensional adjustable cervical thoracic orthosis to a multi-modal program in the treatment of nonspecific neck pain: study protocol for a randomised pilot trial. Trials 2019; 20: 248.

  • 212.

    https://doi.org/10.1186/s13063-019-3337-0.

  • 213.

    PMid:31036033 PMCid:PMC6489278.

  • 214.

    [39] Schuldt K, Ekholm J, Harms-Ringdahl K, Ne'meth G, Arborelius UP. Effects of changes in sitting work posture on static neck and shoulder muscle activity. Ergonomics 1986; 29: 1525-1537.

  • 215.

    https://doi.org/10.1080/00140138608967266.

  • 216.

    PMid:3816746.

  • 217.

    [40] Kotwicki T, Cheneau J. Biomechanical action of a corrective brace on thoracic idiopathic scoliosis: Cheneau 2000 orthosis. Disabil Rehabil Assist Technol 2008; 3: 146-153.

  • 218.

    https://doi.org/10.1080/17483100801905744.

  • 219.

    PMid:18465398.

  • 220.

    [41] Vasavada AN, Li S, Delp SL. Influence of muscle morphometry and moment arms on the moment-generating capacity of human neck muscles. Spine 1998; 23: 412-422.

  • 221.

    https://doi.org/10.1097/00007632-199802150-00002.

  • 222.

    PMid:9516695.

  • 223.

    [42] Vasavada AN, Nevins DD, Monda SM, Hughes E, Lin DC. Gravitational demand on the neck musculature during tablet computer use. Ergonomics 2015; 58: 990-1004.

  • 224.

    https://doi.org/10.1080/00140139.2015.1005166.

  • 225.

    PMid:25643042.

  • 226.

    [43] Quinzi F, Scalia M, Giombini A, Cagno AD, Pigozzi F, Casasco M, Macaluso A. The effect of an orthotic device for balancing neck muscles during daily office tasks. Human Factors 2019; 61: 722-735.

  • 227.

    https://doi.org/10.1177/0018720818814957.

  • 228.

    PMid:30608175.