If FHP is not corrected properly, the repetitive cervical movement with FHP will affect other global-chains over time by increasing thoracic kyphosis and craniocervical lordosis, which could result in movement impairments and associated discogenic or arthrogenic pain ( Page et al, 2010). Lumbopelvic chain instability often results in FHP with increased thoracic kyphosis and craniocervical lordosis (inability to maintain a corrected upright posture), which contribute to musculoskeletal injuries in the other global-chain cervical- thoracic spine, ribs, and shoulder complex ( Clark and Lucett, 2010). Recently, the effect of dynamic neuromuscular stabilization (DNS) on increased activation of the underactive deep neck flexor muscles and deactivation of the overactive superficial SCM muscle in individuals with cervical instability was reported to be superior to those of the abdominal drawing-in maneuver (ADIM) and preferred stabilization (PS) ( Cha et al, 2018). In fact, Jull and her colleagues reported that lumbopelvic chain instability deactivated the deep “uprighting” stabilizers, including the longus colli (LC) and longus capitis muscles, but overactivated the superficial sternocleidomastoid (SCM) and anterior scalene muscles ( Jull et al, 2009). If one local thoracic or lumbopelvic chain is insufficient and/or weak, the other muscles in the cervical kinetic chain are compromised to compensate for the loss of core stability ( Frank et al, 2013). A cervical local core chain is interconnected with the thoracolumbopelvic chain, which provides a stable basis for cervical spinal stability and superimposed movement. Keywords: Cervical flexor muscle thickness, Cervical instability, Dynamic neuromuscular stabilization, Isometric chin-tuck, Sitting height, Thoracic-lumbopelvic chainĬervical chain dysfunction is a common pathomechanical marker in individuals with forward head posture (FHP), which is often implicated with other global thoracolumbopelvic core chain instabilities ( Frank et al, 2013). Therefore, it is considered that DNS exercise can be the recommended exercise for people with FHP. The present results demonstrated that sitting height was greater in the DNS exercise than in the ICT exercise, as well as both corrective postural training exercises were effective on LC/SCM muscle balance ratio when compared with the baseline FHP condition. Sitting height was significantly greater in DNS exercise than in the ICT exercise ( p<.0001). Results:īoth ICT and DNS exercise conditions yielded significantly increased LC muscle thickness, LC/SCM thickness ratio and sitting height than did FHP condition ( p<.0001, respectively). One-way repeated measures ANOVA was used to compare the continuous dependent variables among FHP, ICT, and DNS conditions at p<.016. Outcome measures included sitting height, longus colli (LC) and sternocleidomastoid (SCM) muscle thickness and LC/SCM thickness ratio. Group of subjects with FHP were measured under baseline, ICT, and DNS conditions. Methods:Ĥ3 young subjects (mean age, 24.0±5.0 years) were recruited. Purpose of this study was to compare the immediate effects between ICT and DNS techniques. To overcome the limitations of the isometric chin-tuck (ICT) exercise, dynamic neuromuscular stabilization (DNS), which emphasizes an entire spinal chain exercise, has recently shown promising clinical results. Cervical dysfunction is a common pathomechanical marker in individuals with forward head posture (FHP).
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