The effect of feedback respiratory exercise on muscle activity, craniovertebral angle, and neck disability index of the neck flexors of patients with forward head posture

Abstract

[Purpose] This study aimed to simultaneously investigate the activities of the sternocleidomastoid muscle and scalenus anterior muscle, which are agonists of neck and breathing accessory muscles, by implementing breathing exercises. [Subjects and Methods] Thirteen subjects were selected for the experimental group, which performed feedback respiratory exercises with McKenzie exercises, and 12 subjects were selected for the control group, which performed McKenzie exercises alone. The intervention program was performed for 30 minutes a session, once a day, four times a week, and for 2 weeks before conducting the experiment. Before intervention, muscle activity was measured using surface electromyogram, and the neck disability index was evaluated. [Results] There were meaningful differences in activities of the sternocleidomastoid muscle and the scalenus anterior muscle, craniovertebral angle, and neck disability index within both the experimental group and control group after intervention. There also were meaningful differences in sternocleidomastoid muscle and neck disability index changes between groups. [Conclusion] Neck flexors as accessory respiratory muscle can affect inefficient respiratory imbalance of forward head posture patients. Multimodal intervention method should be studied continually and not be exposed to upper chest breathing patterns by preventing such phenomenon.

Effects of Adding Respiratory Exercises to the Therapeutic Routine in Smartphone Users With Forward Head Posture and Non-Specific Chronic Neck Pain: A Randomised Controlled Trial

“…This situation causes the respiratory pattern to change from nasal breathing to mouth breathing. As compared to the normal posture, both scalene and sternocleidomastoid muscles show a higher activity amount in FHP [5]. Such long-term activation can create poor respiratory habits to facilitate activities in auxiliary respiratory muscles [5].…”

“…This can necessarily affect muscular activity, and place more pressure on the cervical spine where chronic pain originates [3,4]. Individuals with FHP and chronic neck pain often suffer from weakness of the deep neck exor muscles, which is to be compensated by excessive activity of other muscles such as sternocleidomastoid, and scalene [5]. This compensation leads to muscle imbalance and changes in the stress-strain diagram, by which cervical spine overload occurs [5,6].…”

“…Individuals with FHP and chronic neck pain often suffer from weakness of the deep neck exor muscles, which is to be compensated by excessive activity of other muscles such as sternocleidomastoid, and scalene [5]. This compensation leads to muscle imbalance and changes in the stress-strain diagram, by which cervical spine overload occurs [5,6]. This may also be observed in the thoracic spine as some involved muscles are connected to both areas.…”

“…This may also be observed in the thoracic spine as some involved muscles are connected to both areas. Also, disorders or impairments occur in the neck and respiratory system because of the joint activity of the above-mentioned muscles operated on the neck movements and respiratory function [5,6].…”

“…As compared to the normal posture, both scalene and sternocleidomastoid muscles show a higher activity amount in FHP [5]. Such long-term activation can create poor respiratory habits to facilitate activities in auxiliary respiratory muscles [5]. Furthermore, the respiratory function is affected by changed muscle activity due to pain and disability, affecting the neck in a vicious circle.…”