Abnormal Neck Posture Research Articles

Perceived impact of a smartphone application: Knowledge, awareness, attitudes, and intention to change an abnormal neck posture among smartphone-addicted undergraduates.

Objectives: This study explored the perceived impact of a smartphone app on awareness, knowledge, attitudes, help-seeking, behavior change, and intention to change an abnormal posture of the neck while using smartphones among undergraduates addicted to smartphone use. Patients and methods: This descriptive survey involved smartphone-addicted undergraduates recruited between February 2022 and July 2022. The self-administered questionnaires used for gathering the data were a smartphone addiction survey and a mobile app rating scale on app-specific query assessing changes in awareness, knowledge, attitude, intention to change, health-seeking, and behavior change. Results: The questionnaire was completed by 316 participants (218 females, 98 males; mean: 20.7±2.6 years; range, 16 to 35 years). One hundred forty-two (44.9%) of the respondents strongly agreed that the app improved awareness, while 143 (45.3%) strongly agreed that the app improved knowledge about the significance of addressing abnormal posture of the neck while using smartphones. One hundred thirty-two (41.8%) were of the opinion that the app could change participant attitudes, and 135 (42.7%) agreed that the app could increase intentions toward improving abnormal posture of the neck. One hundred eighteen (37.3%) participants agreed that the app could promote help-seeking for abnormal posture of the neck. Respondents' age had a negative weak correlation with intention to treat (r=-0.191, p=0.001) and help-seeking (r=-0.199, p=0.0001). Conclusion: Most of the respondents in this study agreed that the CerviTech app could increase awareness, knowledge, attitude, intention to change, help-seeking, and behavior change of abnormal posture of the neck while using smartphones, with significant impact according to the age of the respondents regarding the intention to change and help-seeking behavior.

A skin-integrated device for neck posture monitoring and correction

Cervical spondylosis is a common disease that is often caused by long-term abnormal cervical curvature due to activities such as reading books and using computers or smartphones. This paper explores building an untethered and skin-integrated device in an e-skin form factor to monitor and haptically correct neck posture. The proposed design features a multilayered structure that integrates all flexible electronic circuits and components into a compact skin space while being untethered and skin conformal. An accelerometer in the e-skin attaches to the neck for posture sensing, while four vibration actuators closely touch the neck skin to provide localized vibrotactile stimuli that encode four-direction correction cues of neck flexion pm alpha and lateral bending pm beta. To ensure the reliability of posture sensing and vibrotactile rendering during neck movement, it is necessary to prevent the e-skin device from shifting position. Thus, a hollow structure-based method is implemented for stably attaching the e-skin to the neck skin. Experiments validated the e-skin device’s sensing precision, skin-conformal compliance, stickiness, stability and effectiveness during the motion of neck postures, including its discrimination of localized four-direction vibrotactile cues. A user study verified the device’s performance for sensing and correcting different abnormal neck postures during activities such as using smartphones, reading books, and processing computer files. The proposed e-skin device may create opportunities for more convenient cervical spondylosis prevention and rehabilitation.

Idiopathic cervical dystonia and non-motor symptoms: a pilot case-control study on autonomic nervous system

PurposeNon-motor symptoms, such as sleep disturbances, fatigue, neuropsychiatric manifestations, cognitive impairment, and sensory abnormalities, have been widely reported in patients with idiopathic cervical dystonia (ICD). This study aimed to clarify the autonomic nervous system (ANS) involvement in ICD patients, which is still unclear in the literature.MethodsWe conducted a pilot case-control study to investigate ANS in twenty ICD patients and twenty age-sex-matched controls. The Composite Autonomic System Scale 31 was used for ANS clinical assessment. The laser Doppler flowmetry quantitative spectral analysis, applied to the skin and recorded from indices, was used to measure at rest, after a parasympathetic activation (six deep breathing) and two sympathetic stimuli (isometric handgrip and mental calculation), the power of high-frequency and low-frequency oscillations, and the low-frequency/high-frequency ratio.ResultsICD patients manifested higher clinical dysautonomic symptoms than controls (p < 0.05). At rest, a lower high-frequency power band was detected among ICD patients than controls, reaching a statistically significant difference in the age group of ≥ 57-year-olds (p < 0.05). In the latter age group, ICD patients showed a lower low-frequency/high-frequency ratio than controls at rest (p < 0.05) and after mental calculation (p < 0.05). Regardless of age, during handgrip, ICD patients showed (i) lower low-frequency/high-frequency ratio (p < 0.05), (ii) similar increase of the low-frequency oscillatory component compared to controls, and (iii) stable high-frequency oscillatory component, which conversely decreased in controls. No differences between the two groups were detected during deep breathing.ConclusionICD patients showed ANS dysfunction at clinical and neurophysiological levels, reflecting an abnormal parasympathetic-sympathetic interaction likely related to abnormal neck posture and neurotransmitter alterations.

Cervicogenic Headache

Cervicogenic headache is a secondary headache that occurs due to referred pain from the cervical region, perceived in the trigeminal nerve distribution. It is a rare entity which is often seen in patients following whiplash injuries belonging to the early 30s age group. The pain generators are facet joints, atlanto-occipital joint, intervertebral discs, neck muscles, and cervical nerves from various pathologies. Clinically, it is a side-locked headache worsened by abnormal neck postures and neck strain. The flexion–rotation test is positive in most cases. Diagnosis is made based on the ICHD-3 criteria. The mainstay of treatment involves physical therapy for 6 weeks along with psychological therapy and pain medications. Interventional pain therapy options include cervical epidural steroid injections, trigger point injections, selective nerve root injections, and radiofrequency thermal neurolysis.

Surgeon's Neck Posture during Spine Surgeries: "The Unrecognised Potential Occupational Hazard".

Study Design:Observational study.Purpose:The purpose of this study is to analyze the surgeon's neck postures while performing lumbar spinal surgeries.Overview of Literature:Lumbar spinal surgeries are on rising trend, and with increase in number of procedures, the average time spent by a spine surgeon performing surgical procedures is also increasing. The effect of operating posture on the surgeon's neck is largely unknown. From the studies conducted on usage of smartphones, abnormal neck postures, especially the forward head posture (FHP), were found to adversely affect the cervical spine of individuals. The present study analyzes the neck position of spine surgeons during lumbar spine surgeries.Methodology:Sixty video recordings (25 open transforaminal lumbar interbody fusions [TLIFs] and 35 lumbar decompression [LD] procedures – 15 with headlight and 20 with operating microscope) of surgeries performed by three spine surgeons of different heights were analyzed. Running videos of the surgeries were recorded concentrating on the surgeons with reflective markers taped to their surface landmarks corresponding to C7 spinous process, tragus of the ear, and outer canthus of the eye. Video recordings were standardized by a fixed video recorder in the same operating theater. Snapshots from the video were obtained whenever the surgeon changes the position. Head flexion angle (HFA), neck flexion angle (NFA), and cervical angle (CA) were measured and analyzed.Results:During TLIF, HFA and NFA were significantly higher during the phases of decompression and fusion (P < 0.05). The average CA of all surgeons was lower, thereby adversely affecting the cervical spine (20.15° ± 5.05°). During LD, CA showed significant difference between usage of microscope and headlight (P < 0.001).Conclusion:Surgeon's FHP is frequently caused by a compromise between the need to perform surgery with hands, without elevating the arms, and simultaneous control of gaze at surgical field. The usage of microscope was found to reduce the stress on neck while performing surgery.

Sensory Tricks Are Associated with Higher Sleep-Related Quality of Life in Cervical Dystonia

<strong>Background:</strong> Sensory tricks are compensatory gestures that cervical dystonia (CD) patients use to reduce abnormal neck posture and movements. Although sensory tricks are common in CD, little is known about whether trick efficacy changes over time or has effect on quality of life. <strong>Methods:</strong> We analyzed clinical data and video recordings from 188 patients with isolated CD. We calculated the duration of CD and assessed the Toronto Western Spasmodic Torticollis Rating Scales and the Cervical Dystonia Impact Profile (CDIP-58). <strong>Results:</strong> A longer duration of CD corresponded to a less effective sensory trick (r(187) = 0.1901, p = 0.009). Patients who demonstrated more effective sensory tricks reported higher sleep-related quality of life than patients with less effective sensory tricks (r(187) = 0.1680, p = 0.0212). There were no significant relationships between the effectiveness of a sensory trick and the other aspects of quality of life as measured by the CDIP-58. <strong>Discussion:</strong> Patients who have had CD longer had less effective sensory tricks consistent with patients’ verbal reports of previously having a trick that no longer works. Patients should be apprised of a wide variety of sensory tricks because their previous tricks may lose efficacy over time and because more effective tricks are associated with higher sleep-related quality of life.

Sensory Tricks Are Associated with Higher Sleep-Related Quality of Life in Cervical Dystonia.

BackgroundSensory tricks are compensatory gestures that cervical dystonia (CD) patients use to reduce abnormal neck posture and movements. Although sensory tricks are common in CD, little is known about whether trick efficacy changes over time or has effect on quality of life.MethodsWe analyzed clinical data and video recordings from 188 patients with isolated CD. We calculated the duration of CD and assessed the Toronto Western Spasmodic Torticollis Rating Scales and the Cervical Dystonia Impact Profile (CDIP-58).ResultsA longer duration of CD corresponded to a less effective sensory trick (r(187) = 0.1901, p = 0.009). Patients who demonstrated more effective sensory tricks reported higher sleep-related quality of life than patients with less effective sensory tricks (r(187) = 0.1680, p = 0.0212). There were no significant relationships between the effectiveness of a sensory trick and the other aspects of quality of life as measured by the CDIP-58.DiscussionPatients who have had CD longer had less effective sensory tricks consistent with patients’ verbal reports of previously having a trick that no longer works. Patients should be apprised of a wide variety of sensory tricks because their previous tricks may lose efficacy over time and because more effective tricks are associated with higher sleep-related quality of life.

Effects of Abnormal Neck Posture on Postural Stability

Effects of Abnormal Neck Posture on Postural Stability

Reflected Vision in Surgical Practice—A Novel Method to Circumvent Posture-Related Musculoskeletal Disorders

Abnormal neck posture while working is a crucial factor that predisposes to incidence of musculoskeletal disorders amongst oral and maxillofacial surgeons. The related spectrum of clinical symptoms may range from severe pain in the lower and upper back, neck and TMJ to neurological deficits of the hand and wrist. These posture-related problems may be prevented by use of reflected vision that ensures a balanced neck posture during surgical procedures.

Frequency and clinical correlates of retrocollis in Parkinson's disease

PurposeTo investigate the incidence of retrocollis and to determine its clinical correlates in patients with idiopathic Parkinson's disease (PD). MethodsSeventy-four patients with PD at Hoehn and Yahr stage 5 were examined for abnormal neck postures and were classified according to neck posture. Differences in age, age at PD onset, disease duration, years from PD onset to Hoehn and Yahr stage 5, cognitive state, the levodopa equivalent dose (LED) for dopaminergic drugs, and rigidity of the neck and upper and lower extremities were examined to determine the clinical correlates of abnormal neck posture. We also evaluated retrocollis in 356 patients with PD at Hoehn and Yahr stage 1, 2, 3, and 4 and 65 age matched normal controls. ResultsOf the 74 patients with PD at Hoehn and Yahr stage 5 examined, 21 (28.4%) had retrocollis, 3 (4.1%) had antecollis, and 1 (1.4%) had antecollis and torticollis. Whereas, only one patient had retrocollis in PD patients at Hoehn and Yahr stage 4 and under. Patients with antecollis were significantly younger than those with normal neck posture and retrocollis. There were no differences in age at PD onset, disease duration, sex, years from PD motor symptom onset to Hoehn and Yahr stage 5, cognitive state, or LED between patients with and without abnormal neck postures. Neck rigidity scores were significantly higher in patients with retrocollis and antecollis than in those with normal neck posture. ConclusionsRetrocollis is not rare in patients with PD at Hoehn and Yahr stage 5, and the incidence appeared to increase as axial rigidity increased.

Botulinum toxin treatment for pain in atypical parkinsonism

The objective of this study is to investigate the efficacy of botulinum toxin A (BTXA) injections in patients with progressive supranuclear palsy (PSP) and multisystem atrophy (MSA) complaining of pain, unresponsive to oral drug therapy. Ten patients with functionally disabling abnormal neck postures were included. Patients were diagnosed according to established criteria and had disabling antecollis ( n : 7, MSA) or retrocollis ( n : 3, PSP) associated with pain and difficulty in feeding and performing activities of daily living. Site and dose of BTXA injections were determined individually, based on clinical examination as well as EMG. A Pain Visual Analogue Scale (VAS) and Health-related Quality of Life Scale (HR-QoL PSP and MSA) were applied. BTXA reduced pain in all patients, subjectively and as demonstrated by improvement of VAS (60% improvement); HR PSP and MSA scores related to physical aspects and social impairment (50% improvement). No adverse effects were observed. BTXA dosages were significantly lower than those usually used in cervical dystonia. Injection effects lasted for a mean of 5 months.

Effect of Acupuncture Therapy for Abnormal Neck Posture and Deviation of Trunk on a Patient with Drug Induced Dystonia

Effect of Acupuncture Therapy for Abnormal Neck Posture and Deviation of Trunk on a Patient with Drug Induced Dystonia

Congenital muscular torticollis

Congenital muscular torticollis

Neck muscle length modulates nociceptive reflex evoked by noxious irritant application to rat neck tissues

The application of mustard oil (MO), a small-fibre excitant and inflammatory irritant, into neck paraspinal muscles of the rat has been shown to produce a significant reflexive increase in electromyographic (EMG) activity in both neck and jaw muscles. It is possible that this nociceptive reflex activity is influenced by muscle length since recent evidence indicates that abnormal neck posture may be associated with cervical musculoskeletal disorders and pain. Therefore, the aim of this study was to test if muscle length modulates this nociceptive reflex response. Three different experimental procedures were employed in rats under halothane anesthesia: (1) MO injected into the left deep neck muscles with the rat placed in a straight body position (Straight group, n = 7); (2) MO injected into lengthened left deep neck muscles with the rat's neck rotated 45 degrees to the right with respect to the head (Stretched group, n = 11); and (3) MO injected into the right deep neck muscles with the rat's neck rotated 45 degrees to the right (Relaxed group, n = 9). The EMG activity of the deep neck, trapezius, and digastric muscles was bilaterally recorded, rectified and integrated into area under the curve (AUC). Control injections of the vehicle, mineral oil, did not evoke any muscle activity but MO evoked EMG activity in the ipsilateral deep neck and trapezius muscles of the Stretched group that was significantly greater than that evoked in the same muscles in the Straight and Relaxed groups. Also, the MO-evoked EMG activity in the contralateral deep neck muscles of the Stretched and Relaxed groups was greater than that of the corresponding muscles in the Straight group. The MO-evoked activity in the digastric, a jaw muscle whose length was not changed, did not show any significant difference between the three groups. These findings indicate that MO application to the rat deep neck muscles results in a larger nociceptive reflex in deep neck and trapezius muscles when they are stretched. This enhanced muscle activity could be associated with changes in the susceptibility of the neck muscles to pain or damage.