Cranial Rotation Research Articles

Improving Function and Quality of Life in Patients with Chronic Neck Pain, Tension-Type Headache, and Forward Head Posture: The Role of Eyeball Exercise and Cervical Stabilization Programs.

BACKGROUND The purpose of this study was to investigate the effects of eyeball exercise and cervical stabilization programs to patients with chronic neck pain, tension-type headache (TTH), and forward head posture (FHP). MATERIAL AND METHODS The design of this study was a randomized controlled trial. A total of 40 participants were randomly divided into 2 groups: the experimental group (n=20) and the control group (n=20). Both groups received cervical manual therapy and biofeedback-guided stabilization exercises (30 min/session, 3 sessions/week, 6 weeks). In addition to the regular treatments, the participants in the experimental group also performed eyeball exercises for 20 minutes per session, 3 sessions per week, for a total of 6 weeks. Changes in neck pain (numeric rating scale, NRS), neck disability index (NDI), quality of life (Short Form-12 Health Survey Questionnaire, SF-12), headache impact test-6 (HIT-6), craniovertebral angle (CVA), cranial rotation angle (CRA), and muscle tone were measured. RESULTS Both groups showed significant improvements in NRS, NDI, SF-12, HIT-6 scores, CVA, CRA, and muscle tone (p<0.05). The experimental group had significant differences in NDI, SF-12, HIT-6 scores, and suboccipital muscle tone compared to the control (p<0.05). CONCLUSIONS Combining the eyeball exercise program with commonly used manual therapy and stabilization exercises for patients with chronic neck pain can help reduce nerve compression and promote muscle relaxation in the eye and neck areas. The method is thus proposed as an effective intervention to enhance function and quality of life in patients with chronic neck pain patients, TTH, and FHP.

Characteristics of head and neck alignment and function of deep cervical flexor muscles in patients with nonspecific neck pain

ObjectivesThe objectives were to compare forward head posture (FHP) in natural and corrected head postures between patients with nonspecific neck pain (NSNP) and controls and to clarify the relationship between natural and corrected head posture angle differences and deep cervical flexor function. This study aimed to provide useful evidence for postural assessment and treatment in patients with NSNP. MethodsIn this cross-sectional study, 19 patients with NSNP reporting a pain score of 3–7 for at least 3 months and 19 participants with no neck pain within the previous 12 months were recruited. To evaluate FHP, the cranial rotation and vertical angles were measured using lateral head and neck photographs. The craniocervical flexion test was used to evaluate deep cervical flexor activation and endurance. We evaluated the head and neck alignment in natural and corrected head postures and the relationship between the degree of change and deep cervical flexor function. ResultsFHP in the natural head posture did not differ between groups. In the corrected head posture, FHP was significantly smaller in the NSNP group than in the control group. In the NSNP group, the cranial rotation and vertical angles were significantly different between the natural and corrected head postures, and the angle difference correlated significantly with deep cervical flexor function. ConclusionsPatients with NSNP show hypercorrection in the corrected head posture, which may be correlated with deep cervical flexor dysfunction. Further investigation into the causal relationship between hypercorrection, deep neck flexor dysfunction, and neck pain is required.

Comparative digital study of two cranial rotation methods of the proximal fragment on the center of rotation of angulation-based leveling osteotomy planning with different tibial distal anatomical axes

The center of rotation of angulation (CORA)-based leveling osteotomy (CBLO) technique was developed for cranial cruciate ligament (CrCL) rupture treatment, aiming to modify the mechanical-anatomical angle (AMA), which is described as a predictive risk factor for the disease and is recommended to be taken into consideration when one is choosing a surgical procedure for tibial plateau slope alteration. Identifying a tibial distal anatomical axis (DAA) is essential in CBLO surgical planning and measuring AMA amplitude. The aim of this study was: to evaluate two methods of cranial rotation of the proximal fragment using four different tibial distal anatomical axes for digital planning on the CBLO technique, comparing its effectiveness in achieving the desired tibial plateau angle (TPAd) and closing the AMA angle. Tibial measurements were made with the vPOP pro software using 30 mediolateral radiographs of canine stifles. The DAA described by four authors was used based on the amount of Rotation completed (Rc) for each. The rotation methods evaluated were: 1) commercial CBLO table (RT) and 2) overlapping the tip of the intercondylar eminence with the corresponding DAA line (RE). The TPAd to be obtained was fixed at 10°, and the final AMA to be achieved at 0°. The mean values and standard deviations of the final TPA and final AMA with the rotation method were TPA(RT)f(%TPAd), TPA(RE)f(%TPAd), AMA(RT)f(%AMAzero), AMA(RE)f(%AMAzero). The results of each author were Hulse 10.0 ± 0.3(46.6%), 9.9 ± 0.1(60%), 0.3 ± 0.3(33.3%), 0.3 ± 0.3(13.3%), Osmond 10.1 ± 0.2(75%), 10,1 ± 0.2(83.3%), 0.4 ± 0.4(33.3%), 0.4 ± 0.3(8,3%), Miles 10.0 ± 0.1(66.6%), 10.0 ± 0.1(75%), 0.2 ± 0.1(16.6%), 0.2 ± 0.1(8.3%), Tudury 9.6 ± 0.6(31.2%), 9.5 ± 0.2(31.2%), 1.0 ± 0.7(18.7%), 1.0 ± 0.6(12.5%), respectively. The initially described RT obtained a higher percentage of AMA at zero degrees. Therefore, the RE method is discarded for use as an alternative to CBLO planning.

Systematic review and meta-analysis on efficacy of various exercise programs to improve postural parameters, pain and disability in neck

Forward head posture is a common abnormal posture characterised by weakness of muscle around neck and shoulder. Persistent forward head posture can impair respiratory functions and cervical proprioception. The aim of this systematic review and meta-analysis is to determine the effectiveness of exercises to improve the forward head posture. The online literature search performed on various databases, i.e. PubMed, Cochrane, PEDro, Science Direct and Scopus databases resulted in 601 articles, but only 11 articles were found relevant to perform meta-analysis. The primary outcome measure was craniovertebral angle and other outcome measures were neck pain, cranial angle, cranial rotation angle and Neck Disability Index (NDI). Methodological quality of studies was assessed by PEDro scoring and risk of bias assessment was performed using Cochrane collaboration tool of risk of bias. Results of meta-analysis revealed that craniovertebral angle (CVA), cranial rotation angle (CRA), visual analogue scale and NDI improved significantly (P&lt;0.00001) in forward head posture participants who followed any type of exercise regime compared to the participants who did not follow any exercise program. However, cranial angle was not found significantly (P=0.73) improved in exercise groups. Exercises are effective in improving postural parameters, such as CVA, CRA and pain and neck disability in subjects with forward head posture. Systematic analysis registry at PROSPERO: CRD42020175372

탄성밴드와 짐볼을 이용한 목 어깨안정화 운동이 경부 통증 및 경부 정렬에 미치는 영향

The purpose of this study was to analyze the effect of neck and shoulder stabilization exercises using thera-bands and gym balls on neck pain relief, strength of deep cervical flexor, and cervical alignment in college students with forward neck position. For this purpose, the exercise program was performed twice a week for 8 weeks and was divided into a thera-band group (11 individuals), a gym ball group (11 individuals), and a combined group using thera-band and gym ball (11 individuals). The Visual Analogue Scale (VAS), Neck Disability Index (NDI), strength of deep cervical flexor, Craniovertebral Angle (CVA), and Cranial Rotation Angle (CRA) were measured at week 0, week 4, and week 8, respectively. According to the results of the study, firstly, VAS, NDI, strength of deep cervical flexor and CVA improved significantly as the term of training increased in every group, but combined group showed the fastest and most significant improvements at week 8 compared to week 4. Second, CRA decreased significantly as the term of training increased in every group. However, at weeks 4 and 8 of exercise, the rate of decline was significantly faster for combined group and gym ball group than for thera-band group. To summarize the results, when neck and shoulder stabilization exercises using thera-band and gym ball were used on patients with neck pain due to frontal head position, positive results were shown in reducing neck pain, increasing the strength of the deep neck flexor and improving cervical spine alignment. Moreover, the group of combined intervention not only improved strength but also motor-sensory skills, which showed better results than single exercise trainig group, leading to implementation of combined training significant.

Morphological comparison of the cranial movement apparatus in mudskippers (Gobiidae: Oxudercinae)

Possession of the neck allows vertebrates to move the head independently from the trunk. Fish do not have the neck and thus the cranial mobility could be limited. Oxudercine gobies show full range of habitat transition from aquatic to terrestrial environments and exhibit flexible cranial movement, yet the cranium-movement apparatus is little known. In this study, we investigated the anatomy of the structure of the eight oxudercine gobies, Oxuderces nexipinnis, Parapocryptes serperaster, Pseudapocryptes elongatus, Scartelaos histophorus, Boleophthalmus boddarti, Periophthalmus chrysospilos, Periophthalmodon schlosseri, and Periophthalmodon septemradiatus. These species share similarities in the specialized features of the craniovertebral joint and the epaxials attaching onto different locations of the neurocranium. On the other hand, large space between the ventral portions of the craniovertebral joint only occurs in O. nexipinnis, Pd. elongatus, Pn. schlosseri and Pn. septemradiatus. Hypaxials are hypertrophied at the insertion point and attach more anteriorly onto the ventral side of the neurocranium in B. boddarti, O. nexipinnis, Pa. serperaster, Pd. elongatus, and S. histophorus, whereas the muscles are small and attach posteriorly in the remaining species. There were significant differences in the area occupancy ratio of the post-cranial neural spines, the lever arm ratio of the cranial rotation, and the angle between the horizontal plane and the plane through the craniovertebral joint among the species. The cranial depression presumably facilitates grazing of oxudercine gobies in their early stage of terrestrial transition, whereas the cranial elevation parameters are contradictory to the terrestrial gradient. The cranium-movement morphometrics partially agree with the phylogeny.

Correlation between the Photographic Cranial Angles and Radiographic Cervical Spine Alignment.

The cranial vertical angle (CVA) and cranial rotation angle (CRA) are used in clinical settings because they can be measured on lateral photographs of the head and neck. We aimed to clarify the relationship between CVA and CRA photographic measurements and radiographic cervical spine alignment. Twenty-six healthy volunteers were recruited for this study. Lateral photographs and cervical spine radiographs were obtained in the sitting position. The CVA and CRA were measured using lateral photographs of the head and neck. The C2-7 sagittal vertical axis (SVA), cervical lordosis (C2-7), and occipito-C2 lordosis (O-C2) were measured using radiographic imaging as a standard method of evaluating cervical spine alignment. Correlations between the CVA and CRA on photographs and cervical spine alignment on radiographs were analyzed. The CVA and SVA were significantly negatively correlated (ρ = −0.51; p < 0.05). Significant positive correlations were found between CVA and C2-7 (ρ = 0.59; p < 0.01) and between CRA and O-C2 (ρ = 0.65; p < 0.01). Evaluating the CVA and CRA on photographs may be useful for ascertaining head and neck alignment in the mid-lower and upper parts of the sagittal plane.

Assessing cervical spine and craniofacial morphology in Class II and Class III malocclusions: A geometric morphometric approach

ABSTRACT To compare craniofacial and cervical morphology between skeletal Classes II and III applying Geometric Morphometric Methods (GMM). Twenty-six cervical and craniofacial landmarks of 40 Class II and 39 Class III individuals were digitalized on lateral cephalograms. Procrustes ANOVA, generalized Procrustes, principal component analyses, and thin-plate spline function were applied to assess the pattern of shape variation of craniofacial structure and the cervical spine in relation to skeletal classes. Compared with Class III, Class II individuals presented a maxillary protrusion, mandibular retrusion, shorter mandibular corpus, posterior mandibular ramus rotation, anterior cranial base rotation, and a smaller centroid size. Furthermore, a forward and smaller cervical spine were observed. With GMM, the shape and size differences between skeletal classes can be analyzed visually and numerically.

The Effect of Cervical Stabilization Exercises with Thoracic Spine Extension Exercises on Forward Head Posture

This study was aimed at comparing the effects of cervical stabilization exercises with thoracic spine extension exercises and cervical stabilization exercises with breathing exercises on head posture in subjects with the forward head posture (FHP). FHP is a poor habitual neck posture that is defined by the forward translation of the cervical vertebrae and hyperextension of the upper cervical vertebrae. Continuous FHP adds the load to posterior cervical structures, for instance, ligament, and transforms scapular kinetics and kinematics, and affects the quality of life and activities of daily living. The study included 30 adults with FHP, with 15 participants in each group. The experimental group was asked to perform cervical stabilization exercises with thoracic spine extension exercises, and the control group was asked to perform cervical stabilization exercises with breathing exercises. After 4 weeks of exercise, the changes in head posture (cranial rotation angle and craniovertebral angle) were measured again. Craniovertebral angle and craniovertebral angle were assessed using digital, lateral-view photographs of the subjects in their usual standing postures. The results showed that there was a significant difference between experimental group and control group before and after exercise (p < 0.05). In between-group comparison, there were significant differences noted in craniovertebral angle and cranial rotation angle in the experimental group compared to the control group (p < 0.05). Both two groups affect cranial rotation angle, craniovertebral angle, and postural alignment, but it is believed that cervical stabilization exercises with thoracic spine extension exercises directly affect the thoracic and cervical spines. As a result, cervical stabilization exercises and thoracic spine extension exercises are recommended to improve postural alignment.

8주간의 등허리부 저항성 운동이 목뼈 척추원반 탈출증 여성 환자의 목 장애지수와 척추 정렬, 정적 균형 능력에 미치는 영향

The purpose of this study was to investigate the effects of 8-week thoracolumbar resistance exercise program on neck disability index(NDI), spinal alignment and static balance ability in patients with cervical herniation of intervertebral disc. The exercise program performed thoracolumbar exercise 3times a week for 8-weeks and consisted of a total of 60minutes. The subjects of this study were 20 middle-aged women patients diagnosed with cervical herniation intervertebral disc. The results of this study were as follows. NDI was significantly decreased in both groups after exercise, and it was more significantly improved in TRG than in CG(p<.001). As for spinal alignment, the cranial vertebra angle (CVA), cranial rotation angle (CRA), and lumbar vertebrae angle (LLA) were significantly changed only in TRG after exercise, and TRG was significantly improved than CG(p<.001). Static balance ability was significantly changed only in TRG after exercise, and TRG was significantly improved than CG(p<.001). These results indicated that thoracolumbar resistance exercise program in patients with cervical herniation of intervertebral disc have the positive effect on changed in NDI, spinal alignment, and static balance ability. Therefore, thoracolumbar resistance exercise is considered to be an effects as exercise therapy program for improvement of cervical herniation of intervertebral disc patients.

Carbon Dioxide Inhalation Mitigates Functional Deficits Elicited by Blast‐Induced Traumatic Brain Injury

Traumatic Brain Injury (TBI) is a significant public health burden affecting nearly 3 million individuals within the US alone annually. Large amounts of research dollars have been spent attempting to ameliorate the effects of TBI, however these efforts have failed to reduce injury rates or minimize the effects of primary injury incurred during activities such as contact sports or active military deployment. Preclinical and clinical work has revealed that mitigating brain SLOSH during cranial rotation or impact provides a profound protective effect against the effects of TBI. The biologic mechanism behind SLOSH mitigation is a filling of the compensatory reverse volume (CRV) of the skull, an effect that minimizes brain movement and the imparting of external forces on brain tissue. The most powerful biologically controllable determinant of CRV and intracranial pressure (ICP) is partial pressures of carbon dioxide (CO2, pCO2) within the bloodstream. We hypothesize that increased CO2 inhalation acting to minimize the CRV acts to minimize SLOSH and is therefore protective in the context of TBI. To initiate testing this hypothesis, we have combined increased environmental CO2 exposure with a murine model for blast-induced TBI. Murine subjects exposed to 5% CO2 for a period of 10 min in an environmental exposure chamber prior to TBI or sham treatments exhibited an increase in freezing behavior, indicative of actual exposure to gas composition, as compared to their medical grade atmospheric air counterparts. TBI treatment resulted in a significant increase in righting reflex time (RRT) as compared to sham treatment, an effect mitigated by prior inhalation of 5% CO2. Three hours post-injury, TBI results in a significant reduction in general exploratory locomotor activity as compared to sham treatment, an effect that is also mitigated by prior inhalation of 5% CO2. Inhalation of CO2 however was found to have no effect on TBI-elicited increases in cortical tnf-α mRNA expression indicative of a complex biologic mechanism behind observed physiologic effects. Future studies will seek to ascertain molecular adaptations associated with the ability of CO2 to mitigate TBI-induced effects in vivo. These studies provide the first in vivo evidence identifying a targetable biologic mechanism to reduce the effects of primary injury and may lead to viable medical devices and methodologies for the prevention of mild TBI in contact sports and/or military operations.

Effects of Cervical Spine Mobilization on Respiratory Function and Cervical Angles of Stroke Patients: A Pilot Study.

The forward head posture (FHP) of stroke patients has a negative impact on respiratory function. Cervical spine mobilization is a manual therapy technique that used to prevent and treat FHP and respiratory function. This pilot study investigated whether cervical spine mobilization can effectively improve outcomes following FHP and respiratory function of stroke patients. Twenty-four patients participated in our assessor-blinded randomized controlled trial. All the participants received neurodevelopmental treatments (gait training and trunk rehabilitation). The experimental group additionally received 15-min sessions of cervical spine mobilization three times per week for 4 weeks. The control group received cervical spine sham mobilization during the same period. For the cervical angles, the cranial vertebral angle (CVA) and cranial rotation angle (CRA) were measured. A respiratory function test was performed to measure the forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), peak expiratory flow (PEF), maximal inspiratory pressure (MIP), maximal expiratory pressure (MEP), and chest circumferences (upper and lower chest sizes). Except for MIP, there was no significant difference between the experimental group and the control group. The CVA and CRA were significantly increased in the experimental group only. Cervical spine mobilization improved cervical angles and inspiratory function of the stroke patients in this study. However, a comparative study with a larger number of patients is needed to confirm this finding from our pilot study, which had a small sample size.

Complete Avulsion of the Hoof Capsule and Subsequent Testicular Degeneration in a Criollo Stallion

Background: Complete avulsion of the hoof in horses, also known as exungulation, is not a commonly reported injury and usually leads to euthanasia due to the great amount of tissue loss, intense pain, secondary complications, expensive and lengthy treatment. It can involve deep structures and cause different complications leading to chronic lameness. In stallions affected by such injury, the reproductive tract and performance may also be affected. The aim of this study was to report a case of complete avulsion of the right front hoof in a Criollo stallion and subsequent bilateral testicular degeneration.Case: A 10-year-old Criollo stallion was referred to the Veterinary Clinical Hospital of the Federal University of Pelotas (HCV- UFPel) with a complete avulsion of the left front hoof. At admission, the stallion had clinical parameters compatible with intense pain and blood loss. Evaluation of the wound demonstrated that the distal end of the third phalanx (P3) was exposed but no fracture was detected on radiological evaluation. No other structure was apparently affected. Initially, anti-inflammatory (phenylbutazone) and opioid (morphine) was given for pain control and supportive fluid therapy was started to restore hydration. Antibiotic (Sulfamethoxazole with trimethoprim) were administered for 10 days. Continued therapy with phenylbutazone, pentoxifylline, omeprazole and supplementation with methionine, biotin and zinc was also given. Local treatment was carried out by cleaning the wound, applying an antimicrobial ointment and dressing it with a bandage. Wound management was adapted according to the evolution and healing process. The stallion was kept in stall rest during its hospitalization time. In the second month after the injury, accumulation of liquid in the scrotum was observed. Clinical and ultrasound evaluation lead to a presumptive diagnosis of testicular degeneration. The stallion was discharged after three months when the wound was almost healed and the hoof had started to grow. Six month later, a follow up by the referring vet showed that the hoof was almost completely grown and the x-ray assessment demonstrated a cranial rotation and resorption of the distal end of the third phalanx.Discussion: The stallion of this report had a complete avulsion of the hoof capsule caused by trauma. Conservative treatment was established including wound cleaning and dressing to avoid contamination, control of pain and inflammation, antimicrobial care and supplementation to support hoof growth. Time period for wound healing and hoof growth was in agreement with other cases described previously. Bone sequestrum of the distal end of the third phalanx, and detachment of a fragment were observed in this case, followed by bone resorption. The stallion was closely monitored to prevent laminitis in the contralateral limb and no alterations were detected during the treatment period. Testicular degeneration was observed, probably caused as a consequence of hoof avulsion and due to a long period of stall rest. Degenerative alterations in testicles interfere with thermoregulation and spermatogenesis, affecting semen quality and reproductive performance. Rotation of the third phalanx was also observed six months later caused by the hoof loss. In conclusion, the patient of this report had a complete regrowth of the hoof capsule although a long intensive treatment was necessary to achieve this result. As a consequence, testicles degeneration may happen impairing its function as a stallion.Keywords: exungulation,hoof trauma, degenerative changes.

자가 스트레칭이 두부전방자세와 경부통증에 미치는 영향

The purpose of this study was to investigate the effects of 8 weeks of self stretching on neck posture and neck pain. This study was randomly assigned to the exercise group(n=14; age 24.50±3.03) and the control group(n=14 age 23.93±2.20) for 28 adults in their 20s with turtle posture and neck pain. The exercise program consists of eight posture stretches. The exercise group performed the self-stretching through the previous research paper three times a week for eight weeks. The experimental results are as follows. After 8 weeks there was a significant difference in Cranial rotation angle(CRA)(p<.05). After 8 weeks there was a significant difference in Craniovertebral angle(CVA)(p<.05). After 8 weeks, there was no significant difference in neck tilt angle and neck load. After 8 weeks there was a significant difference in neck pain(p<.001). The conclusion suggests that self-stretching is effective in improving neck posture and reducing neck pain.

Correlation Between Trapezius Trigger Points and Head/Neck Posture In Subjects With Frozen Shoulder

Objective: To find out correlation between head/neck posture and trigger points in upper trapezius muscle in frozen shoulder subjects. Method: A total of 48 subjects (28 females and 20 males) between the age group 40-60 years with stage 2 of frozen shoulder were selected for the assessment of head/neck posture and trigger points in upper trapezius. Outcome assessment for head/neck posture included cranial vertical angle (CVA), cranial rotation angle (CRA); upper trapezius trigger points were explored through palpation. Both the readings were compared and analysed by Pearson correlation test using SPSS (version 20). Result: Poor correlation between CVA and upper trapezius trigger points-(r=0.1647) whereas correlation between CRA and trigger points in upper trapezius-(r=-0.0972) in subjects with frozen shoulder which was statistically insignificant. Conclusion: There is weak influence of head/neck posture and trigger points in upper trapezius. i.e. there is no greater/smaller deviational change in the forward head posture (FHP) in association with trigger points in upper trapezius in frozen shoulder subjects.

Forward head posture (FHP) angle and plantar pressure resulting from oscillatory stimulation training of the shoulder joint: A randomized controlled trial.

Oscillatory stimulation provides strong sensory stimulation, which can activate muscle spindles, strengthening proprioceptive sense and, therefore, helping to strengthen the muscles involved in posture stability. This study aimed to investigate the difference in average distribution of plantar pressure resulting from changes in the forward head position (FHP) angle caused by controlling muscle activity in the neck and shoulders through Bodyblade. The subjects were divided into an experimental group (Bodyblade, n= 15) and a control group (general physiotherapy, n= 15). Eighteen sessions of exercise were implemented. Craniovertebral angle (CVA) and cranial rotation angle (CRA) were measured to evaluate the change of FHP. The Gaitview AFA-50 (Alfoots Co, Korea) was used to measure the plantar pressure distribution. The experimental group showed a larger increase in CVA than the control group (p< 0.05). Only the experimental group showed a significant decrease in CRA (p< 0.05).Both the anterior pressure and posterior pressure showed a significant improvement only in the experimental group (p< 0.05). The experimental group showed a larger increase in anterior/posterior ratio than the control group (p< 0.05). Bodyblade improves the angle of FHP, thus positively affecting the average ratio of plantar pressure.

Effects of McKenzie exercise, Kinesio taping, and myofascial release on the forward head posture

[Purpose] This study aimed to investigate the effects of McKenzie exercise, Kinesio taping, and myofascial release (MFR) on forward head posture (FHP). [Participants and Methods] Twenty-eight individuals with an FHP were enrolled. participants were randomly assigned to one of three groups: Group A, Group B and Group C. Group A underwent McKenzie exercise and MFR. Group B underwent McKenzie exercise and Kinesio taping. Group C underwent McKenzie exercise, MFR, and Kinesio taping. Interventions for all three groups were provided three times per week for four weeks. The acromion and tragus of ear (A-T length), craniovertebral angle (CVA), Cranial rotation angle (CRA), and neck disability index (NDI) were measured. [Results] The A-T length significantly differed after intervention in all three groups. CVA only significantly differed after intervention in group C. All three groups showed an increase in CRA after intervention; however, these increases were not statistically significant. [Conclusion] Considering these results, these three types of exercise may be recommended as effective exercises to improve posture in adults with FHP.

Effect of scapular stabilization exercise on neck alignment and muscle activity in patients with forward head posture.

[Purpose] The purpose of this study was to investigate the effects of scapula movement on neck alignment and the muscles in patients with forward head posture, who has the structural changes around the neck caused from the forward head posture, when scapular stabilization exercise is applied. [Subjects and Methods] A sample of 30 patients with forward head posture were recruited and participated in an intervention for 30 minutes a day, three times per week for 4 weeks. Fifteen patients were assigned to the scapular stabilization exercise group and the remaining 15 were assigned to the neck stabilization exercise group. Before the intervention, the craniovertebral angle (CVA), cranial rotation angle (CRA), and muscle activity of the muscles around the neck were measured. Four weeks later, these 3 factors were re-measured and analyzed. [Results] Within-group changes in CVA and CRA were observed in both groups and were statistically significant. Only the CVA group had a statistically significant between-group differences. Within-group changes in muscular activity were significant differences in all groups. Between groups, the lower back trapezius and serratus anterior showed statistically significant differences. [Conclusion] Scapular stabilization brought about improvement in posture through activation of the neck muscles, the lower trapezius, and the serratus anterior. Therefore, the intervention has a positive effect on neck alignment by reducing the compensatory movements of the muscles involved in forward head posture. Structural changes are observed.

Are there risk factors for osseous mandibular inferior border defects after bilateral sagittal split osteotomy?

PurposeBone defects of the inferior mandibular border (osseous inferior border defects) can cause unesthetic postoperative outcomes after bilateral sagittal split osteotomy (BSSO). The aim of this study was to estimate the frequency of osseous inferior border defects after BSSO and to identify risk factors for this complication. Materials and methodsThis retrospective study included consecutive patients who underwent BSSO for mandibular retrognathia. The primary outcome was the presence/absence of osseous inferior border defects. Predictors included the mandibular movement, rotation of the occlusal plane, postoperative proximal segment position, pattern of lingual fracture, occurrence of bad split, and presence of third molars. ResultsThe study sample consisted of 200 patients and had a mean follow-up of 13 months. The mean mandibular advancement and rotation was respectively 5.8 mm and 5.4° clockwise. Osseous inferior border defects were present in 7.0% of splits and in 12.5% of patients. Significant risk factors for inferior border defects included increased advancement, increased clockwise rotation, cranial rotation of the proximal segment, and a split originating in the lingual cortex. ConclusionIn conclusion, osseous inferior border defects occur significantly more often in cases with large mandibular advancement, increased clockwise rotation of the occlusal plane, malpositioning of the proximal segment, and a split originating in the lingual cortex.

Thermal Resilience of Feeding Kinematics May Contribute to the Spread of Invasive Fishes in Light of Climate Change.

As a consequence of global warming, tropical invasive species are expected to expand their range pole-ward, extending their negative impacts to previously undisturbed, high-latitude ecosystems. Investigating the physiological responses of invasive species to environmental temperature is important because the coupled effects of climate change and species invasion on ecosystems could be more alarming than the effects of each phenomenon independently. Especially in poikilotherms, the rate of motion in muscle-driven biomechanical systems is expected to double for every 10 °C increase in temperature. In this study, we address the question, “How does temperature affect the speed of jaw-movement during prey-capture in invasive fishes?” Kinematic analysis of invasive-fish prey-capture behavior revealed that (1) movement velocities of key components of the feeding mechanism did not double as water temperature increased from 20 °C to 30 °C; and (2) thermal sensitivity (Q10 values) for gape, hyoid, lower-jaw rotation, and cranial rotation velocities at 20 °C and 30 °C ranged from 0.56 to 1.44 in all three species. With the exception of lower-jaw rotation, Q10 values were significantly less than the expected Q10 = 2.0, indicating that feeding kinematics remains consistent despite the change in environmental temperature. It is conceivable that the ability to maintain peak performance at different temperatures helps facilitate the spread of invasive fishes globally.