Deep Flexor Research Articles

Effect of Craniocervical Flexor Training on Pain, Strength, and Quality of Life in Subjects with Chronic Neck Pain

Background: In context, neck pain is the most prevalent musculoskeletal complaint. Common causes of neck pain include poor posture at work, nervousness, stress, strain, carrying heavy objects, and strenuous physical activity. To enhance a patient’s functional status and quality of life (QOL), knowledge of the structures that can cause pain impairment is essential. It was found that a craniocervical flexor training course provides an improved method of isolating the deep cervical flexors. Objective: The purpose of this training was to assess the effectiveness of craniocervical flexion training in reducing pain, increasing strength, and enhancing well-being in those with persisting neck pain. Methodology: Two sets of 20 subjects were used in this study. The treatment (craniocervical flexion training) was administered 5 days a week for 4 weeks. Pain was evaluated using a Visual Analog Scale (VAS), strength was assessed using the craniocervical flexor test, and QOL was measured with the short form 36 before and after treatment. Results: Both groups improved their strength and QOL from pretreatment levels, and the VAS scores of both groups decreased from pretreatment levels. In contrast, both pain and QOL improved more in Group A. Conclusion: This study concludes that, when it comes to managing chronic neck pain, craniocervical flexion exercise is more effective than isometric exercise, scapulothoracic exercise, and transcutaneous electrical nerve stimulation alone.

Intra-rater and inter-rater reliability of cranio cervical flexion test in symptomatic subjects of neck pain using pressure biofeedback

Objective: To investigate the intra – rater and inter – rater reliability of cranio cervical flexion test in symptomatic subjects. Background of study: Neck flexor muscles endurance was negatively correlated with cervical pain and dysfunction. Cranio cervical flexion test protocol has been advocated to train cranio cervical flexor muscle performance at present there is no consensus to the most effective method. The CCFT is a clinical test of neuromotor control of deep flexor of the cervical spine. Methodology: This was an observational study design with test-retest type and conducted in the ACS medical college and hospital. 50 samples were selected based on inclusion criteria. The CCFT was measured by one tester twice for intra rater reliability and two testers for inter-rater reliability were again tested after 24 Hours (Next day) by keeping time and environment optimal. In this CCFT, the activation pressure score and highest-pressure score was measured using Pressure Biofeedback unit. Result: The mean score for Activation Pressure by intra-rater tester one was found to be 2.24 (1.69) and 2.64 (1.48) in retest. The ICC intrarater score for Highest pressure value by tester one was 23.92 (2.17) and 24.32 (1.99) in retest. The mean score for activation pressure by Inter – rater examiners was found to be 2.92(1.15) by examiner - 1 and 2.72(1.19) by examiner - 2. The ICC Inter – rater score for highest pressure value by examiner - 1 was 24.32(1.95) and 24.4(2.33) by examiner - 2. The ICC value of the study indicated high reliability of the activation pressure and highest-pressure value among the intra and inter-raters. Conclusion: The CCFT has high inter-rater and intra-rater reliabilities in symptomatic subjects. Bangladesh Journal of Medical Science Vol. 22 No. 03 July’23 Page : 617-622

Comparaison des différentes ancres dans les réinsertions transosseuses de tendons fléchisseurs profonds en zone I

Transosseous reinsertion has been used to complement the Bunnell pull-out technique in the repair of zone I deep flexor tendon injuries. The aim of this study is to compare the different devices on the market in terms of complication, functional recovery and ease of use. This is a single-center study including all patients who underwent transosseous anchor reinsertion from 2010 to 2021 with a minimum of 6 months of follow-up. Twenty-seven patients were included. The anchors used were of different types: Microfix® Quickanchor plus® and Miniquick anchor® from DePuy Mitek; Juggerknot® Soft Anchor 1.0mm from Zimmer-Biomet; or Kerifix® 4.0 from KeriMedical. We analyzed intraoperative data, complications and functional recovery by quickDASH score. The average age was 38.6 years (±16.1), the demographic characteristics were identical in the different groups. There was a significant difference in the number of anchors used intraoperatively before definitive placement (P=0.02), to the disadvantage of the Juggerknot® anchors. There was no significant difference in terms of complications and functional recovery evaluated by the quickDASH. Our study did not find significant differences between the different anchors in terms of complications and functional recovery. Some anchors seem to have a better grip during placement than others.

Effect of instrument-assisted soft tissue mobilization combined with exercise therapy on pain and muscle endurance in patients with chronic neck pain: a randomized controlled study

ABSTRACT Objectives The use of instrument-assisted soft tissue mobilization (IASTM) has been documented to be effective for improving pain and function, but it is unclear whether it helps improve muscle performance in musculoskeletal diseases. This study investigated the effects of IASTM combined with exercise therapy on muscle endurance and pain intensity in patients with chronic neck pain. Methods Forty-eight individuals with chronic neck pain were randomly divided into exercise therapy (ET, n = 24) and combined therapy (CT, n = 24) groups. For 4 weeks, each group underwent exercise therapy 3 days a week for a total of 12 sessions. The ET group received exercise therapy only. The CT group received IASTM combined with exercise therapy twice per week for a total of 8 sessions. The muscle endurance of the participants was assessed with the Deep Neck Flexor Muscle Endurance (DNFE) test and pain intensity with Visual Analogue Scale (VAS) at baseline and post-treatment. Results While both groups showed significant improvement in pain intensity (p < 0.05), the CT group showed a greater effect size for pain (CT group: Cohen’s d = 3.28; ET group: Cohen’s d = 2.12). The CT group showed significant improvement for muscle endurance (p < 0.05), whereas the ET group did not (p > 0.05). Conclusion In the current study, the IASTM intervention combined with ET improved pain and muscular endurance in participants with chronic neck pain compared to exercise therapy alone. As an alternative method, IASTM intervention before exercise seems to increase the short-term recovery effect in chronic neck pain conditions.

Cervicogenic headache

IntroductionCervicogenic headache, first proposed as a distinct headache in 1983, is a secondary headache to a primary cervical musculoskeletal disorder. Research into physical impairments was integral to clinical diagnosis and to develop and test research informed conservative management as the first line approach. PurposeThis narrative presents an overview of the body of cervicogenic headache research from our laboratory which was undertaken in the context of a broad program of research into neck pain disorders. ImplicationsEarly research validated manual examination of the upper cervical segments against anaesthetic nerve blocks, which was vital to clinical diagnosis of cervicogenic headache. Further studies identified reduced cervical motion, altered motor control of the neck flexors, reduced strength of flexor and extensor muscles, and occasional presentation of mechanosensitivity of the upper cervical dura. Single measures are variable and not reliable in diagnosis. We proved that a pattern of reduced motion, upper cervical joint signs and impaired deep neck flexor function accurately identified cervicogenic headache and differentiated it from migraine and tension-type headache. The pattern was validated against placebo controlled diagnostic nerve blocks. A large multicentre clinical trial determined that a combined program of manipulative therapy and motor control exercise is effective in the management of cervicogenic headache and outcomes are maintained in the long term.More specific research into cervical related sensorimotor controlled is warranted in cervicogenic headache. Further adequately powered clinical trials of current research informed multimodal programs are advocated to further strengthen the evidence base for conservative management of cervicogenic headache.

필라테스 호흡을 적용한 목 안정화운동이 전방머리자세의 근지구력과 손의 악력에 미치는 영향

Objective: The purpose of this study was to compare the effect on the cranio-cervical flexion exercise which is a neck stabilization exercise, and cranio-cervical flexion exercise applying Pilates breathing on neck muscle endurance, pain, and grip strength. Method: This study was conducted for 8 weeks, 30 minutes twice a week for 27 people, The control group performed cranio-cervical flexion exercise which is a neck stabilization exercise, and the experimental group performed cranio-cervical flexion exercise applying Pilates breathing. Visual Analog Scale was used to evaluate pain, a pressure biofeedback instrument and a stop-watch were used to evaluate the muscle endurance of deep neck flexor muscles, and a Jamar Hand evaluation kit was used to evaluate hand pressure. In this data, Kolmogorov-Smirnov was used to assume the normality of all dependent variables, and descriptive statistics were used for the general characteristics of the subjects. ANCOVA statistical method was used to verify validity, and the significance level was p&lt;.05. Results: There were significant differences in muscle endurance, pain, and grip strength in the group applying Pilates breathing in the cranio-cervical flexion exercise of the neck stability exercises. Conclusion: In the group of applying Pilates breathing in the cranio-cervical flexion exercise of the neck stability exercises, neck muscle endurance and hand grip strength increased and pain decreased.

Comparison of Six-strand and Four-strand Techniques on the Repair of Injured Deep Flexor Tendons of Zone II of the Hand: A Randomized Controlled Clinical Trial

Comparison of Six-strand and Four-strand Techniques on the Repair of Injured Deep Flexor Tendons of Zone II of the Hand: A Randomized Controlled Clinical Trial

Boyun Ağrısı Olan ve Olmayan İnaktif Üniversite Öğrencilerinde Boyun Farkındalığı, Fiziksel ve Psikososyal Parametrelerinin Karşılaştırılması

The aim of the study was to compare neck awareness, muscular endurance, mental state and self-efficacy parameters in young adults with and without neck pain and to examine the relationship of awareness with pain intensity, muscular endurance and anxiety and depression in the group with neck pain. A total of 104 students with neck pain (n=41) and without neck pain (n=63) with a mean age of 22.85 ± 3.53 years were included in the study. Visual Analog Scale (VAS), Cervical Deep Flexor Muscle Endurance Test, Hospital Anxiety and Depression Scale (HADS) and Fremantle Neck Awareness Questionnaire (FreBAQ) were used to collect the data. When the groups were compared in terms of physical and psychosocial data, it was determined that the group with neck pain was negatively affected compared to the group without neck pain in terms of all parameters (p

Ultrasound Morphometry and Mean Echogenicity of Digital Flexor Tendons, Suspensory Ligament, and Accessory Ligament of Digital Deep Flexor Tendon in Gaited Horses.

The objective of this study was to evaluate and compare the sonographic characteristics of the digital flexor tendons and ligaments of the palmar/plantar of the metacarpal and metatarsal regions in gaited horses, as well as to establish normal reference ultrasound values for Mangalarga Marchador (MM) and Campeiro breeds. Transverse sonographic images were obtained of 50 adult and healthy horses from the MM (n = 25) and Campeiro (n = 25) breeds. The images were taken in six metacarpal/metatarsal zones, and the following measurements were taken: transverse area, circumference, dorsopalmar/plantar length, lateromedial length, and mean echogenicity. Differences were observed between breeds in the fore- and hindlimbs, and, even when not significant, the Campeiro breed tended to have higher values for most variables and structures. Variations between zones and between structures in the same zone followed a similar trend in both breeds for all variables. In addition, the dimensions and variations between zones and structures were different between the fore- and hindlimbs, highlighting the need for specific values for the digital flexor tendons and ligaments of the metatarsal plantar region. In conclusion, the digital flexor tendons, suspensory ligaments, and accessory ligaments of the digital deep flexor tendon are influenced by the breed factor in gaited horses, and they are different between the fore- and hindlimbs.

Assessment of pain, scapulothoracic muscle strength, endurance and scapular dyskinesis in individuals with and without nonspecific chronic neck pain: A cross-sectional study

IntroductionThis study is aimed to evaluate pain, muscle strength, scapular muscular endurance and scapular kinesis in individuals with Nonspecific Chronic Neck Pain and to compare them with asymptomatic individuals. In addition, to investigate the effect of mechanical changes in the scapular region on neck pain. Method40 individuals who applied to Kırıkkale University Faculty of Medicine Hospital Physical Therapy and Rehabilitation Center and diagnosed with NSCNP and 40 asymptomatic individuals for the control group were included the study. Pain was evaluated with Visual Analogue Scale, pain threshold and pain tolerance with algometer, cervical deep flexor group muscle strength with Stabilizer Pressure Biofeedback device, and neck and scapulothoracic muscle strength with Hand Held Dynamometer. Scapular Dyskinesia Test, Scapular Depression Test and Lateral Scapular Slide Test were used to evaluate scapular kinesis. A timer was used to evaluate scapular muscular endurance. ResultPain threshold and pain tolerance values of the NSCNP group were lower (p < 0.05). Muscle strength around neck and scapulothoracic region of the NSCNP group were lower than the asymptomatic individuals (p < 0.05). NSCNP group had more scapular dyskinesia (p < 0.05). Scapular muscular endurance values of the NSCNP group were lower (p < 0.05). ConclusionAs a result, pain threshold and pain tolerance decreased, muscle strength of the neck region and the scapular region decreased, scapular endurance values decreased and the incidence of scapular dyskinesia increased in the individuals with NSCNP compared to the asymptomatic individuals. It is thought that our study will provide a different perspective in the evaluation of neck pain and including the scapular region to the evaluations.

Immediate neck hypoalgesic effects of craniocervical flexion exercises and cervical retraction exercises among individuals with non-acute neck pain and a directional preference for retraction or extension: preliminary pretest-posttest randomized experimental design

ABSTRACT Background Selective deep neck flexor muscle activation through craniocervical flexion exercises has been considered to be different from cervical retraction exercises. Objective To compare the immediate analgesic effect of craniocervical flexion versus cervical retraction exercises in individuals with nonacute, directional preference (DP) for cervical retraction or extension Methods A two-arm, assessor-blinded, pretest-posttest randomized experiment was conducted. Participants were randomly assigned to either craniocervical flexion or cervical retraction exercises and those who were confirmed at the post-intervention examination to have a DP for cervical retraction or extension were analyzed. The primary outcome measure was pressure pain thresholds at the C2 and C5-C6 levels. Results A total of 10 (mean age = 20.6 years) and nine participants (mean age = 19.4 years) undertook craniocervical flexion and retraction exercises, respectively. One-way analysis of variance demonstrated no statistically significant (p > 0.05) interaction effect regardless of the neck level. In the pre-post change percentages, retraction exercises provided greater analgesic effects compared to craniocervical flexion exercises at the C2 (Hedges’ g = 0.679) and C5-C6 levels (g = 0.637). Conclusion This study showed a comparable or greater immediate neck analgesic effect from cervical retraction exercises compared to craniocervical flexion exercises in individuals with a DP for cervical retraction or extension.

Early and delayed surgical management of the pronator teres syndrome. Selective reinnervation of the anterior interosseous nerve aimed to restore pinch grip among patients with late clinical presentation

Background. The incidence of pronator teres syndrome (PTS) is low. The misdiagnosis leads to delay in surgical treatment and irreversible changes not only within the median nerve (MN) itself, but within the sensory and muscular apparatus as well.Objective: to compare the outcomes of early and delayed surgical management of PTS; to compare the restoration of the pinch grip (PG) after decompression and reinnervation (nerve transfer, NT) of the anterior interosseous nerve (AIN) vs. decompression of MN alone in late terms of the disease (PTS).Materials and Methods. Six patients with verified PTS were included into the study. Three patients with the history of the disease (HoD) less than 3 mos. received surgical decompression (SD) of MN under standartized methodology alone. Another three patients with the HoD more than 3 mos. received SD of MN, with two of them received simultaneous NT of the branches of the radial or MN to AIN. In all patients sensory and motor deficit (function of "extrinsic"and "intrinsic"muscles), intensity of the neuropathic pain, both pre- and post-surgery have been evaluated according to MRC Scale and VAS, respectively. An ability to reproduce PG, or “OK” sign, with help of the thumb (flexor pollicis longus muscle – FPL) and index finger (deep flexor muscle – FDP2) were evaluated.Results. All patients showed complete relief of the neuropathic pain (VAS0) regardless of the terms of the disease. Three patients with HoD less than 3 mos. showed good recovery of FPL, FDP2 (M4-5) – all patients were able to reproduce "OK" sign. One patient with HoD more than 3 mos. after SD of MN alone showed no recovery of FPL, FDP2 (M0-1). Another two patients with the HoD more than 3 mos. showed good recovery of FPL and FDP2 (M3-4) after NT to AIN. No patient with HoD more than 3 mos. was able to reproduce "OK" sign.Conclusions. Early decompression of MN in PTS cases results in complete relief of the sensory and motor neurologic deficit; late decompression of MN in PTS cases does not lead to relief of the sensory deficit within NCP autonomous area, while the prognosis of the recovery of the median nerve innervated “extrinsic” and “intrinsic” muscles is rather unfavorable; In case of late PTS presentation, NT to AIN allows restoring only a single component ("extrinsics") of the motor functions of the hand which are required for the succesfull reproduction of the pinch grip; In case of late PTS presentation, poor recovery of OP should be expected, hence the succesfull reproduction of the pinch grip due to the thumb hyperadduction would be impossible; carefull interpretation of the clinical, radiological and electophysiological data on the pre-surgical stage could potentially help avoiding the misdiagnosis and improve the outcomes of the surgical treatment in all cases of a single or multilevel MN entrapment.

Comparison of three different exercise trainings in patients with chronic neck pain: a randomized controlled study.

Neck pain is a common problem in the general population and second only to low back pain in musculoskeletal problems. The aim of this study is to compare three different types of exercise training in patients with chronic neck pain. This study was conducted on 45 patients with neck pain. Patients were divided into 3 groups: Group 1 (conventional treatment), Group 2 (conventional treatment plus deep cervical flexor training), and Group 3 (conventional treatment plus stabilization of the neck and core region). The exercise programs were applied for four weeks, three days a week. The demographic data, pain intensity (verbal numeric pain scale), posture (Reedco's posture scale), cervical range of motion ([ROM] goniometer), and disability (Neck Disability Index [NDI]) were evaluated. In all groups, a significant improvement was found in terms of pain, posture, ROM, and NDI values in all groups (P < 0.001). Between the groups, analyses showed that the pain and posture improved more in Group 3, while the ROM and NDI improved more in Group 2. In addition to conventional treatment, applying core stabilization exercises or deep cervical flexor muscle training to patients with neck pain may be more effective in reducing pain and disability and increasing ROM than conventional treatment alone.

Pain, deep neck flexors performance, disability, and head posture in individuals with temporomandibular disorder with and without otological complaints.

Otological complaints (OC) are highly prevalent in subjects with temporomandibular disorders (TMD) and so is the risk of neck dysfunctions. To evaluate pain, deep neck flexor (DNF) performance, disability, and head and neck posture of individuals with TMD with and without OC. In this cross-sectional study, 57 individuals were divided into a group with TMD and OC (n= 31) and a group with TMD without OC (n= 26). Self-reported pain intensity, masticatory and neck muscles pressure pain thresholds, DNF performance, neck disability, and head and neck posture were evaluated. Data were compared between groups using the independent t test and Mann-Whitney test with Bonferroni correction for multiple comparisons. Effect sizes were evaluated using Cohen's index. The TMD with OC group presented less muscle activation [26 (24-28) vs. 24 (24-26) mmHg; p< 0.05], less endurance [105 (46-140) vs. 44 (28-78) points; p< 0.05], and greater neck disability (8.15 ± 5.89 vs. 13.32 ± 6.36 points; p< 0.05). No significant difference was observed in self-reported pain, head and neck posture, or pressure pain thresholds. Individuals with TMD with OC presented decreased DNF performance and increased neck disability compared to individuals with TMD without OC.

Improvement in the Contraction of the Transversus Abdominis Following Lumbo-Pelvic Manipulation – A Case Study

As a clinician, everyone undergoes a difficult time in clinical decision-making when attempting to apply a clinical prediction rule for manipulation (Flynn et al., 2002; Childs et al., 2004) to a patient with a history and physical examination consistent with clinical lumbar instability (Hicks et al., 2005). The effect on neural pathways associated with manipulation has been suggested as one possible mechanism that may improve muscle performance (Pickar, 2002) and patient symptoms. Support exists for an association between spinal manipulation and improved muscle function in the quadriceps (Suter et al., 1999), the erector spinae (Keller and Colloca, 2000), and the deep neck flexors (Sterling et al., 2001). Therefore, it is reasonable to hypothesize that spinal manipulation, by a reflexogenic mechanism, may improve the performance of the deep trunk stabilizers. In turn, improved relaxation and contractility of the lumbar multifidus and the transversus abdominis (TrA) theoretically could lead to improved functional stability of the spine through enhancement of the neurological and active subsystems as defined by Panjabi (1992a, b). This single case study describes changes observed in the TrA musculature pre- to post-manipulation in a patient that presented with a clinical paradox (symptoms suggestive of clinical lumbar instability but also meeting the clinical prediction rule to succeed with lumbar manipulation therapy). Real-time ultrasound imaging (USI) was used to describe the changes in the TrA musculature..

The Effectiveness of Ergonomic Training and Therapeutic Exercise in Chronic Neck Pain in Accountants in the Healthcare System: A Review.

Musculoskeletal illnesses or ailments that are linked to work-related risk factors are known as work-related musculoskeletal conditions. For this study, chronic neck pain is defined as the discomfort experienced between the C1 and C7 anatomic areas of the cervical spineas well as the adjacent muscles, excluding the shoulders. In the workplace, the term "ergonomics" refers to the interactions between workers and other workplace components. Clinically, deep cervical flexor training and retraining are used for treating neck pain and enhancing the capacity to maintain an upright posture. Ergonomic training and therapeutic exercises are significantly effective in reducing painand disability and enhancing posture in the cervical region.

A Novel Device for Assessment and Treatment of Upper Cervical Spine: Test–Retest Reliability Study

Neck pain is one of the most frequent reasons for consultation in primary care. Clinicians evaluate different variables, including movement and cervical strength, to determine the prognosis of patients. Usually, the tools employed for this purpose are expensive and bulky, or more than one is needed. This study aims to describe a novel device designed to assess the cervical spine and describe its test-retest reliability. The Spinetrack device was designed to measure the strength of deep cervical flexor muscles and the chin-in and chin-out movement of the upper cervical spine. A test-retest reliability study was developed. The flexion, extension and strength needed to move the Spinetrack device were registered. Two measurements were developed, with one week between each assessment. Twenty healthy subjects were evaluated. The strength of the deep cervical flexor muscles in the first measurement was 21.18 ± 3.15 Newtons, the displacement movement during chin-in movement was 12.79 mm ± 3.46 and the displacement during chin-out movement was 35.99 mm ± 4.44. The test-retest reliability of strength was ICC 0.97 (95% CI (0.91-0.99)). The Spinetrack device has shown excellent test-retest reliability values for the measurement of the strength of the cervical flexor muscles and for the chin-in and chin-out movements.

Effect of Deep Cervical Flexor versus Core Stability Exercises on Range of Motion and Function in Individuals with Forward Head Posture-A Research Protocol

Introduction: The human spine forms cervical and lumbar lordosis and thoracic kyphosis when it is aligned in the sagittal plane against a vertical reference. When the head protrudes forward from the sagittal plane and appears to be in front of the body, it is called Forward Head Posture (FHP). The atlantooccipital joint and upper cervical vertebrae extend, whereas the lower cervical and upper thoracic vertebrae flex. FHP puts more strain on the neck causing problems with the musculoskeletal, neurological, and respiratory systems. The Deep Cervical Flexor (DCF) muscles have been revealed to have an important role in the cervical spine’s support and strengthening. FHP is one of the most typical incorrect postures that has increased in popularity recently. Aim: To compare the impact of Core Stability Exercises (CSE) to DCF exercises on people who have a FHP. Materials and Methods: In this interventional comparative study, a total of 70 patients with FHP and neck pain will be included with Craniovertebral Angle (CVA) less than 50o . They will be divided into two equal groups. After a warm-up, Group A will receive DCF exercises while Group B will receive CSE for four weeks, and pain, range, and function will be assessed at the beginning, after two weeks, and after four weeks of intervention. Pain will be assessed by the Visual Analogue Scale (VAS), range will be evaluated with a goniometer, and function will be assessed by Neck Disability Index (NDI). The statistical tests used will be Chi-square test and the Student t-test. Expected Outcome: It is hypothesised that DCF exercises will prove to be successful in improving the ROM and function in individuals aged between 20-40 years with FHP. Conclusion: The conclusion will be drawn based on the effect of both the techniques on pain, range, and function in individuals with FHP which will help patients and the therapist in a better approach to rehabilitation.

Assessment of stiffness of the superficial neck muscles in female office workers with impaired endurance of deep neck flexors: a case-control study

IntroductionThe objective of this study was to assess the muscle stiffness parameter in the sternocleidomastoid (SCM) and upper trapezius (UT) in a group of office workers who did not attain the norm in the deep endurance flexor test (DEFT).MethodsIn this case-control study, the myotonometric muscle stiffness parameter (MyotonPro, Tallin, Estonia) was compared in the SCM and UT muscles in a group of female office workers who were unable to achieve the norm in the DEFT, i.e. the research group (RG), in comparison to the control group (CON) who attained the norm during the test. Subjects were matched in terms of their gender, age, BMI, nature and duration of their work, as well as the pain intensity and craniovertebral angle.ResultsSubjects in the RG had significantly higher stiffness of the UT (by 8.8%, 291.4 ± 36.5 in RG and 265.9 ± 25.6 in CON; p = 0.015, t = 2.29) and SCM (by 7.3%, 291.4 ± 36.5 in RG and 265.9 ± 25.6 in CON; p = 0.37, t = 1.85) myofascial tissue in comparison with the CON. The magnitude of the effects of the stiffness of the tested muscles on the results obtained by DEFT was stronger in the UT (Cohen’s d = 0.82, large effect size) than the SCM (Cohen’s d = 0.61, medium effect size).ConclusionsThe women who did not attain the norm in the DEFT had greater stiffness of the superficial UT and SCM muscles. Future studies should evaluate whether SCM and UT stiffness reduction therapy will improve the deep endurance flexor test results.

Evaluation of the Effectiveness of the Active Correction Exercises in Forward Head Posture in Young Adults

Background: The forward head posture is terrible habitual posture of neck that is characterized by forward cervical vertebral translation and upper cervical vertebral hyperextension. Forward head posture for prolonged period of time puts extra strain on posterior aspects of cervical region including ligaments which alters scapular kinetics and kinematics. Objective: To evaluate and assess the efficiency of active correction exercises in forward head posture of young adults. Methodology: A Total 30 subjects with forward head posture were chosen using convenient sampling technique based on inclusion and exclusion criteria. Patients were split into two groups (Intervention group-15, Conventional group-15). The Intervention group received active correction exercises for Thoracic Spine, Sternocleidomastoid, Upper Trapezius, Lower Trapezius, Deep Cervical Flexors. Conventional group were not given any intervention. As an outcome measure, the APECS posture evaluation and correction system was utilized to assess pre- and post-test measurements. Result: The mean value of pre-test was 25.720 and the post-test was 39.140 for conventional group and the mean value of pre-test was 22.187 and the post test was 25.533 for intervention group. Conclusion: As a result of this finding, it has been concluded that exercises on correcting forward head posture were more effective than conventional group.