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Head Posture (head + posture)

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Medical Sciences100%

Selected Abstracts

Myofascial Trigger Points, Neck Mobility, and Forward Head Posture in Episodic Tension-Type Headache

HEADACHE, Issue 5 2007
César Fernández-de-las-Peñas PT
Objective.,To assess the differences in the presence of trigger points (TrPs) in head and neck muscles, forward head posture (FHP) and neck mobility between episodic tension-type headache (ETTH) subjects and healthy controls. In addition, we assess the relationship between these muscle TrPs, FHP, neck mobility, and several clinical variables concerning the intensity and the temporal profile of headache. Background.,TTH is a headache in which musculoskeletal disorders of the craniocervical region might play an important role in its pathogenesis. Design.,A blinded, controlled pilot study. Methods.,Fifteen ETTH subjects and 15 matched controls without headache were studied. TrPs in both upper trapezius, both sternocleidomastoids, and both temporalis muscles were identified according to Simons and Gerwin diagnostic criteria (tenderness in a hypersensible spot within a palpable taut band, local twitch response elicited by snapping palpation, and elicited referred pain with palpation). Side-view pictures of each subject were taken in both sitting and standing positions, in order to assess FHP by measuring the craniovertebral angle. A cervical goniometer was employed to measure neck mobility. All measures were taken by a blinded assessor. A headache diary was kept for 4 weeks in order to assess headache intensity, frequency, and duration. Results.,The mean number of TrPs for each ETTH subject was 3.7 (SD: 1.3), of which 1.9 (SD: 0.9) were active, and 1.8 (SD: 0.9) were latent. Control subjects only had latent TrPs (mean: 1.5; SD: 1). TrP occurrence between the 2 groups was significantly different for active TrPs (P < .001), but not for latent TrPs (P > .05). Differences in the distribution of TrPs were significant for the right upper trapezius muscles (P= .04), the left sternocleidomastoid (P= .03), and both temporalis muscles (P < .001). Within the ETTH group, headache intensity, frequency, and duration outcomes did not differ depending on TrP activity, whether the TrP was active or latent. The craniovertebral angle was smaller, ie, there was a greater FHP, in ETTH patients than in healthy controls for both sitting and standing positions (P < .05). ETTH subjects with active TrPs in the analyzed muscles had a greater FHP than those with latent TrPs in both sitting and standing positions, though differences were only significant for certain muscles. Finally, ETTH patients also showed lesser neck mobility than healthy controls in the total range of motion as well as in half-cycles (except for cervical extension), although neck mobility did not seem to influence headache parameters. Conclusions.,Active TrPs in the upper trapezius, sternocleidomastoid, and temporalis muscles were more common in ETTH subjects than in healthy controls, although TrP activity was not related to any clinical variable concerning the intensity and the temporal profile of headache. ETTH patients showed greater FHP and lesser neck mobility than healthy controls, although both disorders were not correlated with headache parameters. [source]

Trigger Points in the Suboccipital Muscles and Forward Head Posture in Tension-Type Headache

HEADACHE, Issue 3 2006
César Fernández-de-las-Peñas PT
Objective.,To assess the presence of trigger points (TrPs) in the suboccipital muscles and forward head posture (FHP) in subjects with chronic tension-type headache (CTTH) and in healthy subjects, and to evaluate the relationship of TrPs and FHP with headache intensity, duration, and frequency. Background.,Tension-type headache (TTH) is a prototypical headache in which myofascial TrPs in the cervical and pericranial musculature can play an important role. Design.,A blinded, controlled pilot study. Methods.,Twenty CTTH subjects and 20 matched controls without headache participated. TrPs were identified by eliciting referred pain with palpation, and increased referred pain with muscle contraction. Side-view pictures of each subject were taken in sitting and standing positions, in order to assess FHP by measuring the craniovertebral angle. Both measures were taken by a blinded assessor. A headache diary was kept for 4 weeks in order to assess headache intensity, frequency, and duration. Results.,Sixty-five percent (13/20) CTTH subjects showed active TrPs and 35% (7/20) had latent TrPs in the suboccipital muscles. Six (30%) controls also had latent TrPs. Differences in the presence of suboccipital muscle TrPs between both the groups were significant for active TrPs (P < .001) but not for latent TrPs (P > .5). CTTH subjects with active TrPs reported a greater headache intensity and frequency than those with latent TrPs (P < .05). The degree of FHP was greater in CTTH subjects than in controls in both sitting and standing positions (P < .01). Within the CTTH group, there was a negative correlation between the craniovertebral angle and the frequency of headache (rs=,0.6, P < .01, in sitting position; rs=,0.5, P < .05, in standing position). CTTH subjects with active TrPs had a greater FHP than those with latent TrPs, though this difference was not significant. Conclusions.,Suboccipital active TrPs and FHP were associated with CTTH. CCTH subjects with active TrPs reported a greater headache intensity and frequency than those with latent TrPs. The degree of FHP correlated positively with headache duration, headache frequency, and the presence of suboccipital active TrPs. [source]

Is there a relationship between head posture and craniomandibular pain?

JOURNAL OF ORAL REHABILITATION, Issue 11 2002
C. M. Visscher
SUMMARY, An often-suggested factor in the aetiology of craniomandibular disorders (CMD) is an anteroposition of the head. However, the results of clinical studies to the relationship between CMD and head posture are contradictory. Therefore, the first aim of this study was to determine differences in head posture between well-defined CMD pain patients with or without a painful cervical spine disorder and healthy controls. The second aim was to determine differences in head posture between myogenous and arthrogenous CMD pain patients and controls. Two hundred and fifty persons entered the study. From each person, a standardized oral history was taken and blind physical examinations of the masticatory system and of the neck were performed. The participants were only included into one of the subgroups when the presence or absence of their symptoms was confirmed by the results of the physical examination. Head posture was quantified using lateral photographs and a lateral radiograph of the head and the cervical spine. After correction for age and gender effects, no difference in head posture was found between any of the patient and non-patient groups (P > 0·27). Therefore, this study does not support the suggestion that painful craniomandibular disorders, with or without a painful cervical spine disorder, are related to head posture. [source]

Myofascial Trigger Points, Neck Mobility, and Forward Head Posture in Episodic Tension-Type Headache

HEADACHE, Issue 5 2007
César Fernández-de-las-Peñas PT
Objective.,To assess the differences in the presence of trigger points (TrPs) in head and neck muscles, forward head posture (FHP) and neck mobility between episodic tension-type headache (ETTH) subjects and healthy controls. In addition, we assess the relationship between these muscle TrPs, FHP, neck mobility, and several clinical variables concerning the intensity and the temporal profile of headache. Background.,TTH is a headache in which musculoskeletal disorders of the craniocervical region might play an important role in its pathogenesis. Design.,A blinded, controlled pilot study. Methods.,Fifteen ETTH subjects and 15 matched controls without headache were studied. TrPs in both upper trapezius, both sternocleidomastoids, and both temporalis muscles were identified according to Simons and Gerwin diagnostic criteria (tenderness in a hypersensible spot within a palpable taut band, local twitch response elicited by snapping palpation, and elicited referred pain with palpation). Side-view pictures of each subject were taken in both sitting and standing positions, in order to assess FHP by measuring the craniovertebral angle. A cervical goniometer was employed to measure neck mobility. All measures were taken by a blinded assessor. A headache diary was kept for 4 weeks in order to assess headache intensity, frequency, and duration. Results.,The mean number of TrPs for each ETTH subject was 3.7 (SD: 1.3), of which 1.9 (SD: 0.9) were active, and 1.8 (SD: 0.9) were latent. Control subjects only had latent TrPs (mean: 1.5; SD: 1). TrP occurrence between the 2 groups was significantly different for active TrPs (P < .001), but not for latent TrPs (P > .05). Differences in the distribution of TrPs were significant for the right upper trapezius muscles (P= .04), the left sternocleidomastoid (P= .03), and both temporalis muscles (P < .001). Within the ETTH group, headache intensity, frequency, and duration outcomes did not differ depending on TrP activity, whether the TrP was active or latent. The craniovertebral angle was smaller, ie, there was a greater FHP, in ETTH patients than in healthy controls for both sitting and standing positions (P < .05). ETTH subjects with active TrPs in the analyzed muscles had a greater FHP than those with latent TrPs in both sitting and standing positions, though differences were only significant for certain muscles. Finally, ETTH patients also showed lesser neck mobility than healthy controls in the total range of motion as well as in half-cycles (except for cervical extension), although neck mobility did not seem to influence headache parameters. Conclusions.,Active TrPs in the upper trapezius, sternocleidomastoid, and temporalis muscles were more common in ETTH subjects than in healthy controls, although TrP activity was not related to any clinical variable concerning the intensity and the temporal profile of headache. ETTH patients showed greater FHP and lesser neck mobility than healthy controls, although both disorders were not correlated with headache parameters. [source]

Trigger Points in the Suboccipital Muscles and Forward Head Posture in Tension-Type Headache

HEADACHE, Issue 3 2006
César Fernández-de-las-Peñas PT
Objective.,To assess the presence of trigger points (TrPs) in the suboccipital muscles and forward head posture (FHP) in subjects with chronic tension-type headache (CTTH) and in healthy subjects, and to evaluate the relationship of TrPs and FHP with headache intensity, duration, and frequency. Background.,Tension-type headache (TTH) is a prototypical headache in which myofascial TrPs in the cervical and pericranial musculature can play an important role. Design.,A blinded, controlled pilot study. Methods.,Twenty CTTH subjects and 20 matched controls without headache participated. TrPs were identified by eliciting referred pain with palpation, and increased referred pain with muscle contraction. Side-view pictures of each subject were taken in sitting and standing positions, in order to assess FHP by measuring the craniovertebral angle. Both measures were taken by a blinded assessor. A headache diary was kept for 4 weeks in order to assess headache intensity, frequency, and duration. Results.,Sixty-five percent (13/20) CTTH subjects showed active TrPs and 35% (7/20) had latent TrPs in the suboccipital muscles. Six (30%) controls also had latent TrPs. Differences in the presence of suboccipital muscle TrPs between both the groups were significant for active TrPs (P < .001) but not for latent TrPs (P > .5). CTTH subjects with active TrPs reported a greater headache intensity and frequency than those with latent TrPs (P < .05). The degree of FHP was greater in CTTH subjects than in controls in both sitting and standing positions (P < .01). Within the CTTH group, there was a negative correlation between the craniovertebral angle and the frequency of headache (rs=,0.6, P < .01, in sitting position; rs=,0.5, P < .05, in standing position). CTTH subjects with active TrPs had a greater FHP than those with latent TrPs, though this difference was not significant. Conclusions.,Suboccipital active TrPs and FHP were associated with CTTH. CCTH subjects with active TrPs reported a greater headache intensity and frequency than those with latent TrPs. The degree of FHP correlated positively with headache duration, headache frequency, and the presence of suboccipital active TrPs. [source]

Preliminary rapport on head posture and muscle activity in subjects with class I and II

JOURNAL OF ORAL REHABILITATION, Issue 11 2005
I. C. GADOTTI
summary, Forward head posture may cause alterations in the stomatognathic system, including changes in the muscle activity of the masticatory muscles and dental occlusion alterations. Considering the need for further understanding of the relationship between the stomatognathic system and the cervical region, the purpose of this study was to analyse the head posture and the electromyographic (EMG) activity of the anterior portion of temporal and masseter muscles bilaterally among bruxist's subjects with different dental occlusion classifications using the Angle method. The study consisted of 20 female volunteers, between the ages of 17 and 27 years. They were separated into two groups (class I and class II occlusions) according to a dentist-performed evaluation. An assessment of forward head posture was conducted using a photographic technique (angular calculus) combined with a clinical analysis. In the EMG analyses, active differential surface electrodes (Ag) were utilized and were placed bilaterally on the belly of masseter and temporal muscles, perpendicular to the muscles fibres. The EMG signal recorded during bilateral isotonic mastication, was presented using the Root Mean Square and was processed by Matlab software. The results indicated that the EMG responses of temporal and masseter muscles tend to be modified by occlusion alteration class II. Subjects with class II occlusion tended to present more occurrence of forward head posture with alterations in the muscle activity pattern between masseter and temporal muscles. [source]

Is there a relationship between head posture and craniomandibular pain?

JOURNAL OF ORAL REHABILITATION, Issue 11 2002
C. M. Visscher
SUMMARY, An often-suggested factor in the aetiology of craniomandibular disorders (CMD) is an anteroposition of the head. However, the results of clinical studies to the relationship between CMD and head posture are contradictory. Therefore, the first aim of this study was to determine differences in head posture between well-defined CMD pain patients with or without a painful cervical spine disorder and healthy controls. The second aim was to determine differences in head posture between myogenous and arthrogenous CMD pain patients and controls. Two hundred and fifty persons entered the study. From each person, a standardized oral history was taken and blind physical examinations of the masticatory system and of the neck were performed. The participants were only included into one of the subgroups when the presence or absence of their symptoms was confirmed by the results of the physical examination. Head posture was quantified using lateral photographs and a lateral radiograph of the head and the cervical spine. After correction for age and gender effects, no difference in head posture was found between any of the patient and non-patient groups (P > 0·27). Therefore, this study does not support the suggestion that painful craniomandibular disorders, with or without a painful cervical spine disorder, are related to head posture. [source]

Complex mechanisms of sensory tricks in cervical dystonia

MOVEMENT DISORDERS, Issue 4 2004
Axel Schramm MD
Abstract Muscle activities in 26 patients with predominantly rotational torticollis were quantified using surface electromyography. In the subgroup of 19 patients with an effective sensory trick, different modes and bilateral locations of trick application led to significant (P < 0.002) reduction of electromyographic (EMG) activity. A strong correlation was found between the efficacy of trick manoeuvres and the starting head position. Trick application in a neutral or even contralateral position was most effective while no reduction of muscle activity during trick application at the maximum dystonic head position was found (P < 0.001). We propose a two-phase model: First, normalisation of head posture is obtained by counterpressure or volitional antagonistic muscle activity. In a second step, this position can be stabilised using sensory tricks challenging central adaption of distorted sensorimotor integration. © 2003 Movement Disorder Society [source]

Relationship of TMJ osteoarthritis,/,osteoarthrosis to head posture and dentofacial morphology

ORTHODONTICS & CRANIOFACIAL RESEARCH, Issue 1 2008
H Ioi
Structured Abstract Authors,,, Ioi H, Matsumoto R, Nishioka M, Goto TK, Nakata S, Nakasima A, Counts AL Objective,,, The purpose of this study was to test the hypothesis that there is a relationship between the temporomandibular joint (TMJ) osteoarthritis/osteoarthrosis (OA), head posture and dentofacial morphology. Design,,, Case,control study. Subjects and Methods,,, The subjects consisted of 34 Japanese females with TMJ OA (aged 24.7 ± 6.1 years) and a control group of 25 healthy Japanese females (aged 23.6 ± 1.3 years). Six cranio-cervical angular measurements were constructed for head posture analysis. Nine angular and three linear measurements were constructed for the skeletal hard tissue analysis. Five angular and one linear measurements were constructed for the dental hard tissue analysis. Unpaired t -tests were used to compare the mean differences of head posture measurements and dentofacial cephalometric measurements between the TMJ OA and the control group. Results,,, The TMJ OA group had significantly larger cranio-cervical angles (p < 0.05) and had more posteriorly rotated mandibles (p < 0.0001) than those in the control group. They also had a significantly shorter posterior facial height (p < 0.0001). The TMJ OA group had more retroclined lower incisors (p < 0.05). Conclusion,,, These results suggest that an association may exist between TMJ OA, head posture and dentofacial morphology. [source]

Hyoid position, pharyngeal airway and head posture in relation to relapse after the mandibular setback in skeletal Class III

ORTHODONTICS & CRANIOFACIAL RESEARCH, Issue 2 2000
Gaoman Gu
This study evaluates the process of relapse after mandibular setback surgery by an analysis of the role of craniofacial morphology, hyoid position, pharyngeal airway and head posture. Subjects examined were 62 patients who received the sagittal split ramus osteotomies (SSRO). Changes of the craniofacial and related structures were evaluated from the serial cephalograms up to 3 years after the surgery. Results indicated that mandibular relapse represented by Pg occurred mostly within 6 months after the surgery. A net setback of the mandible was 9.1 mm and the superior move was 1.7 mm, with a reduction of 7.2 mm in mandibular length, 4.2 mm in ramus height, 3.7 mm in posterior face height, 2.6° in gonial angle, an increase of 2.9° in mandibular plane angle (MPA) by the last examination. Hyoid bone moved backward and downward and head posture was raised. The forward relapse of Pg was correlated with the changes of ANB, MPA, ramus height and hyoid position. Only hyoid position was predictably correlated with mandibular morphology and head posture. These findings suggest that mandibular setback alters the relationship among the hyoid position, pharyngeal airway and the head posture. It might be critical, therefore, relapse is closely monitored and controlled before the full healing of fragments and new muscular balance is established. [source]

Effects of head posture on the oral, pharyngeal and laryngeal axis alignment in infants and young children by magnetic resonance imaging

PEDIATRIC ANESTHESIA, Issue 6 2008
RENAUD VIALET MD
Summary Background:, Objective anatomical studies supporting the different recommendations for laryngoscopy in infants and young children are scarce. The objective of this study was to measure by magnetic resonance imaging (MRI) the consequences of head extension on the oral, pharyngeal and laryngeal axes in infants and young children. Methods:, Thirty patients (age: 33 ± 28 months; weight 14 ± 9 kg), under general inhalated anesthesia delivered via a laryngeal mask airway, were studied in two anatomic positions: head in the resting position and in simple extension. The following measurements were made on each scan: the face and the neck axes, the pharyngeal axis, the laryngeal axis, and the line of vision of glottis. The various angles between these axes were defined: , angle between line of vision and laryngeal axis, and , angle between pharyngeal axis and laryngeal axis. From an anatomical point of view, laryngoscopy and passage of a naso-tracheal tube would be facilitated if these angles are narrow. Results:, Placing the patient from the resting position into extension led to a narrowing of the angle , but a widening of the angle ,. Conclusions:, In infants and young children, under general anesthesia and with a laryngeal mask airway in place, just a slight head extension improves alignment of the line of vision of the glottis and the laryngeal axis (narrowing of angle ,) but worsened the alignment of the pharyngeal and laryngeal axes (widening of angle ,). [source]

Cervicocephalic kinaesthesia: reliability of a new test approach

PHYSIOTHERAPY RESEARCH INTERNATIONAL, Issue 4 2001
Eythor Kristjansson Faculty of Medicine
Abstract Background and Purpose Relocating either the natural head posture (NHP) or predetermined points in range are clinical tests of impaired neck proprioception but memory might influence these tests. Three new tests, reasoned to be more challenging for the proprioceptive system, were developed. The objectives were to assess the reliability of all tests and whether the three new tests were more challenging for the proprioceptive system. Method A test,retest design was used to assess the reproducibility and errors of all five tests. Twenty asymptomatic volunteers were assessed a week apart, using an electromagnetic movement sensor system, the 3-Space Fastrak. A measure of error magnitude was used to detect kinaesthetic sensibility. Comparison of the means and their corresponding dispersion were analysed descriptively. The between-day intraclass correlation coefficients (ICCs) were calculated and plots of mean differences between days 1 and 2 were conducted to estimate test reliability. Multivariate analysis of variance (MANOVA) and least significant difference (LSD) pairwise comparisons were performed to compare the test accuracy between different target positions. Results ICCs were between 0.35 and 0.9, but plotting the data modified the interpretation in some tests. Relocating a NHP was easier when the trunk was in a neutral position than when pre-rotated (error 2.46° (±0.2°) versus 5.95° (±0.7°). Relocating a 30° rotation position (error 5.8° (±0.6°) and repeatedly moving through a target (error 4.82° (±0.7°) was also difficult. Conclusions The new tests were more challenging than relocating the NHP but the reliability of tests relocating uncommon positions was questionable. Copyright © 2001 Whurr Publishers Ltd. [source]

Relationship between ease of swallowing and deglutition-related muscle activity in various postures

JOURNAL OF ORAL REHABILITATION, Issue 8 2010
T. SAKUMA
Summary, The purpose of this study was to investigate the relationship between the ease of swallowing and the deglutition-related muscle activity in various body and head postures by surface electromyography (EMG). Bipolar surface electrodes were placed on the right suprahyoid and infrahyoid muscles of nine healthy adults (19,28 years) while swallowing jelly. Ten postures per subject were examined: five body angulations (0° [supine], 30°, 60°, 90° [upright] and 120° from the horizontal) and two head positions (chin-up and chin-down). The duration and amplitude of suprahyoid and infrahyoid muscle activity were measured by an electromyograph, and the ease of swallowing was subjectively determined by using a rating scale (0 = difficult to swallow, 10 = easy to swallow). The group-average duration and amplitude of muscle activity and the group-average rating scales mostly showed insignificant changes with the body angulations independent of the head positions. Interestingly, the duration and amplitude of muscle activity during swallowing were negatively correlated with the rating scales, indicating that a shorter duration and smaller activity of muscle activity corresponds to easier swallowing. Consequently, the duration and amplitude of suprahyoid and infrahyoid muscle activity measured by surface EMG would be a useful indicator of the easy-to-swallow performance. [source]