Search Results (99)

Background: This study investigated associations between anthropometric characteristics, postural deviations, musculoskeletal and visceral symptoms, and squat movement quality to clarify how individual physical attributes and symptom profiles influence fundamental movement performance. Method(s): A cross-sectional observational study recruited adults aged 18–65 who could ambulate without pain. Anthropometric and body composition measures were collected. Standardized posture images and multi-angle squat videos were obtained, and visual classifications of posture and squat technique were conducted using predefined criteria. Descriptive statistics characterized the sample, and multivariable logistic regression with LASSO regularization examined associations between demographic, postural, and symptom variables and binary squat outcomes. Results: Two hundred participants (57.5% female; median age 26 years) were included. Males showed higher stature, lean mass, and waist circumference, whereas females exhibited higher body fat and reported more neck pain and headaches. Forward head posture was common (62%), while women demonstrated more favorable upper-body alignment. Most participants maintained neutral lumbar posture and grounded heels during squats, with sex differences in foot rotation and knee path. Higher fat mass predicted reduced squat depth (OR = 1.06, 95% CI: 1.00 to 1.11, p = 0.033); heel lift and absent forward knee movement were associated with better spinal neutrality (OR = 0.07 and 0.18, both p ≤ 0.002); and low skeletal muscle mass (OR = 0.87, 95% CI: 0.79 to 0.95, p = 0.004) and heel lift (OR = 7.09, 95% CI: 1.86 to 26.2, p = 0.003) predicted suboptimal knee tracking. Only 8% achieved a fully “perfect” squat. Conclusion(s): Suboptimal squat mechanics were linked to higher fat mass, lower skeletal muscle mass, and compensatory lower-limb strategies, suggesting that squat quality reflects an interaction among body composition, posture, and motor control rather than any single demographic or anthropometric factor. Full article

Problem Statement: Upper crossed syndrome (UCS), as first described by Janda, refers to a group of muscle imbalances in which tightness in the upper trapezius and levator scapulae dorsally cross with tightness in the pectoralis major and minor muscles, and weakness of deep cervical flexors cross ventrally with weakness of the middle and lower trapezius. Postural alterations from this dysfunction, including forward head, rounded shoulders, and scapular dyskinesis, contribute to upper-back and shoulder pain, particularly among office workers who spend long periods of the workday on a computer. Upper crossed syndrome is a significant contributor to both neck pain and shoulder pain among computer users, which have been rated at 55–69%, and 15–52%, respectively. Despite its prevalence, knowledge about UCS and its treatment remains spotty among primary care physicians. In addition, improvements in workstation ergonomics along with hourly work breaks may be considered as primary prevention strategies for UCS. Objectives: This narrative review examines and synthesizes evidence about the epidemiology and diagnosis of UCS, along with clinical recommendations for physiotherapeutic approaches to treatment. Ergonomic measures in the workplace, including changes in the design of computer workstations so that both the keyboard and monitor are at the proper heights to minimize the risk of long-term musculoskeletal disorders, are also critical. Methods: The first author, a Doctor of Behavioral Health, performed the initial literature search, which was reviewed by the second author, a PhD in sports injury epidemiology. The third author, a chiropractor and practice owner, provided clinical recommendations for stretching and strengthening exercises, which were also described in the literature. Discussion: While easily treatable when caught early, UCS may become resistant to noninvasive approaches over time, and more severe pathologies of the neck and shoulder, including impingement, thoracic outlet syndrome, and cervicogenic headaches may result. Because there is no specific ICD code for UCS, it is important for physicians to recognize the early signs, consider them in the context of workplace-related injuries, and understand physiotherapeutic strategies for symptom resolution. Full article

Background: This study investigated how static postural parameters influence dynamic spinopelvic balance across varying walking speeds. One hundred healthy young adults (aged 18–25) underwent rasterstereographic assessment (DIERS 4Dmotion^®) to quantify static global alignment metrics including craniovertebral angle (CVA), Q-angle, sagittal and coronal imbalance, pelvic rotation, torsion, obliquity, vertebral rotation, thoracic kyphosis, lumbar lordosis, and pelvic tilt, followed by dynamic spinopelvic analysis during treadmill walking at 1, 2, 4, and 5 km/h. Methods: Multiple linear regression models were used to determine the predictive value of static postural measures for dynamic outcomes at each speed. At slower walking speeds (1–2 km/h), static alignment variables significantly predicted dynamic spinopelvic parameters (adjusted R² = 0.53–0.73; RMSE = 0.59–0.81), with CVA, sagittal imbalance, and pelvic torsion emerging as the most consistent predictors. Results: At higher speeds (4–5 km/h), predictive strength declined substantially (adjusted R² = 0.04–0.34), indicating a shift from posture-driven to neuromuscular-governed gait control. The Q-angle showed limited and inconsistent predictive value across all conditions. Conclusions: Overall, static postural alignment, particularly CVA, sagittal imbalance, and pelvic torsion, serves as a moderate predictor of spinopelvic dynamics at slow to moderate gait speeds but loses explanatory power as velocity increases, emphasizing the growing role of neuromuscular control in maintaining dynamic balance. These findings highlight the clinical relevance of integrating both static and dynamic assessments to comprehensively evaluate postural and locomotor function. Full article

Background/Objective: Postural control differs between individuals with lower limb amputation and the general population. Although previous studies examined the effects of unexpected surface perturbations on postural control in individuals with transtibial amputation (TTA) and individuals with transfemoral amputation (TFA), their impact on lower limb muscle activation remains unclear. This study aimed to assess postural control on a stable surface and to evaluate the effects of unexpected surface perturbations on lower limb muscle activation in unilateral TTAs, TFAs, and in a healthy control group (CG). Methods: The study included 10 TTAs, 9 TFAs, and 10 healthy controls. Postural control was assessed using a force platform, and lower limb muscle activity was recorded with surface electromyography during unexpected surface perturbations. Results: The TFAs showed the highest anteroposterior and lateral postural sway under compliant surface eyes closed and the highest lateral sway under normal surface eyes closed, whereas the CG showed the lowest values (p < 0.05). During forward perturbations, rectus femoris (RF) and tibialis anterior (TA) activations were significantly higher than biceps femoris (BF) and medial head of the gastrocnemius (GM) activations, respectively, across all groups (p < 0.05). During backward perturbations, GM activations exceeded TA activations in all groups, while BF activations were higher than RF only in TTAs (p < 0.05). Significant group effects were found for RF and BF during forward perturbations, and side effects for BF (forward) and RF (backward) activations (p < 0.05). Conclusions: Postural control responses vary with the level of lower limb amputation. TFAs relied more on visual input during quiet standing, whereas TTAs demonstrated greater reliance on thigh muscle activation during surface perturbations. These findings highlight the need to consider amputation level in balance and rehabilitation programs. Full article

Head posture assessment commonly involves measuring cranial angles, with photogrammetry favored for its simplicity over CT scans or goniometers. However, most photo-based measurements remain manual, making them time-consuming and inefficient. Existing automatic measuring approaches often requires specific markers and clean backgrounds, limiting their usability. We present AutoMCA, a robust automatic measurement system for cranial angles using accessible markers and tolerating typical indoor backgrounds. AutoMCA integrates MediaPipe Pose, a machine-learning solution, for head–neck segmentation and applies color thresholding and morphological operations for marker detection. Validation tests demonstrated Pearson correlation coefficients above 0.98 compared to manual Kinovea measurements for both the craniovertebral angle (CVA) and cranial rotation angle (CRA), confirming high accuracy. Further validation on individuals with neck disorders showed similarly strong correlations, supporting clinical applicability. Speed comparison tests revealed that AutoMCA significantly reduces measurement time compared to traditional photogrammetry. Robustness tests confirmed reliable performance across varied backgrounds and marker types. In conclusion, AutoMCA measures head posture efficiency and lowers the requirements for instruments and space, making the assessment more versatile and applicable. Full article

Background: Children with autism spectrum disorder (ASD) frequently show postural abnormalities and elevated muscle tone, which can hinder participation in education and rehabilitation. Evidence on the immediate physiological effects of standardized multisensory environments is limited. Objective: To evaluate feasibility, safety and short-term physiological/postural responses to an automated multisensory smart relaxation system in children with severe ASD. Methods: In a single-session pilot across three sites, 30 children (27 boys; 6–16 years) underwent pre–post postural observation and bilateral surface EMG of the upper trapezius, biceps brachii and rectus abdominis. The system delivered parameterized sound, vibration, and mild heat. EMG was normalized to a quiet-sitting baseline. Results: The intervention was well tolerated with no adverse events. Most children sat independently (25/30; 80%) and a majority stood up unaided after the session (24/30; 76.9%). Postural profiles reflected common ASD features (neutral trunk 76%, forward head 52%, rounded/protracted shoulders 46%), while limb behavior was predominantly calm (73%). Normalized EMG amplitudes were low, with no significant pre–post changes and no meaningful left–right asymmetries (all p > 0.05; Cohen’s d < 0.20), indicating physiological calmness rather than tonic co-contraction. Conclusions: A single session with a smart multisensory relaxation system was safe, feasible, and physiologically calming for children with severe ASD, without increasing postural or muscular tension. The platform’s standardization and objective monitoring support its potential as a short-term calming adjunct before therapy or classroom tasks. Larger, gender-balanced, multi-session trials with behavioral outcomes are warranted. Full article

Swimming research has determined that rounded shoulders, forward head, and scapular dyskinesis are common imbalances that may lead to injury without correction. This case study aimed to evaluate a preventative exercise program designed to reduce injuries, correct postural deviations, and improve shoulder function over one collegiate swimming season. Twenty female NCAA Division I swimmers (average age = 21.6 ± 1.3 years) participated over 25 weeks, completing pre-, mid-, and post-season assessments of injury rates, shoulder range of motion, and stability using standardized tests. Injuries were included as diagnosed and reported by an athletic trainer. Testing included internal rotation, external rotation, the Hawkins-Kennedy test, Neer’s sign, Sulcus sign, and the Closed Kinetic Chain Upper-Extremity Stability Test (CKCUEST). Compared to the season prior with no intervention, swimmers who completed the program were 44% less likely to sustain an upper-extremity injury, as assessed from the CKCUEST scores (p < 0.01 for all metrics), shoulder internal rotation (p < 0.01 for both shoulders), and total range of motion (p < 0.01 for both shoulders). These findings suggest that a targeted corrective exercise program can effectively reduce injury rates and improve shoulder mobility and function in collegiate athletes. The interpretation of these results is limited by the study’s non-randomized design and absence of a control group. Full article

Forward head posture and altered scapular alignment are associated with musculoskeletal dysfunctions and impaired physical performance. However, the relationship between postural alignment indices and physiological function in young adults remains unexplored. A total of 54 healthy participants (mean age: 21.88 ± 2.06 years) were evaluated. Craniovertebral angle (CVA) and scapular index were measured as indicators of postural alignment. Upper trapezius muscle tone was assessed using the MyotonPRO device. Pulmonary function parameters, including the forced vital capacity (FVC) and forced expiratory volume in one second (FEV₁)/FVC, were measured using spirometry. Balance control was evaluated using the Tetrax system, and cervical proprioception was assessed using joint position error (JPE) tests. CVA showed statistically significant but weak correlations with the muscle tone (r = −0.191), weight distribution index in the eyes-open condition (r = −0.199), and cervical flexion JPE (r = −0.198) and a positive correlation with FVC (r = 0.251) (p < 0.05). Scapular index showed a positive correlation with FEV₁/FVC (r = 0.241) and a negative correlation with balance control (r = −0.213) (p < 0.05). Improved postural alignment, as reflected by a higher CVA and scapular index, was associated with reduced muscle tone, enhanced pulmonary function, better balance control, and more accurate cervical proprioception. Full article

The effectiveness of breathing interventions on postural alignment, pain reduction, and functional improvement in patients with forward head posture (FHP) and chronic neck pain remains uncertain. Previously conducted randomized controlled trials (RCTs) that involved breathing interventions were identified through searches of the PubMed, Cochrane Library, Web of Science, and Scopus databases. Studies were included if they applied diaphragmatic breathing, breathing muscle training, or feedback breathing exercises for at least 2 weeks to chronic neck pain (duration ≥ 3 months) and/or forward head posture. The craniovertebral angle (CVA), the visual analog scale (VAS), and the neck disability index (NDI) were the primary outcome measures. The results showed that breathing interventions had a moderate effect size in terms of improving the CVA. Limited effects were observed for pain reduction, and improvements in neck disability approached statistical significance. However, despite these positive findings, the overall evidence was rated as ‘very low certainty’ in the GRADE assessment, primarily due to high heterogeneity among studies, limited sample sizes, and the potential for unit-of-analysis errors in diagnosis-based subgroup analyses. Consequently, their overall effectiveness in chronic neck pain was limited. Future research is needed to explore a multidisciplinary approach to neck pain using standardized protocols and larger samples. Full article

Background/Objectives: The aim of this study was to examine the effectiveness of an exercise program based on principles of motor learning with cognitive elements (such as attention) in the correction of Forward Head Posture (FHP). Methods: A total of 55 university students from the University of Thessaly, aged between 18 and 25 years, participated in this study. Volunteers found to have a craniovertebral angle <50° were randomly divided into two groups: the intervention group IG (n = 27) and the control group CG (n = 28). The IG followed a treatment protocol consisting of three 30–45-min sessions per week for four weeks, a total of twelve sessions, while the control group received the same content instructions and group sessions upon completion. Results: After the four-week intervention period, significant improvements were observed in both static and dynamic craniovertebral angle measurements (p < 0.05) when comparing the IG to the CG. Additionally, there was a notable increase in the endurance of the deep neck flexors (p < 0.05), even though the intervention for the IG did not include specific strength exercises. Furthermore, participants with FHP were able to transfer (B–C) motor skills (p < 0.01) acquired during static position tasks to a similar but dynamically untrained task. They also retained (B–D) improvements in posture and strength during the two-week detraining period (p < 0.01), indicating sustained motor learning effects. Conclusions: The exercise intervention was successful at decreasing FHP in subjects, sustaining the results for a two-week period. This study supports the effectiveness of postural training by a program based on motor learning principles. New rehabilitation strategies based on motor control and motor learning could be introduced into physiotherapy practice to increase effectiveness. Full article

Infants discriminate faces early in the first year, but research on infants’ discrimination of bodies is plagued by mixed findings. Using a familiarisation novelty preference method, we investigated 7- and 9-month-old infants’ discrimination of body postures presented in upright and inverted orientations, and with and without heads, along with relationships with gross and fine motor development. In our initial studies, 7-month-old infants discriminated upright headless postures with forward-facing and about-facing images. Eye tracking revealed that infants looked at the bodies of the upright headless postures the longest and at the heads of upright whole figures for 60–70% of the time regardless of the presence of faces, suggesting that heads detract attention from bodies. In a more stringent test, with similarly complex limb positions between test items, infants could not discriminate postures. With longer trials, the 7-month-olds demonstrated a familiarity preference for the upright whole figures, and the 9-month-olds demonstrated a novelty preference, albeit with a less robust effect. Unlike previous studies, we found that better gross motor skills were related to the 7-month-olds’ better discrimination of upright headless postures compared to inverted postures. The 9-month-old infants’ lower gross and fine motor skills were associated with a stronger preference for inverted compared to upright whole figures. This is further evidence of a configural representation of bodies in infancy, but it is constrained by an upper bias (heads in upright figures, feet in inverted), the test item similarity, and the trial duration. The measure and type of motor development reveals differential relationships with infants’ representations of bodies. Full article

Modern electronic devices such as smartphones, wearable devices, and robots typically integrate three-dimensional sensors to track the device’s movement in the 3D space. However, sensor measurements in three-dimensional vectors are highly sensitive to device orientation since a slight change in the device’s tilt or heading can change the vector values. To avoid complications, applications using these sensors often use only the magnitude of the vector, as in geomagnetic-based indoor positioning, or assume fixed device holding postures such as holding a smartphone in portrait mode only. However, using only the magnitude of the vector loses the directional information, while ad hoc posture assumptions work under controlled laboratory conditions but often fail in real-world scenarios. To resolve these problems, we propose a universal vector calibration algorithm that enables consistent three-dimensional vector measurements for the same physical activity, regardless of device orientation. The algorithm works in two stages. First, it transforms vector values in local coordinates to those in global coordinates by calibrating device tilting using pitch and roll angles computed from the initial vector values. Second, it additionally transforms vector values from the global coordinate to a reference coordinate when the target coordinate is different from the global coordinate by correcting yaw rotation to align with application-specific reference coordinate systems. We evaluated our algorithm on geomagnetic field-based indoor positioning and bidirectional step detection. For indoor positioning, our vector calibration achieved an 83.6% reduction in mismatches between sampled magnetic vectors and magnetic field map vectors and reduced the LSTM-based positioning error from 31.14 m to 0.66 m. For bidirectional step detection, the proposed algorithm with vector calibration improved step detection accuracy from 67.63% to 99.25% and forward/backward classification from 65.54% to 100% across various device orientations. Full article

Background/Objectives: A randomized controlled trial (RCT) was designed to test the emerging role of respiratory mechanics as part of physiotherapy in patients with non-specific chronic neck pain (NSCNP). Methods: Ninety patients with NSCNP and symptom duration >3 months were randomly allocated to three intervention groups of equal size, receiving either cervical spine (according to the Mulligan Concept) and diaphragm manual therapy plus breathing reeducation exercises (experimental group—EG1), cervical spine manual therapy plus sham diaphragmatic manual techniques (EG2), or conventional physiotherapy (control group—CG). The treatment period lasted one month (10 sessions) for all groups. The effect on the cervical spine range of motion (CS-ROM) and on the craniovertebral angle (CVA) was examined. Outcomes were collected before treatment (0/12), after treatment (1/12), and three months after the end of treatment (4/12). The main analysis comprised a two-way mixed ANOVA with a repeated measures factor (time) and a between-groups factor (group). Post hoc tests assessed the source of significant interactions detected. The significance level was set at p = 0.05. Results: No significant between-group baseline differences were identified. Increases in CS-ROM and in CVA were registered mainly post-treatment, with improvements maintained at follow-up for CS-ROM. EG1 significantly improved over CG in all movement directions except for flexion and over EG2 for extension only, at 1/12 and 4/12. All groups improved by the same amount for CVA. Conclusions: EG1, which included diaphragm manual therapy and breathing re-education exercises, registered the largest overall improvement over CG (except for flexion and CVA), and for extension over EG2. The interaction between respiratory mechanics and neck mobility may provide new therapeutic and assessment insights of patients with NSCNP. Full article

Objectives: New smartphone-based methods for measuring cervical spine range of motion (CS-ROM) and posture are emerging. The purpose of this study was to assess the reliability and validity of three such methods in patients with non-specific chronic neck pain (NSCNP). Methods: The within-day test–retest reliability of CS-ROM and forward head posture (craniovertebral angle-CVA) was examined in 45 patients with NSCNP. CS-ROM was simultaneously measured with an accelerometer sensor (KFORCE Sens^®) and a mobile phone device (iHandy and Compass apps), testing the accuracy of each and the parallel-forms reliability between the two methods. For construct validity, correlations of CS-ROM with demographics, lifestyle, and other cervical and thoracic spine biomechanically based measures were examined in 90 patients with NSCNP. Male–female differences were also explored. Results: Both methods were reliable, with measurements concurring between the two devices in all six movement directions (intraclass correlation coefficient/ICC = 0.90–0.99, standard error of the measurement/SEM = 0.54–3.09°). Male–female differences were only noted for two CS-ROM measures and CVA. Significant associations were documented: (a) between the six CS-ROM measures (R = 0.22–0.54, p < 0.05), (b) participants’ age with five out of six CS-ROM measures (R = 0.23–0.40, p < 0.05) and CVA (R = 0.21, p < 0.05), (c) CVA with two out of six CS-ROM measures (extension R = 0.29, p = 0.005 and left-side flexion R = 0.21, p < 0.05), body mass (R = −0.39, p < 0.001), body mass index (R = −0.52, p < 0.001), and chest wall expansion (R = 0.24–0.29, p < 0.05). Significantly lower forward head posture was noted in subjects with a high level of physical activity relative to those with a low level of physical activity. Conclusions: The reliability of both CS-ROM methods was excellent. Reductions in CS-ROM and increases in CVA were age-dependent in NSCNP. The significant relationship identified between CVA and CWE possibly signifies interconnections between NSCNP and the biomechanical aspect of dysfunctional breathing. Full article

Advances in information technology and the widespread adoption of smartphones have improved human convenience and quality of life by facilitating extensive information sharing. However, the increasing frequency and duration of smartphone use is linked to a high risk of musculoskeletal disorders, particularly manifesting as changes in posture and gait. These alterations can lead to various physical issues, including spinal deformities, reduced gait stability, and increased muscle fatigue. Furthermore, excessive smartphone use can negatively affect mental health, contributing to depression, anxiety, and cognitive impairment. This narrative review primarily aims to systematically examine the effects of smartphone-related posture and gait alterations on physical function and identify associated problems. This study systematically summarized individual studies published between 2009, when smartphones first became widespread, and 2024 that investigated the effects of smartphone-induced posture and gait alterations. Through identifying issues related to these alterations, we aim to propose preventive strategies to avoid further complications. Full article