Effects of suboccipital release with craniocervical flexion exercise on craniocervical alignment and extrinsic cervical muscle activity in subjects with forward head posture

• Published in: Journal of electromyography and kinesiology Vol. 30; no. NA; pp. 31 - 37
• Main Authors: Kim, Bo-Been, Lee, Ji-Hyun, Jeong, Hyo-Jung, Cynn, Heon-Seock
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01.10.2016
• Subjects: Cervical range of motion; Cervical Vertebrae - physiology; Craniocervical flexion exercise; Craniovertebral angle; Cross-Sectional Studies; Exercise - physiology; Female; Forward head posture; Head Movements - physiology; Humans; Male; Neck Muscles - physiology; Occipital Bone - physiology; Physical Medicine and Rehabilitation; Pilot Projects; Posture - physiology; Random Allocation; Range of Motion, Articular - physiology; Skull - physiology; Suboccipital release; Young Adult; Craniovertebral angle; Suboccipital release; Cervical range of motion; Craniocervical flexion exercise; Forward head posture
• ISSN: 1050-6411; 1873-5711; 1873-5711
• DOI: 10.1016/j.jelekin.2016.05.007

Forward head posture is a head-on-trunk malalignment, which results in musculoskeletal dysfunction and neck pain. To improve forward head posture, both the craniocervical flexion exercise and the suboccipital release technique have been used. Objectives: The purpose of this study was to compare the immediate effects of craniocervical flexion exercise and suboccipital release combined with craniocervical flexion exercise on craniovertebral angle, cervical flexion and extension range of motion, and the muscle activities of the sternocleidomastoid, anterior scalene, and splenius capitis during craniocervical flexion exercise in subjects with forward head posture. In total, 19 subjects (7 males, 12 females) with forward head posture were recruited using G-power software. Each subject performed craniocervical flexion exercise and suboccipital release combined with craniocervical flexion exercise in random order. After one intervention was performed, the subject took a 20min wash out period to minimize any carry-over effect between interventions. Craniovertebral angle, cervical flexion and extension range of motion, and the muscle activities of the sternocleidomastoid, anterior scalene, and splenius capitis were measured. A one-way, repeated-measures ANOVA was used to assess differences between the effects of the craniocervical flexion exercise and suboccipital release combined with craniocervical flexion exercise interventions in the same group. Craniovertebral angle (p<0.05), cervical flexion range of motion (p<0.05), and cervical extension range of motion (p<0.001) were significantly greater after suboccipital release combined with craniocervical flexion exercise compared to craniocervical flexion exercise alone. The muscle activities of the sternocleidomastoid, anterior scalene, and splenius capitis were significantly lower during suboccipital release combined with craniocervical flexion exercise than during craniocervical flexion exercise alone across all craniocervical flexion exercise phases except the first (all p<0.05). The addition of suboccipital release to craniocervical flexion exercise provided superior benefits relative to craniocervical flexion exercise alone as an intervention for subjects with forward head posture.