DOI QR코드

DOI QR Code

The Effect of Exhalation Breathing Exercise on Respiratory Synergist Muscle Activity and Pulmonary Functions in Patients with Forward Head Posture

  • Received : 2016.03.22
  • Accepted : 2016.04.05
  • Published : 2016.04.30

Abstract

Purpose: The aim of this study is to suggest an intervention method for clinical use in the future by analyzing the effect of breathing exercise on activity of sternocleidomastoid muscle and scalenus anterior muscle, which are respiratory synergist muscles, and pulmonary functions in patients with forward head posture. Methods: Prior to the experiment, 12 patients (experimental group) performed feedback exhalation exercise along with conventional deep neck exercise, and 11 subjects (control group) performed feedback deep neck exercise along with conventional deep neck exercise. The intervention programs were performed for 40 minutes once a day (three times a week for four weeks). Results: Before intervention, %RMS was measured for surface electromyography (sEMG), and FVC, FEV1, and FEV1/FVC were measured using a spirometer. After four weeks, these items were re-measured under the same condition and analyzed. In within-group comparison of the experimental group, activity of sternocleidomastoid muscle and scalenus anterior muscle showed a significant decrease (p<0.05)(p<0.001), and forced vital capacity (FVC) showed a significant increase (p<0.05). In within-group comparison of the control group, activity of sternocleidomastoid muscle and scalenus anterior muscle showed a significant decrease (p<0.05), and in between-group comparison, there were significant differences in activity of sternocleidomastoid muscle and FVC (p<0.05). Conclusion: Long-term forward head posture restrains exercise performance of the neck and leads to exercise avoidance of the neck during daily activities, thus restraint factors might be created even while breathing. To cut off this link, a constant effort is required and diversified research on the correlation between neck functions and breathing should be conducted.

Keywords

References

  1. Kang JH, Park RY, Lee SJ et al. The effect of the forward head posture on postural balance in long time computer based worker. Ann Rehabil Med. 2012;36:98-104. https://doi.org/10.5535/arm.2012.36.1.98
  2. Falla D, Farina D. Neuromuscular adaptation in experimental and clinical neck pain. J Electromyogr Kinesiol. 2008;18(2):255-61. https://doi.org/10.1016/j.jelekin.2006.11.001
  3. Shin SH, Choi JD. Effects of specific exercise on chronic neck pain in elderly women. J Kor Phys Ther. 2010;22(3):1-8. https://doi.org/10.1589/jpts.22.1
  4. Wirth B, Amstalden M, Perk M et al. Respiratory dysfunction in patients with chronic neck pain–influence of thoracic spine and chest mobility. Man Ther. 2014;19(5):440-4. https://doi.org/10.1016/j.math.2014.04.011
  5. Page P. Current concepts in muscle stretching for exercise and rehabilitation. Int J Sports Phys Ther. 2012;7(1):109-19.
  6. Jull G, Kristjansson E, Dall’Alba P. Impairment in the cervical flexors: a comparison of whiplash and insidious onset neck pain patients. Man Ther. 2004;9(2):89-4. https://doi.org/10.1016/S1356-689X(03)00086-9
  7. O'Leary S, Falla D, Jull G et al. Muscle specificity in tests of cervical flexor muscle performance. J Electromyogr Kinesiol 2007;17(1):35-40. https://doi.org/10.1016/j.jelekin.2005.10.006
  8. Liebenson C, Karpowicz AM, Brown SH et al. The active straight leg raise test and lumbar spine stability. PM&R. 2009;1(6):530-5. https://doi.org/10.1016/j.pmrj.2009.03.007
  9. Dimitriadis Z, Kapreli E, Strimpakos N et al. Respiratory weakness in patients with chronic neck pain. Man Ther. 2013;18(3):248-53. https://doi.org/10.1016/j.math.2012.10.014
  10. Gupta BD, Aggarwal S, Gupta B et al. Effect of deep cervical flexor training vs. conventional isometric training on forward head posture, pain, neck disability index in dentists suffering from chronic neck pain. J Clin Diagn Res. 2013;7(10):2261-4.
  11. Nezamuddin M, Anwer S, Khan SA et al. Efficacy of pressure-biofeedback guided deep cervical flexor training on neck pain and muscle performance in visual display terminal operators. J Musculoskelet Res. 2013;16(3):141-6.
  12. Dusunceli Y, Ozturk C, Atamaz F et al. Efficacy of neck stabilization exercises for neck pain: a randomized controlled study. J Rehabil Med. 2009;41(8):626-31. https://doi.org/10.2340/16501977-0392
  13. Kapreli E, Vourazanis E, Billis E et al. Strimpakos N. Respiratory dysfunction in chronic neck pain patients. A pilot study. Cephalalgia. 2009;29(7):701-710. https://doi.org/10.1111/j.1468-2982.2008.01787.x
  14. Kapreli E, Vourazanis E, Strimpakos N. Neck pain causes respiratory dysfunction. Med Hypotheses 2008;70(5):1009-13. https://doi.org/10.1016/j.mehy.2007.07.050
  15. Mäntyselkä P, Lupsakko T, Kautiainen H et al. Neck-shoulder pain and depressive symptoms: a cohort study with a 7-year follow-up. Eur J Pain. 2010;14(2):189-93. https://doi.org/10.1016/j.ejpain.2009.04.004
  16. Weon JH, Oh JS, Cynn HS et al. Influence of forward head posture on scapular upward rotators during isometric shoulder flexion. J Bodyw mov ther. 2010;14(4):367-74. https://doi.org/10.1016/j.jbmt.2009.06.006
  17. Jeong DK. The effects of breathing exercise on respiratory synergist muscle activity and SpO2 in patients with chronic obstructive pulmonary disease. J Kor Phys Ther. 2015;27(4):234-9. https://doi.org/10.18857/jkpt.2015.27.4.234
  18. Kang Jl, Jeong DK, Park SK et al. Effects of chest resistance exercise on forced expiratory volume in one second and fatigue in patients with COPD. J Kor Phys Ther. 2011;23(2):37-43. https://doi.org/10.1589/jpts.23.37
  19. Kang DY. Deep cervical flexor training with a pressure biofeedback unit is an effective method for maintaining neck mobility and muscular endurance in college students with forward head posture. J Phys Ther Sci. 2015;27(10):3207-10. https://doi.org/10.1589/jpts.27.3207
  20. Kang JI, Kim BR, Park SK et al. Effects of deep abdominal muscle strengthening exercises on pulmonary function and the ability to balance in stroke patients. J Kor Phys Ther. 2015;27(4):258-63. https://doi.org/10.18857/jkpt.2015.27.4.258
  21. Cho WH, Lee WY, Choi HK. An Investigation on the biomechanical effects of turtle neck syndrome through EMG analysis. IJPEM. 2008; 8:195-6.
  22. Key J, Clift A, Condie F et al. A model of movement dysfunction provides a classification system guiding diagnosis and therapeutic care in spinal pain and related musculoskeletal syndromes: a paradigm shift-Part 1. J Bodyw Mov Ther. 2008;12(1):7-21. https://doi.org/10.1016/j.jbmt.2007.04.005
  23. Koh EK, Jung DU. Effect of head posture and breathing pattern on muscle activities of sternocleidomastoid and scalene during inspiratory respiration. KJSB. 2013;23(3):279-84.
  24. Borisut S, Vongsirinavarat M, Vachalathiti R et al. Effects of strength and endurance training of superficial and deep neck muscles on muscle activities and pain levels of females with chronic neck pain. J Phys Ther Sci. 2013;25(9):1157-62. https://doi.org/10.1589/jpts.25.1157
  25. Cagnie B, Danneels L, Cools A et al. The influence of breathing type, expiration and cervical posture on the performance of the craniocervical flexion test in healthy subjects. Man ther. 2008;13(3):232-8. https://doi.org/10.1016/j.math.2007.01.009
  26. Perrin C, Unterborn JN, Ambrosio CD et al. Pulmonary complications of chronic neuromuscular diseases and their management. Muscle Nerve. 2004;29(1):5-27. https://doi.org/10.1002/mus.10487
  27. Okuro RT, Morcillo AM, Ribeiro MA et al. Mouth breathing and forward head posture: effects on respiratory biomechanics and exercise capacity in children. J Bras Pneumol. 2011;37(4):471-9. https://doi.org/10.1590/S1806-37132011000400009
  28. Kim SY, Kim NS, Jung JH et al. Effect of forward head posture on respiratory function in young adults. J Korean Soc Phys Ther. 2013;25 (5):311-5.
  29. Vandevoorde J, Verbanck S, Schuermans D et al. Obstructive and restrictive spirometric patterns: fixed cut-offs for FEV1/FEV6 and FEV6. Eur Respir J. 2006;27(2):378-83. https://doi.org/10.1183/09031936.06.00036005

Cited by

  1. 시각적 되먹임을 이용한 배가로근 수축이 건강한 성인의 폐기능에 미치는 효과 vol.4, pp.2, 2016, https://doi.org/10.15268/ksim.2016.4.2.023
  2. 전방머리자세와 중립자세에 대한 인위적 자세변화가 호흡에 미치는 영향 vol.5, pp.1, 2017, https://doi.org/10.15268/ksim.2017.5.1.067
  3. Comparison of muscular fatigue and tone of neck according to craniocervical flexion exercise and suboccipital relaxation in cervicogenic headache patients vol.29, pp.5, 2016, https://doi.org/10.1589/jpts.29.869
  4. Effect of Self-Postural Control with Visual Feedback in the Foot Pressures in the Subject with Forward Head Posture vol.29, pp.4, 2016, https://doi.org/10.18857/jkpt.2017.29.4.153
  5. The Effect of Breathing Training on the Physical Function and Psychological Problems in Patients with Chronic Stroke vol.32, pp.3, 2020, https://doi.org/10.18857/jkpt.2020.32.3.146
  6. Pulmonary Function and Its Influence Factors of Healthy Adults vol.16, pp.1, 2016, https://doi.org/10.24332/aospt.2020.16.1.05
  7. The Effect of Dynamic Neuromuscular Stabilization (DNS) on the Respiratory Function of Subjects with Forward Head Posture (FHP) vol.16, pp.3, 2016, https://doi.org/10.13066/kspm.2021.16.3.55