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Feb 02 2014

Effects of thoracic kyphosis and forward head posture on cervical range of motion in older adults

Abstract

It is unclear how age-related postural changes such as thoracic spine kyphosis influence cervical range-of-motion (ROM) in patients with cervical spine dysfunction. The purpose of this study was to explore the mediating effects of forward head posture (FHP) on the relationship between thoracic kyphosis and cervical mobility in older adults with cervical spine dysfunction. Fifty-one older adults (30 females, mean[SD]age = 66[4.9] years) with cervical spine dysfunction – that is, cervical pain with or without referred pain, numbness or paraesthesia – participated. Pain-related disability was measured using the neck disability index (NDI). Thoracic kyphosis was measured using a flexicurve. FHP was assessed via the craniovertebral angle (CVA) measured from a digitized, lateral-view photograph of each subject. Cervical ROM – namely, upper and general cervical rotation and cervical flexion – was measured by the Cervical Range-of-Motion (CROM) device. Greater thoracic kyphosis was significantly associated with lesser CVA (Spearman ρ = -0.48) whereas greater CVA was significantly associated with greater cervical flexion (Spearman ρ = 0.30) and general rotation ROM (ρ = 0.33), but not with upper cervical rotation ROM (ρ = 0.15). Bootstrap mediational analyses, adjusted for age, gender, weight and NDI, revealed significant indirect effects of thoracic kyphosis on cervical flexion and general rotation ROM through a FHP. Our results show that FHP mediated the relationship between thoracic kyphosis and cervical ROM, specifically general cervical rotation and flexion. These results not only support the justifiable attention given to addressing FHP to improve cervical impairments, but they also suggest that addressing thoracic kyphosis impairments may constitute an “upstream” approach.

Written by Robert Libbey, RMT · Categorized: Blog, Research

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Course Lessons

Introduction

  • Shoulder Watch Me First!

Section One

  • Shoulder Section 1 – Anatomy Discussion

Section Two

  • Shoulder Section 2 – Anatomy Discussion

Section Three

  • Shoulder Section 3 – Anatomy Discussion

Section Four

  • Shoulder Section 4 – Anatomy Discussion

Conclusion

  • Conclusion to the Shoulder Course

Bonus Material

  • Shoulder Bonus Material – Full Treatment 1 Hr

Lessons

  • Knee Introduction
    • Watch Me First!
    • Welcome to the Knee Course
    • History, Principles & Research Supporting the Theory of L.A.S.T.
    • Ligament Referral Patterns for the Knee
    • Knee Course – Neurophysiological Model for Referred Pain
    • Understanding Pain Science and Your Practice
  • Knee Section 1
    • Technique for Popliteal Fascia
    • Technique for Posterior Meniscus
    • Technique for Anterior Meniscus
  • Knee Section 2
    • Technique for Medial Collateral Ligament
    • Technique for Lateral Collateral Ligament
  • Knee Section 3
    • Technique for General Cruciate Ligaments
    • Technique for Anterior Cruciate Ligament
    • Technique for Posterior Cruciate Ligament
  • Knee Section 4
    • Technique for Articularis Genu
    • Technique for Patellar Ligament & Infra-Patellar Fat Pad
    • (Bonus Video) Technique for Proximal Tibiofibular Joint
    • (Bonus Video) Technique for the Fibula
  • Knee Section 5 – Conclusion
    • Conclusion to the Knee Course
    • Online Knee Exam
    • Knee Ligament Pain Referral Pattern Posters
  • Knee Section 6 – Treatment Section – Vanessa
    • Vanessa Interview
    • Vanessa Assessment
    • Vanessa Pre-Treatment Gait
    • Vanessa Treatment
    • Vanessa Post-Treatment Gait
    • Vanessa Post-Treatment Interview

Lessons

  • Leg & Foot Introduction
    • Leg & Foot Watch Me First!
    • Welcome to the Leg & Foot Course
    • Leg & Foot History, Principles & Research Supporting the Theory of L.A.S.T.
    • Ligament Referral Patterns for the Leg & Foot
    • Leg & Foot – Neurophysiological Model for Referred Pain
    • Understanding Pain Science and Your Practice
  • Leg & Foot Section 1
    • Calcaneus (Boot Jack) Technique
    • Technique for General Talocrural Joint
    • Technique for Talus Anterior
    • Technique for Talus Posterior
  • Leg & Foot Section 2
    • Technique for General Tarsals & Metatarsals
    • Technique for MTP/PIP/DIP
  • Leg & Foot Section 3
    • Technique for Proximal Tibiofibular Joint
    • Technique for the Fibula
    • Technique for Interosseous Membrane
  • Leg & Foot Section 4
    • Technique for Dorsiflexors of the Foot/Pretibial Fascia
    • Technique for Plantar Flexors of the Foot
    • Technique for Plantar Connective Tissue
  • Leg & Foot Section 5 – Conclusion
    • Conclusion to the Leg & Foot Course
    • Online Leg & Foot Exam
    • Ligament Pain Referral Pattern Posters
  • Leg & Foot Section 6 – Treatment Section
    • Michelle – Pre Treatment Interview
    • Michelle – Pre Treatment Assessment
    • Michelle – Full Treatment 1 Hr
    • Michelle – Post Treatment Assessment
    • Michelle – Post Treatment Interview

Lessons

  • Shoulder Introduction
    • Shoulder Watch Me First!
    • Welcome to the Shoulder Course
    • Shoulder History, Principles & Research Supporting the Theory of L.A.S.T.
    • Ligament Referral Patterns for the Shoulder
    • Shoulder – Neurophysiological Model for Referred Pain
    • Understanding Pain Science and Your Practice
  • Shoulder Section 1
    • Shoulder Section 1 – Anatomy Discussion
    • Technique for Anterior Cervical Fascia
    • Technique for SCM
    • Technique for Anterior Sternoclavicular Joint Capsule/Ligament
    • Technique for Posterior Sternoclavicular Capsule/Ligament
    • Technique for Interclavicular Ligament
  • Shoulder Section 2
    • Shoulder Section 2 – Anatomy Discussion
    • Technique for Costoclavicular Ligament/ Upper Mediastinum
    • Technique for for Rib 1
    • Technique for Subclavious
    • Technique for Coracoclavicular Ligaments (Conoid & Trapazoid)
  • Shoulder Section 3
    • Shoulder Section 3 – Anatomy Discussion
    • Technique for Pectoralis Minor, Coracobrachialis & Short Head Biceps
    • Technique for Pectoralis Major
    • Technique for Long Head Biceps
    • Technique for Teres Major & Minor
    • Technique for Glenohumeral Capsule Disengagement
  • Shoulder Section 4
    • Shoulder Section 4 – Anatomy Discussion
    • Technique for Restoring the Bucket-Handle Motion of the Ribs
    • Technique for Respiratory Diaphragm
  • Shoulder Section 5 – Conclusion
    • Conclusion to the Shoulder Course
    • Shoulder Online Shoulder Exam
    • Shoulder Ligament Pain Referral Pattern Posters
  • Shoulder Section 6 – Treatment Section
    • Shoulder – Bonus Material – Pre-Treatment Interview
    • Shoulder Bonus Material – Full Treatment 1 Hr
    • Shoulder Bonus Material – Post-Treatment Interview

Course Lessons

  • Shoulder Introduction
    • Shoulder Watch Me First!
    • Welcome to the Shoulder Course
    • Shoulder History, Principles & Research Supporting the Theory of L.A.S.T.
    • Ligament Referral Patterns for the Shoulder
    • Shoulder – Neurophysiological Model for Referred Pain
    • Understanding Pain Science and Your Practice
  • Shoulder Section 1
    • Shoulder Section 1 – Anatomy Discussion
    • Technique for Anterior Cervical Fascia
    • Technique for SCM
    • Technique for Anterior Sternoclavicular Joint Capsule/Ligament
    • Technique for Posterior Sternoclavicular Capsule/Ligament
    • Technique for Interclavicular Ligament
  • Shoulder Section 2
    • Shoulder Section 2 – Anatomy Discussion
    • Technique for Costoclavicular Ligament/ Upper Mediastinum
    • Technique for for Rib 1
    • Technique for Subclavious
    • Technique for Coracoclavicular Ligaments (Conoid & Trapazoid)
  • Shoulder Section 3
    • Shoulder Section 3 – Anatomy Discussion
    • Technique for Pectoralis Minor, Coracobrachialis & Short Head Biceps
    • Technique for Pectoralis Major
    • Technique for Long Head Biceps
    • Technique for Teres Major & Minor
    • Technique for Glenohumeral Capsule Disengagement
  • Shoulder Section 4
    • Shoulder Section 4 – Anatomy Discussion
    • Technique for Restoring the Bucket-Handle Motion of the Ribs
    • Technique for Respiratory Diaphragm
  • Shoulder Section 5 – Conclusion
    • Conclusion to the Shoulder Course
    • Shoulder Online Shoulder Exam
    • Shoulder Ligament Pain Referral Pattern Posters
  • Shoulder Section 6 – Treatment Section
    • Shoulder – Bonus Material – Pre-Treatment Interview
    • Shoulder Bonus Material – Full Treatment 1 Hr
    • Shoulder Bonus Material – Post-Treatment Interview

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