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Effects of Exercise Type on Neck Disability, Pain, and Postural Changes in Subjects with Forward Head Posture: Systematic Review and Meta-Analysis
J Korean Soc Phys Med 2018;13(3):121-132
Published online August 31, 2018;
© 2018 Journal of The Korean Society of Physical Medicine.

Jeong-Gon Na, PT⋅Han-Suk Lee, PT, Ph.D1† ⋅Sun-Wook Park, PT, Ph.D2

Department of Physical Therapy, Graduate School of Eulji University
1Department of Physical Therapy, Eulji University
2Department of Physical Therapy, Samsung Medical Center
Received June 13, 2018; Revised June 22, 2018; Accepted July 14, 2018.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
PURPOSE: This study was conducted to investigate the effects of type of exercise on neck disability, pain, and postural changes in subjects with forward head posture.
METHODS: Two independent researchers conducted a search using KISS, RISS, DBpia (domestic), PubMed, OVID, and Science Direct (overseas) databases. We selected randomized controlled clinical trials by searching using the terms “forward head posture”, “exercise therapy”, and “therapeutic exercise”. Studies published from 2007 to December 2017 were included. PEDro Scale was used to evaluate the quality of the selected studies, and meta-analysis was conducted using the CMA program. This review was registered at PROSPERO (CRD42018068633).
RESULTS: Of the total 13768 studies searched, 17 were selected. Positive effects on neck disability were achieved with the base and biomechanical elements (ES=1.63, 95% confidence interval [CI] .49 to 2.75) as well as base, modulator, and biomechanical elements (ES=1.50, 95% [CI] .69 to 2.30). Neck pain improved with the base, modulator, and biomechanical elements (ES=1.96, 95% [CI] 1.08 to 2.82), while postural changes improved with biomechanical elements (ES=1.45, 95% [CI] .64 to 2.25). Additionally, type of exercise had a positive effect.
CONCLUSION: The most effective exercises for neck disability are of the base and biomechanical elements, while the most effective types for neck pain are of the base, modulator, and biomechanical elements and the most effective exercise for posture is of biomechanical elements. Combined exercises targeting biomechanical elements were effective at treating disability, pain, and postural changes.
Keywords : Exercise therapy, Meta-analysis, Posture

August 2018, 13 (3)
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