The effect of various therapeutic exercises on forward head posture, rounded shoulder, and hyperkyphosis among people with upper crossed syndrome: a systematic review and meta-analysis.

OBJECTIVES: This review study aimed to evaluate the impact of therapeutic exercises on Upper-Crossed Syndrome (UCS). The study utilized a systematic review and meta-analysis approach to investigate the effects of various therapeutic exercises on forward head posture, rounded shoulders, and hyperkyphosis associated with upper crossed syndrome. METHODS: The study identified relevant keywords for each independent and dependent variable and conducted a search in scientific databases, including PubMed, Web of Science, Scopus, and Google Scholar, without any time limitations until 12 August 2023. Overall, 4625 articles were found in the selected databases, which were reduced to 1085 after being entered into the EndNote software and removing duplicate data. The full texts of 30 remaining studies were reviewed; ten articles meeting the criteria were included. Additionally, 12 studies from the Google Scholar database were included, resulting in 22 studies. Using Comprehensive meta-analysis software (CMA ver 3), data heterogeneity was measured with I2 and the Q tests. The Funnel Plot and Egger test methods were utilized to determine the possibility of publication bias. The JBI checklist was used to assess the quality of the studies. RESULTS: The results of the meta-analysis showed that therapeutic exercises were effective in improving forward head, rounded shoulders, and thoracic kyphosis angles (CI 95% = -1.85-1.161, P = 0.001, P = 0.001, CI95%=-1.822-1.15, and P = 0.001, CI 95%= -1.83-1.09, respectively). CONCLUSION: Based on the results, it appears that performing therapeutic exercises in the form of strength exercises, stretching, shoulder-based exercises, and incredibly comprehensive exercises that target all muscles may be effective in reducing forward head, rounded shoulders, thoracic kyphosis, and overall UCS.

The effectiveness of fatigue on repositioning sense of lower extremities: systematic review and meta-analysis.

INTRODUCTION: An injury can significantly harm both individual and team performance. One of the most important risk factors for sports-related injuries, especially non-collision injuries, is fatigue. It seems that poor proprioception may play an essential role to impose athletes to further injuries. This systematic review and meta-analysis aimed to examine the effectiveness of fatigue on the repositioning sense of the lower extremity joints. METHOD: The electronic databases, including PubMed, Web of Science, Scopus, and Google Scholar were systematically searched from inception to 11January 2024. The obtained records were exported to the EndNote Software version 8. Then, two investigators examined the records independently to find eligible studies based on the inclusion/exclusion criteria. In the case of disagreements, a consequence method was utilized. The quality of the eligible studies was evaluated using the Downs and Black checklist. Comprehensive Meta-Analysis (CMA) software ver. 3 software was used for statistical analysis. Q-test and I2 were employed to examine the data homogeneity. In addition, considering the risk of bias, the Funnel Plot and trim-and-fill method were used. RESULTS: After reviewing the titles and abstracts of 3883 studies found in the selected databases, 43 articles were found to be eligible to include in meta-analyses. The results showed that fatigue led to a significant increase in the active absolute error of the knee (SDM = 0.524, 95% CI = 0.406-0.841), ankle in the horizontal plane (SDM = 0.541, 95% CI = 0.367-0.715), ankle in the sagittal plane (SDM = 0.443, 95% CI = 0.088-0.798), and hip (SDM = 0.988, 95% CI = 0.135-1.841). However, fatigue had no significant effects on the passive absolute error of the knee and ankle in horizontal plane and relative angular error of the knee. CONCLUSION: Fatigue can diminish the active joint position sense of the lower extremities and thus may increase the risk of injury by reducing proprioception. Therefore, future research could be conducted to investigate the potential impact of integrated fatigue-mitigating exercises into athletes' training programs, with the aim of reducing the incidence of sports-related injuries.

Association between physical activity and body posture: a systematic review and meta-analysis.

OBJECTIVE: To estimate the possible associations between posture and physical activity (PA). DESIGN: A systematic review and meta-analysis. DATA SOURCES: The search was conducted in seven databases (PubMed, Web of Science, SportDiscus, EMBASE, Scopus, Cochrane Library, and CINAHL) for studies published from inception to January 2023. ELIGIBILITY CRITERIA FOR SELECTING STUDIES: Studies were required to meet following criteria: (1) study design: cross-sectional, case control and cohort studies. (2) Participants: people of all ages without any diagnosed diseases. (3) Exposure and outcome: studies that examined the possible effect or correlations between PA, physical inactivity, physical exertion and human body posture. RESULTS: Sixteen cross-sectional studies, two cohort studies and one case control study involving a total of 16772 participants aged from 6 to 79 years were included. Correlational studies showed that there was a significant relationship between PA and posture (C = 0.100, CI 95% = 0.012-0.186). However, regression studies demonstrated that there was not a significant association between PA and posture (C = 1.00, CI 95% = 0.998-1.002). Three studies investigated the association between PA and the lumbar lordosis and showed that there was not a significant association between the lordosis and PA (CI 95%: -0.253-0.048, P = 0.180). In addition, four studies showed that there were not any associations between scoliosis and PA (CI 95%: 0.819, 1.123, P = 0.607). The evidence of heterogeneity and publication bias was found among all analyzed data (P < 0.05). Also, meta regression was used for age and BMI and the results were not significant. CONCLUSION: Although a weak correlation was shown to exist between PA and human posture, the odds ratio indicated that there was not a significant association between PA and human posture. The lack of a significant relationship may indicate that multiple biopsychosocial factors may be involved in human posture. In summary, our study highlights the need for caution when interpreting the results of meta-analyses, particularly when there is significant heterogeneity and publication bias in the included studies.

Effectiveness of Therapeutic Exercise on Forward Head Posture: A Systematic Review and Meta-analysis.

OBJECTIVE: The purpose of this systematic review and meta-analysis was to summarize the results related to the effects of corrective exercises on postural variables in individuals with forward head posture (FHP). METHODS: A systematic review of the electronic literature through February 2017 was independently performed by 2 investigators. The electronic databases searched included PubMed, MEDLINE, Web of Science, ScienceDirect, Cochrane Central Register of Controlled Clinical Trials, Google Scholar, and Scopus. Methodological quality was evaluated using the Physiotherapy Evidence Database scale. Meta-analyses were carried out for craniovertebral angle (CVA), cranial angle (CA), and pain intensity. RESULTS: Seven randomized clinical trials comprising 627 participants met the study criteria. The between-groups pooled random odds ratios for CVA, CA, and pain were 6.7 (confidence interval [CI] = 2.53-17.9, P = .0005), 0.7 (CI = 0.43-1.2, P = .2), and 0.3 (95% CI = 0.13-0.42, P < .001), respectively. No publication bias was observed. Level 1a evidence (strong) indicates exercise training can effectively modify CVA, and level 1b evidence (moderate) indicates exercise may improve pain but not CA. CONCLUSION: The findings suggest that therapeutic exercises may result in large changes in CVA and moderate improvement in neck pain in participants with FHP. The precise nature of the relationship between FHP and musculoskeletal pain, and improvements in both after therapeutic exercise, remains to be established.