The Impact of Forward Head Posture on Neck and Ankle Joint Position Sense: A Cross-Sectional Study.

BACKGROUND: Forward head posture (FHP) decreases the neck position sense and creates tension in the neck muscles, which inversely affects the mechanics of the distal joints through body myofascia. Thus, this study investigated the effects of FHP on neck and ankle joint position sense, and conducted a comparison between the joint position sense of the right and left ankle. METHODS: Fifty-seven subjects were assigned according to the craniovertebral angle (CVA) into the FHP group (CVA <49°; n = 27) or the control group (CVA >49°; n = 30). Head and ankle joint repositioning accuracy was measured by using a cervical range-of-motion device and an isokinetic dynamometer, respectively. RESULTS: There was a significant increase in the joint position error (JPE) of the cervical flexion, extension, and right and left side bending motions of the FHP group compared to the control group (P < .05). There were significant increases in the JPE of the right and left ankle dorsiflexion and plantarflexion of the FHP group compared to the healthy group (P < .05). Moreover, the JPE of the right ankle dorsiflexion and plantarflexion of the FHP group were significantly higher than the left ankle (P < .05). CONCLUSIONS: The FHP decreases the position sense of cervical flexion, extension, and right and left side bending motions, and the plantarflexion and dorsiflexion of both ankle joints, especially the right ankle joint.

Effect of magnesium sulfate iontophoresis on myofascial trigger points in the upper fibres of the trapezius.

OBJECTIVE: To investigate the immediate and post-treatment effect of magnesium sulfate (MgSO4) iontophoresis on myofascial trigger points (MTrPs) in the upper fibres of the trapezius muscle. METHOD: Sixty participants (41 women and 19 men, aged 19-24 years) with active MTrPs on the dominant upper fibres of trapezius were enrolled in this study. They were randomly divided into 2 equivalent groups: the intervention and the control group. The intervention group (iontophoresis group; n = 30) was treated with MgSO4 iontophoresis on the upper fibres of the trapezius twice a week for four weeks, and the control group (direct current group; n = 30) received direct current (without medication) in the upper fibres of the trapezius twice a week for four weeks. The outcome measures were: pain intensity, pain threshold, neck range of motion, and neck function The participants were assessed before treatment, immediately after the first session, and finally after treatment. RESULTS: The differences within and between groups were measured using a mixed design, multivariate analysis of variance (MANOVA). The within- and between-group analysis of all outcome measures in both groups revealed significant differences in favour of the intervention group (p < 0.05). CONCLUSION: MgSO4 iontophoresis is effective in improving pain level, neck ROM, and neck function immediately after the first session and causes more significant improvement after treatment in subjects with active MTrPs on the dominant upper fiber of trapezius.