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Emadi Andani, M.; Lotfalian, B.; Moshayedi, A.J. Forward Head Posture and Biofeedback. Encyclopedia. Available online: https://encyclopedia.pub/entry/54279 (accessed on 18 May 2024).
Emadi Andani M, Lotfalian B, Moshayedi AJ. Forward Head Posture and Biofeedback. Encyclopedia. Available at: https://encyclopedia.pub/entry/54279. Accessed May 18, 2024.
Emadi Andani, Mehran, Bahar Lotfalian, Ata Jahangir Moshayedi. "Forward Head Posture and Biofeedback" Encyclopedia, https://encyclopedia.pub/entry/54279 (accessed May 18, 2024).
Emadi Andani, M., Lotfalian, B., & Moshayedi, A.J. (2024, January 24). Forward Head Posture and Biofeedback. In Encyclopedia. https://encyclopedia.pub/entry/54279
Emadi Andani, Mehran, et al. "Forward Head Posture and Biofeedback." Encyclopedia. Web. 24 January, 2024.
Forward Head Posture and Biofeedback
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This entry is adapted from the peer-reviewed paper 10.3390/app14020781

Forward Head Posture (FHP) is when the head leans forward due to factors such as heavy backpacks or poor computer ergonomics. FHP can lead to neck strain and discomfort as well as potential long-term issues such as arthritis. Treatment options include specialized exercises, orthopedic devices, manual therapy, physical exercises, and visual feedback techniques, along with guidance from specialists in physical medicine and rehabilitation. In this study, a visual feedback-based approach was used to address FHP in female students. 

forward head posture visual feedback bio-feedback Arduino UNO 3D accelerometer healthcare

1. Introduction

One of the prevailing issues concerning bodily posture pertains to the phenomenon of Forward Head Posture (FHP). FHP is a condition characterized by the forward positioning of the head in relation to the shoulders and spine. In light of the predominant nature of human interaction occurring anteriorly vis-à-vis the countenance, protracted engagements with computer usage, television consumption, video game indulgence, unforeseen mishaps, or the protracted carriage of backpacks have been identified as potential antecedents to the proclivity of cranial inclination towards the anterior plane [1].

2. Forward Head Posture Reasons and Causes

In the broad spectrum of causative elements contributing to this phenomenon, a succinct enumeration of pivotal determinants is presented in the following sections: Backpack Overloading [2], Computer Utilization Ergonomics [3], Traumatic Incidents [4], Ocular Impairment [5], and Ambulation Anomalies [6]. Notably, this constellation of secondary effects encompasses an array of deleterious consequences, including but not limited to those delineated in Figure 1.
Applsci 14 00781 g001
Figure 1. Comparing forward head (red) and correct head (green) positions: A, Tragus; B, 𝛼 (Head/Neck angle); C, C7 (seventh cervical vertebra).
In an optimal scenario, the cranial region should be impeccably aligned with the cervical and scapular regions, akin to the harmonious equilibrium of a golf ball atop its pedestal. In stark contrast, the human cranium presents a significantly heftier mass, more akin to that of a bowling ball; consequently, the anterior inclination of the head imposes a substantial biomechanical strain on the cervical and dorsal musculature. It is noteworthy that the gravitational burden on the cervical spine escalates for every increment of the anterior displacement of the cranium, as reported in Table 1 [7].
Table 1. Intensity of pressure on the neck in different neck angular positions.
Neck Angular Position Intensity of Pressure in the Neck (kg)
4–5 Head in normal position
12 Head forward 𝛼� =15 degrees
18 Head forward 𝛼� = 30 degrees
22 Head forward 𝛼� = 45 degrees
27 Head forward 𝛼� = 60 degrees
As delineated in Table 1, each increment of 15 degrees in the anterior displacement of the head imposes an excessive load akin to the initial pressure upon the cervical region [7].
Consequently, this increased pressure engenders cervical weariness and concomitant persistent or predominant cervical discomfort. The musculature spanning the cervical and scapular regions is entrusted with the perpetual sustenance of this burdensome load, and sustains an isometric contraction, culminating in hemodynamic impairment, tissue trauma, and exhaustion ultimately manifesting as elongation, soreness, a burning sensation, and fibromyalgia [8]. Furthermore, the anterior inclination of the head and neck precipitates the erasure of the inherent cervical lordosis, thereby compromising the integrity of the intervertebral discs and potentially fostering premature arthritic degeneration [9].

3. Treatment Modalities and Strategies

The initial phase of addressing ailments related to the head and neck necessitates thorough evaluation by a specialist in physical medicine and rehabilitation complemented by radiographic assessments to gauge the progression of the condition. Subsequent to this comprehensive assessment, a tailored treatment regimen is prescribed encompassing specialized exercises and an array of therapeutic interventions. Several therapeutic modalities warrant consideration, including stretching and strengthening regimens, offered by a physical medicine and rehabilitation specialist as a series of exercises [10], utilization of a bespoke orthopedic apparatus such as an orthopedic device (e.g., braces or lumbar supports) designed to facilitate optimal bodily posture [11], manual techniques such as the application of massage therapy [12], structured physical exercises or corrective movements [13][14], and biofeedback techniques such as therapeutic–educational modalities wherein individuals are instructed on the volitional regulation of innate autonomic physiological functions to influence overall bodily wellbeing [15].

4. Biofeedback

Biofeedback, in its canonical manifestation, emerges as a therapeutic method underpinned by the sophisticated apparatus of modern electronics, serving as a conduit for the comprehensive measurement and intricate analysis of the multifarious neural, muscular, and autonomic processes inherent to the human corpus [16]. These invaluable insights gleaned from the depths of biofeedback instrumentation are subsequently imparted to the patient and their medical practitioner(s) through the medium of auditory or visual feedback, culminating in a symbiotic dyad of informed collaboration [17][18][19]. For patients, the biofeedback apparatus functions as a quasi-sensorial adjunct, affording them the rarefied capacity to perceive and cognize the inner workings of their corporeal vessel [20]. In a notable example, someone using a blood pressure monitor can actually lower their own blood pressure by simply concentrating on the screen [21]. When acquiring skills such as biking, driving, or sports, this unspoken skill of blood pressure control combines mental and physical aspects. It is developed through trial and error, hands-on learning, and dedicated practice [22]. Biofeedback equipment translates physiological signals into audio–visual feedback, aiding in the treatment of various conditions including neurological and muscular issues, tension-related problems, and gastrointestinal disorders [23]. These devices are temporary tools for learning and experimentation, becoming unnecessary when proficiency is attained. Biofeedback is particularly effective in cases where pharmaceutical interventions fall short [24].
A recent paper [25] introduced a biofeedback system using an accelerometer. In a five-hour study with six participants, the authors found that the system significantly reduced time spent in poor posture. The biofeedback system interfaced with a computer and provided real-time feedback on the user’s neck angle through a visual display and auditory cues. While initial sessions recorded neck movements without feedback, subsequent sessions with active biofeedback showed improved posture. It is worth noting that continuous use of the biofeedback system was required in order to maintain good posture, and there was no information on lasting effects after the study.
In [26], researchers introduced an innovative biofeedback system with a camera on a computer monitor, auditory cues, and a tactile feedback necklace. Participants read on their computers with the option of using auditory or tactile feedback. Results showed improved neck angles with both feedback methods, and there was a significant change in neck angle even without feedback. While this study demonstrated the rapid effectiveness of biofeedback within a single 90-min session, the long-term benefits remain uncertain. In [27], the authors suggested that individuals can learn to improve their head and neck posture through the use of a biofeedback system. The system continuously monitors head and neck alignment, providing real-time feedback through a smartphone app. It uses signals such as sounds, music, vibrations, and flashes to warn users about poor posture. Data collected are securely stored and can be shared with healthcare professionals; however, the device does not quantify the extent of posture improvement, highlighting the need for web services to access comprehensive data.
In another study, [28] used neurofeedback to improve neck posture in individuals with forward head syndrome. Participants were split into two groups, one receiving neurofeedback training and the other acting as a control. Both groups underwent a four-week, thrice-weekly program that included unique activities such as pottery and brainwave-controlled archery to enhance concentration. After the training, the neurofeedback group showed significant improvements in neck mobility, as documented through post-training assessments.
In [29], a study was conducted in which participants performed a one-hour typing task twice, once with biofeedback and once without. The researchers attached the biofeedback device to the participants and instructed them on maintaining an upright posture. Using motion analysis and discomfort assessments, this study found that the biofeedback device significantly improved the posture of individuals experiencing neck discomfort during computer-related tasks. Forward head posture is a common issue with potential health risks, and various treatments have been explored. Common biofeedback methods are reviewed in Table 2, although biofeedback can refer to other devices as well [30][31].
Table 2. Biofeedback methods and principle.
Method Principle
Surface Electromyography (sEMG) Measures muscle activity in the neck and upper back, offering feedback on muscle activation during poor posture [32].
Pressure Biofeedback Utilizes a device under the neck or upper back to measure pressure changes, aiding in teaching individuals how to maintain proper posture [33].
Wearable Posture Sensors Devices such as posture correctors or sensors provide real-time alerts or reminders when users deviate from correct posture, encouraging
better habits [34].
Visual Feedback Systems Mirrors, video monitoring, or software applications offer visual cues about current posture, allowing users to adjust and correct
their alignment [35].
Auditory Feedback Devices Devices produce sounds or alerts when posture deviates, serving as a reminder to adjust and maintain proper alignment [36].
Virtual Reality (VR) Augmented Reality (AR) Postures is simulated to provide interactive feedback in order to help individuals learn to correct their forward head posture [37].
In terms of performance, according to the Table 2, advanced sEMG and VR/AR methods provide more complete feedback but are less accessible due to their complexity. On the other hand, wearable sensors and visual and auditory feedback devices have slightly different performance, are more accessible, and are more popular while requiring less specific settings [38].

References

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Subjects: Instruments & Instrumentation
Contributors MDPI registered users' name will be linked to their SciProfiles pages. To register with us, please refer to https://encyclopedia.pub/register :
Mehran Emadi Andani
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Bahar Lotfalian
,
Ata Jahangir Moshayedi
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Update Date: 29 Jan 2024
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