Thesis (Ph. D.)--University of Washington, 2002. / Vita. Includes bibliographical references (leaves 73-84).

Objetivo: A postura de cabeça relaciona-se com o equilíbrio do sistema estomatognático podendo alterar-se em casos de deformidades dentofaciais com indicação cirúrgica. Dessa forma, o presente estudo teve por objetivo verificar se a cirurgia ortognática, realizada para corrigir a deformidade dentofacial, caracterizada por mordida cruzada total, leva, a curto prazo, à modificação na postura de cabeça de indivíduos com fissura labiopalatina. Modelo: Utilizou-se um protocolo específico de anamnese e avaliação visual da postura da cabeça, da coluna cervical e da altura do ombro, da tonicidade muscular e da presença de dor à palpação. Local: Laboratório de Fisiologia – HRAC/USP. Participantes: Foram avaliados 6 indivíduos, 3 de cada gênero, entre 19 e 33 anos, com mordida cruzada total e fissura labiopalatina reparada antes e, em média, 4 meses após a cirurgia ortognática. Resultados: Não foram detectadas alterações importantes nos parâmetros avaliados. Conclusão: Assim, pode-se concluir que, na amostra avaliada, não houve modificação na postura da cabeça após a cirurgia ortognática nos indivíduos com fissura labiopalatina e mordida cruzada. / Objective: Head posture is related to the balance of the stomathognathic system and may be altered in individuals with dentofacial deformities in need of surgical treatment. Thus, the present study investigated if orthognathic surgery performed to correct dentofacial deformities characterized by complete crossbite leads to short-term changes in head posture of individuals with cleft lip and palate. Design: A specific protocol was followed, including anamnesis, visual assessment of head posture, cervical spine and shoulder height, muscle tonicity and muscle pain to palpation. Setting: Physiology Laboratory – HRAC/USP. Subjects: The sample comprised six individuals, being 3 males and 3 females, aged 19 to 33 years, presenting complete crossbite and repaired cleft lip and palate. Patients were assessed before and approximately 4 months after orthognathic surgery. Results: No important alterations were observed in the study parameters. Conclusion: Thus, it could be concluded that there were no changes in head posture after orthognathic surgery in the present sample of individuals with cleft lip and palate and crossbite.

Objetivo: A postura de cabeça relaciona-se com o equilíbrio do sistema estomatognático podendo alterar-se em casos de deformidades dentofaciais com indicação cirúrgica. Dessa forma, o presente estudo teve por objetivo verificar se a cirurgia ortognática, realizada para corrigir a deformidade dentofacial, caracterizada por mordida cruzada total, leva, a curto prazo, à modificação na postura de cabeça de indivíduos com fissura labiopalatina. Modelo: Utilizou-se um protocolo específico de anamnese e avaliação visual da postura da cabeça, da coluna cervical e da altura do ombro, da tonicidade muscular e da presença de dor à palpação. Local: Laboratório de Fisiologia – HRAC/USP. Participantes: Foram avaliados 6 indivíduos, 3 de cada gênero, entre 19 e 33 anos, com mordida cruzada total e fissura labiopalatina reparada antes e, em média, 4 meses após a cirurgia ortognática. Resultados: Não foram detectadas alterações importantes nos parâmetros avaliados. Conclusão: Assim, pode-se concluir que, na amostra avaliada, não houve modificação na postura da cabeça após a cirurgia ortognática nos indivíduos com fissura labiopalatina e mordida cruzada. / Objective: Head posture is related to the balance of the stomathognathic system and may be altered in individuals with dentofacial deformities in need of surgical treatment. Thus, the present study investigated if orthognathic surgery performed to correct dentofacial deformities characterized by complete crossbite leads to short-term changes in head posture of individuals with cleft lip and palate. Design: A specific protocol was followed, including anamnesis, visual assessment of head posture, cervical spine and shoulder height, muscle tonicity and muscle pain to palpation. Setting: Physiology Laboratory – HRAC/USP. Subjects: The sample comprised six individuals, being 3 males and 3 females, aged 19 to 33 years, presenting complete crossbite and repaired cleft lip and palate. Patients were assessed before and approximately 4 months after orthognathic surgery. Results: No important alterations were observed in the study parameters. Conclusion: Thus, it could be concluded that there were no changes in head posture after orthognathic surgery in the present sample of individuals with cleft lip and palate and crossbite.

Title: The evaluation of the head posture of children playing piano Aims: The aim of this work was the evaluation of an influence of playing the piano on school age children who had played piano for 4 or 5 years. Methods: 46 probands participated in the research, out of which 23 children represented the research group and 23 children represented the control group. Probands head movements were observed while playing a piece of their own choice without the aid of musical notesfirstly in a relaxed seated position and secondly in aadjusted seated position according to Brugger. Probands from the control group undertook the same observations, but without playing the piano. During the observations of the relaxed and adjusted seating position, probands looked directly to the front of them while their head position and their eyes remained still. The TrackIR tool (Natural Point Company) was used to conduct the measurements of the head movements. Results: The conclusion derived from the results is that piano playing from 4 to 5 years does not have a negative influence on the head posture of the children who play the instrument for 4 or 5 years. Key words: piano playing, head posture with preference, TrackIR, variations of head posture in time.

Title: Effect of forward head posture on postural stabilization measured by postural somatooscillography. Objectives: The aim of this thesis was to assess the influence of the forward head posture on the overall ability of postural stabilization using postural somatooscillography method. Methods: This thesis was prepared using analytical - comparative study. It compared two groups of fifteen subjects using the challenge test "3 steps - standing on one leg" in standart conditions. The measurement was recorded to the Microswing 6.0 and collected data was evaluated by Posturomed Commander. Results: The research did not achieve clear results at all, but in the overall assessment, we could say, that people with forward head posture have different, maybe slightly worse ability of postural stabilization. Keywords: postural stability, forward head posture, Posturomed, cervical spine

Backpacks are used by more than 90% of schoolchildren worldwide and over 40 million students in the United States on a regular basis. The carriage of loaded backpacks is associated with kinematic and physiological changes, as well as complaints of neck and back pain. Since a history of backpain in childhood is the strongest predictor of having musculoskeletal discomfort and back pain as an adult, development of back pain due to backpack use is of prognostic concern. The purpose of this dissertation was to examine the effects of backpack weights (up to 20% body weight (BW)) on children’s posture, subjective complaints of pain and perceived exertion, and walking endurance. A secondary goal was to examine the data to identify and recommend a weight limit for backpacks carried by elementary school children based on the results. In Chapter 2, we performed a preliminary study designed to examine the effects of loaded backpacks on forward head posture in school children. The results of this study found that forward head posture increased with both backpack weight and condition. The greatest differences were noted at the 15% and 20%BW backpack loads with initial loading, but after 6 minutes of walking the forward head posture was similar for all backpack loads. In Chapter 3, we conducted a study to evaluate multiple postural angles and the subjective complaints of pain and perceived exertion/fatigue in children to determine the effects of both the weight and time spent carrying loaded backpacks up to 20%BW. Subjects showed significant changes in all measures including the Six Minute Walk Test (6MWT), OMNI Walk/Run Scale of perceived exertion/fatigue and subjective complaints of pain, as well as the postural angles of Craniovertebral Angle, Forward Trunk Lean, and Pelvic Tilt. Subjects demonstrated immediate and significant changes in forward head posture, forward trunk lean, and pelvic tilt while wearing backpacks weighing 10%, 15% and 20%BW, but the 10%BW backpack resulted in the least amount of change. This study also found that these postural angles changed additionally after walking 6 minutes while carrying the loaded backpacks. Subjects also demonstrated decreased 6MWT distances and increased reports of perceived exertion and pain after carrying backpacks weighing 10%, 15% and 20%BW. In Chapter 4, we discussed the clinical implications of this research. It was determined that backpack loads weighing 10%, 15% and 20%BW of a child’s body weight result in immediate changes in posture, which continue to increase after walking six minutes with the loaded backpack. The backpack loads significantly impacted the children’s walking endurance as well as their reports of perceived exertion/fatigue and regional pain. This study found that of the loads tested, the 10%BW resulted in the least amount of change in all outcome measures. However, the 10%BW load was not innocuous, as it still created significant changes in posture and subjective complaints. Backpack weight limit guidelines need to be written to protect children from carrying backpacks weighing more than 10% body weight.

Struck-by fatalities involving heavy equipment such as trucks and cranes accounted for 24.6% of the fatalities between 1997-2007 in the construction industry. Limited visibility due to blind spots and travel in reverse direction are the primary causes of these fatalities. Blind spots are spaces surrounding an equipment that are invisible to the equipment operator. Thus, a hazard is posed to the ground personnel working in the blind spaces of an equipment operator. This research presents a novel approach to intelligently identify potential hazards posed to workers operating near an equipment by determining the visible and blind space regions of an equipment operator in real-time. A depth camera is used to estimate the head posture of the equipment operator and continuously track the head location and orientation using Random Forests algorithm. The head posture information is then integrated with point cloud data of the construction equipment to determine both the visible and the blindspots region of the equipment operator using Ray-Casting algorithm. Simulation and field experiments were carried out to validate this approach in controlled and uncontrolled environment respectively. Research findings demonstrate the potential of this approach to enhance safety performance by detecting hazardous proximity situations.

Purpose: 1, to determine effect of education and exercise on neck pain, disability, cervical posture and muscle function in office workers with sub-clinical neck symptoms; 2, to determine differences in forward head posture in preferred and standardized posture, and 3, to explore the influence of time on work posture in a sub-group of office workers. Subjects: Sixty-six office workers with sub-clinical neck symptoms who utilize computers at least 4 hours per day participated. A sub-group of 27 were videotaped to assess posture over a workday. Methods: Videotaping was performed 15 minutes of the first and last hour of the workday for analysis of the craniovertebral angle. Cervical posture using the CROM was measured on all subjects in standardized and preferred positioning of the trunk and lower extremities. Subjects were randomly assigned to one of three groups: education only (EOG), education and exercise (EEG), or control (CG). Pre and post-test measurements of pain (Visual Analog Scale), disability (NeckDisability Index), forward head posture (FHP), and deep cervical flexor muscle function (Craniocervical Flexion Test and Short Neck Flexor Endurance Test) were assessed for change within group as well as differences between groups over the 8 week period. Results: No difference was found for FHP over 8 hours in the subgroup. FHP was greater in preferred position compared to standardized by 7.59 mm (95% CI 6.27-8.92, p<.001). Median and mean scores improved for all 3 groups on pain and disability with greater improvement in intervention groups. FHP was unchanged/slightly worse in the CG and EOG, and improved in the EEG. Muscle function improved for the EEG. Statistical significance was not found for change scores between groups. Posttest scores were statistically significant for the NDI between EEG (20.45) and the CG (34.47), p=.042, and between the EEG and the EOG (34.59), p=.023 using Kruskall Wallis with adjusted significance for pairwise comparisons. Discussion/Conclusions: Posture over the workday did not change, differences were found based on preferred and standardized positions. Exercise and education intervention for those with sub-clinical neck symptoms show promise but did not demonstrate significance improvement over controls in this study.

Introduction: The Modified Mallampati Tongue score is a quick and reliable method commonly used in anesthesiology to assess airway patency and predict the ease of intubation. Modified Mallampati Tongue scores range from I – IV with higher Mallampati scores being associated with more difficult intubations as well as increased sleep-disordered breathing, such as obstructive sleep apnea. The Mallampati Tongue score is determined by visibility of the oropharynx when the mouth is opened as wide as possible with the tongue maximally protruded and is directly affected by the position of the tongue. The tongue is an influential muscle to the craniofacial complex; it plays an essential role in the development of the dentoalveolar structures, and its position affects airway volume which influences natural head posture, which influences craniofacial growth. Objective: The primary aims of this study were to identify if any associations exist between Modified Mallampati Tongue scores (I-IV) and 1) craniofacial sagittal and vertical relationships of the jaws and 2) craniofacial head posture (including the postural relationships of the cervical vertebrae, hyoid bone, cranium, and tongue). A secondary aim was to identify if any associations exist between Modified Mallampati Tongue score and age, sex, or race/ethnicity. Methods: This retrospective study included 400 subjects from the Temple University Kornberg School of Dentistry Department of orthodontics who had pre-orthodontic treatment diagnostic records obtained from June 1st 2020 through September 1st 2021. Each patient’s Modified Mallampati Tongue score (I-IV) was recorded in an intraoral photograph of maximum mouth opening with tongue protrusion. All lateral cephalograms were traced in Dolphin Imaging and Amira Morphometrics Software by two examiners tracing 200 subjects each. The craniofacial morphological features were analyzed through the Steiner, Wits, and McNamara analyses for assessment of the sagittal relationships of the maxilla and mandible and by the Jarabak analysis for assessment of the vertical relationships and divergence. Craniofacial head posture was assessed through an analysis that represents the postural relationships of the cervical vertebrae, cranium, length/height of the tongue, and position of the hyoid bone. For statistical analysis, One-way ANOVA, Pearson’s correlation, and Chi-square tests were conducted. Probability values of <0.05 were considered significant. Results: Overall, this study included 400 subjects with ages ranging from 7-73 years old (mean age of 17.99 years), of which there were 288 females (72%) and 112 males (28%). Of the 400 subjects, 60% (241) were African American, 32% (127) Hispanic, 7% (26) Caucasian, and 2% (6) Asian. The most prevalent Modified Mallampati Tongue Score was III (142 subjects, 36%). Out of all of the craniofacial morphology and head posture variables compared against Modified Mallampati Tongue scores (I-IV), significant findings from the one-way ANOVA tests included vertical position of the hyoid bone to the neck, vertical position of the hyoid bone to the mandible, ANB, and Wits values. Higher Mallampati Tongue scores were associated with higher ANB and higher Wits values. Greater Mallampati scores were associated with increased vertical distance of the hyoid bone to the mandible and to the neck, meaning a lower position of the hyoid bone. In addition, correlations that were statistically significant given a 95% confidence interval, included significant positive correlations between Mallampati Tongue score and increased ANB, Wits, and distance of the hyoid to the mandible and to the neck. Pearson’s Correlation Index also showed a significant negative correlation between Mallampati Tongue scores and craniofacial morphology values for SNB and pogonion to nasion-perpendicular, showing that increased Modified Mallampati Tongue scores correlate with more retrognathic mandibles. When evaluating the results of the Chi-Square analyses, there were no significant differences between Modified Mallampati Tongue score and race/ethnicity or age, but there was a significant difference between genders showing that women were more likely to have lower Mallampati Tongue scores than men. Inter-examiner and intra-examiner reliability for the craniofacial head posture measurements, craniofacial morphology measurements, and Modified Mallampati Tongue scores were excellent (correlation coefficients: 0.84 – 0.99). Conclusions: This study reveals that a higher Modified Mallampati Tongue score correlates with higher ANB and Wits values, meaning that higher Modified Mallampati Tongue scores are associated with a Skeletal Class II relationship of the jaws, which could be due to retrognathic mandibular growth. In addition, a higher Modified Mallampati Tongue score is significantly associated with increased distance of the hyoid bone to the mandible and to the neck. This study also found women more likely to have lower Modified Mallampati Tongue scores than men. The results of this study allude to the potential for Mallampati Tongue scores to be used as predictors of Class II skeletal sagittal growth which would ultimately help with orthodontic treatment planning decisions and enhance overall treatment outcomes. / Oral Biology

Objective: A scoping review was employed to consolidate what is currently being studied and reported on concerning interactions with smartphone devices and correlated negative health-outcomes, specifically within the college student population. We are specifically concerned with this population due to the unique demands of technology use coupled with free time use of smartphone devices. Information such as study focus, study design, and summarized results are be provided within this compilation of available data. Results: The existing data findings are heavily skewed in favor of a positive correlation between smartphone use and negative health-outcomes. Sampling 17,069 total participants across 41 studies, which utilized 36 various tools and scales in at least 4 different study designs, only 2 articles found a lack of correlative evidence for negative health-outcomes within this population. Designs were commonly cross-sectional, which can only assign correlation and not causation. The top scales utilized were the Neck Disability Index (NDI), the Nordic Musculoskeletal Questionnaire (NMQ), and the Smartphone Addiction Scale (SAS-SV). Conclusions: Due to the variable nature of Smartphone use and lack of gold standard tools to clearly define, measure, and intervene in this area of study, goals to create and apply such standards are imperative in securing a high level of understanding to contribute towards an improved Health-Related Quality of Life for this population. Correlative findings are currently what has been found to be available. There is a critical lack of temporality within available work as a result. Causative findings are required to fully grasp and rectify the problems surrounding smartphone overuse. Note that the oldest article included was published in 2014 with a slow increase in volume of work leading into 2024, which is a positive trend in concern but is still not enough to fully understand the scope of risks involved.