Dissertation submitted in partial compliance with the requirements for a Master's Degree in Technology: Chiropractic, Durban University of Technology, 2010. / Forward head posture (FHP) is a common postural abnormality, often associated with myofascial trigger points which can result in head and neck pain. The craniovertebral (CV) angle lies between a horizontal line running through C7 spinous process and a line connecting C7 spinous process to the tragus of the ear. The smaller the angle the greater the FHP. Cervical musculoskeletal abnormalities have often been linked to headache types, most especially episodic tension-type headache (ETTH) and cervicogenic headaches (CGH). Objectives: To determine whether an association exists between FHP, distance of the external auditory meatus (EAM) from the plumbline and cervical range of motion and the presentation of ETTH and CGH. Method: This was a quantitative comparative study (n=60) comparing three equal groups, one with ETTH, CGH and healthy controls. The FHP of the Subjects FHP was assessed by measuring the CV angle. A lateral digital photograph was taken to assess the distance of the external auditory meatus from the plumbline. Lastly, cervical range of motion was measured. The two symptomatic groups also received a headache diary for a fourteen day period monitoring frequency, intensity and duration of their headaches. Result: The two symptomatic groups had a smaller CV angle and a greater distance from the plumbline (p<0.05) than the asymptomatic group. The asymptomatic group had a significantly greater flexion (p=0.009), extension (p=0.038) and left rotation (p=0.018) range of motion than the two symptomatic groups. The CGH group had a significant positive correlation between the distance of the EAM from the plumbline and the intensity of headaches. The ETTH group had a significant positive correlation between the right craniovertebral angle and the mean duration of headaches. Conclusion: Therefore, it can be concluded that patients presenting with ETTH and/or CGH may have associated postural abnormalities that may act as a trigger or a contributory factor to the presenting headache. / Durban University of Technology

Dissertation submitted in partial compliance with the requirements for a Master's Degree in Technology: Chiropractic, Durban University of Technology, 2010. / Forward head posture (FHP) is a common postural abnormality, often associated with myofascial trigger points which can result in head and neck pain. The craniovertebral (CV) angle lies between a horizontal line running through C7 spinous process and a line connecting C7 spinous process to the tragus of the ear. The smaller the angle the greater the FHP. Cervical musculoskeletal abnormalities have often been linked to headache types, most especially episodic tension-type headache (ETTH) and cervicogenic headaches (CGH). Objectives: To determine whether an association exists between FHP, distance of the external auditory meatus (EAM) from the plumbline and cervical range of motion and the presentation of ETTH and CGH. Method: This was a quantitative comparative study (n=60) comparing three equal groups, one with ETTH, CGH and healthy controls. The FHP of the Subjects FHP was assessed by measuring the CV angle. A lateral digital photograph was taken to assess the distance of the external auditory meatus from the plumbline. Lastly, cervical range of motion was measured. The two symptomatic groups also received a headache diary for a fourteen day period monitoring frequency, intensity and duration of their headaches. Result: The two symptomatic groups had a smaller CV angle and a greater distance from the plumbline (p<0.05) than the asymptomatic group. The asymptomatic group had a significantly greater flexion (p=0.009), extension (p=0.038) and left rotation (p=0.018) range of motion than the two symptomatic groups. The CGH group had a significant positive correlation between the distance of the EAM from the plumbline and the intensity of headaches. The ETTH group had a significant positive correlation between the right craniovertebral angle and the mean duration of headaches. Conclusion: Therefore, it can be concluded that patients presenting with ETTH and/or CGH may have associated postural abnormalities that may act as a trigger or a contributory factor to the presenting headache. / Durban University of Technology / M

Stillasittande arbete och medföljande dålig hållning har kommit att bli ett stort problem i samhället. Framskjutet huvud, så kallad FHP (Forward Head Posture), är ett vanligt exempel på dålig hållning som har starka kopplingar till nacksmärta. Produkten FixaSpine är ett smarthalsband vars funktion är att komma till rätta med problemen genom att påminna användaren att räta upp sin hållning. Då produkten i dagsläget är i prototypstadiet behöver en stor mängd testning göras för att utveckla sensorteknologi och mjukvara. För att kunna testa prototyper på ett kontrollerat sätt uppstår behovet av en testanordning. Olika grad av FHP och hopsjunken rygg behöver kunna återskapas och det behöver kunna ske upprepade gånger med precision. Testanordningen bör även kunna utföra en störningsrörelse som Fixaspine ska kunna ignorera. Arbetets syfte är att möjliggöra en systematiserad testning och utveckling av FixaSpines sensorteknologi och funktionalitet, genom att ta fram en mekanisk testanordning som kan simulera dåliga hållningar samt en störningsrörelse. Genom att kartlägga olika positioner och rörelsemönster vid dålig hållning tas ett underlag fram för en mekanisk testanordning. Koncept utarbetas, beräkningar för drivning och motorer utförs, och slutligen görs konstruktion och detaljutveckling. Den resulterande testanordningen kan inta positioner som efterliknar olika grad av framskjutet huvud, som mest motsvarande en hög grad av FHP (CVA 22°). Den kan även efterlikna olika grad av hopsjunken rygg som motsvarar en rotation av bröst korgen på mer än 15°. Anordningen kan lutas framåt mer än 30° för att utföra en störningsrörelse. Dessutom kan den åstadkomma en kombination av ovan positioner och rörelser. Anordningen drivs av linjära ställdon som kan programmeras efter behov. Genom att använda testanordningen som utvecklingsredskap kan felvariabler och brus som testning på människor annars medför undvikas. På så vis underlättar testanordningen utvecklingen av FixaSpine och bidrar i förlängningen till minskad nacksmärta. / The prevalence of poor posture as a consequence of sedentary work has become a major issue in today’s society. A common example of poor posture is the so-called Forward Head Posture (FHP), which has strong associations with neck pain. FixaSpine is a smart necklace attempting to correct these problems by reminding its users to improve their posture when necessary. As the product is currently in the prototyping stage, thorough testing has to be conducted so that its software and sensor technology can be further developed. However, testing prototypes in a controlled manner has proven difficult. Hence, there is a need for a test apparatus able to simulate poor posture repeatedly and with precision. This device should be able to achieve various degrees of FHP and hunched back. Furthermore, it should also be able to perform a disruptive movement that Fixaspine ought to ignore.  The purpose of the project is to facilitate the systematized testing and development of FixaSpine’s sensor technology and functionality, by developing a mechanical test device. By analyzing lateral photographs of poor postures, positions and movement patterns are mapped, and the prerequisites for a mechanical test device determined. Concepts are drawn up, calculations for motor loads are carried out, and the final design and mechanical construction developed.  The resulting test device can simulate positions with varying degrees of Forward Head Posture. It is capable of achieving a high degree of FHP (CVA 22°). The device can simulate different degrees of hunched back equivalent to a thorax rotation of more than 15°. In addition, the device can be tilted forward more than 30°, performing a disruptive movement. Furthermore, it can perform a combination of these positions and movements. The device is powered by linear actuators that can be programmed as needed. Using it as a development tool minimizes error variables and noise otherwise prevalent when testing on humans. Subsequently, this test device is able to facilitate the development of FixaSpine and ultimately contribute to reducing neck pain.