Brief Report  |   January 2017
Forward Head Posture and Activation of Rectus Capitis Posterior Muscles
Author Notes
  • From the Departments of Physical Medicine and Rehabilitation (Dr Hallgren); and Osteopathic Manipulative Medicine (Drs Hallgren and Rowan) and the Center for Statistical Training and Consulting (Drs Pierce and Sharma) at Michigan State University in East Lansing. 
  • Support: This study has been supported in part by research grant no. 09-05-586 from the American Osteopathic Association. 
  •  *Address correspondence to Richard C.Hallgren, PhD, Department of Physical Medicine and Rehabilitation, Michigan State University, East Lansing, MI 48824-1316. E-mail: hallgren@msu.edu
     
Article Information
Neuromusculoskeletal Disorders
Brief Report   |   January 2017
Forward Head Posture and Activation of Rectus Capitis Posterior Muscles
The Journal of the American Osteopathic Association, January 2017, Vol. 117, 24-31. doi:10.7556/jaoa.2017.004
The Journal of the American Osteopathic Association, January 2017, Vol. 117, 24-31. doi:10.7556/jaoa.2017.004
Abstract

Context: Rectus capitis posterior (RCP) muscles have physical attachments to the pain-sensitive spinal dura. Atrophy of these muscles is associated with chronic headache in some patients. The authors suspect that the significance of atrophy in the RCP muscles has been undervalued because the functional role of these muscles is not well defined.

Objective: To determine whether a statistically significant change in normalized levels of electromyographic activity in RCP muscles occurs when the head is voluntarily moved from a self-selected neutral head position to a protruded head position.

Methods: Fine wire, intramuscular electrodes were used to collect electromyographic data as asymptomatic participants moved their head from a neutral head position into a forward head position and back into the neutral head position. This sequence was repeated 4 times. Normalized levels of electromyographic activity were quantified using a 2-head position × 2 sides of the body repeated measures design that incorporated mixed-effects β regression models.

Results: Twenty participants were studied. Electromyographic activity collected from RCP muscles was found to increase as the head was voluntarily moved from a self-selected neutral head position (11% of maximum voluntary isometric contraction [MVIC] in RCP minor, 14% of MVIC in RCP major) into a protruded head position (35% of MVIC in RCP minor, 39% of MVIC in RCP major) (P<.001).

Conclusion: Rectus capitis posterior muscles may contribute to segmental stabilization of the occipitoatlantal and atlantoaxial joints by helping to maintain joint congruency during movement of the head.

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