Effect of kinesiotaping vs brueggers exercise on forward head posture in physiotherapy students of age group 18 to 25 A randomized clinical trail

Forward head posture is when the head is positioned excessively forward in relation to a vertical line .This posture leads to an increased curvature in the cervical spine,with the upper neck extending and the lower neck flexing . This adjustment in the upper cervical spine helps the body maintain balance and alignment in response to the forward head posture. Additionally rounded shoulder and thoracic kyphosis increased curvature of upper back can develop in later stages of forward head posture. (1) Forward head posture could be causing weakness in the deep neck flexor , upper trapezius ,pectoralis major and levator scapulae, while the surrounding muscle may become tight and overworked. The discomfort in movement and radiating pain in the upper extremities could be due to muscle imbalance ,nerve compression and poor alignment of spine and shoulders (2)

When the head is forward it can lead to decreased craniovertebral angle , which is the angle between the head and the neck . Some of the symptoms of forward head posture like chronic pain in the neck, shoulder and back , can occur due to the strain on the muscles from the head being in an unnatural position . TMJ dysfunction and teeth clenching can also result from the misalignment caused by forward head posture .(3)

 Additionally , issues like fatigue , headaches, numbness or tingling in the arms and hands , and muscle spasms can occur due to nerve compression or poor blood circulation resulting from the posture .  (3)

 Prevalence of forward head posture is increasing ,especially among children and adolescents due to the extended use of mobile phones and laptop which often leads to poor neck posture .  Physiotherapist work involves prolonged standing position that can contribute to forward head posture. A study conducted by Shivani Goswami and Dr.Edrish Contractor there is an 70% of prevalence rate among physiotherapy students in Ahmedabad.  Its concerning to see such a high percentage of students affected by this posture issue (1)

               There are indeed many factors that could contribute to forward head posture, including age ,gender, in that female students are more were dominant by 60%, frequency of physical activity, occupation, computer and smart phone usage and various other lifestyle habits.(4)

 Sitting in the wrong position can lead to muscle imbalance, causing pain, changes in the spin, rounded shoulders, biomechanical alteration a decrease in the number of sarcomeres and shortening of muscle contraction reduce the range of  motion and ultimately affect  the functional activity of the neck, for every 2.5cm of head movement forward the of around 4.5 muscle and affect balance. This extra load can shift the body’s center of gravity forward, causing a disturbance in balance by altering the body’s line of gravity and the base of support.  (5)

         The craniovertebral angle is indeed a measurement used for diagnosis of forward head posture . It indicates the angle between the horizontal line and the line connecting the tragus of ear to the seventh cervical vertebra (3). Additionally neck disability index is the tool used to access the functional disability related to neck pain .(2)

 Kinesiotape is one of the technique which is used for the treatment of forward head posture . It is a therapeutic tape that is used to support muscle and joint as well as facilitate the body natural healing process .Dr. Kenzo kase creator of kinesiotape ,proposed various mechanisms through which kinesiotape may exert its effects such as altered muscle function , effect on weakened muscle , improves circulation facilitate better blood flow and lymphatic drainage , pain relief through neurological suppresion , repositioning of subluxed  joint, relieving abnormal muscle tension affecting the function of fascia and muscle.(3)

                       Kinesiotape is its technique that involves applying to external element to enhance the performance of muscle and other tissue the unique future of kinesiotape is its thin and elastic design , allowing it to stretch significantly up to 40% to 60 % of its original length ) this expection elasticity sets it part from traditional taping materials , enabling a wider ROM while providing support to muscles and tissues .(6)

                         Studies have shown that applying kinesiotape in the direction from the muscles origin to its insertion can lead to increased muscle activity . While the exact physiological mechanism are not entirely understood , the theory is that this taping method may enhance motor neuron recruitment , potentially improving muscle function . This intriguing possibility has led to a growing interest in research studies aiming to wheather the cutaneous stimulation provided by kinesiotape could indeed enhance muscle strength . It`s fascinating how such a simple intervention like applying external tape can have such significant implications for muscle performance and function.(7)

                               The  Bruegger`s exercise is indeed used to address muscle imbalance , particularly in the context of posture. Developed by Dr. Alois bruegger, this exercise aims to promote better alignment and activation of the phasic muscles while encouraging proper relaxation of the tonic muscle. The tonic muscles in the upper body , like the neck extensors , pectoral muscles , upper trapezius and levator scapulae are responsible for action such as pulling the head forward , bringing the shoulders forward and up pulling the arm in and flexing the wrist and finger . On other hand the brueggers exercise involves using the antagonistic muscles , which are those that extend the thumb , fingers, wrist and extend and externally rotate the shoulder.(7)