Baş Önde Postürü ve Kas Aktivasyonuna Etkisi

Öz

Başın servikal omurga üzerinde öne doğru yer değiştirmesi olarak tanımlanan baş önde postürü, sık görülen bir postür bozukluğudur. Bu dizilim bozukluğunun omurga üzerindeki yükleri değiştirdiği, kaslardaki uzunluk-gerilim ilişkisini etkilediği ve kas aktivasyonunu değiştirdiği ileri sürülmektedir. Bu nedenle bu derlemenin amacı, baş önde postürünün kas aktivasyonu üzerinde yaptığı değişikliklerin incelenmesine yönelik çalışmaların sonuçlarını incelemektir. Baş önde postürünü değerlendirmek için kullanılan birçok yöntem olmasına rağmen, bu açının doğru ölçümü için standart bir klinik yöntem yoktur. Fotoğrafik ölçüm en yaygın kullanılan geçerli ve güvenilir değerlendirme yöntemidir. Kraniovertebral açı (KVA), fotografik ölçümlerde baş önde postürü değerlendirmek için en yaygın kullanılan değerdir. KVA'nın norm değerinde farklılıklar olmakla birlikte, 48-50°'nin altındaki bir KVA, baş önde postürü olarak tanımlanır. Baş önde postürlü bireylerde kas aktivasyonundaki değişiklikleri göstermek için KVA'ya göre baş önde postürü olan ve olmayan olarak sınıflandırma yaparak boyun ve omuz kaslarının aktivasyonundaki farklılıkları değerlendiren birçok çalışma bulunmaktadır. Birçok çalışma sternocleidomastoideus ve üst trapezius kaslarının aktivasyonunun arttığını göstermiş olsa da, fark olmadığını gösteren çalışmalar da vardır. Alt trapezius ve serratus anterior kasları için benzer çelişkili sonuçlar mevcuttur. Çalışmalarda kas aktivasyonu ile ilgili çelişkili sonuçlar olmasına rağmen, baş önde postürü olan bireylerde kas aktivasyonunun değişmiş olması muhtemel görünmektedir. Fizyoterapistlere baş önde postürü olan bireylerde kas aktivasyonundaki bu farklılıkları göz önünde bulundurarak müdahaleler yapmaları önerilebilir.

Anahtar Kelimeler

• Baş önde postürü
• fotogrametri
• kraniovertebral açı
• kas aktivasyonu
• elektromiyografi

Forward Head Posture and Its Effect on Muscle Activation

Öz

Forward head posture (FHP), which is defined as a forward displacement of the head on the cervical spine, is a common postural disorder. It is suggested that this malalignment alters the loads on the spine, affects the length-tension relationship in muscles, and changes muscle activation. Therefore, the aim of this review is to investigate the results of studies on the examination of the changes exerted by FHP on muscle activation. Although there are many methods used to assess FHP, there is no standard clinical method for accurate measurement of this angle. Photographic measurement is the most widely used, valid, and reliable assessment method. Craniovertebral angle (CVA) is the most widely used value to assess FHP in photographic measurements. A CVA of less than 48-50° is defined as FHP, although there are differences regarding the norm value of the CVA. There are many studies on the assessment of differences in the activation of the neck and shoulder muscles by making FHP and non-FHP classifications according to the CVA to show the changes in muscle activation in individuals with FHP. Although many studies have shown increased sternocleidomastoideus and upper trapezius activation, there are also others indicating no difference. Similar conflicting results exist for the lower trapezius and serratus anterior muscles. Although there are conflicting results regarding muscle activation in studies, it seems likely that muscle activation is altered in individuals with FHP. It may be recommended that physiotherapists conduct interventions by considering these differences in muscle activation in individuals with FHP.

Anahtar Kelimeler

• Forward head posture
• photogrammetry
• craniovertebral angle
• muscle activation
• electromyography

Kaynakça

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