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Posture can be defined as Qualified displays of body part for a particular movement or characteristics approach of position ones organization. Forward head pose is characterized by amplified flexion of the lower cervical region, higher thoracic area and enlarged accumulation of the upper cervical spine. Poor posture is a serious health problem which causes more musculoskeletal disorders with age. Children showed the habit of forward head posture at a very early age due to study in various odd positions. Epidemiological studies have shown high occurrence of spinal postural variation in adults with forward head pose and absolute shoulder position being two of the most general postural deviation [12]
In modern time, extensive apprehension of cellular phone and computer has enlarged load posture interiorly on cervical spine that show the way to a range of musculoskeletal disorder linked to the neck by shifting the biomechanical pressure on the cervical spine.
Forward head posture can be cleared as: any display in which the outer hearing meatus is placed interiorly to the examine line up through the shoulder joint.
Frontward head position is generally known as types of condensed head posture in sagital flat surface .It is one of the main reasons that changes biomechanical tension around the cervical vertebrae that leads towards cervical ache , head pain, tempromandibular and muscular dysfunctions. Photogrammetric is an goal practice to determine location of diverse body parts and also has good strength for assessment of craniovertebral posture .This easy process can be used to make a finding of forward head posture .Diverse studies have different measurement angles such as craniovertebral direction, cervical inclination approach, head slope angle, crania-rotational angle to measure forward head pose. Out of all angles craniovertebral angle is measured to be the most general angle use for measurement of forward head position as it examines head condition in relation to seventh cervical vertebrae(C7).[1]
Forward head pose is also associated with increased thoracic hypnosis, reduced lumbar lordosis, in addition to condensed proprioception. Therefore it is essential to improve from forward head position to ease from neck tenderness, build up posture, increases the selection of movement[2]
The study can be regarding occurrence of forward head attitude among undergraduates campus students. In undergraduates student, terrible posture due to delay sitting is very common mainly in cervical area. By finding the frequency of forward head pose in undergraduates students, study will highlight the perfection of posture and helps in improve the quality of life in undergraduates students [10]
Previous study by Kown J .W on shows occurrence of forward head posture to be 85.5% and a considerable relationship was seen between forward head posture and sexual characteristics .[3]
A study by Nejati .P ,showed that forward head pose has revealed some association with neck soreness .Imperfect attitude during computer labor is the cause for even bad soreness that is associated with neck ache .[6]
A study by Lee K, show that forward head posture decreased the EMG actions of the middle trapezium ,splenius and Sternocleidomastoid muscle and these reduced behavior resulted from changes in muscle extent due to forward head posture and were related with a decreased capacity to produce power .[7]
A study by Shih, showed comparing outcome of kinesio taping (KT) and therapeutic education showed that both had positive outcome on the forward head posture management but generally therapeutic exercise was more helpful .[8]
The objective of this study is to find the incidence of forward head pose among university students because there is a lack of awareness about proper posture among them.
3. LITERATURE REVIEW:
Jung won kown conducted a study in 2015 on changes in upper margin muscle actions due to head site in subject with a forward head arrangement and curved shoulders and concluded that upper extremity muscles activities in usual model and corrected head positions and improvement of normal upper trapezium and serratus anterior muscle function plays an main part in correcting forward head posture and rounded shoulders.[2]
Farzin halabichi conducted a study in 2015 on rate of common postural disorders among educational dental panel and investigate the incidence of general postural disorders of the spinal column and shoulder girdle among the dentists and possible connection between demographic ,anthropometric and professional individuality of these irregular posture .The study concluded a high occurrence of postural disorders particularly FHP,RSP and scoliosis among Iranian dental staff , female dental staff less at risk to FHP and scoliosis. [3]
Yeoung sung Kim conducted a study in 2016 on the effect of thoracic and lumbar maintain fittings on forward head posture (FHP) during visual display terminal (VDT) work and concluded that VDT work using thoracic and lumbar support fixtures has a positive outcome on forward head position in white collar employees[5]
Parisa nejati conducted a study in 2015 on the relationship between neck pain and badly chosen posture of the head ,cervicothoracic vertebrae, shoulders and concluded that forward head posture and thoracic kyphosis were accompany with neck tenderness but shoulder position were not linked with neck pain .[6]
Hsu sheng conducted a study in 2017 on comparison of kinesio taping and therapeutic exercises for forward head position on fixed posture, forceful mobility and efficient outcomes and concluded that both kinesio-taping and therapeutic training improve forward head pose after participation and a 2 week evidence and the competence of therapeutic movements is better than a taping .[8]
Drashti talati conducted a study in 2018 to examine the cause of forward head pose in relation with spinal curvatures in good physical shape subjects and concluded that there is no considerable association between forward head posture , thoracic kyphosis and lumbar lordosis in normal adults aged 18-35years.[9]
Fahad Tanveer conducted a study in 2018 to recognize the result of forward head position on neck disability and level of stress in undergraduates students and concluded that forward head posture has a strong effect on level of tension but no effect on functional disability .[10]
4. OBJECTIVE:
To find out the occurrence of forward head posture among undergraduates university students across Punjab, Pakistan
6. RATIONALE:
If we conducted a study then this study will help us to determine the incidence of forward head position among university students .Students would be aware of the fact that for achieving successful goal in the studies they must be aware of the physical fitness and motivation towards improved quality of life. This study will help the students to know about the correct position of the sitting.
7. OPERATIONAL DEFINATION:
Title: Prevalence of forward head posture among university students across Punjab, Pakistan.
-CVA angle by Adobe reader Acrobat DC:
Adobe Acrobat Reader DC software could be efficiently used for the occurrence of forward head posture among university students. [12]
8. MATERIALS AND METHODS:
8.1. Study design:
Cross sectional study.
8.2. Setting:
Punjab, Pakistan.
Public division Universities/Degree Awarding univsesities
University of Punjab, Lahore
University of Engineering and Technolog ,Lahore
Lahore College of Women University, Lahore.
University of Education, Lahore
University of Vertinary and Animal Sciences, Lahore
Bahauddin Zakariya University, Lahore
Islamia University ,Bahawalpur.
UET, Taxilla.
Agriculture University, Faisalabad
University of Gujrat, Gujrat .
Government College University, Faisalabad.
University of Sargodha, Sargodha
Private division Universities/Degree Awarding Institutes
Ali Institute of Education
Beacon house National University
Forman Christian College
GIFT University
HITEC University
Hajvery University
Imperial College of Business Studies
Institute of Management Sciences
Institute of Southern Punjab
Lahore Garrison University
Lahore Leads University
Lahore School of Economics
Lahore University of Management Sciences
Minhaj University
National College of Business Administration & Economics
Qarshi University
The Superior College-Superior university
The University of Faisalabad
University of Central Punjab
University of Lahore
University of Management & Technology
University of South Asia
8.3. Study Population:
University students from Punjab, Pakistan.
8.4. Duration of study:
This study will be completed in 3 months.
8.5. Sample size:
8.6. Sampling technique:
Quota sampling technique will be used for sample selection.
8.7. Eligibility criteria:
8.7.1. Inclusion criteria:
University students who willingly want to participate in this study will be selected for this study.
8.7.2 Exclusion criteria:
Students who had postural disorders due to genetic defect-
Neuromuscular disorders.
Musculoskeletal disorders.
Upper limb fractures.
Whiplash trauma.
Congenital disorders.
Psychiatric disorders
Will be excluded from this study.
8.8. Data collection procedure:
Students who satisfied the inclusion criteria will be chosen from different universities of Punjab,Pakistan which are as follow-
Punjab, Pakistan.
Public division Universities/Degree Awarding Institutes
UET Lahore
Punjab university Lahore
Lahore college of women university Lahore
University of education Lahore
UVAS Lahore
BZU Multan
Islamia University Bahawalpur
UET Taxila
Agriculture University Faisalabad
University of Gujrat, Gujrat
Government College University, Faisalabad
University of Sargodha, Sargodha
Private division Universities/Degree Awarding Institutes
Ali institute of education
Beacon house national university
Forman university
GIFT university
HITEC university
Hajvery university
Imperial college of management sciences
Institute of management sciences
Institute of southern Punjab
Lahore garrison university
Lahore leads university
Lahore school of economics
Lahore university of management and sciences
Minhaj University
National College of Business Administration and Economics
Qarshi University
The Superior College-Superior University
The University of Faisalabad
University of Lahore
University of Central Punjab
University of Management and Technology
University of South Asia
Informed consent will be taken from the subjects. Adobe Acrobat Reader DC software will be use for measurement of Forward head posture.
8.9. Ethical consideration:
In the entire phase of the study, ethics will be kept under consideration. The personal information of subjects will be kept hidden and secure. The study will not affect the individuals ethical values and researcher will follow all ethics of medical field. Written informed permission will be taken from all the study subjects.
8.10. Statistical procedure:
SPSS 16 will be use for the investigation of the data.
