중재 형태에 따른 앞쪽머리자세의 구조 및 기능 개선 효과와 추적 관찰 : 대면, 온라인, 멀티미디어 중재

다국어 초록 (Multilingual Abstract)

This study investigated adults aged 20–30 years with forward head posture (FHP), who were allocated to an Face-to-Face group (n = 13), an online group (n = 13), or a multimedia group (n = 13). All groups received 6 weeks of corrective exercise combined with ergonomic advice. Effects were compared across intervention modes, and follow-up assessments were conducted at 4 and 8 weeks post-intervention to examine the persistence of changes. Outcomes included the craniovertebral angle (CVA), neck pain (VAS), neck disability (NDI), cervical range of motion (C-ROM), cervical muscle strength, cervical muscle activity (EMG), and cervical joint position error (JPE). The study examined how the online and multimedia interventions changed relative to the Face-to-Face intervention across these outcomes. The main findings are as follows. 1. CVA increased significantly within the Face-to-Face, online, and multimedia groups and showed a tendency to decrease at 4 and 8 weeks post-intervention. 2. VAS decreased significantly within the Face-to-Face and online groups and tended to be maintained at 4 and 8 weeks post-intervention. 3. NDI decreased significantly within the Face-to-Face and online groups and tended to be maintained at 4 and 8 weeks post-intervention. 4. Cervical muscle strength increased significantly within the Face-to-Face, online, and multimedia groups and tended to be maintained at 4 and 8 weeks post-intervention. 5. C-ROM increased significantly within the Face-to-Face, online, and multimedia groups and tended to be maintained at 4 and 8 weeks post-intervention. 6. For cervical flexion, JPE decreased significantly within the Face-to-Face group and was maintained at 4 and 8 weeks post-intervention. In addition, the Face-to-Face group showed significantly smaller flexion JPE than the multimedia group at both 4 and 8 weeks post-intervention. 7. For EMG, SCM-L decreased significantly within the online group during the CCFT at 22mmHg and tended to be maintained at 4 and 8 weeks post-intervention. SCM-R decreased significantly within the Face-to-Face group during the CCFT at 22mmHg and within the online group during the CCFT at 30mmHg, and tended to be maintained at 4 and 8 weeks post-intervention. AS-L decreased significantly within the Face-to-Face group (22–30mmHg) and the online group (22, 24, and 30mmHg) and tended to be maintained at 4 and 8 weeks post-intervention. AS-R decreased significantly within the Face-to-Face group (22mmHg) and the online group (22–30mmHg) and tended to be maintained at 4 and 8 weeks post-intervention. Overall, the findings indicate that non-face-to-face interventions alone can meaningfully improve CVA, cervical muscle strength, and C-ROM. In contrast, improvements in VAS, NDI, and SCM and AS EMG were more evident in the Face-to-Face and online groups, suggesting that pain-related outcomes and the reorganization of muscle recruitment patterns may depend strongly on immediate postural correction and precise sensory feedback. In addition, significant improvement in JPE was observed only in the Face-to-Face intervention, indicating that outcomes requiring high-precision sensorimotor control, such as JPE, may require direct sensorimotor relearning supported by real-time feedback. Accordingly, multimedia-based interventions should be designed to go beyond simple exercise instruction and incorporate feedback elements that enable users to correct posture in real time. Keywords: Forward Head Posture, Craniovertebral Angle, Muscle Activity, Joint Position Error, Neck Function

목차 (Table of Contents)

• Ⅰ. 서론 1
• 1. 연구의 필요성 1
• 2. 연구의 목적 4
• 3. 연구의 문제 4
• 4. 연구의 제한점 7
• 5. 용어의 정의 8
• Ⅱ. 이론적 배경 11
• Ⅲ. 연구방법 15
• 1. 연구절차 15
• 2. 연구대상 17
• 3. 측정 도구 및 측정 방법 18
• 4. 중재 프로그램 27
• 5. 자료분석 33
• Ⅳ. 연구 결과 34
• 1. 중재프로그램 적용에 따른 CVA 차이 34
• 2. 중재프로그램 적용에 따른 VAS 차이 36
• 3. 중재프로그램 적용에 따른 NDI 차이 38
• 4. 중재프로그램 적용에 따른 C-ROM 차이 40
• 5. 중재프로그램 적용에 따른 목 JPE 차이 42
• 6. 중재프로그램 적용에 따른 목 근력 차이 44
• 7. 중재프로그램 적용에 따른 왼쪽 목빗근 근활성도 차이 46
• 8. 중재프로그램 적용에 따른 오른쪽 목빗근 근활성도 차이 49
• 9. 중재프로그램 적용에 따른 왼쪽 앞목갈비근 근활성도 차이 52
• 10. 중재프로그램 적용에 따른 오른쪽 앞목갈비근 근활성도 차이 56
• V. 논의 60
• VI. 결론 및 제언 69