Department of Physical Therapy Student Theses, Dissertations and Capstones

Document Type


Degree Name

Doctor of Philosophy (PhD) in Physical Therapy

Copyright Statement

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College of Health Care Sciences - Physical Therapy Department

First Advisor

Leah Nof

Date of original Performance / Presentation


Publication Date / Copyright Date



Nova Southeastern University


Purpose: 1, to determine effect of education and exercise on neck pain, disability, cervical posture and muscle function in office workers with sub-clinical neck symptoms; 2, to determine differences in forward head posture in preferred and standardized posture, and 3, to explore the influence of time on work posture in a sub-group of office workers. Subjects: Sixty-six office workers with sub-clinical neck symptoms who utilize computers at least 4 hours per day participated. A sub-group of 27 were videotaped to assess posture over a workday. Methods: Videotaping was performed 15 minutes of the first and last hour of the workday for analysis of the craniovertebral angle. Cervical posture using the CROM was measured on all subjects in standardized and preferred positioning of the trunk and lower extremities. Subjects were randomly assigned to one of three groups: education only (EOG), education and exercise (EEG), or control (CG). Pre and post-test measurements of pain (Visual Analog Scale), disability (NeckDisability Index), forward head posture (FHP), and deep cervical flexor muscle function (Craniocervical Flexion Test and Short Neck Flexor Endurance Test) were assessed for change within group as well as differences between groups over the 8 week period. Results: No difference was found for FHP over 8 hours in the subgroup. FHP was greater in preferred position compared to standardized by 7.59 mm (95% CI 6.27-8.92, p<.001). Median and mean scores improved for all 3 groups on pain and disability with greater improvement in intervention groups. FHP was unchanged/slightly worse in the CG and EOG, and improved in the EEG. Muscle function improved for the EEG. Statistical significance was not found for change scores between groups. Posttest scores were statistically significant for the NDI between EEG (20.45) and the CG (34.47), p=.042, and between the EEG and the EOG (34.59), p=.023 using Kruskall Wallis with adjusted significance for pairwise comparisons. Discussion/Conclusions: Posture over the workday did not change, differences were found based on preferred and standardized positions. Exercise and education intervention for those with sub-clinical neck symptoms show promise but did not demonstrate significance improvement over controls in this study.


Physical Therapy


Health and environmental sciences, Cervical, Deep cervical flexor muscles, Forward head posture, Posture, VDT use

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