Posture Correction

Injury type: Chronic

Category: Allied Health Options

Rating: No research

What is it?

Clinical biomechanics of posture (also known as Chiropractic BioPhysics) (CBP) rehabilitation involves specific chiropractic adjustments including: mirror-image drop table adjustments, mirror-image handheld instrument adjustments, mirror-image isometric exercise and mirror-image extension-compression traction techniques. Posture correction may also include analysis of posture to check the alignment of your spine, advice and/or exercises to help correct any deviations from the ideal situation. It may also involve devices to remind you to check and adjust your posture throughout the day (i.e. mirror, back braces, alarms/reminders).

How does it work?

The aim of posture correction is to place the spine in its correct anatomical alignment in order to reduce the stress on the muscles and joints of the body. Often neck pain (after whiplash and in general) is associated with a forward position of the head (where the chin pokes forward). This posture may place a great deal of strain on the muscles at the back of the neck, which can cause a lot of pain. Thus, correction or reduction of this poor posture can help reduce pain levels.

Is it effective?

A CBP rehabilitation protocol has been examined in two recent single patient case studies. In one case study¹, CBP treatment encompassing extension exercises, manual adjustments and cervical extension traction was used to treat a patient, who sustained chronic neck pain and headaches following whiplash. The patient was previously treated with chiropractic spinal manipulative therapy but reported no improvements in symptoms. After five months of CBP treatment, the patient reported dramatic improvements in symptoms by 90-100%, with a full restoration of the cervical curve. Similarly, another case study² also revealed benefits associated with CBP protocol (including cervical extension traction, extension exercises and spinal manipulative therapy). In particular, this patient was initially treated three times per week for 16 weeks followed by once a month thereafter for multiple symptoms resulted from whiplash (e.g. neck pain and stiffness, dizziness, ringing in ears, spots in eyes, heart palpitations, low back pain, bilateral knee and shoulder pains). The patient reported a resolution of daily dizziness and neck pain, along with dramatic improvements in all other reported symptoms. Additionally, improvements in forward head posture and cervical curve were also observed in the patient. The postural measures were further improved at one-year follow-up. While both case studies reported positive outcomes associated with using CBP rehabilitation protocol for the management of whiplash related symptoms, there are several methodological concerns of these research (e.g. small sample size, lack of generalisability, potential conflict of interest reported by the researchers).

Are there any disadvantages?

There were no disadvantages to treatment according to the single patient case study. This type of treatment is only provided by qualified professionals, thus there may be considerable costs involved, especially if multiple treatments are required.

Where do you get it?

Chiropractors provide this specific type of posture correction. Other professionals that may provide advice and exercises in relation to posture correction may include doctors, physiotherapists, osteopaths, ergonomists and exercise/rehabilitation providers.

Recommendations

Although small studies on two patients found CBP to be effective, its routine use cannot be recommended due to methodological concerns of these research. Learning how to sit and stand correctly may be useful in conjunction with other treatments, especially if there has been no improvement already. Postural advice and/or postural exercises are recommended in the sub-acute stage (between 2 and 12 weeks) following whiplash injury.

References contributing to the treatment rating

Dehner, C, Heym, B, Maier a, D, Sander, S, Arand, M, Elbel, M, Hartwig, E & Kramer, M 2008, ‘Postural control deficit in acute QTF grade II whiplash injuries’, Gait and Posture, vol. 28, no. 1, pp. 113–119.

Dehner, C, Elbel, M, Strobel, P, Scheich, M, Schneider, F, Krischak, G & Kramer, M 2009, ‘Grade II whiplash injuries to the neck: what is the benefit for patients treated by different physical therapy modalities?’, Patient Safety in Surgery , vol. 3, no. 2, doi: 10.1186/1754-9493-3-2.

Ferrantelli, JR, Harrison, DE, Harrison, DD & Stewart, D 2005, ‘Conservative treatment of a patient with previously unresponsive whiplash associated disorders using clinical biomechanics of posture rehabilitation methods’, Journal of Manipulative and Physiological Therapeutics, vol. 28, no. 3, pp. e1-e8.

1. Fortner MO, Oakley PA, Harrison DE. Cervical extension traction as part of a multimodal rehabilitation program relieves whiplash-associated disorders in a patient having failed previous chiropractic treatment: a CBP® case report. Journal of physical therapy science. 2018;30(2):266-70.

2. Fortner MO, Oakley PA, Harrison DE. Alleviation of posttraumatic dizziness by restoration of the cervical lordosis: a CBP® case study with a one year follow-up. Journal of physical therapy science. 2018;30(5):730-3.

Mercer, C, Jackson, A & Moore, A 2007, ‘Developing clinical guidelines for the physiotherapy management of whiplash associated disorder (WAD)’, International Journal of Osteopathic Medicine, vol.10, no. 2-3, pp. 50-54.

Motor Accidents Authority 2007, Your guide to whiplash recovery in the first 12 weeks after the accident, MAA, Sydney, Australia.