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Effect ofthe Exam Period on the Pressure Pain Thresholds and Perceived Stress Levels of Students with Forward Head Posture

  • Journal of the Korean Society of Physical Medicine
  • Abbr : J Korean Soc Phys Med
  • 2026, 21(1), pp.67~76
  • Publisher : The Korean Society of Physical Medicine
  • Research Area : Medicine and Pharmacy > Physical Therapy > Other physical therapy
  • Received : September 29, 2025
  • Accepted : November 6, 2025
  • Published : February 28, 2026

Ho Jeong Shin 1,  Ho Hee Son ORD ID 1

1부산가톨릭대학교

Accredited

ABSTRACT

PURPOSE: Forward head posture (FHP) is associated with neck pain and is influenced by physical and psychological factors. Pressure pain threshold (PPT) has been reported to be inversely related to psychological stress such as anxiety. This study aimed to determine the effect of the exam period on PPT and perceived stress in students with FHP. METHODS: There were 32 college students in this study. Based on a cranio-vertebral angle (CVA) of 50°, the students were divided into the FHP group (CVA < 50°; n = 16; mean age, 21.06 ± 1.57 years) and the normal alignment group (CVA ≥ 50°; n = 16; mean age, 21.25 ± 1.57 years). The visual analog scale (VAS) scores, the Korean version of the perceived stress scale (K-PSS) scores, and PPT of the bilateral trapezius muscles were assessed during the semester and exam period. RESULTS: The FHP group showed significant differences in the VAS score, K-PSS score, and bilateral PPT between the semester and exam period, while the normal alignment group showed a significant difference only in the right PPT. Pearson bivariate correlation analysis of all participants revealed a moderate correlation of CVA with the right PPT (r = .408, p = .020) and left PPT (r = .462, p = .008) during the exam period, but a weak correlation with the semester. CONCLUSION: Students with FHP showed higher neck pain and stress scores and lower PPT during the exam period than during the semester, highlighting the importance of maintaining correct posture to reduce neck pain and manage stress during periods of academic demand.

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This paper was written with support from the National Research Foundation of Korea.
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