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Mohammad Jabbar K, Gandomi F. The Effects of National Academy of Sports Medicine and Sahrmann Training on Foot Pressure Distribution in Flexed Posture Students. Iranian Rehabilitation Journal 2021; 19 (1) :99-110
URL: http://irj.uswr.ac.ir/article-1-1281-fa.html

Objectives: Flexed posture with Hyperkyphosis (HKP) and Forward Head Posture (FHP), due to changes in the spine alignment, lead to the displacement of the center of pressure and increased postural sways; ultimately, this condition disrupts the distribution of foot pressure. Therefore, the present study aimed to compare the effects of 8 weeks of National Academy of Sports Medicine (NASM) and Sharman training on Foot Pressure Distribution (FPD) in flexed posture students.
Methods: In this double-blind randomized clinical trial, 30 students with HKP and FHP were randomly assigned in two groups of NASM and Sahrmann (n=15/group). The angle of HKP and FHP were evaluated by Spinal Mouse and Image J software. FPD was also assessed by a Payatek foot scaner (PT-scan) device. The obtained data were analyzed in SPSS using one-way Analysis of Covariance (ANCOVA).
Results: The present research results suggested that both intervention groups presented significant differences in reducing the angle of HKP (P<0.001) and FHP (P<0.001), COP minor axis length (P<0.05), COP major axis length (P<0.001), COP path length (P<0.001), the standard deviation of internal-external sways (P<0.001), and standard deviation of anterior-posterior sways (P<0.001); however, t there was no significant difference concerning the COP area (P>0.05) and symmetry index between the two legs (P>0.05). 
Discussion: Both provided corrective exercises reduced HKP and FHP angles and reduced postural sways. However, Sahrmann intervention with adjusted muscle stiffness and reduced electromechanical latency was more effective than NASM exercises in improving postural control and foot pressure symmetry index.