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Kawasaki T, Ohji S, Aizawa J, Sakai T, Hirohata K, Koseki T, Kuruma H, Okawa A, Jinno T. Characteristics of head and neck alignment and function of deep cervical flexor muscles in patients with nonspecific neck pain. J Bodyw Mov Ther 2024; 39:565-571. [PMID: 38876686 DOI: 10.1016/j.jbmt.2024.03.063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 03/08/2024] [Accepted: 03/20/2024] [Indexed: 06/16/2024]
Abstract
OBJECTIVES The objectives were to compare forward head posture (FHP) in natural and corrected head postures between patients with nonspecific neck pain (NSNP) and controls and to clarify the relationship between natural and corrected head posture angle differences and deep cervical flexor function. This study aimed to provide useful evidence for postural assessment and treatment in patients with NSNP. METHODS In this cross-sectional study, 19 patients with NSNP reporting a pain score of 3-7 for at least 3 months and 19 participants with no neck pain within the previous 12 months were recruited. To evaluate FHP, the cranial rotation and vertical angles were measured using lateral head and neck photographs. The craniocervical flexion test was used to evaluate deep cervical flexor activation and endurance. We evaluated the head and neck alignment in natural and corrected head postures and the relationship between the degree of change and deep cervical flexor function. RESULTS FHP in the natural head posture did not differ between groups. In the corrected head posture, FHP was significantly smaller in the NSNP group than in the control group. In the NSNP group, the cranial rotation and vertical angles were significantly different between the natural and corrected head postures, and the angle difference correlated significantly with deep cervical flexor function. CONCLUSIONS Patients with NSNP show hypercorrection in the corrected head posture, which may be correlated with deep cervical flexor dysfunction. Further investigation into the causal relationship between hypercorrection, deep neck flexor dysfunction, and neck pain is required.
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Affiliation(s)
- Tomoko Kawasaki
- Department of Rehabilitation Medicine, Graduate School of Medical and Dental Science, Tokyo Medical and Dental University, Tokyo, Japan; Clinical Center for Sports Medicine and Sports Dentistry, Tokyo Medical and Dental University, Tokyo, Japan.
| | - Shunsuke Ohji
- Clinical Center for Sports Medicine and Sports Dentistry, Tokyo Medical and Dental University, Tokyo, Japan
| | - Junya Aizawa
- Department of Physical Therapy, Faculty of Health Science, Juntendo University, Tokyo, Japan
| | - Tomoko Sakai
- Department of Rehabilitation Medicine, Graduate School of Medical and Dental Science, Tokyo Medical and Dental University, Tokyo, Japan
| | - Kenji Hirohata
- Department of Rehabilitation Medicine, Graduate School of Medical and Dental Science, Tokyo Medical and Dental University, Tokyo, Japan; Clinical Center for Sports Medicine and Sports Dentistry, Tokyo Medical and Dental University, Tokyo, Japan
| | - Taiichi Koseki
- Department of Rehabilitation, Sasaki Orthopedic Clinic, Kanagawa, Japan
| | - Hironobu Kuruma
- Division of Physical Therapy, Tokyo Metropolitan University, Tokyo, Japan
| | - Atsushi Okawa
- Department of Rehabilitation Medicine, Graduate School of Medical and Dental Science, Tokyo Medical and Dental University, Tokyo, Japan
| | - Tetsuya Jinno
- Department of Rehabilitation Medicine, Graduate School of Medical and Dental Science, Tokyo Medical and Dental University, Tokyo, Japan; Department of Orthopaedic Surgery, Dokkyo Medical University Saitama Medical Center, Saitama, Japan
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Daffin L, Innes S, Stuelcken MC. An investigation of the reproducibility of a self-selected natural feet position when standing: Implications for the assessment of upright standing posture. Musculoskelet Sci Pract 2024; 69:102896. [PMID: 38101271 DOI: 10.1016/j.msksp.2023.102896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Revised: 11/14/2023] [Accepted: 12/07/2023] [Indexed: 12/17/2023]
Abstract
BACKGROUND Photogrammetry is often used to evaluate standing static postural alignment. Patients are often instructed to self-select a natural feet position but it's unclear whether this position can be consistently replicated across repeated assessments. OBJECTIVE To determine whether people can replicate a self-selected natural feet position in upright standing across three sessions on different days. DESIGN Between days test-retest reliability. SETTING University laboratory. METHODS Three variables - Base of Support (BoS), Foot Width (FW), Feet Opening Angle (FOA) - were measured from foot tracings of 150 participants (18-30 years) using established procedures. BoS data were assessed for systematic bias (Analysis of Variance), and absolute (Coefficient of Variation - CV%) and relative (Intraclass Correlation Coefficient - ICC) reliability. RESULTS There was systematic bias in the BoS data across the three testing sessions. The CV% for the BoS data was 15.2%. The ICC (95% CI) for the BoS data was 0.84 (0.79-0.87). There were moderate-large correlations between the BoS and both FOA and FW respectively within each session. CONCLUSION If clinicians want to allow patients to use their self-selected natural feet position for repeated photogrammetric assessment of their static postural alignment it would be better to standardise the position of the feet, for example, by creating a tracing of a patient's self-selected natural feet position.
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Affiliation(s)
- Lee Daffin
- School of Allied Health, Murdoch University, 90 South St, Murdoch, WA, 6150, Australia.
| | - Stanley Innes
- Research Associate, Eastern Adult Health Mental Health and Wellbeing Program, Victoria, Australia; Faculty of Allied Health & Wellbeing, UCLAN, Preston, UK.
| | - Max C Stuelcken
- School of Health, University of the Sunshine Coast (UniSC), 90 Sippy Downs Dr, Sippy Downs, 4556, Queensland, Australia.
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Yan Z, Zhou W, Chen G, Xie Z, Zhao Z, Zhang C. Measurement of human body parameters for human postural assessment via single camera. JOURNAL OF BIOPHOTONICS 2023; 16:e202300041. [PMID: 37559471 DOI: 10.1002/jbio.202300041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 07/17/2023] [Accepted: 08/07/2023] [Indexed: 08/11/2023]
Abstract
We present a camera-based human body parameters measurement approach and develop a human postural assessment system. The approach combines the conventional contact measurement method and the non-contact measurement method to overcome some shortcomings in terms of time, expense, and professionalism in early methods. The entire measurement system consists of a computer, a high-definition camera, and the sticky points that are applied to the participant's body before the measurement. The camera captures the triple view image of human body. Then, the human body outline and the joint points of the human skeleton are extracted to locate the bone feature points. Finally, measurements and extractions of the human parameters are made. Experimental results demonstrate that the global postural assessment system provides quantitative guidance for human postural evaluation, and it completely changes how human postural is evaluated. The postural assessment system is significant for early diagnosis of diseases and medical rehabilitation treatment.
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Affiliation(s)
- Zheng Yan
- Department of Physics and Information Engineering, Fuzhou University, Fuzhou, China
- Fujian (Quanzhou)-HIT Research Institute of Engineering and Technology, Quanzhou, China
| | - Wenqiang Zhou
- Quanzhou Hospital of Traditional Chinese Medicine, Quanzhou, China
| | - Guodong Chen
- Department of Physics and Information Engineering, Fuzhou University, Fuzhou, China
| | - Zhexin Xie
- Fujian (Quanzhou)-HIT Research Institute of Engineering and Technology, Quanzhou, China
- Pcn-Tung Sah Institute of Micro-Nano Science and Technology, Xiamen University, Xiamen, China
| | - Ziyang Zhao
- Fujian (Quanzhou)-HIT Research Institute of Engineering and Technology, Quanzhou, China
| | - Chentao Zhang
- Pcn-Tung Sah Institute of Micro-Nano Science and Technology, Xiamen University, Xiamen, China
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Norton TC, Oakley PA, Harrison DE. Re-establishing the cervical lordosis after whiplash: a Chiropractic Biophysics ® spinal corrective care methods pre-auto injury and post-auto injury case report with follow-up. J Phys Ther Sci 2023; 35:270-275. [PMID: 36866005 PMCID: PMC9974326 DOI: 10.1589/jpts.35.270] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2022] [Accepted: 12/06/2022] [Indexed: 03/04/2023] Open
Abstract
[Purpose] To document the re-establishment of the cervical lordosis following radiographically verified altered sagittal plane alignment both prior to, and following a motor vehicle collision. [Participant and Methods] A 16-year-old male presented for a non-motor collision complaint of low back pain. Initial lateral cervical radiograph demonstrated cervical hypo-lordosis. The patient was treated with a 6-week plan (18 visits) utilizing Chiropractic BioPhysics® (CBP) methods to increase the cervical lordosis. Eight months later the patient presented with new complaints as a result of a motor collision. The cervical lordosis straightened. The patient received another round of similar treatment to improve the lordosis. There was also a 6.5-month follow-up. [Results] The initial round of treatment achieved a 21° improvement in cervical lordosis. The motor vehicle collision caused a loss of 15° of lordosis. The second round of treatment achieved a 12.5° improvement in lordosis that was demonstrated to be maintained at a 6.5-month follow-up. [Conclusions] This case illustrates how a whiplash event occurring during a motor vehicle collision subluxated the cervical spine. It was also shown that CBP methods reliably corrected the lordosis after two separate treatment programs using specialized methods. Beyond trauma, radiographic screening of specific cervical subluxation is recommended following all motor collisions.
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Affiliation(s)
| | - Paul A. Oakley
- Private Practice: 11A-1100 Gorham St., Newmarket, Ontario
L3Y8Y8, Canada,Corresponding author. Paul A. Oakley (E-mail: )
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de Albuquerque PMNM, de Oliveira DA, do Nascimento Alves LI, da Silva Alves Gomes VM, Bezerra LMR, de Souza Melo TM, de Alencar GG, da Silva Tenório A, de Siqueira GR. The accuracy of computerized biophotogrammetry in diagnosing changes in the cervical spine and its reliability for the cervical lordosis angle. J Back Musculoskelet Rehabil 2023; 36:187-198. [PMID: 35964169 DOI: 10.3233/bmr-210375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Accuracy studies of biophotogrammetry protocols require standardization similar to radiography. OBJECTIVE To estimate the diagnostic accuracy of a biophotogrammetric assessment protocol for cervical hyperlordosis, compared to radiography, and its intra- and inter-examiner reliability for measuring the cervical lordosis angle. METHODS A study of diagnostic accuracy in women complaining of cervical pain. Two photos were taken using the CorelDraw biophotogrammetric protocol and one radiograph using the Cobb C1-C7 method. The Intra- and Inter-examiner reliability was calculated using the Kappa index and the intraclass correlation coefficient (ICC). The Bland-Altman plot and the ROC curve were presented. RESULTS The sample consisted of 19 women. The accuracy of biophotogrammetry was 94.73% and the reliability between biophotogrammetry and radiography presented an ICC of 0.84 and a Kappa of 0.87. The excellent intra (ICC = 0.94) and inter-examiner (ICC = 0.86) reliability of the biophotogrammetry was confirmed. The area under the ROC curve was 93.5%. The Bland-Altman plot indicated differences between the two instruments close to the mean (1.5∘). CONCLUSION The biophotogrammetric protocol proved to be accurate in diagnosing cervical hyperlordosis, with excellent reliability between the biophotogrammetric and radiographic assessments. It also demonstrated excellent intra- and inter-examiner reliability in measuring the cervical lordosis angle.
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Correlation between the Photographic Cranial Angles and Radiographic Cervical Spine Alignment. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19106278. [PMID: 35627816 PMCID: PMC9141407 DOI: 10.3390/ijerph19106278] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Revised: 05/18/2022] [Accepted: 05/18/2022] [Indexed: 11/22/2022]
Abstract
The cranial vertical angle (CVA) and cranial rotation angle (CRA) are used in clinical settings because they can be measured on lateral photographs of the head and neck. We aimed to clarify the relationship between CVA and CRA photographic measurements and radiographic cervical spine alignment. Twenty-six healthy volunteers were recruited for this study. Lateral photographs and cervical spine radiographs were obtained in the sitting position. The CVA and CRA were measured using lateral photographs of the head and neck. The C2-7 sagittal vertical axis (SVA), cervical lordosis (C2-7), and occipito-C2 lordosis (O-C2) were measured using radiographic imaging as a standard method of evaluating cervical spine alignment. Correlations between the CVA and CRA on photographs and cervical spine alignment on radiographs were analyzed. The CVA and SVA were significantly negatively correlated (ρ = −0.51; p < 0.05). Significant positive correlations were found between CVA and C2-7 (ρ = 0.59; p < 0.01) and between CRA and O-C2 (ρ = 0.65; p < 0.01). Evaluating the CVA and CRA on photographs may be useful for ascertaining head and neck alignment in the mid-lower and upper parts of the sagittal plane.
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Lin G, Wang W, Wilkinson T. Changes in deep neck muscle length from the neutral to forward head posture. A cadaveric study using Thiel cadavers. Clin Anat 2022; 35:332-339. [PMID: 35038194 PMCID: PMC9304288 DOI: 10.1002/ca.23834] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 11/30/2021] [Accepted: 01/07/2022] [Indexed: 11/11/2022]
Abstract
Forward head posture (FHP) is one of the most common postural deviations. Deep neck muscle imbalance of individuals with FHP is of primary concern in clinical rehabilitation. However, there is scarce quantitative research on changes in deep neck muscle length with the head moving forward. This study aimed to investigate changes in deep neck muscle length with different severity levels of FHP. Six Thiel‐embalmed cadavers (four males and two females) were dissected, and 16 deep neck muscles in each cadaver were modeled by a MicroScribe 3D Digitizer in the neutral head posture, slight FHP, and severe FHP. The craniovertebral angle was used to evaluate the degrees of FHP. Quantitative length change of the deep neck muscles was analyzed using Rhinoceros 3D. In slight FHP significant changes in length occurred in four muscles: two shortened (upper semispinalis capitis, rectus capitis posterior minor) and two lengthened (longus capitis, splenius cervicis). In severe FHP all occipital extensors were significantly shortened (10.6 ± 6.4%), except for obliquus capitis superior, and all cervical extensors were significantly lengthened (4.8 ± 3.4%), while longus capitis (occipital flexor) and the superior oblique part of the longus colli (cervical flexor) were lengthened by 8.8 ± 3.8% and 4.2 ± 3.1%, respectively. No significant length change was observed for the axial rotator. This study presents an alternate anatomical insight into the clinical rehabilitation of FHP. Six muscles appear to be important in restoring optimal head posture, with improvements in FHP being related to interventions associated with the occipital and cervical extensors.
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Affiliation(s)
- Guohao Lin
- Centre for Anatomy and Human Identification, School of Science and Engineering, University of Dundee, Dundee, UK
| | - Weijie Wang
- Department of Orthopaedic and Trauma Surgery, School of Medicine, University of Dundee, Dundee, UK
| | - Tracey Wilkinson
- Centre for Anatomy and Human Identification, School of Science and Engineering, University of Dundee, Dundee, UK
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Lopes MA, Coleman RR, Cremata EJ. Radiography and Clinical Decision-Making in Chiropractic. Dose Response 2021; 19:15593258211044844. [PMID: 34675758 PMCID: PMC8524714 DOI: 10.1177/15593258211044844] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2021] [Revised: 08/11/2021] [Accepted: 08/17/2021] [Indexed: 12/25/2022] Open
Abstract
The concern over x-ray exposure risks can overshadow the potential benefit of radiography, especially in cases where manual therapy is employed. Spinal malalignment cannot be accurately visualized without imaging. Manual therapy and the load tolerances of injured spinal tissues raise different criteria for the use of x-rays for spinal disorders than in medical practice. Current regulatory bodies rely on radiography risk assessments based on Linear-No-Threshold (LNT) risk models. There is a need to consider radiography guidelines for chiropractic which are different from those for medical practice. Radiography practice guidelines are summaries dominated by frequentist interpretations in the analysis of data from studies. In contrast, clinicians often employ a pseudo-Bayesian form of reasoning during the clinical decision-making process. The overrepresentation of frequentist perspectives in evidence-based practice guidelines alter decision-making away from practical assessment of a patient's needs, toward an overly cautious standard applied to patients without regard to their risk/benefit likelihoods relating to radiography. Guidelines for radiography in chiropractic to fully assess the condition of the spine and spinal alignment prior to manual therapy, especially with high velocity, low amplitude spinal manipulation (HVLA-SM), should necessarily differ from those used in medical practice.
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Affiliation(s)
- Mark A. Lopes
- Gonstead Clinical Studies Society, Santa Cruz, CA, USA
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Barassi G, Di Simone E, Galasso P, Cristiani S, Supplizi M, Kontochristos L, Colarusso S, Visciano CP, Marano P, Antonella DI, Giancola O. Posture and Health: Are the Biomechanical Postural Evaluation and the Postural Evaluation Questionnaire Comparable to and Predictive of the Digitized Biometrics Examination? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18073507. [PMID: 33800610 PMCID: PMC8038060 DOI: 10.3390/ijerph18073507] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 03/22/2021] [Accepted: 03/22/2021] [Indexed: 01/16/2023]
Abstract
Background: Postural tone alterations are expressions of myofascial and, therefore, of structural, visceral, and emotional disorders. To prevent these disorders, this study proposes a quantitative investigation method which administers a postural evaluation questionnaire and a postural biomechanical evaluation to 100 healthy subjects. Methods: The reliability of the method is studied by comparing both assessments with digitized biometrics. In addition, 50 subjects undergo the biomechanical evaluation form twice, by four different operators, to study the intraoperative repeatability. Results: The results show a satisfactory overlap between the results obtained with the postural evaluation questionnaire and the postural biomechanical evaluation compared to computerized biometrics. Furthermore, intraoperative repeatability in the use of the biomechanical evaluation form is demonstrated thanks to a minimal margin of error. Conclusions: This experience suggests the importance of undertaking this path in both the curative and the preventive sphere on a large scale and on different types of people who easily, and even unknowingly, may face dysfunctional syndromes, not only structural and myofascial but also consequently of the entire body’s homeostasis.
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Affiliation(s)
- Giovanni Barassi
- Physiotherapy, Rehabilitation and Reeducation Training Center (CeFiRR), Venue Gabriele d’Annunzio, School of Medicine and Health Sciences, University of Chieti-Pescara, 66100 Chieti, Italy; (E.D.S.); (M.S.); (L.K.); (C.P.V.)
- Correspondence:
| | - Edoardo Di Simone
- Physiotherapy, Rehabilitation and Reeducation Training Center (CeFiRR), Venue Gabriele d’Annunzio, School of Medicine and Health Sciences, University of Chieti-Pescara, 66100 Chieti, Italy; (E.D.S.); (M.S.); (L.K.); (C.P.V.)
| | | | | | - Marco Supplizi
- Physiotherapy, Rehabilitation and Reeducation Training Center (CeFiRR), Venue Gabriele d’Annunzio, School of Medicine and Health Sciences, University of Chieti-Pescara, 66100 Chieti, Italy; (E.D.S.); (M.S.); (L.K.); (C.P.V.)
| | - Leonidas Kontochristos
- Physiotherapy, Rehabilitation and Reeducation Training Center (CeFiRR), Venue Gabriele d’Annunzio, School of Medicine and Health Sciences, University of Chieti-Pescara, 66100 Chieti, Italy; (E.D.S.); (M.S.); (L.K.); (C.P.V.)
| | - Simona Colarusso
- Communication, Research, Innovation, Department of Communication and Social Research, Sapienza University, 00185 Rome, Italy;
| | - Christian Pasquale Visciano
- Physiotherapy, Rehabilitation and Reeducation Training Center (CeFiRR), Venue Gabriele d’Annunzio, School of Medicine and Health Sciences, University of Chieti-Pescara, 66100 Chieti, Italy; (E.D.S.); (M.S.); (L.K.); (C.P.V.)
| | - Pietro Marano
- Department of Neuro-Rehabilitation, Madonna del Rosario Clinic, 95125 Catania, Italy;
| | - Di Iulio Antonella
- U.O.C. Thoracic Surgery, Santo Spirito Hospital Pescara, ASL Pescara, 65124 Pescara, Italy;
| | - Orazio Giancola
- Department of Social and Economic Sciences, Sapienza University, 00185 Rome, Italy;
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Martinez-Merinero P, Nuñez-Nagy S, Achalandabaso-Ochoa A, Fernandez-Matias R, Pecos-Martin D, Gallego-Izquierdo T. Relationship between Forward Head Posture and Tissue Mechanosensitivity: A Cross-Sectional Study. J Clin Med 2020; 9:jcm9030634. [PMID: 32120895 PMCID: PMC7141123 DOI: 10.3390/jcm9030634] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Revised: 02/19/2020] [Accepted: 02/19/2020] [Indexed: 01/19/2023] Open
Abstract
The relationship between forward head posture (FHP) and neck pain is not clear. FHP could possibly increase the mechanosensitivity of cervical tissues, which could lead to the development of pain depending on the adaptation capability of the central nervous system. The purpose of this study was to analyse the influence of FHP in the mechanosensitivity of articular, muscular, and neural tissues related to the cervical spine. The pressure pain threshold was bilaterally measured in different muscles and nerves and the second cervical vertebrae. The cervical spine’s range of movement was also examined. The measurements were obtained from people with (n = 32) and without (n = 64) FHP. The analyses included a 2-by-2 mixed analysis of variance (ANOVA), pairwise comparisons with Bonferroni correction, and point-biserial correlation coefficients. Subjects with FHP showed a less pressure pain threshold (PPT) in all locations except for the upper trapezius and scalenus medius muscles. They also showed less extension and right-rotation range of motion. There was no association between FHP, neck pain, disability, and headache. Nevertheless, more research is needed to evaluate the relationship between FHP, tissue mechanosensitivity, and neck pain.
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Affiliation(s)
- Patricia Martinez-Merinero
- Department of Physiotherapy, Faculty of Biomedical and Health Sciencies, Universidad Europea de Madrid, 28670 Madrid, Spain
- Research Institute of Physiotherapy and Pain, University of Alcalá, 28805 Madrid, Spain
| | - Susana Nuñez-Nagy
- Department of Physical Therapy, University of Alcalá, 28871 Madrid, Spain
| | | | | | - Daniel Pecos-Martin
- Department of Physical Therapy, University of Alcalá, 28871 Madrid, Spain
- Physiotherapy and Pain Group, University of Alcalá, 28871 Madrid, Spain
- Correspondence:
| | - Tomas Gallego-Izquierdo
- Research Institute of Physiotherapy and Pain, University of Alcalá, 28805 Madrid, Spain
- Department of Physical Therapy, University of Alcalá, 28871 Madrid, Spain
- Physiotherapy and Pain Group, University of Alcalá, 28871 Madrid, Spain
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Mahmoud NF, Hassan KA, Abdelmajeed SF, Moustafa IM, Silva AG. The Relationship Between Forward Head Posture and Neck Pain: a Systematic Review and Meta-Analysis. Curr Rev Musculoskelet Med 2019; 12:562-577. [PMID: 31773477 PMCID: PMC6942109 DOI: 10.1007/s12178-019-09594-y] [Citation(s) in RCA: 81] [Impact Index Per Article: 16.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
PURPOSE OF REVIEW Forward head posture (FHP) is the most common cervical postural fault in the sagittal plane that is found with different severity levels in almost all populations. Despite claims that FHP may be related to neck pain, this relation seems to be controversial. Thus, our purpose is to determine whether FHP differs between asymptomatic subjects and those with neck pain and to investigate if there is a relationship between head posture and neck pain. RECENT FINDINGS A total of 15 cross-sectional studies were eligible for inclusion for this systematic review and meta-analysis. Ten studies compared FHP between a group of asymptomatic participants and a group of participants with neck pain and an overall mean difference (MD) of 4.84 (95% CI = 0.14, 9.54), indicating a significant between-group difference, contrary to adolescent (MD = - 1.05; 95% CI = - 4.23, 2.12). Eight studies showed significant negative correlations between FHP and neck pain intensity (r = - 0.55; 95% CI = - 0.69, - 0.36) as well as disability (r = - 0.42; 95% CI = - 0.54, - 0.28) in adults and older adults, while in adolescents, only lifetime prevalence and doctor visits due to neck pain were significant predictors for FHP. This systematic review found that age played an important role as a confounding factor in the relation between FHP and neck pain. Also, the results showed that adults with neck pain show increased FHP when compared to asymptomatic adults and that FHP is significantly correlated with neck pain measures in adults and older adults. No association was found between FHP and most of neck pain measures in adolescents.
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Affiliation(s)
- Nesreen Fawzy Mahmoud
- Department of Musculoskeletal Disorders & Surgery, Faculty of Physical Therapy, Cairo University, Cairo, 14531 Egypt
| | - Karima A. Hassan
- Department of Musculoskeletal Disorders & Surgery, Faculty of Physical Therapy, Cairo University, Cairo, 14531 Egypt
| | - Salwa F. Abdelmajeed
- Department of Musculoskeletal Disorders & Surgery, Faculty of Physical Therapy, Cairo University, Cairo, 14531 Egypt
| | - Ibraheem M. Moustafa
- Department of Physiotherapy, College of Health Sciences, University of Sharjah, Sharjah, UAE
| | - Anabela G. Silva
- School of Health Sciences & CINTESIS.UA, University of Aveiro, Aveiro, Portugal
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