Reliability and Validity of Non-radiographic Methods of Forward Head Posture Measurement: A Systematic Review (original) (raw)
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European Journal of Physiotherapy, 2017
Introduction: Current clinical practice lacks a user-friendly quantitative method of measuring head posture in individuals with neck-related musculoskeletal disorders. Literature reveals that photogrammetry is a valid and reliable method to evaluate forward head posture (FHP) based on the angles and distance measured on a digital image. However, the adoption of the photogrammetry-based FHP assessment is not common clinical practice. This may be due to technical difficulties, high cost, and complexity of posture assessment software. Advancements in and access to information technology have allowed wide numbers of open resource software applications to be available for measurement of FHP in patients with neck pain in the clinical setting. Aim: To determine the technical feasibility of quantitative forward head posture assessment in clinical settings. Methods: A total of 15 subjects without history of neck pain and 16 subjects with neck pain were recruited for the study. Sagittal head tilt angle (SHA), craniocervical angle (CCA), and shoulder angle (SA) were measured using photogrammetry method. Angles on digital images taken were then analysed using a multi-professional open resource, the Web Plot Digitizer (WPD). Results: The CCA and SA were lower (CCA ¼ 43.54 , SA ¼ 49.39) in subjects with neck pain than normal subjects (CCA ¼ 47.43 , SA ¼ 52.28) indicating FHP and protracted shoulder. Subjects with neck pain demonstrated high sagittal head tilt angle (SHA ¼ 19.89) indicating greater upper cervical extension. Conclusion: Quantitative FHP assessment in the clinical setup using photogrammetry is technically feasible with a basic computer setup and WPD to measure the angles on a digital image.
Quantitative Assessment of Head Posture of Young Adults Based on Lateral View Photographs
Journal of Physical Therapy Science, 2012
the aims of the present study were to quantitatively characterize upright static sagittal head posture and to determine differences among children according to their age and sex. [Subjects and Methods] This cross-sectional study was conducted on 186 Arabic school children of both sexes aged between 7 to 9 years. They were photographed with a digital camera while maintaining a natural static upright position. The value of craniovertebral angle was calculated using Able Image Analyzer software. [Results] The results revealed a non-significant effect of age and a highly significant effect of sex on head posture. Moreover, a significant effect of age × sex interaction was also shown. [Conclusion] Head posture varies considerably with the sex of children aged 7 to 9 years old. This study may serve as a guideline for physiotherapists and clinicians when conducting head posture assessments and in clinical decision making regarding possible interventions.
Indian Journal of Public Health Research and Development, 2020
Background: Forward head posture (FHP) means that the head is in an anterior position in relation to the postural line and it is considered to coexist with hyperextension of upper cervical spine, flattening of lower cervical spine, rounding of the upper back and elevation and protraction of the shoulders. Because of associated problems, assessment of head posture has become increasingly important in clinical practices in evaluating and designing treatment regimens. For clinical diagnosis, angle measurements have been utilized as information for evaluating physical characteristics, determining the effects of rehabilitation and preventing injury induced by physical activity. There are various software’s available for measuring angles, one of them being Surgimap. In recent years, angle measurements using Electronic head posture instrument (EHPI) have been clinically researched as new angle measurement methods for the forward head posture apart from photographic measurement methods. Thu...
Journal of Voice, 2014
Introduction. Different professionals such as speech and language pathologists and voice scientists are involved in the evaluation of head and neck posture. Therefore, a reliable, time-efficient, and precise method of posture assessment is essential for use in clinical and research settings. Photogrammetry is one of the most commonly used methods to assess head and neck posture. The objectives of this study were to evaluate the intrarater reliability of the method with a large sample size and the interrater reliability by two different specialists (a physiotherapist and a speech and language pathologist). Method. A total of three hundred four subjects (144 males and 160 females) aged between 18 and 28 years participated in the study. During the test session, a photograph was taken of the left-side profile of each subject in their ordinary and comfortable position. The head posture angle of each picture was calculated by two raters. The whole procedure was repeated in a retest session, 24 hours later. A total number of eight analyses were performed for each subject. The reliability was evaluated at several stages hierarchically and after confirming the reliability in each step, the next step was investigated. Paired t tests on the differences of scores obtained at all the aforementioned stages were used to ensure the absence of any systematic bias. To assess the reliability, intraclass correlation coefficients (ICCs) and the standard error of measurements (SEMs) were calculated. Results. There was no significant difference between the mean values of the test and the retest angles at any stage of calculating the head posture angle in both pictures by both examiners (P > 0.05). The ICC and SEM values calculated for all stages were between 0.86-0.97 and 0.52-1.53, respectively. Conclusion. Systematic bias has not occurred at any stage. The ICC and SEM values calculated have demonstrated that there were appropriate relative and absolute reliabilities in all stages. This method is suggested to be used simply in research and clinical areas by different specialists.
Middle East Journal of Rehabilitation and Health Studies
Background: Abnormal head and neck postures play a significant role in developing cervical spine dysfunction. Forward head posture (FHP) is one of the most common findings in individuals who experience head and neck disorders. Objectives: This study used a photographic method to analyze the head, upper neck, and lower neck postures in forward head posture in both static and quasi-static states. Since timely diagnosis and appropriate treatment are important in preventing further complications of this kinematic chain disorder, the postural variables of the head and neck were evaluated by focusing on their separate parts in both static and quasi-static states. Methods: This observational-analytical case-control study included 175 individuals with no history of neck pain in the past 6 months, 138 with FHP, and 37 with non-FHP. The postural angles, including the upper cervical, lower cervical, craniovertebral, head posture, and head tilt angles, were measured through photography in both ...
Assessing the impact of certain exercises on the spatial head posture
International journal of occupational medicine and environmental health, 2019
OBJECTIVES The head constitutes 6% of the total body weight, which is linked to the cervical spine and all other joints through the kinematic chain by various muscles. The forward head posture is one of the most common postural disorders and seems to be especially dangerous. The goal of the work was to assess the impact of 4 weeks of training neck and nape muscles on the head posture. MATERIAL AND METHODS The subjects were 20 participants, who performed neck exercises for 20 days. The head posture in a sagittal and frontal plane was assessed photogrammetrically twice: before and after the exercises. The following have been used for the assessment: craniovertebral (CV) angle, head tilt angle (HT), and frontal head tilt angle (FHT). RESULTS After a 20-day program of neck and nape exercises the values of specific angles were compared. The results indicated significant changes in the head posture. In the sagittal plane: the average value of the CV angle before the training was 47.17°, a...
Modified Universal Goniometer for Objective Assessment of Forward Head Posture in Clinical Settings
MGM Journal of Medical Sciences, 2018
Accurate assessment of the forward head posture needs sophisticated, high-end equipment, which may not be available always. A modified universal goniometer was designed for routine clinical use by which forward head posture can be assessed by measuring craniovertebral and craniohorizontal angles. The device was tested in 23 young male subjects by two independent tester s and was found to be reasonably accurate. The device is simple, cost-effective and reliable for use in clinical physiotherapy for objective assessment of the forward head posture.
Investigation of natural head posture in different head types
Journal of Oral Science, 2004
The aim of this study was to investigate natural head posture (NHP) in different head types. Lateral cephalograms of 99 adults (Mean age, 21.8 years ± SD, 2.2 yrs, range between 19 and 29 yrs) were examined. Head types were determined as Hyperbrachycephal, Brachycephal, Mesocephal or Dolichocephal according to the cephalic index. Analysis of variance and the Duncan's test were performed to assess inter-group differences for the parameters. The findings revealed that, NHP was statistically not different between the head type groups. Thus, it was suggested that environmental factors during growth may alter NHP, as well as craniofacial morphology but in a different manner (i.e. degree and direction) in each head type.
Forward Head Posture in Young Adults: A Systematic Review
THE THERAPIST (Journal of Therapies & Rehabilitation Sciences)
A recent study shows that almost 78% of population have its neck in working position within 24 hours causing continuous stress on neck and shoulders which is forcing the neck in anterior or forward head posture. This may lead to upper back tightness and muscle spasm causing nagging to sharp pain. Hence, cervical pain and neck pain getting more attention. This study is designed to narratively review the prevalence of forward head posture in young adults Methods: A structured search on literature was done through various electronic and print data bases such as: Pubmed, cinhal, google scholar, science direct, cochrane library and scopus. Those studies were included in which age ranged from 20 to 45 years. Young adults from any profession were included. Those studies were excluded in which forward head posture was reported due to any systemic issue Results: A total of 120 studies had gone through in which 65 studies were short listed and on further review only 4 studies were included as...