Background The craniovertebral angle (CV angle) measurement is a convenient and easy clinical method for the cervical posture assessment. “Markus Bader (MB) ruler software” assists to measure angles and distances on the computer screen. The MB-ruler protractor is almost transparent; hence, it can be easily used on the computer screen. Many studies in physiotherapy have used this software for postural assessment with the photographic method, but the reliability of this software is not available to our knowledge in the Indian population. Aim The aim of this study was to find inter-rater and intra-rater reliabilities of “MB-Ruler software”, by using the photographic method to measure the CV angle for the cervical postural assessment. Study Design This is an observational study in healthy young population. Subjects and Method Total 30 young student volunteers with no clinical symptoms were enrolled for this study. A single standard lateral view image in a sitting position was used for CV angle measurement with “MB ruler software.” Three readings of the CV angle were taken by three different observers (A, B, and C) separately at intervals of time. The CV angle measured by three observers was compared. Results Cronbach's ɑ coefficient value for intra-rater (ICC 0.999) (intra-class correlation coefficient) as well as inter-rater (ICC 0.892) reliability for measuring CV angle was very high. Conclusion MB ruler demonstrates high intra-rater and inter-rater reliabilities and can be used for the photographic evaluation of posture by assessing the CV angle.

Introduction Cervical spine is closely approximated with neurovascular structures. Therefore, misalignment of cervical spine so commonly seen today may lead to altered blood pressure (BP). There could be a relationship between head neck posture as measured by craniovertebral angle and peripheral arterial BP. Aim The aim of this study is to compare peripheral arterial BP in individuals with and without forward head posture (FHP). Study Design This is a comparative, prospective, observational study in healthy population. Subjects and Methods A total of 150 students were selected randomly and screened so that there were equal and desired number of subjects in the two groups (64 in each group) for this comparative, prospective, observational study. Three readings of BP were taken in sitting position on brachial artery at interval of 2 to 3 minutes. One standard image was taken in lateral view used for measuring craniovertebral angle with “MB ruler software.” Craniovertebral angle, systolic blood pressure (SBP), and diastolic blood pressure (DBP) of the two groups were compared. Results The aim of the study was to compare peripheral arterial BP in individuals with and without FHP. The mean SBP and DBP of both the groups were within the normal range as was expected because the subjects were young students with no clinical symptoms. However, it was seen that the mean SBP was significantly higher in subjects with FHP than in subjects without FHP (p = 0.0009). Conclusion Peripheral arterial BP in individuals with FHP is statistically significantly higher than in individuals without FHP.