Studies comparing surrogate measures for head posture in individuals with and without neck pain

Abstract

Background: Head posture (HP) assessment of patients with neck pain (NP) is claimed to be useful in aiding diagnosis, determining treatment strategies and monitoring patient progress. It is assumed that patients with NP have poorer HP than asymptomatic individuals. Objectives: To determine whether there are differences in angles or linear distances between anatomical landmarks used as surrogates for HP between individuals with and without NP. Methods: Studies were sought from PubMed, CINAHL, Physiotherapy Evidence Database, Sports Discus, Web of Science, Academic Search Premier and The Cochrane Library. Two reviewers screened titles and abstracts, and assessed full reports for potentially eligible studies. Data extraction and synthesis: Two reviewers independently extracted information on participants' characteristics, study methods and study quality. Discrepancies were resolved using a third reviewer as arbiter. Study heterogeneity prevented meta-analysis so a tally of study outcome was performed. Results: Seven of 13 included studies found no statistically significant differences in measurements of components of HP between participants with NP and asymptomatic participants. When compared to asymptomatic individuals NP patients were found to have greater forward HP in 4 of 19 comparisons (11 studies), greater head extension/flexion in two of nine comparisons (six studies) and less side-flexion and less rotation in one of one comparison (one study). Conclusion: There is insufficient good quality evidence to determine whether forward HP, head extension, side-flexion and rotation differ between participants with NP and asymptomatic participants.

Use of Outcome Measures in Managing Neck Pain: An International Multidisciplinary Survey

“…Posture has been supported as a contributor to NP in some studies [8, 41-43]. However, clinical measurement studies have not been supportive [44-46] and a systematic review concluded that there was insufficient evidence to determine whether forward head posture, head extension, side-flexion or rotation differ between people with or without NP [47]. The findings from a systematic review of inter-examiner reliability of passive assessment of segmental intervertebral motion in the cervical and lumbar spine [20] found low inter-rater reliability.…”

Within‐Session and Between‐Session Reliability, Construct Validity, and Comparison Between Individuals With and Without Neck Pain of Four Neck Muscle Tests

“…Most neck pain episodes are termed idiopathic or of unknown origin [7], which are associated with a variety of functional deficits such as poor postural control, decreased range of motion, neuromuscular deficits, and postural deviations [8‐12]. In particular, adult patients with neck pain show impaired performance of the neck flexor muscles [13‐15]. For this reason, the performance of the neck flexor muscles is usually a variable of interest in a variety of clinical trials that have investigated the effectiveness of interventions for patients with neck pain [16,17].…”

Correlation between ventral neck muscle endurance and cervical progressive ısoinertial lifting capacity

“…According to the literature findings, studies about relationship of endurance and posture are limited. But it was reported that head and neck movements showed some differences between neck pain and asymptomatic subjects 34 . And it also showed that there was a significant relation between lower endurance capacity and head posture 35 .…”