Head posture and neck pain of chronic nontraumatic origin: a comparison between patients and pain-free persons.
OBJECTIVE
To compare standing head posture measurements between patients with nontraumatic neck pain (NP) and pain-free individuals.


METHODS
Single-blind (assessor) cross-sectional study.


METHODS
Hospital and general community.


METHODS
Consecutive patients (n=40) with chronic nontraumatic NP and age- and sex-matched pain-free participants (n=40).


METHODS
Not applicable.


METHODS
Three angular measurements: the angle between C7, the tragus of the ear, and the horizontal; the angle between the tragus of the ear, the eye, and the horizontal; and the angle between the inferior margins of the right and the left ear and the horizontal were calculated through the digitization of video images.


RESULTS
NP patients were found to have a significantly smaller angle between C7, the tragus, and the horizontal, resulting in a more forward head posture than pain-free participants (NP, mean +/- SD, 45.4 degrees +/-6.8 degrees ; pain-free, mean +/- SD, 48.6 degrees +/-7.1 degrees ; P<.05; confidence interval [CI] for the difference between groups, 0.9 degrees -6.3 degrees ). Dividing the population according to age into younger (</=50y) and older (>50y) revealed an interaction, with a statistically significant difference in head posture for younger participants with NP compared with younger pain-free participants (NP, mean +/- SD, 46.1 degrees +/-6.7 degrees ; pain-free, mean +/- SD, 51.8 degrees +/-5.9 degrees ; P<.01; CI for the difference between groups, 1.8 degrees -9.7 degrees ) but no difference for the older group (NP, mean +/- SD, 44.8 degrees +/-7.1 degrees ; pain-free, mean +/- SD, 45.1 degrees +/-6.7 degrees ; P>.05; CI for the difference between groups, -4.9 degrees -4.2 degrees ). No other differences were found between patients and pain-free participants.


CONCLUSIONS
Younger patients with chronic nontraumatic NP were shown to have a more forward head posture in standing than matched pain-free participants. However, the difference, although statistically significant, was perhaps too small to be clinically meaningful.
Faculty of Health, Leeds Metropolitan University, Leeds, UK.
Anabela G
AG
Silva
T David
TD
Punt
Paul
P
Sharples
João P
JP
Vilas-Boas
Mark I
MI
Johnson
D000328:Adult; D000368:Aged; D002908:Chronic Disease; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009333:Neck / Q000033:anatomy & histology; D019547:Neck Pain / Q000503:physiopathology*; D011187:Posture / Q000502:physiology*; D016037:Single-Blind Method