The main objective is to check if there are significant differences in the measurement of the craniovertebral angle (CVA) between adults with nonspecific chronic neck pain (CNP) vs without neck pain. A secondary objective is to measure the intra and interobserver reliability of the measurement of CVA between two novice evaluators; as well as the correlation between measurements of the CVA in sitting and standing position.
Observational, cross-sectional study with a comparative design between two groups, participants with and without CNP, in which CVA was measured in sitting and standing position through photogrammetry. In addition, sociodemographic and anthropometric variables, prevalence of musculoskeletal pain, pain intensity, general health status, level of physical activity, risk of CNP progression, and neck disability were analyzed. Intra- and inter-observer reliability of CVA was assessed using Kinovea software.
No between-group differences were found for CVA in sitting (p=0.98) or standing position (p=0.46); and neither group exhibited FHP. Women had lower CVA values than men, both seated (49.4 ± 5.1 vs. 50.6 ± 4.9; p=0.016) and standing (50.6 ± 4.9 vs. 52.8 ± 4.1; p=0.035), with women exhibiting FHP. Young adults also showed FHP when seated compared to older adults (49.2 ± 4.8 vs 52.2 ± 5.5; p=0.04). Overweight/obese individuals had FHP both seated (48.1 ± 4.8; p=0.009) and standing (49.1 ± 4.5; p=0.004) compared to those with normal weight. Interobserver reliability (ICC= 0.98 for both sitting and standing) and intraobserver reliability in sitting (ICC= 0.92 rater 1, ICC= 0.93 rater 2) and standing position (ICC=0.90 rater 1, ICC=0.92 rater 2) were almost perfect.
Individuals with CNP did not have FHP measured through CVA in either sitting or standing when compared to controls without CNP. Gender, age, and BMI may be potential factors contributing to FHP. The inter and intraobserver reliability in novice evaluators of CVA measurement is excellent, demonstrating that photogrammetry is a good option for evaluating CVA by novice evaluators.
The study provides key insights, including enhanced assessment of the CVA through photogrammetry in both seated and standing positions, demonstrating its effectiveness for novice evaluators. This study also highlights the importance of considering additional factors associated with FHP in clinical practice. By recognizing these factors, physical therapists can enhance the management of patients with FHP, leading to improved prevention strategies and therapeutic interventions.
Forward Head Posture
Craniovertebral Angle
