RELATIONSHIP BETWEEN THE CRANIO- VERTEBRAL ANGLE AND MEDIAN NERVE NEURAL TENSION

M.F. Chevidikunnan¹, N.K. Alkhwaildi¹, L.O. AlSaidi¹, O.E. Awad¹, S.Y. Osailan¹, A.S. AlZiyadi¹

Background: Forward Head Posture (FHP) is commonly defined as the head protrusion in the sagittal plane, which places the head anterior to the trunk. It can occur because of lower cervical flexion, anterior movement of the head or both and it is measured by specific angle called the cranio-vertebral (CV) angle. The angle is measured by taking the intersection of a horizontal line of the 7th cervical spinous process and the tragus of the ear. It is possible that a decreased cranio-vertebral angle may compromise cervical nerve roots, leading to median nerve problems. The Upper Limb Neurodynamic Tests (ULNT) for the median nerve is more sensitive compared to other upper limb nerves, and more specific for the median nerve. The median nerve can have limited mobility due to ischemia of the nerve or anatomic, systemic and occupational factors that may reproduce neural symptoms.

Purpose: The postural changes may have an impact on the neural mobility. Therefore, the current study aimed to find out the mechanical causes or changes in CV angle can affect the neural tension in the median nerve or not. So the objective of the current study is to find out the relationship between CV angle and median nerve neural tension among the young female subjects.

Methods: This was a cross-sectional study design, where 72 healthy female college students whose age ranged between 18-30 years were included. The basic demographic data which includes; age, height, weight, and the BMI were documented. Following which, the CV angle was measured by using the mobile app named Angle and Ratio. The median nerve mobility was assessed by using the methodology described by Butler with Upper Limb Neurodynamic Test 1 where the elbow extension angle was measured by the universal goniometer on both sides.

Results: The data were analyzed by using Pearson Correlation test and the results show that there is no correlation exists between CV angle and elbow extension angle of right and left sides (r = 0. 109, r = -0.100, p ≥ 0.05).   There is no correlation between BMI score either with CV angle (r = -0.237, p ≤ 0.05) or with elbow extension angle for the right and left sides(r = -0. 308, r = -0.279, p ≤ 0.05). There is high positive correlation exists between right and left elbow extension angles (r = 0.819, p ≤ 0.05).

Conclusion(s): The study results shows that, the variation in the CV angle does not alter the elbow extension angle of median nerve neural tension test in young female subjects. Further studies to be conducted on males, as the  current study was done only on female subjects and the fitness level of the subjects also must be considered, as lifestyle may have an impact on the sensitivity of nerve.

Implications: The results of the current study will help the physical therapists to understand that median nerve neural tension or sensitivity does not alter in response to change in CV angle in young female subjects, which will ultimately have an impact on the better outcome of treatment of such kind of subjects.

Funding, acknowledgements: No Funding Received

Keywords: Cranio-Vertebral Angle, Median Nerve Tension Test, Elbow Extension Angle

Topic: Occupational health & ergonomics

Did this work require ethics approval? Yes

Institution: Department of Physical Therapy

Committee: King Abdul Aziz University

Ethics number: KAU/FAMS/PT/2019/20