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Rahnama L.1, Karimi N.1, Eshaghi-Moghadam R.1, Amiri M.1, Rahnama M.2, Saberi M.3
1University of Social Welfare and Rehabilitation Sciences, Tehran, Iran, 2Shiraz University of Medical Sciences, Tehran, Iran, 3Shiraz University of Medical Sciences, Shiraz, Iran
Background: Forward Head Posture (FHP) is highly prevalent among mobile and computer users. A common feature of FHP is altered length of dorsal and ventral neck muscles with resultant increased cervical lordosis and head hyper extension. There is an alteration of neck muscles activity leading to muscles hypertrophy or atrophy. However, the morphological changes of ventral neck muscles in individuals with FHP have not yet been investigated.
Purpose: The purpose of the present study was to investigate the alterations in neck flexor muscles dimensions among individuals with FHP and compare with those with Normal Head Posture (NHP).
Methods: Eighteen individuals with FHP and 18 controls with NHP (all females), voluntarily participated in this case-control study. FHP was assessed with digital photography calculating CranioVertebral Angle (CVA). Right sternocleido mastoid (SCM) muscle thickness in addition to right deep flexor muscles including longus colli and longus capitis muscles cross-section were measured using an ultrasound device with a 4.5 cm, 12 MHz, linear array transducer. The level of measurements was at C5 vertebra. SPSS software version 20 was used to analyze data. Alpha level was set at 0.05.
Results: Participants were aged 23.44 ± 2.54 and 24.50 ± 3.36 years in NHP and FHP groups respectively. The means Body Mass Index (BMI) were 20.97 ± 1.76 kg/m2 in NHP group and 22.07± 2.37 kg/m2 in FHP group. Participants with FHP and NHP were comparable in terms of age and BMI. The mean CVA for the NHP was 53.20 ± 2.35 degrees which was significantly higher than CVA for FHP group; 45.03 ± 4.43 degrees. There was no significant difference in the SCM thickness between NHP (0.60 ± 0.07) cm and FHP (0.63 ± 0.1) cm. No significant difference was observed for deep flexor muscles cross-section between NHP (0.39 ± 0.3) cm2 and FHP (0.37 ± 0.02) cm2 neither.
Conclusion(s): The results of the present study indicate no substantial morphological alterations in superficial (SCM) and deep flexor (longus colli and longus capitis) muscles in individuals with FHP in comparison with individuals with NHP. In the other word, mechanical displacement of the head and neck in FHP seems to have no negative impact on neck flexor muscles dimensions. These findings may suggest that individuals with FHP have no atrophy or hypertrophy of neck flexor muscles at the level of C5 caused by their length alteration.
Implications: According to the results of the present study, the existing positional changes of head and neck have no negative effect on neck flexor muscles dimensions which means there are no atrophy in such muscles. Therefore, in managing FHP, clinicians may need to consider other treatment strategies than regular neck deep flexor strengthening exercises. Further research studies are warranted to evaluate the effects of different treatment strategies on managing FHP.
Funding acknowledgements: There is no funding source supported this study, although the authors sincerely thank all participants of this study.
Topic: Musculoskeletal: spine
Ethics approval: Ethical Approval NO: IR.USWR.REC.1394.350 (Ethics Board of University of Social Welfare and Rehabilitation Sciences)
All authors, affiliations and abstracts have been published as submitted.
