Quantitative measurements of forward head posture in a clinical settings: a technical feasibility study

Abstract

Introduction: Current clinical practice lacks a user-friendly quantitative method of measuring head posture in individuals with neck-related musculoskeletal disorders. Literature reveals that photogrammetry is a valid and reliable method to evaluate forward head posture (FHP) based on the angles and distance measured on a digital image. However, the adoption of the photogrammetry-based FHP assessment is not common clinical practice. This may be due to technical difficulties, high cost, and complexity of posture assessment software. Advancements in and access to information technology have allowed wide numbers of open resource software applications to be available for measurement of FHP in patients with neck pain in the clinical setting.Aim: To determine the technical feasibility of quantitative forward head posture assessment in clinical settings.Methods: A total of 15 subjects without history of neck pain and 16 subjects with neck pain were recruited for the study. Sagittal head tilt angle (SHA), craniocervical angle (CCA), and shoulder angle (SA) were measured using photogrammetry method. Angles on digital images taken were then analysed using a multi-professional open resource, the Web Plot Digitizer (WPD).Results: The CCA and SA were lower (CCA = 43.54°, SA = 49.39°) in subjects with neck pain than normal subjects (CCA = 47.43°, SA = 52.28°) indicating FHP and protracted shoulder. Subjects with neck pain demonstrated high sagittal head tilt angle (SHA = 19.89°) indicating greater upper cervical extension.Conclusion: Quantitative FHP assessment in the clinical setup using photogrammetry is technically feasible with a basic computer setup and WPD to measure the angles on a digital image.