A Comparison of demographic variables and posture between patients with chronic cervical pain and healthy volunteers.

Talbot, Heather Ann.
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Physiotherapists commonly assess head and shoulder posture and correct poor posture on the grounds that there is an association between the patients’ cervical symptoms and their posture. The aims of this study were firstly to compare the sagittal head and shoulder posture and demographic variables of patients with chronic cervical pain to those of “healthy” volunteers. Secondly, to investigate the relationship between the frequency and severity of pain and the sagittal head and shoulder posture of patients with chronic cervical pain. Lateral view photographs were taken of nineteen patients (experimental group) and eighteen “healthy” volunteers (control group) in a supported sitting position. The following five static postural positions were assessed: (1) neutral or natural head and shoulder posture (2) maximum head protraction (3) maximum head retraction (4) maximum shoulder protraction and (5) maximum shoulder retraction. The active range of anteroposterior glide (total excursion) of the participants’ head and shoulders was also assessed. The participants completed a questionnaire that included their demographic variables, medical history and leisure time activities. Differences in head and shoulder posture were observed between the two groups. Some of these differences supported postural relationships that have been described in the literature. The experimental group had a more forward head resting position than the control group. The range of motion (total excursion) of the head and shoulders of the experimental group was less than the control group. In contrast to clinical assumptions that have been described in the literature, a forward resting head posture was not related to a protracted shoulder position or to upper cervical spine extension when measured in the sagittal plane. A relationship was observed between the frequency and severity of pain in certain body regions and selected postural measurements in the experimental group. It is suspected that most of the findings might be the result of poor cervical and scapular muscle control caused by chronic pain. This emphasises the need to assess the influence of tissue and joint extensibility and muscle control on head and shoulder posture. Analysis of the questionnaires demonstrated that the experimental group’s ability to carry out activities of daily living was significantly affected by pain (p=0,001). There was no significant difference in the number of hours worked per week between the experimental and control groups (p=1,000). There was a tendency (p=0,118) for the control group to devote a greater number of hours to “active” leisure time activities. The control group might have been less symptomatic as a result thereof. This highlights the necessity to further investigate the effect of exercise on postural correction and prevention of cervical symptoms.
Faculty of Medicine School of Physiotherapy 82-29610 Tel: 011 452 3175
Posture , Chronic , Cervical pain