Background: There is sparse literature that provides evidence of cervical and shoulder
postural alignment of 15 to 17-year-old adolescents and that analyzes sex
differences. Objectives:To characterize the postural alignment of the head and shoulder in the sagittal
plane of 15 to 17-year-old Portuguese adolescents in natural erect standing and
explore the relationships between three postural angles and presence of neck and
shoulder pain. Method:This cross-sectional study was conducted in two secondary schools in Portugal. 275
adolescent students (153 females and 122 males) aged 15 to 17 were evaluated.
Sagittal head, cervical, and shoulder angles were measured with photogrammetry and
PAS software. The American Shoulder and Elbow Surgeons Shoulder Assessment (ASES)
was used to assess shoulder pain, whereas neck pain was self-reported with a
single question. Results:Mean values of sagittal head, cervical, and shoulder angles were 17.2±5.7,
47.4±5.2, and 51.4±8.5º, respectively. 68% of the participants revealed
protraction of the head, whereas 58% of them had protraction of the shoulder. The
boys showed a significantly higher mean cervical angle, and adolescents with neck
pain revealed lower mean cervical angle than adolescents without neck pain. 53% of
the girls self-reported regular neck pain, contrasting with 19% of the boys. Conclusions: This data shows that forward head and protracted shoulder are common postural
disorders in adolescents, especially in girls. Neck pain is prevalent in
adolescents, especially girls, and it is associated with forward head posture.
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