Cervical and shoulder postural assessment of adolescents between 15 and 17 years old and association with upper quadrant pain

Abstract

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.

Analysis of relationships between the use of visual display terminals, craniocervical angle and physical activity: A pilot study

“…They obtained significant differences in the craniocervical angle between subjects with and without neck pain. These data agree with those found by Ruivo et al (Ruivo, Pezarat-Correia & Carita, 2014), who, in a research conducted with cases and controls, showed that subjects with neck pain had a more marked forward head posture, 68% of subjects exhibiting this postural disorder. According to these authors, the inappropriate use of heavy backpacks, as well as the psychosocial factors such as depression or stress, the lack of ergonomic furniture, the hours spent in incorrect postures in front of visual display units, may be some causes for this problem.…”

Association Between Forward Head, Rounded Shoulders, and Increased Thoracic Kyphosis: A Review of the Literature

“…FHP has been associated with shortened levator scapulae, sternocleidomastoids, upper trapezius, and posterior cervical spine muscles, 18 that is, suboccipital muscles. 30 FHP has been linked to chronic tension-type, cervical, and tension type headaches.…”

“…If the acromion processes are more anteriorly positioned compared with the mastoid processes, a condition known as forward shoulder posture (FSP) or rounded shoulders or protracted shoulders 11,15 occurs (Fig 3); this condition is characterized by protracted, internally rotated, anteriorly tilted, elevated, and abducted scapula along with winging of scapula. 15,18,19 This poor alignment of the shoulders leads to greater torque production by gravitational forces, which is being offset by greater internal forces generated by muscles and other soft tissues around the shoulder.…”

Photogrammetric Assessment of Upper Body Posture Using Postural Angles: A Literature Review

“…Photogrammetry quantifies postural assessment by measuring linear distances and angles (formed between lines produced through body markers and horizontal or vertical lines) on digital photographs by using software specifically designed for this purpose. 7,8 Goniometry, which uses a handheld goniometer, has a disadvantage when used to record values for postural angles, since it becomes difficult to read the goniometer while the goniometer's arm is held by the therapist in a horizontal manner. 1 There are a number of different postural angles routinely used by the authors in a clinical setting for patients presenting with biomechanical faults.…”