| Summary: | Faculty of Medicine
School of Physiotherapy
82-29610
Tel: 011 452 3175 === 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.
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