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Is Neck Pain Related to Sagittal Head and Neck Posture?: A Systematic Review and Meta-analysis

  • Review Article
  • Published:
Indian Journal of Orthopaedics Aims and scope Submit manuscript

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Abstract

Background

Neck pain (NP) is common in all age groups and adversely affects the patients’ entire lifestyle. There exists inconclusive evidence relating faulty craniocervical posture with pain-related disability. This review aims to determine whether sagittal head and neck posture differs in NP and pain-free subjects, to critically appraise the correlation of posture with NP.

Methods

Of 3796 articles identified at primary search from CINAHL, PubMed, Google Scholar, EMBASE, 26 were included based on eligibility criteria. Mean pooled difference (MPD) and effect size (ES) were calculated to establish relationship among studies, to assess postural correlation with NP measures [Visual Analogue Scale (VAS), Numeric Pain Rating Scale (NPRS), neck disability index (NDI), Northwick Park NP Questionnaire (NPQ)] and for age- and gender-wise variation. Risk of bias was assessed using Newcastle–Ottawa Quality Assessment Scale.

Results

Craniovertebral angle (CVA) had a significant MPD of − 2.93(95% CI − 4.95 to − 0.91). Sagittal head angle (SHA) and forward head posture (FHP) had an insignificant MPD of 1.15 (95% CI − 1.16 to 3.46) and − 0.26 (95% CI − 1.89 to 1.36), respectively. Age- and gender-wise CVA difference was found to be 2.36° and 2.57°, respectively. ES was significant for correlation between CVA and pain intensity [NPRS: − 0.44 (95% CI − 0.61 to − 0.26); VAS: − 0.31 (95% CI − 0.46 to − 0.16)], and between CVA and disability [NDI: − 0.18 (95% CI − 0.31 to − 0.05); NPQ: − 0.47 (95% CI − 0.61 to − 0.320)].

Conclusion

CVA differs for age, gender, and pain vs pain-free subjects, and correlates negatively with NP measures. Other surrogate measures (SHA, cranial and cervical angles, FHP) warrant further research.

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Data Availability

The original contributions presented in the study are included in the article, further inquiries can be directed to the corresponding author.

Change history

  • 17 February 2023

    An article note has been removed.

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  1. Department of Physical Rehabilitation and Medicine (Physiotherapy), PGIMER, Physiotherapy OPD, Ground Floor, New OPD Block, Sector 12, Chandigarh, 160012, India

    Babina Rani & Abhijit Paul

  2. Evidence Based Health Informatics Unit, Department of Telemedicine, PGIMER, Chandigarh, India

    Anil Chauhan

  3. MLIS, ICMR Advanced Centre for Evidence Based Child Health, PGIMER, Chandigarh, India

    Pranita Pradhan

  4. Department of Orthopedics, PGIMER, Chandigarh, India

    Mandeep S. Dhillon

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BR: conceptualization, data curation, methodology, writing—original draft preparation, and writing—reviewing and editing. AP: data curation, writing—original draft preparation. AC: formal analysis, methodology, and software. PP: software and data curation. MSD: conceptualization, methodology, and writing—reviewing and editing.

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Rani, B., Paul, A., Chauhan, A. et al. Is Neck Pain Related to Sagittal Head and Neck Posture?: A Systematic Review and Meta-analysis. JOIO 57, 371–403 (2023). https://doi.org/10.1007/s43465-023-00820-x

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