Skip Navigation
Skip to contents

PHRP : Osong Public Health and Research Perspectives



Page Path
HOME > Osong Public Health Res Perspect > Volume 9(6); 2018 > Article
Original Article
Neck Pain in Adults with Forward Head Posture: Effects of Craniovertebral Angle and Cervical Range of Motion
Dae-Hyun Kima, Chang-Ju Kimb, Sung-Min Sonb
Osong Public Health and Research Perspectives 2018;9(6):309-313.
Published online: December 31, 2018

aDepartment of Physical Therapy, Chonbuk National Hospital, Jeonju, Korea

bDepartment of Physical Therapy, College of Health Science, Cheongju University, Cheongju, Korea

*Corresponding author: Chang-Ju Kim, Department of Physical Therapy, College of Health Science, Cheongju University, Cheongju, Korea, E-mail:
• Received: August 30, 2018   • Revised: September 30, 2018   • Accepted: October 7, 2018

Copyright ©2018, Korea Centers for Disease Control and Prevention

This is an open access article under the CC BY-NC-ND license (

  • 218 Download
  • 42 Crossref
  • 44 Scopus
  • Objectives
    The purpose of this study was to determine whether the cranial vertebral angle (CVA) and the range of motion (ROM) was different between participants with a forward head posture (FHP), with or without pain.
  • Methods
    Forty-four participants who had FHP participated in this study. The FHP was assessed digitally by measuring a lateral view the CVA for each subject. A cervical ROM device measured the cervical ROM. The volunteers were allocated to either, with pain (n = 22), or without pain (n = 22) groups, and pain was evaluated using the Numeric Pain Rating Scale.
  • Results
    The FHP in the pain group showed a significant difference in the CVA, and the cervical ROM in both flexion and extension, compared with those in the FHP without pain group (p < 0.05). Logistic regression analysis indicated that the occurrence of cervical area pain was higher amongst subjects who had a decreased CVA and flexion motion.
  • Conclusion
    This study suggested that decreased CVA and cervical flexion range, were predictive factors for the occurrence of pain in the cervical region.
Body posture can be defined as a state of alignment of the body for a specific amount of time, while ideal posture describes a state of maintaining balance in the body using minimal musculoskeletal activity without causing pain or discomfort [ 1 , 2 ]. The tendency to stay seated for long periods of time is increasing as is the percentage of the population that use a personal computer or smartphone [ 3 , 4 ]. This can cause changes in the alignment of the spine, leading to improper posture, such as a rounded shoulder or forward head posture (FHP) [ 5 ].
This change in posture can lead to a spatial change between the spine and the line of gravity, causing an overload on muscles and connective tissues [ 6 ]. Neck pain or neck dysfunction is a musculoskeletal disorder caused by improper posture with physical impairment or functional limitation. The FHP is known as an internal factor that causes dysfunction with shoulder and neck pain [ 7 , 8 ]. A FHP results in a posture in which the extended head and upper cervical, and the lower cervical vertebrae flex [ 9 ]. This increases the length of the external moment (the arm) by moving the gravitational center (the head) ahead of the load bearing axis [ 10 ]. The exposure to this constant load on the craniovertebral extension muscles and the noncontractile structures causes a change in the biomechanical movement, and this increased stress can cause musculoskeletal damage or pain [ 11 ]. In addition, FHP can also limit the functional movement in the head and neck area [ 12 ]. These limitations are caused by irregular rotation and gliding movement inside the articular capsule whilst moving the joint. Moreover, it was reported that extended periods of FHP can result in a decreased number of sarcomere, as well as shortening of the muscle fibers, which can affect muscular contraction [ 5 , 13 , 14 ].
As mentioned above, there are frequent occurrences of functional movement limitations or non-specific pain in the head and neck region in patients with FHP [ 15 ]. Therefore, many studies have described the aspects of FHP that lead to functional movement limitations, and the pain in the head and neck area [ 7 , 10 , 16 ]. In a study by Kim et al on the correlation between the degree of the FHP, according to the craniovertebral angle (CVA), and the neck disability indices, it was reported that the degree of FHP according to the CVA, can be used as a significant index in determining the resulting functional disability of the neck [ 17 ]. Furthermore, it was reported that the CVA is related to the manifestation of neck pain, and the severity of the pain is related to the degree of the functional disability [ 8 , 18 , 19 ]. As such, FHP is closely related to functional movement limitations and the manifestation of pain. However, most of the previous studies have been limited to functional movement, muscular strength, and muscle activity, by comparing the participants with and without FHP, or by correlating how movement and pain influence patients with FHP [ 5 , 6 , 10 , 20 , 21 ].
There has been no study to date, examining whether there is a difference between the CVA or the functional movement in those with FHP, with and without pain. This study aimed to determine whether functional movement limitations or CVA could be used as factors to predict the occurrence of pain. Therefore, the differences in the CVA and the active range of motion (ROM) of the cervical area were determined in this study in subjects with FHP who were either with or without pain around the neck.
1. Participants
FHP in volunteers employed at the J Hospital in Jeollabuk-do, Republic of Korea were selected for this study (n = 44). The criteria for participants also included having a CVA of < 52° and aged between 20 and 40 years. There were 22 participants without pain, whose Numeric Pain Rating Scale (NPRS) score was < 1, and 22 participants who experienced pain and their NPRS score was > 3. The exclusion criteria included those with complaints of dizziness, a medical diagnosis of damage in the central nervous system or vestibular organs, complaints of radicular pain, had surgery in the last 6 months due to orthopedic damage, pathology in the spine or the upper limbs, and patients currently undergoing treatment or taking medication due to neck pain.
Prior to participation, the purpose of this study was explained, and written informed consent was given by all participants. This study was conducted in accordance with the ethical standards of the Declaration of Helsinki. Ethical approval was given by the local university research ethics committee (the Institutional Review Board of a Daejeon University, Daejeon, Republic of Korea; 1040647-201706-HR-013-03).
2. Measuring the Presence of Pain
The NPRS is used to evaluate the neck pain index of the participants. On a scale of 0 to 10, 0 being no pain and 10 being excruciating pain, the patient was asked to mark the average pain felt in the last 24 hours. The NPRS expresses pain in a simple way, and the reliability was reported to be 0.90 [ 22 ].
3. Measurement of CVA
In order to accurately measure the degree of FHP, photogrammetry was used to measure the CVA on a sagittal plane. The CVA measurement is defined as the angle a horizontal line passing the neural spine of C7 in relation to the line connecting the tragus and the neural spine of C7 [ 19 , 23 ]. The greater the measured CVA value, the more ideal the alignment of the head and the neck; whereas the smaller the angle, the more serious the degree of FHP.
4. Measurement of Active ROM in Cervical
For the measurement of the ROM in the cervical area, CROM equipment (CROM Basic MedNet-Sites, USA) was used. First, the subject sat on a chair with a backrest that could support the spine. Next, the inspector placed the CROM equipment on the subject’s head, and measured the movement of the head (i.e. flexion, extension, left/right rotation). Here, participants were asked to maximally move their head to each side, as far as possible. The test was performed twice for each side, and the average was recorded. The CROM equipment was reported to have a high reliability (intraclass correlation coefficient = 0.87–0.94 in asymptomatic participants and intraclass correlation coefficient = 0.88–0.96 in neck pain participants) [ 24 , 25 ].
5. Statistical Method
All data analysis of the measured values was performed using SPSS 22.0 (IBM Corp., Armonk, NY, USA). For the general characteristics of the participants (i.e. age, height, weight), descriptive statistics were used, and normality test was verified using the Kolmogorov-Smirnov test. For the comparison of those with and those without pain among those with FHP, the CVA and cervical ROM of the flexion, extension, and left/right rotation were measured via independent t-tests. Additionally, a logistic regression was used to identify, whether the CVA and the 4 movements of flexion, extension, and left/right rotation are factors that can predict the occurrence of pain. The level of significance was set as α = 0.05.
In the general characteristics (i.e. gender, age, height, weight) of the participants with a FHP, no significant difference between the participants with pain and those without pain was observed (Table 1). There was a significant difference in the CVA and the cervical extension and flexion, but there was no significant difference in the left/right rotation (Table 2). Table 3 shows the analysis of factors affecting the occurrence of pain in those with a FHP using a logistic regression. These factors were the CVA [odds ratio (OR) = 0.513, 95% confidence interval (CI) = 0.286–0.922, p < 0.05] and the cervical flexion ROM (OR = 0.710, 95% CI = 0.515–0.981, p < 0.05). There was no significant relation to the cervical extension or the right/left rotation joint ROM.
χ1 refers to the CVA, and χ2 is the cervical flexion ROM. The regression equation of the logistic regression is as follows:
Risk of the occurrence of pain,Y=51.952-(0.667×χ1+0.342×χ2)
This study focused on FHP and reported the differences in the CVA and the active cervical ROM in participants with and without pain, and identified whether these differences were related to pain. The results showed that there was a difference in the extension and flexion ROM in the cervical area and the CVA, in the participants that experienced pain, compared to those that did not experience pain. This indicated that a decreased angle of the lordotic curve, a decreased ROM in the cervical extension and flexion (due to a decreased CVA) was related to pain. Additionally, logistic regression analysis showed that the CVA and the cervical flexion were significant risk factors for pain.
CVA is a factor that significantly influences pain in those individuals with a FHP. The decreased CVA causes flexing of the cervical vertebrae in a forward position which if maintained for a long period of time, increases the load in the extension muscle (by increasing the external moment arm) and its surrounding connective tissues [ 10 , 19 ]. In previous studies, it has been reported that constant stress on the extension muscle and connective tissue in the craniocervical area, leads to an imbalance in the neck that induces pain [ 7 , 8 , 26 ]. Chiu et al reported that maintaining a FHP for a long period of time increases the load on noncontractive structures, causing abnormal stress on the extension muscle in the posterior craniocervical area, which can lead to myofascial pain [ 7 ]. Furthermore, it has been reported that if the CVA is 5° less than that reported in individuals who do not have FHP, then it can increase the stress in the posterior region of the craniocervical area [ 27 ]. In this study, the difference between individuals with FHP with and without pain, was 4.2°. A reason for differences in CVA may be due to the difference in the participants. While the previous study compared participants experiencing pain with either normal posture or FHP, in this study all participants had FHP either with or without pain. Additionally, Yip et al and Sohn et al, reported that the reduction of the CVA contributes significantly to the occurrence of pain in the craniocervical area, thus supporting the results of this study [ 19 , 23 ].
This study showed that active cervical ROM was decreased in the extension and flexion movements in the cervical area of participants with pain compared to those without pain, indicating pain is significantly associated with the decrease in the flexion and extension of the ROM in the cervical area. Specifically, the flexion ROM in the cervical area was shown to have a significant correlation with the occurrence of pain, along with the CVA, in logistic regression analysis. A FHP increases the external moment by moving the head forward, causing the rear extension muscles to contract persistently. Moreover, a FHP maintains tightness in the muscles through the shortening of the rear extension muscles in the craniocervical area and the lengthening of the front flexion muscles [10, 11]. These biomechanical changes may affect the muscle thickness of the craniocervical area and may also affect the functional activity of the muscles in this area [ 20 ]. Sohn et al [23] showed that the ROM in the cervical area is more reduced in the FHP participants with a greater decrease of the CVA. In this study there was a significant decrease in the CVA in FHP participants with pain compared to those without pain, supporting the findings in the previous study. Walmsley et al and Ordway et al reported in their studies that a FHP can negatively affect movement in the craniocervical area because it overloads the facet joint and the posterior region of the spine, as well as creating a biomechanical change in the craniocervical area [28,29]. A FHP can also limit normal rotations and gliding movements in the glenoid cavity when joints move [ 14 , 28 ]. This limits functional movements in the craniocervical area. The reduced cervical ROM of flexion and extension in individuals with a FHP experiencing pain is considered to be as a result of the limitation of the arthrokinematic movements within the joint capsule, and the increased pressure between the facet joint in addition to the physiological change of the muscles around the craniocervical area, caused by a decreased CVA.
In this study, no significant changes were observed in the right/left rotation in individuals with a FHP. This posture is improper, with an extension in the upper cervical and a flexion in the lower cervical region. For this reason, it is considered that a FHP influences the posture change in the sagittal plane but cannot act as a significant factor in the right/left rotation, which is in a horizontal plane. Meisingset et al [29] also reported that cervical flexion and extension, which is a movement in the sagittal plane, was the only variable associated with neck pain and neck disability. These results are in agreement with a previous study which suggested that there was no significant difference in the movement in horizontal rotation when FHP was compared with normal participants [ 12 ]. Additionally, in this study a significant difference was observed in FHP between individuals with and without pain in the cervical extension as shown by using the independent t test used for analysis of 1 variable. However, a significant difference between both groups was not observed when FHP logistic regression was applied which is influenced by the interaction among other variables (e.g. CVA, Flexion, RR, and LR). Therefore, these results are probably due to differences in statistical analysis methods.
A FHP is an internal factor that leads to the development of pain through poor postural alignment. When comparing the FHP of participants with pain and those without pain, the individuals with pain had a reduced cervical ROM in the sagittal plane and a decreased CVA. These results suggest that a decreased CVA and ROM of cervical flexion, can be predictors of pain. Therefore, the assessment of the CVA and the flexion joint ROM in the cervical area could be used clinically as a rudimentary reference to predict or possibly prevent the occurrence of pain in those with a FHP. However, there are limitations to this study.
Firstly, pain around the neck causes mechanical limitations to the cervical joint, which can lead to physical limitations such as the loss of ROM and contraction of muscle fibers, and ankyloses [ 18 ] but it could not be verified whether FHP influenced pain or limitations in movement caused pain. Secondly, variables that can predict the occurrence of pain in the cervical area (excluding the CVA and the ROM), could not be additionally examined and so many participants could not be included in this study. More scientific efforts to investigate variables that could affect the occurrence of pain in the participants with a FHP are required in further research.

Conflicts of Interest

No potential conflicts of interest relevant to this article was reported.

  • 1. Gangnet N, Pomero V, Dumas R, Skalli W, Vital JM. Variability of the spine and pelvis location with respect to the gravity line: a three-dimensional stereoradiographic study using a force platform. Surg Radiol Anat 2003;25(5–6). 424−33. PMID: 10.1007/s00276-003-0154-6. PMID: 13680185.ArticlePubMedPDF
  • 2. McEvoy MP, Grimmer K. Reliability of upright posture measurements in primary school children. BMC Musculoskelet Disord 2005;6:35PMID: 10.1186/1471-2474-6-35. PMID: 15985186. PMID: 1180447.ArticlePubMedPMCPDF
  • 3. Eltayeb S, Staal JB, Hassan A, de Bie RA. Work related risk factors for neck, shoulder and arms complaints: a cohort study among Dutch computer office workers. J Occup Rehabil 2009;19(4). 315−22. PMID: 10.1007/s10926-009-9196-x. PMID: 19685174. PMID: 2775111.ArticlePubMedPMC
  • 4. Larsson B, Sogaard K, Rosendal L. Work related neck-shoulder pain: a review on magnitude, risk factors, biochemical characteristics, clinical picture and preventive interventions. Best Pract Res Clin Rheumatol 2007;21(3). 447−63. PMID: 10.1016/j.berh.2007.02.015. PMID: 17602993.ArticlePubMed
  • 5. Kang JH, Park RY, Lee SJ, Kim JY, Yoon SR, Jung KI. The effect of the forward head posture on postural balance in long time computer based worker. Ann Rehabil Med 2012;36(1). 98−104. PMID: 10.5535/arm.2012.36.1.98. PMID: 22506241. PMID: 3309315.ArticlePubMedPMCPDF
  • 6. Harrison DE, Harrison DD, Betz JJ, Janik TJ, Holland B, Colloca CJ, et al. Increasing the cervical lordosis with chiropractic biophysics seated combined extension-compression and transverse load cervical traction with cervical manipulation: nonrandomized clinical control trial. J Manipulative Physiol Ther 2003;26(3). 139−51. PMID: 10.1016/S0161-4754(02)54106-3. PMID: 12704306.ArticlePubMed
  • 7. Chiu TT, Lam TH, Hedley AJ. Correlation among physical impairments, pain, disability, and patient satisfaction in patients with chronic neck pain. Arch Phys Med Rehabil 2005;86(3). 534−40. PMID: 10.1016/j.apmr.2004.02.030. PMID: 15759241.ArticlePubMed
  • 8. Cote P, Hogg-Johnson S, Cassidy JD, Carroll L, Frank JW. The association between neck pain intensity, physical functioning, depressive symptomatology and time-to-claim-closure after whiplash. J Clin Epidemiol 2001;54(3). 275−86. PMID: 10.1016/S0895-4356(00)00319-X. PMID: 11223325.ArticlePubMed
  • 9. Yoo WG, Kim MH. Effect of different seat support characteristics on the neck and trunk muscles and forward head posture of visual display terminal workers. Work 2010;36(1). 3−8. PMID: 20555171.ArticlePubMed
  • 10. Edmondston SJ, Sharp M, Symes A, Alhabib N, Allison GT. Changes in mechanical load and extensor muscle activity in the cervico-thoracic spine induced by sitting posture modification. Ergonomics 2011;54(2). 179−86. PMID: 10.1080/00140139.2010.544765. PMID: 21294015.ArticlePubMed
  • 11. Bae YH, Lee GC. Effect of Motor Control Training with Strengthening Exercises on Pain and Muscle Strength of Patients with Shoulder Impingement Syndrome. J Korean Soc Phys Ther 2011;23(6). 1−7.
  • 12. Quek J, Pua YH, Clark RA, Bryant AL. Effects of thoracic kyphosis and forward head posture on cervical range of motion in older adults. Man Ther 2013;18(1). 65−71. PMID: 10.1016/j.math.2012.07.005.ArticlePubMed
  • 13. Raine S, Twomey LT. Head and shoulder posture variations in 160 asymptomatic women and men. Arch Phys Med Rehab 1997;78(11). 1215−23. PMID: 10.1016/S0003-9993(97)90335-X.Article
  • 14. Silva AG, Johnson MI. Does forward head posture affect postural control in human healthy volunteers? Gait Posture 2013;38(2). 352−3. PMID: 10.1016/j.gaitpost.2012.11.014.ArticlePubMed
  • 15. Chiu TT, Ku WY, Lee MH, et al. A study on the prevalence of and risk factors for neck pain among university academic staff in Hong Kong. J Occup Rehabil 2002;12(2). 77−91. PMID: 10.1023/A:1015008513575. PMID: 12014228.ArticlePubMed
  • 16. Vicenzino B, Collins D, Wright A. The initial effects of a cervical spine manipulative physiotherapy treatment on the pain and dysfunction of lateral epicondylalgia. Pain 1996;68(1). 69−74. PMID: 10.1016/S0304-3959(96)03221-6. PMID: 9252000.ArticlePubMed
  • 17. Kim EK, Kim JS. Correlation between rounded shoulder posture, neck disability indices, and degree of forward head posture. J Phys Ther Sci 2016;28(10). 2929−32. PMID: 10.1589/jpts.28.2929. PMID: 27821964. PMID: 5088155.ArticlePubMedPMC
  • 18. Shin YJ, Kim WH, Kim SG. Correlations among visual analogue scale, neck disability index, shoulder joint range of motion, and muscle strength in young women with forward head posture. J Exerc Rehabil 2017;13(4). 413−7. PMID: 10.12965/jer.1734956.478. PMID: 29114506. PMID: 5667618.ArticlePubMedPMCPDF
  • 19. Yip CH, Chiu TT, Poon AT. The relationship between head posture and severity and disability of patients with neck pain. Man Ther 2008;13(2). 148−54. PMID: 10.1016/j.math.2006.11.002.ArticlePubMed
  • 20. Bokaee F, Rezasoltani A, Manshadi FD, Naimi SS, Baghban AA, Azimi H. Comparison of cervical muscle thickness between asymptomatic women with and without forward head posture. Braz J Phys Ther 2017;21(3). 206−11. PMID: 10.1016/j.bjpt.2017.04.003. PMID: 28465132. PMID: 5537461.ArticlePubMedPMC
  • 21. Cheon S, Park S. Changes in neck and upper trunk muscle activities according to the angle of movement of the neck in subjects with forward head posture. J Phys Ther Sci 2017;29(2). 191−3. PMID: 10.1589/jpts.29.191. PMID: 28265137. PMID: 5332968.ArticlePubMedPMC
  • 22. Farrar JT, Young JP Jr, LaMoreaux L, Werth JL, Poole RM. Clinical importance of changes in chronic pain intensity measured on an 11-point numerical pain rating scale. Pain 2001;94(2). 149−58. PMID: 10.1016/S0304-3959(01)00349-9. PMID: 11690728.ArticlePubMed
  • 23. Sohn JH, Choi HC, Lee SM, Jun AY. Differences in cervical musculoskeletal impairment between episodic and chronic tension-type headache. Cephalalgia 2010;30(12). 1514−23. PMID: 10.1177/0333102410375724. PMID: 20974583.ArticlePubMed
  • 24. Capuano-Pucci D, Rheault W, Aukai J, Bracke M, Day R, Pastrick M. Intratester and intertester reliability of the cervical range of motion device. Arch Phys Med Rehabil 1991;72(5). 338−40. PMID: 2009054.PubMed
  • 25. Fletcher JP, Bandy WD. Intrarater reliability of CROM measurement of cervical spine active range of motion in persons with and without neck pain. J Orthop Sports Phys Ther 2008;38(10). 640−5. PMID: 10.2519/jospt.2008.2680. PMID: 18827326.ArticlePubMed
  • 26. Oh HJ, Song GB. Effects of neurofeedback training on the cervical movement of adults with forward head posture. J Phys Ther Sci 2016;28(10). 2894−7. PMID: 10.1589/jpts.28.2894. PMID: 27821957. PMID: 5088148.ArticlePubMedPMC
  • 27. Watson DH, Trott PH. Cervical headache: an investigation of natural head posture and upper cervical flexor muscle performance. Cephalalgia 1993;13(4). 272−84. discussion 232.PMID: 10.1046/j.1468-2982.1993.1304272.x. PMID: 8374943.ArticlePubMed
  • 28. Pearson AM, Ivancic PC, Ito S, Panjabi MM. Facet joint kinematics and injury mechanisms during simulated whiplash. Spine 2004;29(4). 390−7. PMID: 10.1097/01.BRS.0000090836.50508.F7. PMID: 15094535.ArticlePubMed
  • 29. Meisingset I, Stensdotter AK, Woodhouse A, Vasseljen O. Neck motion, motor control, pain and disability: A longitudinal study of associations in neck pain patients in physiotherapy treatment. Man Ther 2016;22:94−100. PMID: 10.1016/j.math.2015.10.013.ArticlePubMed
Table 1
General characteristics of the participants.
Parameters With pain Without pain χ2 or t p Total
Gender (male/female) 9/13 8/14 0.096 0.47 17/27
Age (y) 28.55 ± 5.15 26.64 ± 4.54 1.30 0.38 27.59 ± 4.90
Height (cm) 164.86 ± 7.83 166.93 ± 7.67 0.89 0.95 165.90 ± 7.73
Weight (kg) 60.18 ± 9.85 57.59 ± 8.80 0.92 0.54 58.89 ± 9.32

Data are presented as mean ± SD.

Table 2
Comparison of CVA and craniocervical ROM in individuals with a forward head posture who experience pain and those without pain.
Parameters With pain Without pain t p
CVA 44.44 ± 4.43* 48.63 ± 1.99 4.04 0.00
Flexion 32.32 ± 7.21* 41.05 ± 3.84 5.01 0.00
Extension 30.27 ± 8.11* 38.41 ± 6.46 3.68 0.01
RR 52.77 ± 6.36 53.14 ± 7.47 0.174 0.863
LR 53.55 ± 6.38 53.05 ± 6.14 0.265 0.792

Data are presented as mean ± SD.

* significant difference compared with the “without pain group” (p < 0.05).

CVA = craniovertebral angle; LR = left rotation; RR = right rotation.

Table 3
Logistic regression analysis of risk factor for the occurrence pain in individuals with a forward head posture.
Parameters Beta SE p OR 95% CI
Maximum Minimum
CVA −0.667 0.299 0.026* 0.513 0.286 0.922
Flexion −0.342 0.165 0.038* 0.710 0.515 0.981
Extension −0.163 0.104 0.119 0.850 0.693 1.043
RR −0.142 0.112 0.207 0.868 0.697 1.082
LR 0.105 0.138 0.447 1 .111 0.847 1.456

* Statistically significant, p < 0.05.

CI = confidence interval; LR = left rotation; OR = odds ratio; RR = right rotation.

Figure & Data



    Citations to this article as recorded by  
    • Examining accuracy of and determining the best cutoff point for photographic-based postural angles to discriminate between slight and moderate-to-severe forward head posture
      Neda Mostafaee, Nahid Pirayeh, Fatemeh HasanNia, Hossein Negahban, Mahsa Kasnavi
      Physiotherapy Theory and Practice.2024; 40(2): 377.     CrossRef
    • Examining the factors influencing postpartum musculoskeletal pain: a thorough analysis of risk factors and pain assessment indices
      Meng Li, Dan Li, Jingyu Bu, Xinwen Zhang, Yuanyuan Liu, Heng Wang, Lan Wu, Ke Song, Tian Liu
      European Spine Journal.2024; 33(2): 517.     CrossRef
    • The linear intra-articular motions of the temporomandibular joint in individuals with severe forward head posture: A cross-sectional study
      Cyrus Taghizadeh Delkhoush, Mahdis Purzolfi, Majid Mirmohammadkhani, Hasti Sadollahi, Shiva Tavangar
      Musculoskeletal Science and Practice.2024; 70: 102908.     CrossRef
    • Effect of Stabilization Exercises on Craniovertebral Angle and Cervical Range of Motion among Visual Display Users with Forward Head Posture
      Singh Shyama, Sibbalа Nagaraj
      Bulletin of Rehabilitation Medicine.2024; 22(5): 48.     CrossRef
    • A comparison of muscle activity, posture and body discomfort during the use of different computer screen sizes
      Praphatson Sengsoon, Kanruethai Siriworakunsak
      International Journal of Occupational Safety and E.2023; 29(1): 424.     CrossRef
    • Therapeutic and stabilization exercises after manual therapy in patients with non-specific chronic neck pain: A randomised clinical trial
      Okan Demir, Emine Atıcı, Mustafa Savaş Torlak
      International Journal of Osteopathic Medicine.2023; 47: 100639.     CrossRef
    • Severity of slouched posture during smartphone use is associated with the musculoskeletal discomfort, daily usage, and school year among adolescents
      Sharon M.H. Tsang, Gladys L.Y. Cheing, Jess W.K. Chan
      Ergonomics.2023; 66(9): 1340.     CrossRef
    • Social Media Devices’ Influence on User Neck Pain during the COVID-19 Pandemic: Collaborating Vertebral-GLCM Extracted Features with a Decision Tree
      Bassam Al-Naami, Bashar E. A. Badr, Yahia Z. Rawash, Hamza Abu Owida, Roberto De Fazio, Paolo Visconti
      Journal of Imaging.2023; 9(1): 14.     CrossRef
    • Musculoskeletal disorders and functional characteristics of the neck and shoulder: Comparison between office workers using a laptop or desktop computer
      Martin Argus, Mati Pääsuke
      Work.2023; 75(4): 1289.     CrossRef
    • Is Neck Pain Related to Sagittal Head and Neck Posture?: A Systematic Review and Meta-analysis
      Babina Rani, Abhijit Paul, Anil Chauhan, Pranita Pradhan, Mandeep S. Dhillon
      Indian Journal of Orthopaedics.2023;[Epub]     CrossRef
    • Commentary on “The Influence of the Weight of the Backpack on the Biomechanics of the Child and Adolescent: A Systematic Review and Meta-analysis With a Meta-Regression”
      Frances E. Kistner, Jennifer McParland, Monica Bruno
      Pediatric Physical Therapy.2023; 35(2): 227.     CrossRef
    • Comparison of neck muscle strength, range of motion, and craniovertebral angle among Malaysian young adults using different electronic devices
      Vinosh Kumar Purushothaman, Soonia Guna Segar, Yughdtheswari Muniandy, Arun Vijay Subbarayalu, Sivasankar Prabaharan, Palanivel Rubavathi Marimuthu
      Electronic Journal of General Medicine.2023; 20(4): em499.     CrossRef
    • (Community Care Preparation) Identification of Musculoskeletal Problems for the Elderly in Rural Areas and Presentation of Regional and Inter-university Health Management Models
      Sung-hak Cho
      The Journal of Korean Physical Therapy.2023; 35(2): 37.     CrossRef
    • The correlation between strength and range of motion of the neck muscles and opium smoking in Iran
      Omid Massah, Amir Masoud Arab, Ali Farhoudian, Mehdi Noroozi, Fahimeh Hashemirad
      Frontiers in Psychiatry.2023;[Epub]     CrossRef
    • Indian surgery Trainee's perspective on surgical ergonomics principles and education: A long road ahead
      Sanjay Kumar Yadav, Geeta Lal, Sapana Bothra Jain, Chandan Kumar Jha, Claudia Corwin, Barbara Van Gorp, Chitresh Kumar Sharma, Amit Kumar, Dipendra Kumar Sinha
      The American Journal of Surgery.2023; 226(5): 735.     CrossRef
    • Neck muscle activation in response to eye movement depends on sitting posture and is modified in whiplash associated disorders: Cross-sectional study
      Catharina S.M. Bexander, Paul W. Hodges
      Musculoskeletal Science and Practice.2023; 67: 102837.     CrossRef
    • Effectiveness of McKenzie approach and segmental spinal stabilization exercises on neck pain in individuals with cervical postural syndrome: An experimental study
      RutujaR Avaghade, SandeepB Shinde, SayaleeB Dhane
      Journal of Education and Health Promotion.2023; 12(1): 225.     CrossRef
    • Impact of Laptop Usage, Typing Skills, and Ergonomics on Musculoskeletal Pain among Medical Resident Doctors – An Observational Study
      Sonal Goyal, Bhavna Gupta
      Indian Journal of Pain.2023; 37(Suppl 1): S55.     CrossRef
    • Effects of carrying school bags on cervical and shoulder posture in static and dynamic conditions in adolescent students
      Shivani Mandrekar, Dinesh Chavhan, Ashok K. Shyam, Parag K. Sancheti
      International Journal of Adolescent Medicine and H.2022;[Epub]     CrossRef
    • Forward flexed posture: reliability and determinants of tragus-to-wall measurement
      Frank T. Tudini, Bradley J. Myers, Richard W. Bohannon
      Physiotherapy Theory and Practice.2022; 38(4): 579.     CrossRef
    • Investigation on the biomechanical behaviour of the lower cervical spine induced by facet tropism with respect to the sagittal plane
      Zhi Huang, Yali Zhang, Xin Rong, Xiaogang Zhang, Hao Liu, Zhongmin Jin
      Medical Engineering & Physics.2022; 102: 103779.     CrossRef
    • Effect of suboccipital release technique in forward head posture: A comparative study
      Amita Aggarwal, Ashwani Nair, TusharJ Palekar, Dhammapal Bhamare
      Medical Journal of Dr. D.Y. Patil Vidyapeeth.2022; 15(4): 534.     CrossRef
    • Aufrechte Haltung schützt nicht vor Nackenschmerz

      Schmerz.Therapie.2022; 5(02): 61.     CrossRef
    • Establishing minimal clinically important difference for effectiveness of corrective exercises on craniovertebral and shoulder angles among students with forward head posture: a clinical trial study
      Zahra Heydari, Rahman Sheikhhoseini, Shahnaz Shahrbanian, Hashem Piri
      BMC Pediatrics.2022;[Epub]     CrossRef
    • Effect Of Forward Head Posture with Neck Disability and Quality of Life in Freelancer
      Rabia Tasmeer, Syed Asad Ullah Arslan, Ashfaq Ahmad, Fareeha Amjad
      Pakistan BioMedical Journal.2022; : 288.     CrossRef
    • Evaluating Differences Between Participants With Various Forward Head Posture With and Without Postural Neck Pain Using Craniovertebral Angle and Forward Shoulder Angle
      Neda Mostafaee, Fatemeh HasanNia, Hossein Negahban, Nahid Pirayeh
      Journal of Manipulative and Physiological Therapeu.2022; 45(3): 179.     CrossRef
    • Prevalence Of Neck and Back Pain Among Gynecologists and Obstetrics in Tertiary Care Hospital of Lahore
      Rahat Afzal, Samrood Akram, Haseeb-Ur- Rehman, Anam Abbas, Muhammad Talha Hassan Javed, Hafiza Sana Ashraf
      Pakistan BioMedical Journal.2022; : 23.     CrossRef
    • A Study on the VR Goggle-based Vision System for Robotic Surgery
      Young Gyun Kim, Gyeongbin Mun, Myungjoon Kim, Byoungjun Jeon, Jong Hyeon Lee, Dan Yoon, Byeong Soo Kim, Seong-Ho Kong, Chang Wook Jeong, Kyu Eun Lee, Minwoo Cho, Sungwan Kim
      International Journal of Control, Automation and S.2022; 20(9): 2959.     CrossRef
    • Efficacy of physiotherapy intervention on craniovertebral and craniohorizontal angle using on protractor mobile app and neck muscle strength in chronic nonspecific neck pain
      Rajalaxmi V., Niranjana R, C.V. Senthil Nathan, G. Mohan Kumar
      Biomedicine.2022; 42(3): 589.     CrossRef
    • The incidence of work-related musculoskeletal pain among administrators in a South African university
      L.M. Moraba, T.J. Ellapen, Y. Paul
      African Journal for Physical Activity and Health S.2022; 28(3): 218.     CrossRef
    • Exercises in the management of forward head posture: much needed posture care for online way of life
      Shabnam Joshi, Bharti Chawla, Alka Pawalia
      Physiotherapy Quarterly.2022; 30(4): 41.     CrossRef
    • Magnification loupes influence on neck and trunk flexion of dental hygienists while scaling—A pilot study
      Emily A Ludwig, Susan L Tolle, Eric Jenkins, Daniel Russell
      International Journal of Dental Hygiene.2021; 19(1): 106.     CrossRef
    • Morphometric characteristics of cervical vertebrae in subjects with short, normal, and long faces
      V. Anusuya, Jitendra Sharan, Ashok Kumar Jena
      Surgical and Radiologic Anatomy.2021; 43(6): 865.     CrossRef
    • Analysis of neck and back muscle activity during the application of various pillow designs in patients with forward head posture
      Sirirat Kiatkulanusorn, Bhornluck Paepetch Suato, Phurichaya Werasirirat
      Journal of Back and Musculoskeletal Rehabilitation.2021; 34(3): 431.     CrossRef
    • Relación entre los factores estáticos y dinámicos de la región cervical y escapular en el dolor de cuello en auxiliares administrativas de Areandina-Pereira 2020
      Libni Madai Mejía Morales, Melisa Torres Arias, Diana Marcela Marín Diaz, Angela María Rincón Hurtado, Yuber Andrés Gálvez Castaño, Tatiana Rodríguez Amador
      Cuaderno de investigaciones: semilleros andina.2021; (13): 168.     CrossRef
    • Is Neck Posture Subgroup in Late Adolescence a Risk Factor for Persistent Neck Pain in Young Adults? A Prospective Study
      Karen V Richards, Darren J Beales, Anne L Smith, Peter B O’Sullivan, Leon M Straker
      Physical Therapy.2021;[Epub]     CrossRef
    • Catering Work Profession and Medico-Oral Health: A Study on 603 Subjects
      Sabina Saccomanno, Stefano Mummolo, Silvia Giancaspro, Rebecca Jewel Manenti, Rodolfo Francesco Mastrapasqua, Giuseppe Marzo, Vincenzo Quinzi
      Healthcare.2021; 9(5): 582.     CrossRef
      Ritika Save, Annamma Varghese (PT)
    • Effects of Instrumental, Manipulative and Soft Tissue Approaches for the Suboccipital Region in Subjects with Chronic Mechanical Neck Pain. A Randomized Controlled Trial
      Juan José Arjona Retamal, Alejandro Fernández Seijo, José David Torres Cintas, Ana I. de-la-Llave-Rincón, Andrea Caballero Bragado
      International Journal of Environmental Research an.2021; 18(16): 8636.     CrossRef
    • Effect of forward head and rounded shoulder posture on hand grip strength in asymptomatic young adults: a cross-sectional study
      Dalia Mohammed Mosaad, Amr Almaz Abdel-aziem, Ghada Ismail Mohamed, Enas Anwr Abd-Elaty, Karima Salah Mohammed
      Bulletin of Faculty of Physical Therapy.2020;[Epub]     CrossRef
    • A review on the lactic acid fermentation from low-cost renewable materials: Recent developments and challenges
      Ashfaq Ahmad, Fawzi Banat, Hanifa Taher
      Environmental Technology & Innovation.2020; 20: 101138.     CrossRef
    • Reliability and validity of measurements of cervical retraction strength obtained with a hand-held dynamometer
      Frank Tudini, Bradley Myers, Richard Bohannon
      Journal of Manual & Manipulative Therapy.2019; 27(4): 222.     CrossRef

    • PubReader PubReader
    • Cite
      export Copy
    • XML DownloadXML Download

    PHRP : Osong Public Health and Research Perspectives