Assessment of Head and Trunk Posture in Men with Cervicogenic Headache via Photogrammetry: A Pilot Study

Document Type : Original Articles

Authors

1 MSc Student, Student Research Committee (Treata), Department of Physical Therapy, School of Rehabilitation Sciences, Isfahan University of Medical Sciences, Isfahan, Iran

2 Instructor, Department of Physical Therapy, School of Rehabilitation Sciences, Isfahan University of Medical Sciences, Isfahan, Iran

3 MSc Student, Department of Physical Therapy, School of Rehabilitation Sciences, Isfahan University of Medical Sciences, Isfahan, Iran

4 PhD Candidate, Department of Biostatistics and Epidemiology, Student Research Committee, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran

5 Assistant Professor, Department of Physical Therapy, School of Rehabilitation Sciences, Isfahan University of Medical Sciences, Isfahan, Iran

10.22122/jrrs.v12i4.2753

Abstract

Introduction: Cervicogenic headache (CGH) is a type of chronic and recurrent headache that originates from cervical musculoskeletal impairments. The muscular disorders observed in patients with CGH, relation between head and neck posture and cervical muscles dysfunction, and association between pelvic alignment and spinal curves highlight the importance of postural assessment in these patients. Therefore, the objective of this study was the assessment of spinal and pelvic posture in men with CGH via photogrammetry in static standing position by measuring different angles.Materials and Methods: In this case-control study, 10 men with CGH and 10 healthy men with matched age and body mass index (BMI) were recruited. A digital camera was used to take photographs from anterior, posterior, and lateral views (3 photographs from each viewpoint). The postural angles were measured using the AutoCAD software.Results: Among the measured postural angles, the mean of cervical inclination (C2-T2) (P = 0.022), head horizontal alignment (P = 0.001), scapula horizontal alignment (P < 0.001), anterior superior iliac spine horizontal alignment (P = 0.031), and posterior superior iliac spine horizontal alignment angles (P = 0.038) were significantly different between the two groups. The intra-rater reliability of the different angles was high and acceptable [Intraclass correlation coefficient (ICC) > 0.72].Conclusion: It seems that the upper cervical position of men with CGH differs from that of healthy subjects and C2 is more forward relative to the cervicothoracic spine. Therefore, the cervical inclination angle could be a suitable indicator of C2 position through photogrammetry.

Keywords

  1. Nilsson N. The prevalence of cervicogenic headache in a random population sample of 20-59 year olds. Spine (Phila Pa 1976) 1995; 20(17): 1884-8.
  2. Sjaastad O, Bakketeig LS. Prevalence of cervicogenic headache: Vaga study of headache epidemiology. Acta Neurol Scand 2008; 117(3): 173-80.
  3. Bogduk N, Govind J. Cervicogenic headache: an assessment of the evidence on clinical diagnosis, invasive tests, and treatment. Lancet Neurol 2009; 8(10): 959-68.
  4. Jull G, Barrett C, Magee R, Ho P. Further clinical clarification of the muscle dysfunction in cervical headache. Cephalalgia 1999; 19(3): 179-85.
  5. Zito G, Jull G, Story I. Clinical tests of musculoskeletal dysfunction in the diagnosis of cervicogenic headache. Man Ther 2006; 11(2): 118-29.
  6. Watson DH, Trott PH. Cervical headache: an investigation of natural head posture and upper cervical flexor muscle performance. Cephalalgia 1993; 13(4): 272-84.
  7. Jull G, Amiri M, Bullock-Saxton J, Darnell R, Lander C. Cervical musculoskeletal impairment in frequent intermittent headache. Part 1: Subjects with single headaches. Cephalalgia 2007; 27(7): 793-802.
  8. Dumas JP, Arsenault AB, Boudreau G, Magnoux E, Lepage Y, Bellavance A, et al. Physical impairments in cervicogenic headache: traumatic vs. nontraumatic onset. Cephalalgia 2001; 21(9): 884-93.
  9. Kendall FP, McCreary EK, Provance PG, Rodgers MM, Romani WA. Muscles: Testing and function, with posture and pain. 5th ed. Philadelphia, PA: Lippincott Williams and Wilkins; 2005.
  10. Lee KJ, Han HY, Cheon SH, Park SH, Yong MS. The effect of forward head posture on muscle activity during neck protraction and retraction. J Phys Ther Sci 2015; 27(3): 977-9.
  11. Levangie PK, Norkin CC. Joint structure and function: A comprehensive analysis. 5th ed. Philadelphia, PA: F. A. Davis; 2011.
  12. Budelmann K, von Piekartz H, Hall T. Is there a difference in head posture and cervical spine movement in children with and without pediatric headache? Eur J Pediatr 2013; 172(10): 1349-56.
  13. Farmer PK, Snodgrass SJ, Buxton AJ, Rivett DA. An investigation of cervical spinal posture in cervicogenic headache. Phys Ther 2015; 95(2): 212-22.
  14. Lau KT, Cheung KY, Chan KB, Chan MH, Lo KY, Chiu TT. Relationships between sagittal postures of thoracic and cervical spine, presence of neck pain, neck pain severity and disability. Man Ther 2010; 15(5): 457-62.
  15. Black KM, McClure P, Polansky M. The influence of different sitting positions on cervical and lumbar posture. Spine (Phila Pa 1976) 1996; 21(1): 65-70.
  16. Caneiro JP, O'Sullivan P, Burnett A, Barach A, O'Neil D, Tveit O, et al. The influence of different sitting postures on head/neck posture and muscle activity. Man Ther 2010; 15(1): 54-60.
  17. Hertling D. Management of common musculoskeletal disorders: Physical therapy principles and methods. 4th ed. Philadelphia, PA: Lippincott Williams and Wilkins; 2005.
  18. Antonaci F, Fredriksen TA, Sjaastad O. Cervicogenic headache: clinical presentation, diagnostic criteria, and differential diagnosis. Curr Pain Headache Rep 2001; 5(4): 387-92.
  19. Ferreira EA, Duarte M, Maldonado EP, Bersanetti AA, Marques AP. Quantitative assessment of postural alignment in young adults based on photographs of anterior, posterior, and lateral views. J Manipulative Physiol Ther 2011; 34(6): 371-80.
  20. Rosario JL. Biomechanical assessment of human posture: a literature review. J Bodyw Mov Ther 2014; 18(3): 368-73.
  21. do Rosario JL. Photographic analysis of human posture: a literature review. J Bodyw Mov Ther 2014; 18(1): 56-61.
  22. Gadotti IC, Armijo-Olivo S, Silveira A, Magee D. Reliability of the craniocervical posture assessment: visual and angular measurements using photographs and radiographs. J Manipulative Physiol Ther 2013; 36(9): 619-25.
  23. Pausic J, Pedisic Z, Dizdar D. Reliability of a photographic method for assessing standing posture of elementary school students. J Manipulative Physiol Ther 2010; 33(6): 425-31.
  24. Moradi N, Maroufi N, Bijankhan M, Hosseinzadeh NT, Salavati M, Jalayer T, et al. Intrarater and interrater reliability of sagittal head posture: a novel technique performed by a physiotherapist and a speech and language pathologist. J Voice 2014; 28(6): 842-6.
  25. Salahzadeh Z, Maroufi N, Ahmadi A, Behtash H, Razmjoo A, Gohari M, et al. Assessment of forward head posture in females: observational and photogrammetry methods. J Back Musculoskelet Rehabil 2014; 27(2): 131-9.
  26. Shaghayegh FB, Ahmadi A, Maroufi N, Sarrafzadeh J. Evaluation of forward head posture in sitting and standing positions. Eur Spine J 2016; 25(11): 3577-82.
  27. Dimitriadis Z, Podogyros G, Polyviou D, Tasopoulos I, Passa K. The reliability of lateral photography for the assessment of the forward head posture through four different angle-based analysis methods in healthy individuals. Musculoskeletal Care 2015; 13(3): 179-86.
  28. Hanten WP, Olson SL, Russell JL, Lucio RM, Campbell AH. Total head excursion and resting head posture: normal and patient comparisons. Arch Phys Med Rehabil 2000; 81(1): 62-6.
  29. Youdas JW, Hollman JH, Krause DA. The effects of gender, age, and body mass index on standing lumbar curvature in persons without current low back pain. Physiother Theory Pract 2006; 22(5): 229-37.
  30. Claeys K, Brumagne S, Deklerck J, Vanderhaeghen J, Dankaerts W. Sagittal evaluation of usual standing and sitting spinal posture. J Bodyw Mov Ther 2016; 20(2): 326-33.
  31. Hertzog MA. Considerations in determining sample size for pilot studies. Res Nurs Health 2008; 31(2): 180-91.
  32. Refshauge K, Goodsell M, Lee M. Consistency of cervical and cervicothoracic posture in standing. Aust J Physiother 1994; 40(4): 235-40.
  33. Gadotti IC, Magee DJ. Validity of surface measurements to assess craniocervical posture in the sagittal plane: a critical review. Phys Ther Rev 2008; 13(4): 258-68.
  34. Ruivo RM, Pezarat-Correia P, Carita AI. Intrarater and interrater reliability of photographic measurement of upper-body standing posture of adolescents. J Manipulative Physiol Ther 2015; 38(1): 74-80.
  35. Leroux MA, Zabjek K, Simard G, Badeaux J, Coillard C, Rivard CH. A noninvasive anthropometric technique for measuring kyphosis and lordosis: an application for idiopathic scoliosis. Spine (Phila Pa 1976) 2000; 25(13): 1689-94.
  36. Faul F, Erdfelder E, Lang AG, Buchner A. G*Power 3: a flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav Res Methods 2007; 39(2): 175-91.
  37. Howard PD, Behrns W, Martino MD, DiMambro A, McIntyre K, Shurer C. Manual examination in the diagnosis of cervicogenic headache: a systematic literature review. J Man Manip Ther 2015; 23(4): 210-8.
  38. Jull GA, O'Leary SP, Falla DL. Clinical assessment of the deep cervical flexor muscles: the craniocervical flexion test. J Manipulative Physiol Ther 2008; 31(7): 525-33.
  39. Sahrmann S. Movement impairment syndromes of the shoulder girdle. In: Sahrmann S, editor. Diagnosis and treatment of movement impairment syndromes. 1st ed. Philadelphia, PA: Mosby; 2001. p. 196-8.
  40. Kuo YL, Tully EA, Galea MP. Video analysis of sagittal spinal posture in healthy young and older adults. J Manipulative Physiol Ther 2009; 32(3): 210-5.