Abstract
Background There is conflicting evidence on the association between sagittal neck posture and neck pain.
Objective The purposes of this study were: (1) to determine the existence of clusters of neck posture in a cohort of 17-year-olds and (2) to establish whether identified subgroups were associated with biopsychosocial factors and neck pain.
Design This was a cross-sectional study.
Methods The adolescents (N=1,108) underwent 2-dimensional photographic postural assessment in a sitting position. One distance and 4 angular measurements of the head, neck, and thorax were calculated from photo-reflective markers placed on bony landmarks. Subgroups of sagittal sitting neck posture were determined by cluster analysis. Height and weight were measured, and lifestyle and psychological factors, neck pain, and headache were assessed by questionnaire. The associations among posture subgroups, neck pain, and other factors were evaluated using logistic regression.
Results Four distinct clusters of sitting neck posture were identified: upright, intermediate, slumped thorax/forward head, and erect thorax/forward head. Significant associations between cluster and sex, weight, and height were found. Participants classified as having slumped thorax/forward head posture were at higher odds of mild, moderate, or severe depression. Participants classified as having upright posture exercised more frequently. There was no significant difference in the odds of neck pain or headache across the clusters.
Limitations The results are specific to 17-year-olds and may not be applicable to adults.
Conclusion Meaningful sagittal sitting neck posture clusters were identified in 17-year-olds who demonstrated some differences with biopsychosocial profiling. The finding of no association between cluster membership and neck pain and headaches challenges widely held beliefs about the role of posture in adolescent neck pain.
Footnotes
All authors provided concept/idea/research design and writing. Dr O'Sullivan and Dr Straker provided data collection and project management. Ms Richards, Dr Beales, Dr Smith, and Dr Straker provided data analysis. Dr Straker provided fund procurement, facilities/equipment, and institutional liaisons. The authors thank the Raine study participants and their families, and the Raine study team for cohort coordination and data collection.
Ethical approval for the study was obtained from the Curtin University Human Research Ethics Committee (Reference HR 84/2005) and the Princess Margaret Hospital Human Research Ethics Committee (Reference 1214EP).
The authors acknowledge National Health and Medical Research Council (NHMRC) program grant 353514 and NHMRC project grant 323200 and additional funding for core management from The University of Western Australia (UWA); Raine Medical Research Foundation; Telethon Kids Institute; UWA Faculty of Medicine, Dentistry and Health Sciences; Women and Infants Research Foundation; Curtin University; and Edith Cowan University. Dr Beales and Dr Straker were supported by research fellowships from the NHMRC of Australia.
- Received December 2, 2015.
- Accepted April 14, 2016.
- © 2016 American Physical Therapy Association
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