The Interplay of Static and Dynamic Postural Factors in Neck Pain

The objectives of this study were to compare published methods of measuring cervical posture and to determine whether these measures were associated with clinical endpoints such as pain and disability levels, and postural muscle performance in the upper quarter. A cross-sectional study design was used, and the study was conducted at two call centres in Newcastle, New South Wales. The participants comprised 34 call centre operators with no history of neck trauma, using visual display terminals for a minimum of 4 hours per day. The main outcome measurements were correlations between angular measurements of posture, and correlations of postural measures with Northwick Park neck pain questionnaire, deep cervical flexor muscle performance, global neck flexor muscle and shoulder girdle endurance, and demographic factors. Moderate correlations of craniovertebral angle with cervical inclination (r = 0.61) and lower cervical angle (r = 0.47) existed. Moderate correlation existed between upper thoracic inclination and lower cervical angle (r = 0.55). Neck pain questionnaire scores were significantly associated with craniovertebral angle (p = 0.01). No postural muscle performance measures were associated with postural measures. Stratification by sex revealed trends between posture and demographic and muscle performance measures, with systematic reversal of correlations between sexes. Three postural measures indicated forward head posture with some agreement. Contradictory findings between sexes are systematic and indicate that sexes should be analysed separately.