Baş Önde Postürü Olan Genç Yetişkinlerde Baş Postürü Yürüyüş Parametrelerini ve Simetrisini Değiştirir mi? Kesitsel Bir Çalışma

Abstract

Amaç: Baş önde postür (BÖP) bozukluğu yaygın bir postüral problemdir. Bununla birlikte, yürüyüş kinematiği üzerindeki etkisi belirsizliğini korumaktadır. Bu çalışmanın amacı, genç yetişkinlerde baş postürünün yürüyüşün spatio-temporal parametreleri ve asimetrisine etkisini araştırmaktır. Gereç ve Yöntem: Genç erişkinlerde gerçekleştirilen bu kesitsel çalışmada katılımcılar kraniovertebral açı (KVA) değerine göre BÖP ve normal postür olmak üzere iki gruba ayrıldı. Katılımcıların KVA, kranial rotasyon açısı ve kraniohorizontal açıları lateralden çekilen fotoğraflar ile değerlendirildi ve MB-Ruler yazılımı ile analiz edildi. Katılımcıların demografik bilgileri (cinsiyet, yaş, boy, kilo) kaydedildi ve yürüyüş spatiotemporal parametreleri—ilk temas, destek, sallanma fazları, adım döngüsü, dinamik basınç ve yürüyüş simetri skorları—FreeMED force platformu (Sensor Medica, İtalya) kullanılarak ölçüldü. Yürüyüş simetrisi simetri indeksi kullanılarak hesaplandı. Bulgular: Çalışmaya ortalama yaşları 23 yıl (22-23 ÇAA) olan 66 katılımcı (41 kadın ve 25 erkek) dahil edildi. Sol adım döngüsü uzunluğu ile kranial rotasyon açısı arasında orta düzeyde pozitif bir ilişki bulundu (r=0,316, p=0,024). Ancak, gruplar arasında diğer yürüyüş kinematik parametrelerinde anlamlı fark bulunmadı (p>0,05). Ayrıca, CVA ile yürüyüş spatio-temporal parametreleri veya yürüyüş simetrisi arasında anlamlı bir korelasyon bulunmadı (p>0,05). Sonuç: Baş önde postürün genç yetişkinlerde kinematik spatio-temporal yürüyüş parametrelerini ve yürüyüş simetrisini önemli ölçüde değiştirmediğini göstermektedir. Daha hassas ölçümler sağlayabilecek üç boyutlu postür ve yürüme analizi yöntemleri ile planlanan çalışmalara ihtiyaç vardır. Anahtar Kelimeler: Kraniovertebral açı, baş önde postür, yürüyüş, simetri.

Keywords

• Kraniovertebral açı
• baş önde postür
• yürüyüş
• simetri

Does Head Posture Alter Gait Parameters and Symmetry in Young Adults with Forward Head Posture? A Cross-Sectional Study

Abstract

Objective: Forward head posture (FHP) is a common postural problem. However, its influence on gait kinematics remains unclear. The purpose of this study was to investigate the effect of head posture on gait spatiotemporal parameters and asymmetry in young adults. Material and Method: A cross-sectional study was conducted on young adults categorized into two groups: FHP and normal posture, based on the cut-off value of the craniovertebral angle (CVA). The CVA, cranial rotation angle, and cranial horizontal angle were calculated using lateral photographs and analyzed using MB-Ruler software. Demographic information, including gender, age, height, and weight, was recorded, and gait spatio-temporal parameters—initial contact, support, swing, step phases, dynamic pressure, and gait symmetry scores—were measured using the FreeMED force platform (Sensor Medica, Italy). Gait symmetry was calculated using the symmetry index. Results: A total of 66 participants (41 females and 25 males) were included in the study, with an average age of 23 (22–23 IQR). There was a moderate positive correlation between left step cycle length and cranial rotation angle (r=0.316, p=0.024). However, no significant differences were determined in other gait kinematic parameters between groups (p>0.05). Additionally, no significant correlation was found between CVA and gait spatiotemporal parameters or gait symmetry (p>0.05). Conclusion: The findings suggest that FHP does not significantly alter kinematic spatiotemporal gait parameters and gait symmetry in young adults. Research is required to investigate three-dimensional posture and gait analysis methods that can provide more accurate measurements. Keywords: Craniovertebral angle, forward head posture, gait, symmetry.

Keywords

• Craniovertebral angle
• forward head posture
• gait
• symmetry

References

1. 1. Griegel-Morris P, Larson K, Mueller-Klaus K, Oatis CA. Incidence of common postural abnormalities in the cervical, shoulder, and thoracic regions and their association with pain in two age groups of healthy subjects. Phys Ther. 1992 Jun;72(6):425–31. DOI: 10.1093/ptj/72.6.425.
2. 2. Magnani RM, Bruijn SM, van Dieën JH, Vieira MF. Head orientation and gait stability in young adults, dancers and older adults. Gait Posture. 2020;80:68–73. DOI: 10.1016/j.gaitpost.2020.05.035.
3. 3. Abdulwahab SS, Sabbahi M. Neck retractions, cervical root decompression, and radicular pain. J Orthop Sports Phys Ther. 2000;30(1):4. DOI: 10.2519/jospt.2000.30.1.4.
4. 4. Diab AA, Moustafa IM. The efficacy of forward head correction on nerve root function and pain in cervical spondylotic radiculopathy: a randomized trial. Clin Rehabil. 2012;26(4):351–61. DOI: 10.1177/0269215511419536.
5. 5. Moustafa IM, Diab AA. The effect of adding forward head posture corrective exercises in the management of lumbosacral radiculopathy: a randomized controlled study. J Manipulative Physiol Ther. 2015;38(3):167–78. DOI: 10.1016/j.jmpt.2014.11.009.
6. 6. Falla D, O’Leary S, Fagan A, Jull G. Recruitment of the deep cervical flexor muscles during a postural-correction exercise performed in sitting. Man Ther. 2007;12(2):139–43.
7. 7. Keshner EA, Cromwell RL, Peterson BW. Mechanisms controlling human head stabilization. II. Head-neck characteristics during random rotations in the vertical plane. J Neurophysiol. 1995;73(6):2302–12.
8. 8. Pozzo T, Berthoz A, Lefort L. Head stabilization during various locomotor tasks in humans. Exp Brain Res. 1990;82(1):97–106.

9. 9. Grossman GE, Leigh RJ, Abel LA, Lanska DJ, Thurston SE. Frequency and velocity of rotational head perturbations during locomotion. Exp Brain Res. 1988;70(3):470–6.
10. 10. Hirasaki E, Moore ST, Raphan T, Cohen B. Effects of walking velocity on vertical head and body movements during locomotion. Exp Brain Res. 1999;127(2):117–30.
11. 11. Latt MD, Menz HB, Fung VS, Lord SR. Walking speed, cadence and step length are selected to optimize the stability of head and pelvis accelerations. Exp Brain Res. 2008;184(2):201–9.
12. 12. Holt KJ, Jeng SF, Ratcliffe R, Hamill J. Energetic cost and stability during human walking at the preferred stride frequency. J Mot Behav. 1995;27(2):164–78.
13. 13. Yun SH, Lee YM, Kwon JW. Spatiotemporal and kinematic parameters during uphill, downhill, and overground walking in forward head posture: a preliminary study. J Biomech. 2025 Jul 11;190:112866. DOI: 10.1016/j.jbiomech.2025.112866. Epub ahead of print.
14. 14. Cromwell R, Schurter J, Shelton S, Vora S. Head stabilization strategies in the sagittal plane during locomotor tasks. Physiother Res Int. 2004;9(1):33–42.
15. 15. Cromwell RL, Newton RA, Carlton LG. Horizontal plane head stabilization during locomotor tasks. J Mot Behav. 2001;33(1):49–58.
16. 16. Sadeghi H, Allard P, Prince F, Labelle H. Symmetry and limb dominance in able-bodied gait - a review. Gait Posture. 2000;12(1):34–45.
17. 17. Kogler A, Lindfors J, Ödkvist LM, Ledin T. Postural stability using different neck positions in normal subjects and patients with neck trauma. Acta Otolaryngol. 2000;120(2):151–5.
18. 18. Vuillerme N, Rougier P. Effects of head extension on undisturbed upright stance control in humans. Gait Posture. 2005;21(3):318–25.
19. 19. Harman K, Hubley-Kozey CL, Butler H. Effectiveness of an exercise program to improve forward head posture in normal adults: a randomized, controlled 10-week trial. J Man Manip Ther. 2005;13(3):163–76.
20. 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.
21. 21. Yoo WG, An DH. The relationship between the active cervical range of motion and changes in head and neck posture after continuous VDT work. Ind Health. 2009;47(2):183–8.
22. 22. Goodarzi F, Rahnama L, Karimi N, Baghi R, Jaberzadeh S. The effects of forward head posture on neck extensor muscle thickness: an ultrasonographic study. J Manipulative Physiol Ther. 2018;41(1):34–41.
23. 23. Weon JH, Oh JS, Cynn HS, Kim YW, Kwon OY, Yi CH. Influence of forward head posture on scapular upward rotators during isometric shoulder flexion. J Bodyw Mov Ther. 2010;14(4):367–74.
24. 24. 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.
25. 25. Lin G, Zhao X, Wang W, Wilkinson T. The relationship between forward head posture, postural control and gait: a systematic review. Gait Posture. 2022 Oct;98:316–29. DOI: 10.1016/j.gaitpost.2022.10.008.
26. 26. Shaghayegh Fard B, Ahmadi A, Maroufi N, Sarrafzadeh J. Evaluation of forward head posture in sitting and standing positions. Eur Spine J. 2016 Nov;25(11):3577-3582. DOI: 10.1007/s00586-015-4254-x. Epub 2015 Oct 17. Erratum in: Eur Spine J. 2021 Oct;30(10):3135. DOI: 10.1007/s00586-021-06923-z.
27. 27. Ha NR, Shin HM, Kim MC, Oh HJ. Effects of abdominal breathing and thoracic expansion exercises on head position and shoulder posture in patients with rotator cuff injury. Journal of the Korean society of physical medicine 2016;11(4):1-9.
28. 28. Mo SW, Xu DQ, Li JX, Liu M. Effect of backpack load on the head, cervical spine and shoulder postures in children during gait termination. Ergonomics 2013;56(12):1908-16.
29. 29. Diéguez-Pérez M, de Nova-García MJ, Mourelle-Martínez MR, González-Aranda C. The influence of crossbite in early development of mandibular bone asymmetries in paediatric patients. J Clin Exp Dent. 2017;9(9):e1115.
30. 30. Correale L, Carnevale Pellino V, Marin L, Febbi M, Vandoni M. Comparison of an inertial measurement unit system and baropodometric platform for measuring spatiotemporal parameters and walking speed in healthy adults.Motor Control.2020;25(1):89–99. DOI:10.1123/mc.2020-0060.
31. 31. Rožac D, Kasović M, Knjaz D. Spatiotemporal Gait Asymmetries Remain Unaffected by Increased Load Carriage in Professional Intervention Police Officers. Bioengineering 2024;11(11):1140.
32. 32. Pallant J. SPSS survival manual: a step by step guide to data analysis using IBM SPSS. 7th ed. Routledge; 2020. ISBN: 1003117457.
33. 33. Titcomb DA, Melton BF, Bland HW, Miyashita T. Evaluation of the Craniovertebral Angle in Standing versus Sitting Positions in Young Adults with and without Severe Forward Head Posture. International Journal of Exercise Science. 2024;17(1):73.
34. 34. Kang FJ, Lin KY. Observing the effect of physical activity on forward head posture and rounded shoulder posture in young healthy adults.J Phys Ther Sci. 2023;35(8):564–7. DOI:10.1589/jpts.35.564.
35. 35. Mahmoud NF, Hassan KA, Abdelmajeed SF, Moustafa IM, Silva AG. The relationship between forward head posture and neck pain: a systematic review and meta-analysis. Curr Rev Musculoskelet Med. 2019;12(4):562–77. DOI:10.1007/s12178-019-09594-y.
36. 36. Lin G, Zhao X, Wang W, Wilkinson T. The relationship between forward head posture, postural control and gait: a systematic review.Gait Posture. 2022;98:316–29. DOI:10.1016/j.gaitpost.2022.10.008.
37. 37. Mosaad DM, Abdel-aziem AA. The relationship between neck angles and ground reaction forces in school children during backpack carriage. Biomed Hum Kinet. 2020;12(1):1–9.
38. 38. Latour E, Latour EE, Nowaszczuk J, Arlet J, Zavatska L. Gait performance changes after ten cervical retractions. Phys Educ Stud. 2024;28(5):286–95.
39. 39. Saad N, Moustafa IM, Ahbouch A, Alsaafin NM, Oakley PA, Harrison DE. Are rotations and translations of head posture related to gait and jump parameters? J Clin Med. 2023;12(19):6211. DOI:10.3390/jcm12196211.
40. 40. Jafarnezhadgero A, Sheikhalizade H. Gait ground reaction force characteristics in children with and without forward head posture. J Kerman Univ Med Sci. 2019;26(1):55–66.
41. 41. Kawasaki T, Ohji S, Aizawa J, Sakai T, Hirohata K, Kuruma H, et al. Correlation between the Photographic Cranial Angles and Radiographic Cervical Spine Alignment. International Journal of Environmental Research and Public Health, 2022;19(10):6278. DOI: 10.3390/ijerph19106278.
42. 42. John CT, Seth A, Schwartz MH, Delp SL. Contributions of muscles to mediolateral ground reaction force over a range of walking speeds. J Biomech. 2012;45(14):2438–43.
43. 43. Lythgo N, Wilson C, Galea M. Basic gait and symmetry measures for primary school-aged children and young adults. II: walking at slow, free and fast speed. Gait Posture. 2011 Jan;33(1):29-35. DOI: 10.1016/j.gaitpost.2010.09.017.
44. 44. Liu YT, Lin AC, Chen SF, Shih CJ, Kuo TY, Wang FC, et al. Superior gait performance and balance ability in Latin dancers. Front Med. 2022;9:834497.