Öğrencilerin baş ve boyun postürlerinin anatomi uygulama derslerinde maket kullanım sırasında fotoantropometrik çalışması

Abstract

Amaç: Anatomi maketleri, kullanım kolaylığı ve etkili öğrenme-öğretme sürecinden dolayı anatomi uygulama derslerinde yaygın olarak kullanılmaktadır. Bu çalışma, öğrencilerin anatomi maketlerini kullanımı sırasında baş ve boyun postürünü fotoantropometri yöntemiyle değerlendirmeyi ve bu duruşu nötr ayakta durma ve oturma pozisyonlarıyla karşılaştırmayı amaçlamaktadır. Yöntemler: Çalışmaya Tıp Fakültesi ve Sağlık Bilimleri Fakültesi’nde eğitim almakta olan 120 öğrenci dahil edildi. Öğrencilerin ayakta durma ve oturma pozisyonlarında, nötr duruşta ve maket kullanımı sırasında dijital fotoğraf makinesi kullanılarak anterior, posterior ve lateral görünüşten fotoğrafları alındı. Her bir katılımcının 12 adet fotoğrafı kaydedildi. Öğrencilerin sagittal baş tilt açısı, koronal baş tilt açısı, baş pozisyon açısı, boyun tilt açısı ve ileri baş değişimi fotoantropometrik yöntem ve ImageJ yazılım programı kullanılarak değerlendirildi. Bulgular: Elde edilen veriler cinsiyet, postür (oturma/ayakta durma), maket kullanımı (var/yok), fakülte, vücut kitle indeksi ve genel postür açısından analiz edildi. Cinsiyet ile ileri baş değişimi (0,319) ve fakülte ile boyun tilt açısı (0,303) arasında orta düzeyde pozitif ilişki bulundu. Bu durum, postürün cinsiyet ve akademik program açısından değiştiğini göstermektedir. Fakülteler ile baş pozisyon açısı arasında bulunan güçlü negatif ilişki (-0,394), fakültelerde göreve bağlı postüral farklılığı göstermektedir. Vücut kitle indeksi ile ileri baş değişimi arasında güçlü pozitif ilişki (0,374) ve vücut kitle indeksi ile baş pozisyon açısı arasında negatif ilişki (-0,279) olduğu bulundu. Bu durum, yüksek vücut kitle indeksinin maket kullanımı sırasında belirgin ileri baş değişimi ve düşük baş açılarıyla bağlantılı olduğunu göstermektedir. Sonuç: Öğrenciler anatomi eğitiminden önce yaygın baş ve boyun postüral bozuklukları hakkında bilgilendirilmelidirler.

Keywords

• baş ve boyun
• kas iskelet sistemi ağrısı
• fotoantropometri
• postür
• uygulama dersi
• öğrenciler

Project Number

BBAP.2023.008

A photo-anthropometric study of students' head and neck posture during the use of anatomical models in practical anatomy classes

Abstract

Aims: Anatomical models are widely used in practical anatomy classes for their ease of use and effectiveness in learning and teaching. This study aimed to assess head and neck posture via photo-anthropometry while students viewed anatomical models, and to compare it with neutral standing and sitting postures. Methods: This study included 120 young adults participants from the Faculties of Medicine and Health Sciences. Each student was photographed with a digital camera from anterior, posterior, and lateral views in neutral sitting, neutral standing, model usage sitting and model usage standing. This resulted in 12 photographs per participant. Measurements were taken using photo antropometric methods and the ImageJ software. These are sagittal head tilt angle, coronal head tilt angle, head position angle, neck tilt angle, and forward head shift when evaluating different postural conditions. . Results: The collected data were analyzed for correlations with variables such as gender, posture (sitting/standing), model usage (with/without), faculty and BMI. A moderate positive correlation was found between gender and forward head shift (0.319), and between faculty affiliation and neck tilt angle (0.303). This indicates posture differences based on gender and academic program. A strong negative correlation between faculty affiliation and head position angle (-0.394) suggests task-specific posture variation between faculties. BMI showed a strong positive correlation with forward head shift (0.374) and a negative correlation with head position angle (-0.279). This implies that higher BMI is related to higher forward head posture and lower head angles during model use. Conclusion: Students should be informed about common incorrect head and neck postures before anatomy training.

Keywords

• Head and neck
• musculoskeletal pain
• photo-anthropometry
• posture
• practice lesson
• student

Supporting Institution

This work has been supported by Izmir Bakircay University Scientific Research Projects Coordination Unit, under grant number BBAP.2023.008.

Project Number

BBAP.2023.008

Ethical Statement

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The study received approval from the Ethical Review Board of Bakircay University School of Medicine, and written informed consent was obtained from all participants prior to testing (Decision No: 1042, Research No: 1022, Date: May 17, 2023).

Thanks

The authors would like to thank all volunteers and students who participated in this study.

References

1. Abadiyan F, Hadadnezhad M, Khosrokiani Z, Letafatkar A, Akhshik H. Adding a smartphone app to global postural re-education to improve neck pain, posture, quality of life, and endurance in people with nonspecific neck pain: a randomized controlled trial. Trials. 2021;22(1): 274. doi:10.1186/s13063-021-05214-8
2. Azar M, Babaee T, Kamyab M, Ghandhari H. Effect of the type of brace on head to pelvis sagittal alignment of adolescents with Scheuermann's kyphosis. Assist Technol. 2023;5 (5):399-408. doi:10.1080/10400435.2022.2102092
3. Caneiro JP, O’Sullivan P, Burnett A, et al. The influence of different sitting postures on head/neck posture and muscle activity. Man Ther. 2010;15(1):54-60. doi:10.1371/journal.pone.0151789
4. Elgendy MH, Ghaffar MAA, Sabbahi SAE, Abutaleb EES, Elsayed SEB. Efficacy of head postural correction program on craniovertebral angle, scapular position, and dominant hand grip strength in forward head posture subjects: a randomized controlled trial. Physiother Res Int. 2024; 29(3):2093. doi:10.1002/pri.2093
5. Govsa F, Nteli Chatzioglou G, Hepguler S, Pinar Y, Bedre O. Variable lower limb alignment of clinical measures with digital photographs and the footscan pressure system. J Sport Rehabil. 2020;30(3):437-444. doi:10.1123/jsr.2018-0283
6. Hasegawa K, Okamoto M, Hatsushikano S, Ono M, Watanabe K. Normative values of spino-pelvic sagittal alignment, balance, age, and health-related quality of life in a cohort of healthy adult subjects. Eur Spine. J. 2016;25(11):3675-3686. doi:10.1007/s00586-016-4702-2
7. Matsumoto H, Shiraishi M, Higashi A, et al. The forward and lateral tilt angle of the neck and trunk measured by three-dimensional gait and motion analysis as a candidate for a severity index in patients with Parkinson's disease. Neurol Int. 2022;14(3):727-737. doi:10.3390/neuroli nt14030061
8. Mehri A, Letafatkar A, Khosrokiani Z. Effects of corrective exercises on posture, pain, and muscle activation of patients with chronic neck pain exposed to anterior-posterior perturbation. J Manipulative Physiol Ther. 2020;43(4):311-324. doi:10.1016/j.jmpt.2018.11.032

9. Nakphet N, Chaikumarn M. A comparison of neck and shoulder postures in symptomatic and asymptomatic female office workers in the actual work environment. Heliyon. 2024;10(7):e28628. doi:10.1016/j.heliyon.2024.e28628
10. Bhalala US, Hemani M, Shah M, et al. Defining optimal head-tilt position of resuscitation in neonates and young infants using magnetic resonance imaging data. PLoS One. 2016;11(3):e0151789. doi: 10.1371/jo urnal.pone.0151789
11. Jeong GH, Lee BH. Effects of telerehabilitation combining diaphragmatic breathing re-education and shoulder stabilization exercises on neck pain, posture, and function in young adult men with upper crossed syndrome: a randomized controlled trial. J Clin Med. 2024;13(6): 1612. doi:10.3390/jcm13061612
12. Moon YJ, Ahn TY, Suh SW, et al. A preliminary diagnostic model for forward head posture among adolescents using forward neck tilt angle and radiographic sagittal alignment parameters. Diagnostics (Basel). 2024; 14(4):394. doi:10.3390/diagnostics14040394
13. Mun WL, Roh SY. Effects of 60 versus 30 minutes of pilates exercise on cervicothoracic alignment, muscle strength, and endurance in university students with upper crossed syndrome. J Clin Med. 2024;13(15):4376. doi:10.3390/jcm13154376
14. Ruivo RM, Pezarat-Correia P, Carita AI. Cervical and shoulder postural assessment of adolescents between 15 and 17 years old and association with upper quadrant pain. Braz. J Phys Ther. 2014;18(4):364-371. doi:10.1590/bjpt-rbf.2014.0027
15. Ruivo RM, Pezarat-Correia P, Carita AI. Effects of a resistance and stretching training program on forward head and protracted shoulder posture in adolescents. J Manipulative Physiol Ther. 2017; 40(1):1-10. doi:10.1016/j.jmpt.2016.10.005
16. Titcomb DA, Melton BF, Miyashita T, Bland HW. The effects of postural education or corrective exercise on the craniovertebral angle in young adults with forward head posture: a randomized controlled trial. Int J Exerc Sci. 2023;16(1):954-973. doi:10.70252/PYPQ8483
17. 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. Int J Exerc Sci. 2024;17(1):73-85. eCollection 2024.X. doi:10.70252/GDNN4363
18. Hofler RC, Muriuki MG, Havey RM, et al. Neutral cervical sagittal vertical axis and cervical lordosis vary with T1 tilt. J Neurosurg Spine. 2020;33(2):158-164. doi:10.3171/2020.2.SPINE191363
19. Rateaux M, Espinasse-Berrod MA, Couret C, Bremond-Gignac D, Robert MP. Pseudo-gaze deviation resulting from positive angle kappa and esotropia. J Neuroophthalmol. 2021; 41(2):234-236. doi:10.1097/W NO.0000000000001068
20. Singla D, Veqar Z. Association between forward head, rounded shoulders, and increased thoracic kyphosis: a review of the literature. J.Chiropr Med. 2017;16(3):220-229. doi:10.1016/j.jcm.2017.03.004
21. Shibasaki S, Kishino T, Sei Y, et al. Validity of a qualitative visual method for diagnosing forward head posture. Musculoskelet. Sci Pract. 2025;76:103282. doi:10.1016/j.msksp.2025.103282
22. Govsa F, Ozer MA, Sirinturk S, Eraslan C, Alagoz AK. Creating vascular models by postprocessing computed tomography angiography images: a guide for anatomical education. Surg Radiol Anat. 2017;39(8):905-910. doi:10.1007/s00276-017-1822-2
23. Petersch B, Dierkes K. Gaze-angle dependency of pupil-size measurements in head-mounted eye tracking. Behav Res Methods. 2022; 54(2):763-779. doi:10.3758/s13428-021-01657-8
24. Singla D, Veqar Z, Hussain ME. Photogrammetric assessment of upper body posture using postural angles: a literature review. J Chiropr Med. 2017;16(2):131-138. doi:10.1016/j.jcm.2017.01.005
25. Raine S, Twomey LT. Head and shoulder posture variations in 160 asymptomatic women and men. Arch Phys Med Rehabil. 1997;78(11): 1215-1223. doi:10.1016/s0003-9993(97)90335-x
26. Suwaidi ASA, Moustafa IM, Kim M, Oakley PA, Harrison DE. A comparison of two forward head posture corrective approaches in elderly with chronic non-specific neck pain: a randomized controlled study. J Clin Med. 2023;12(2):542. doi:10.3390/jcm12020542
27. Ustinova K, Perkins J. Gaze and viewing angle influence visual stabilization of upright posture. Brain Behav. 2011;1(1):19-25. doi:10.10 02/brb3.10
28. Oakley PA, Moustafa IM, Haas JW, Betz JW, Harrison DE. Two methods of forward head posture assessment: radiography vs. posture and their clinical comparison. J Clin Med. 2024;13(7):2149. doi:10.3390/jcm13072149.2
29. Shaghayegh Fard B, Ahmadi A, Maroufi N, Sarrafzadeh J. Evaluation of forward head posture in sitting and standing positions. Eur Spine J. 2016;25(11):3577-3582. doi:10.1007/s00586-015-4254-x
30. Shih HS, Chen SS, Cheng SC, et al. Effects of kinesio taping and exercise on forward head posture. J Back Musculoskelet Rehabil. 2017; 30(4):725-733. doi:10.3233/BMR-150346
31. Bati AH, Ozer MA, Govsa F, Pinar Y. Anxiety of first cadaver demonstration in medical, dentistry and pharmacy faculty students. Surg Radiol Anat. 2013;35(5),419-426. doi:10.1007/s00276-013-1075-7
32. 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):619-625. doi:10.1016/j.jmpt.2013.09.002
33. Guan X, Fan G, Wu X, et al. Photographic measurement of head and cervical posture when viewing mobile phone: a pilot study. Eur Spine J. 2015;24: 2892-2898. doi: 10.1007/s00586-015-4143-3
34. Ankrum DR, Nemeth KJ. Head and neck posture at computer workstations-what’s neutral? In: proceedings of the human factors and ergonomics society annual meeting. SAGE Publications. 2000;44(30):5-565. doi:10.1177/15419312000 4403046
35. Straker LM, O'Sullivan PB, Smith A, Perry M. Computer use and habitual spinal posture in Australian adolescents. Public health reports. 2007;122(5):634-643. doi:10.1177/003335490712200511
36. Kılınç HE, Karaduman AA. Investigation of relationship between body mass index and neck biomechanics in healty young adults: a cross-sectional study in a single center. Turkish Journal of Diabetes and Obesity. 2021;5(2):173-179. doi:10.25048/tudod.852027