Postural neck pain: an investigation of habitual sitting posture, perception of 'good' posture and cervicothoracic kinaesthesia.

Impairments of cervico-cephalic kinaesthesia and habitual forward head posture have been considered important in the aetiology of postural neck pain, yet these factors have not been specifically examined in a homogeneous clinical population. The objective of this study was to compare the habitual sitting posture (HSP), perception of good posture and postural repositioning error (PRE) of the cervico-thoracic (CT) spine in individuals with postural neck pain, with a matched group of asymptomatic subjects. Twenty-one subjects with postural neck pain and 22 asymptomatic control subjects were recruited into the study. An optical motion analysis system was used to measure the HSP and perceived 'good' sitting posture. PRE was measured over six trials where the subject attempted to replicate their self-selected 'good' posture. There was no difference between the groups in the HSP but significant differences were identified in the perception of 'good' posture. Posture repositioning error was higher for the head posture variables than for CT and shoulder girdle variables in both groups. However, there was no significant difference in posture repositioning error between groups for any of the posture measures. The findings suggest that individuals with postural neck pain may have a different perception of 'good' posture, but no significant difference in HSP or kinaesthetic sensibility compared with matched asymptomatic subjects.

[1]  D. Watson,et al.  Cervical Headache: An Investigation of Natural Head Posture and Upper Cervical Flexor Muscle Performance , 1993, Cephalalgia : an international journal of headache.

[2]  C. Oatis,et al.  Incidence of common postural abnormalities in the cervical, shoulder, and thoracic regions and their association with pain in two age groups of healthy subjects. , 1992, Physical therapy.

[3]  L. Straker,et al.  A comparison of symptomatic and asymptomatic office workers performing monotonous keyboard work--2: neck and shoulder kinematics. , 2005, Manual therapy.

[4]  Jeffrey D. Boyling,et al.  Grieve's Modern Manual Therapy: The Vertebral Column , 1994 .

[5]  G. Jull,et al.  A study of five cervicocephalic relocation tests in three different subject groups , 2003, Clinical rehabilitation.

[6]  S. Raine,et al.  Head and shoulder posture variations in 160 asymptomatic women and men. , 1997, Archives of physical medicine and rehabilitation.

[7]  J. Levine,et al.  Delayed activation of nociceptors: correlation with delayed pain sensations induced by sustained stimuli. , 1991, Journal of neurophysiology.

[8]  S. May,et al.  Chapter 18 – Mechanical Diagnosis and Therapy for the Cervical and Thoracic Spine , 2002 .

[9]  T. Åkerstedt,et al.  A shorter workday as a means of reducing the occurrence of musculoskeletal disorders. , 2003, Scandinavian journal of work, environment & health.

[10]  B E Moen,et al.  The Impact of Psychosocial Work Factors on Musculoskeletal Pain: A Prospective Study , 2001, Journal of occupational and environmental medicine.

[11]  H Heikkilä,et al.  Cervicocephalic kinesthetic sensibility in patients with whiplash injury. , 1996, Scandinavian journal of rehabilitation medicine.

[12]  P M Bongers,et al.  Are neck flexion, neck rotation, and sitting at work risk factors for neck pain? Results of a prospective cohort study , 2001, Occupational and environmental medicine.

[13]  P. O'Sullivan,et al.  The relationship beween posture and back muscle endurance in industrial workers with flexion-related low back pain. , 2006, Manual therapy.

[14]  K. Refshauge,et al.  The Relationship Between Cervicothoracic Posture and the Presence of Pain , 1995 .

[15]  Julia Treleaven,et al.  Dizziness and unsteadiness following whiplash injury: characteristic features and relationship with cervical joint position error. , 2003, Journal of rehabilitation medicine.

[16]  J. Winkel,et al.  Incidence of shoulder and neck pain in a working population: effect modification between mechanical and psychosocial exposures at work? Results from a one year follow up of the Malmö shoulder and neck study cohort , 2005, Journal of Epidemiology and Community Health.

[17]  Leon M Straker,et al.  A comparison of symptomatic and asymptomatic office workers performing monotonous keyboard work--1: neck and shoulder muscle recruitment patterns. , 2005, Manual therapy.

[18]  G. Jull,et al.  Clinical tests of musculoskeletal dysfunction in the diagnosis of cervicogenic headache. , 2006, Manual therapy.

[19]  G. Németh,et al.  Load moments and myoelectric activity when the cervical spine is held in full flexion and extension. , 1986, Ergonomics.

[20]  Mary Ruhl,et al.  Ability to Reproduce Head Position After Whiplash Injury , 1997, Spine.

[21]  D. Neumann.  Kinesiology of the Musculoskeletal System , 2002 .

[22]  N Nilsson,et al.  The ability to reproduce the neutral zero position of the head. , 1999, Journal of manipulative and physiological therapeutics.

[23]  G. Allison,et al.  Estimating Three-Dimensional Spinal Repositioning Error: The Impact of Range, Posture, and Number of Trials , 2003, Spine.

[24]  D Rempel,et al.  Risk factors for musculoskeletal disorders among computer users. , 1999, Occupational medicine.

[25]  L Straker,et al.  A comparison of the postures assumed when using laptop computers and desktop computers. , 1997, Applied ergonomics.

[26]  K. P. Singer,et al.  The Clinical Anatomy and Management of Thoracic Spine Pain , 2000 .

[27]  A. Aarås,et al.  Musculoskeletal problems among VDU workers in a Hong Kong bank. , 1996, Occupational medicine.

[28]  H V Heikkilä,et al.  Cervicocephalic kinesthetic sensibility, active range of cervical motion, and oculomotor function in patients with whiplash injury. , 1998, Archives of physical medicine and rehabilitation.

[29]  Function of longus colli and longissimus cervicis muscles in man. , 1966 .

[30]  S J Linton,et al.  A review of psychological risk factors in back and neck pain. , 2000, Spine.

[31]  An investigation of poor cervical resting posture. , 1997, The Australian journal of physiotherapy.

[32]  R H Westgaard,et al.  A case-control study of trapezius muscle activity in office and manual workers with shoulder and neck pain and symptom-free controls , 1995, International archives of occupational and environmental health.

[33]  Ruth Grant.  Physical therapy of the cervical and thoracic spine , 1994 .

[34]  Peter J McNair,et al.  Head and neck position sense in whiplash patients and healthy individuals and the effect of the cranio-cervical flexion action. , 2005, Clinical biomechanics.

[35]  J. Kenardy,et al.  Characterization of Acute Whiplash-Associated Disorders , 2004, Spine.

[36]  S. Keller,et al.  Good Postural Habits: A Pilot Investigation Using EMG Scanning of the Paraspinals , 1997, Applied psychophysiology and biofeedback.

[37]  L. Straker,et al.  A field comparison of neck and shoulder postures in symptomatic and asymptomatic office workers. , 2002, Applied ergonomics.

[38]  P M Bongers,et al.  Psychosocial risk factors for neck pain: a systematic review. , 2001, American journal of industrial medicine.

[39]  K. Grimmer.  The Relationship Between Cervical Resting Posture and Neck Pain , 1996 .

[40]  R H Westgaard,et al.  Working hours as a risk factor in the development of musculoskeletal complaints. , 1991, Ergonomics.

[41]  J. Bagust,et al.  Cervicocephalic kinesthetic sensibility in patients with chronic, nontraumatic cervical spine pain. , 2001, Archives of physical medicine and rehabilitation.

[42]  L. Fine,et al.  Job task and psychosocial risk factors for work-related musculoskeletal disorders among newspaper employees. , 1994, Scandinavian journal of work, environment & health.

[43]  R H Westgaard,et al.  Trapezius muscle activity as a risk indicator for shoulder and neck pain in female service workers with low biomechanical exposure , 2001, Ergonomics.

[44]  E. Viikari-Juntura,et al.  Work related and individual predictors for incident neck pain among office employees working with video display units , 2003, Occupational and environmental medicine.