HEAD AND SHOULDER POSTURE VARIATIONS IN 160 ASYMPTOMATIC WOMEN AND MEN

Objective: To quantitatively describe the postural alignment of the he ad and shoulders and the surface curvature of the thoracic spine in co mfortable erect standing and to examine the effect of age and gender o n head and shoulder alignment. Design: Descriptive survey. Setting: Ga it research laboratory. Participants: One hundred sixty asymptomatic v olunteers aged between 17 and 83 years. Main Outcome Measures: Five ph otographic measurements of head and shoulder posture in the coronal an d sagittal planes and a photographic measurement of the surface curvat ure of the thoracic spine in the sagittal plane. Results: Mean values of coronal head tilt, coronal shoulder angle, sagittal head tilt, sagi ttal C7-tragus angle, and sagittal shoulder-C7 angle were 180.1 degree s, 181 degrees, 172.1 degrees, 131.1 degrees, and 53.7 degrees, respec tively. The 95% confidence intervals for the means ranged between 1 de grees and 3.8 degrees. For each of the head and shoulder measurements there was no significant gender difference (p = .33 to .99). Of the fi ve measurements, only sagittal C7-tragus angle was significantly corre lated with age (r = .44), and none was correlated with surface curvatu re of the thoracic spine. Conclusions: Head and shoulder posture was s imilar between genders. Only one postural description that has been de scribed anecdotally was identified, ie, that age was related to the po sition of the head with respect to the trunk in the sagittal plane, al though the strength of the association was of questionable clinical si gnificance. In contrast, other longstanding assumptions were not suppo rted, and accordingly, a forward head was not associated with increase d thoracic curvature or upper cervical spine extension. (C) 1997 by th e American Congress of Rehabilitation Medicine and the American Academ y of Physical Medicine and Rehabilitation.