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. 2021 Aug;29(4):227-234.
doi: 10.1080/10669817.2020.1854010. Epub 2020 Nov 30.

Does forward head posture change subacromial space in active or passive arm elevation?

Behdokht Dehqan  1 , Cyrus Taghizadeh Delkhoush  1   2 , Majid Mirmohammadkhani  3   4 , Fatemeh Ehsani  1   2
Affiliations

Does forward head posture change subacromial space in active or passive arm elevation?

Behdokht Dehqan et al. J Man Manip Ther. 2021 Aug.

Abstract

Objectives: Forward head posture (FHP) is one of the most common musculoskeletal disorders that appears to affect the shoulder joint through the shared muscles between the head and neck area and the shoulder girdle. The present study compared the acromiohumeral distance between individuals with normal head and neck alignment and those with moderate and severe FHP in active and passive arm elevation.Methods: Based on the craniovertebral angle, 60 volunteers were selected and equally distributed among three groups, including group one with normal head and neck alignment, group two with moderate FHP and group three with severe FHP. The space between the humeral head and the acromion was measured in 10°, 45° and 60° of active and passive arm elevation as the acromiohumeral distance.Results: The acromiohumeral distance was only different between the three groups at 45° arm elevation angle, and this difference was significant between groups one and three. In active and passive arm elevation, increased arm elevation angle reduced the subacromial space significantly. Also, in each arm elevation angle, the subacromial space differed significantly between the active and passive arm elevations.Conclusions: The acromiohumeral distance was significantly lower in the severe FHP group than the group with normal head and neck alignment in the 45° active arm elevation angle, which could be due to the changed tension in tissues between active and passive arm elevation and also the maximum muscle activity in the 45° active arm elevation angle.

Keywords: Posture; cervical vertebrae; shoulder joint; ultrasonography.

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Conflict of interest statement

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Plumb method, A severe forward head posture, Line A; posterior margin of the earlobe, Line B; distance between the posterior margin of the earlobe and the plumb line
Figure 2.
Figure 2.
Imaging method, a normal head and neck alignment, the craniovertebral angle is the angle of the line connecting the ear tragus to the C7 spinous process and the horizontal line
Figure 3.
Figure 3.
Mean changes in the AHD during passive arm elevation at 10°, 45° and 60° in all the three groups; error bars indicate 95% confidence intervals
Figure 4.
Figure 4.
Mean changes in the AHD during active arm elevation at 10°, 45° and 60° in all the three groups; error bars indicate 95% confidence intervals
See this image and copyright information in PMC

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