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. 2023 Feb 23;12(5):1780.
doi: 10.3390/jcm12051780.

Alterations in Cervical Nerve Root Function during Different Sitting Positions in Adults with and without Forward Head Posture: A Cross-Sectional Study

Maryam Kamel  1 , Ibrahim M Moustafa  1   2 , Meeyoung Kim  1 , Paul A Oakley  3   4   5 , Deed E Harrison  3
Affiliations

Alterations in Cervical Nerve Root Function during Different Sitting Positions in Adults with and without Forward Head Posture: A Cross-Sectional Study

Maryam Kamel et al. J Clin Med. .

Abstract

The current study aimed to determine whether participants with and without forward head posture (FHP) would respond differently in cervical nerve root function to various sitting positions. We measured peak-to-peak dermatomal somatosensory-evoked potentials (DSSEPs) in 30 participants with FHP and in 30 participants matched for age, sex, and body mass index (BMI) with normal head posture (NHP), defined as having a craniovertebral angle (CVA) >55°. Additional inclusion criteria for recruitment were individuals between the ages of 18 and 28 who were in good health and had no musculoskeletal pain. All 60 participants underwent C6, C7, and C8 DSSEPs evaluation. The measurements were taken in three positions: erect sitting, slouched sitting, and supine. We identified statistically significant differences in the cervical nerve root function in all postures between the NHP and FHP groups (p < 0.001), indicating that the FHP and NHP reacted differently in different positions. No significant differences between groups for the DSSEPs were identified for the supine position (p > 0.05), in contrast to the erect and slouched sitting positions, which showed a significant difference in nerve root function between the NHP and FHP (p < 0.001). The NHP group results were consistent with the prior literature and had the greatest DSSEP peaks when in the upright position. However, the participants in the FHP group demonstrated the largest peak-to-peak amplitude of DSSEPs while in the slouched position as opposed to an erect position. The optimal sitting posture for cervical nerve root function may be dependent upon the underlying CVA of a person, however, further research is needed to corroborate these findings.

Keywords: cervical spine; evoked potentials; posture; radiculopathy; sitting.

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Conflict of interest statement

P.A.O. is a paid consultant for CBP NonProfit, Inc. D.E.H. teaches continuing education conferences to health care providers, is the CEO of Chiropractic BioPhysics, teaches rehabilitation methods, and sells products for patient rehabilitation to physicians in the USA. All the other authors declare that they have no competing interests.

Figures

Figure 1
Figure 1
Measurement of the cranio-vertebral angle (CVA). The CVA is represented as the angle above. It is formed by the line connecting two adhesive markers placed at the tragus of the ear and the C7 spinous process; then, this line is assessed relative to a horizontal line drawn through the C7 marker. The angle θ represents the CVA.
Figure 2
Figure 2
Sitting Positions. (A): Erect sitting, (B): Slouched sitting.
Figure 3
Figure 3
Left: Electrode placement following the 10–20 international EEG system; Right: Reference and recording electrode placements.
Figure 4
Figure 4
Participant flowchart.
Figure 5
Figure 5
Short latency somatosensory-evoked potential of a normal head posture (NHP) participant before prolonged slouched sitting for C6, C7 and C8. The amplitudes measured between N20 and P23 are: 2.45 μV, 2.8 μV, and 1.14 μV, respectively.
Figure 6
Figure 6
Short latency somatosensory-evoked potential of normal head posture (NHP) participant after prolonged slouched sitting for C6, C7, and C8. The amplitudes measured between N20 and P23 are: 2.81 μV, 2.81 μV, and 0.945 μV, respectively.
Figure 7
Figure 7
Scatterplot line of cervical nerve C6 amplitude relationship with the different sitting positions for participants with forward head posture (FHP) and normal head posture (NHP). The graph highlights that the FHP group has shown an increased amplitude during slouched sitting compared to erect sitting. The supine position shows the highest nerve peak from all three positions.
Figure 8
Figure 8
Scatterplot line of cervical nerve C7 amplitude relationship with the different sitting positions for participants with forward head posture (FHP) and normal head posture (NHP). The graph highlights that the FHP group has shown an increased amplitude during slouched sitting compared to erect sitting. The supine position shows the highest nerve peak from all three positions.
Figure 9
Figure 9
Scatterplot line of cervical nerve C8 amplitude relationship with the different sitting positions for participants with forward head posture (FHP) and normal head posture (NHP). The graph highlights that the FHP group has shown an increased amplitude during slouched sitting compared to erect sitting. The supine position shows the highest nerve peak from all three positions.
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