Association of forward head posture with neck pain, cervicogenic headache, neuropathy, and neck mobility among university students: a cross-sectional study

  • Ayesha Basharat University of Sargodha, Pakistan
  • Muhammad Mustafa Qamar University of Sargodha, Pakistan
  • Hamna Afzal University of South Asia, Lahore, Pakistan.
  • Kirran Sikandar Gondal University of Lahore, Sargodha campus, Pakistan
  • Shanza Tanveer University of Lahore, Sargodha campus, Pakistan
  • Tubaa Saleem University of Sargodha, Pakistan
Keywords: Craniovertebral angle, forward head posture, headache, hypomobility, neuropathy, photogrammetry


Background: With the rising popularity of media devices, frequent users often exhibit poor habitual neck posture and suffer from a forward head deformity that may lead to neck and upper limb dysfunctions.

Objective: To determine the association of forward head posture (FHP), neck pain, cervicogenic headache, neuropathy, and neck mobility among university students.

Methods: An observational cross-sectional survey was conducted on students. There were four hundred participants in this study who were divided into two groups, Group 1's (G1) study hour was >6hrs and Group 2's (G2) study hour was <6hrs. The craniovertebral angle was measured by using a mobile app Photogrammetry Maneuver to evaluate head neck alignment. A digital camera of 12 megapascals was placed approximately 5 feet away from the participant. The camera's height was adjusted parallel to the participant's shoulder level, and they were asked to stand in their anatomical posture barefooted. Outcomes were measured as headache, local tenderness, neuropathy and range of motion associated with FHP. Data was collected through questionnaire and analyzed by using SPSS version 23.

Results: There was significant association of duration of study with forward head posture (P<0.05). A strong positive correlation was found between forward head posture neck pain (r=0.78), cervicogenic headache (r=0.54), and neuropathy (r=0.29). Students also presented with decreased cervical range of motion.

Conclusion: Students with prolonged study hours suffered more from forward head posture, neck pain, headache, hypomobility and neuropathy as compared to students with less study duration.

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