The Negative Effects of Forward Head Posture on Health & Performance!

I’m your host Dr. Marc Dupuis on this show we discuss tips, tools and strategies to improve the health & wellness of you and your family!

New forward head posture study, just came out this past July 2022

Journal of Sport Rehabilitation: high level journal
Comparison of Sensorimotor Integration and Skill-Related Physical Fitness Components Between College Athletes With and Without Forward Head Posture
authored by Ibrahim Moustafa, Meeyoung Kim, Deed Harrison.

Case control study.  What is a case control study?
This is pretty neat.  First you identify a condition you want to investigate.  Then you design a study to try and determine, if the condition in question, has any effect on a particular function/task/performance or on health.
Then you must come up with two groups of people to study.
The first group has the condition you want to study
The 2nd group does not have the condition in question.
Next you match the groups in terms of certain factors like age/sex/work/ etc to try to ensure equality in the groups you are comparing minus the key condition being studied

Then determine what types of tests to perform on each group to see if there is a difference between the people with and without the condition

This study looked at the condition of:
Forward head posture

100 Young athletes
College Level athletes high performing athletes
NO symptoms

Q: Was there a Difference in athletic performance skills tests between those with FHP and those without?
How did they determine if someone had FHP?
They used a postural measurement called the CVA (cranial vertebral angle) ear (tragus) relative to C7 spinous relative to horizontal.  This measurement can be confusing to clinicians not familiar with it because a bigger angle, means the head is being held in a more neutral position; while a lower angle means they have more FHP.  Here the CVA cut point was 50° 

The Cut point was based of other well-established studies in the literature
cranial vertebral angle (on 4 view posture screen)

What do these values mean in terms of x-rays

55° or more = Less than 20mm FHP.  That is consistent with what research has shown, most people can get away with about 20mm of FHP and not have any negative consequences.  MC neck p, Has, cervical degeneration & disability

Their cut point of 50° = ~ 25mm or more FHP 1’’

They measured Sensory motor integration: which is how a
stimulus at either the wrist/hand/finger – is processed in the higher centers of the brain

If there is a difference in Sensory motor integration, does it affect athletic skills tests: 

They used 4 key tests, which highlight skills useful in ALL Sports: Basically: Do you have speed/power/strength?
T-test
Time sprint T test:
    Sprint 10m straight
    Sprint left 5m
    Sprint right 10m makes “T”
    Sprint back to center 5m
    Sprint back to start

Vertical Leap

Static Single Leg Balance Test – stork

Dynamic Stretch Balance Test – 3 plane dynamic stretch test for agility

Findings: They DID Find a Difference between the 2 groups in amplitude in regions of the brain that process sensory motor integration as it goes into the motor cortex.  Problems in this region would in theory create down going / descending motor cortex issues. As we have known for some time, abnormal sensory inputs create abnormal motor output. 

The athletes with FHP and differences in sensory motor integration, DID in fact score worse on all 4 of the athletic skills tests, and YES, the differences were statistically significant?

On the T-test: They were 10% slower, 1 full second.  For College level athletes, that is huge!&n