Does Sensorimotor Dysfunction Exist in Asymptomatic Individuals with Forward Head Posture? A Case-Control Study

Abstract

Background: Forward head posture (FHP), an anterior deviation of the cervical spine, is a common postural malalignment and contributor to neck pain. Impaired muscle activity and continuous excessive loading are commonly seen in individuals with FHP. Centrally, the postural impairment alters incoming sensory information, it's processing in the brain, and consequent output to muscles, causing sensorimotor dysfunction. This study aimed to find whether sensorimotor dysfunction exists in asymptomatic individuals with Forward Head Posture. Our secondary objective was to study whether sensorimotor tests could discriminate between persons with FHP and persons with neutral posture.Case Summary: A case-control study of 31 individuals with FHP and 58 controls with neutral head posture was conducted. We assessed all participants on outcome measures. In addition, a between-group comparison withappropriate statistical analytic tests and AUC plotting of outcome measures was done.Outcome measures: The following outcome measure was used for this study. 1. Cervical joint position error (JPE). 2. Craniocervical flexion test (CCFT). 3. Laterality judgement accuracy. 4. Movement control tests (MCT). 5. Fear Avoidance Behavioral Questionnaire (FABQ)Results: The results of the study indicate that there were significant differences in performance cervical joint position error test (p value<0.05), movement control tests (Total score of 13 MCT <0.05), CCFT activation scores, and performance index scores (p value=0.00) between the two groups. Values of areas under the curve (AUC) indicate that tests for JPE (0.993), CCFT AS (0.841), CCFT PI (0.941), and MCT (0.996) could discriminate well between the two groups. Amongst the 13 movement control tests 3 most discriminative tests are rotation (AUC=0.988), lateral flexion (AUC=0.988) and protraction-retraction (AUC=1.0).Conclusion: We conclude that asymptomatic individuals with forward head posture alter sensorimotor functions. This study gives an insight into the sensorimotor deficits present in asymptomatic individuals with FHP. Emphasis on early correction of FHP should be done to limit these sensorimotor deficits.