Reliability of the Cervical Range of Motion (CROM) Device and Plumb-Line Techniques in Measuring Resting Head Posture (RHP)

Abstract

Background: Individuals with forward head posture (FHP) and related postural abnormalities are at increased risk for various musculoskeletal and/or neurovascular related cervical pathologies. The Cervical Range Of Motion (CROM) device has shown to be a reliable tool in measuring total cervical range of motion (ROM) and upper cervical flexion and extension. However, the CROM has yet to be used to evaluate reliability in measuring resting head posture (RHP). Purpose: This study compared reliability of RHP measurements using the CROM instrument with that of a plumb-line measurement. Method: A convenience sample of 122 healthy volunteers (80 women and 42 men, ages 18 to 60 years) was obtained via classroom announcement from the University of Massachusetts Lowell student body. All subjects were screened for cranial, cervical, and/or upper thoracic dysfunction. Both testers performed two CROM and two plumb-line measurements. Results: Moderate intra-tester reliability was demonstrated for measuring RHP using the CROM instrument (ICCs = 0.774, 0.775), whereas high intra-tester reliability was observed using the plumb-line technique (ICCs = 0.830, 0.846). Moderate inter-tester reliability was found for CROM measurement (ICCs = 0.675, 0.723) and the plumb-line technique (ICCs = 0.738, 0.781). Conclusion: Reliable measures of RHP can be obtained using either the CROM device or plumb-line technique.