Postural Deviations Research Articles

Acute and chronic effect of stretching exercise on posture and flexibility of nurses and licensed practical nurses

Introduction: nurses and licensed practical nurses are among the most affected by postural deviations and their drawbacks, in the world. One of the ways to mitigate these ills is physical exercise, and it can be done at work environment, however, not as a form of workout gymnastics. Objective: To verify the effects of a muscle stretching exercise program (MSE) on posture and flexibility of nurses. Methods: Controlled clinical experiment with 28 nurses, aged 18-60 years, divided into experimental group (n=15) and control group (n=13). Anthropometric measures, flexibility and body posture of the trunk were performed. The intervention was of 08 weeks of MSE; each session lasted 40 min. The exercises had four sets of 30s of tension for 30s of the interval. An independent t-test compared the characteristics of the samples. The chi-square test treated the results regarding body posture, and the level of significance was p ≤ 0.05. Results: MSE promoted positive and chronic positive changes in the Experimental Group with attenuation of the concavities of the vertebral column in the cervical and thoracic regions. In the alignment of the cervical region and the curvature of the lumbar region, the effects were observed after the eight weeks of training, including sharp reduction of gibbosity in the scapula region after the exercise session. Conclusion: MSE promoted acute and chronic positive changes in body posture and flexibility in nurses.

ANÁLISIS DE LAS ALTERACIONES POSTURALES OCASIONADAS POR LA PRÁCTICA DEL SURF

Introducción: El surf es un deporte que se ha popularizado y ampliado alrededor del mundo, de ahí la importancia de conocer las alteraciones que se pueden producir por su práctica.
 Métodos: Se elaboró una revisión sistemática de estudios no experimentales de corte transversal en las bases de datos como: PubMed, Scopus, Annual Reviews, Sport Discus y PEDro, siguiendo los parámetros de la estructura PRISMA.
 Resultados: A partir del análisis de los estudios incluidos se muestran cambios en la postura por la práctica del Surf y se encontró que los deportistas del surf amateurs (recreativos) tienen mayor incidencia en desviaciones posturales versus profesionales. Con relación a las alteraciones posturales la zona más afectada del cuerpo es la región lumbar y entre las alteraciones más comunes de la región superior se encuentran las desviaciones del hombro anterior y lateral.
 Conclusión: Se concluye que la práctica del surf crea modificaciones que alteran la postura debido al gesto propio del deporte y que están condicionadas con base al tiempo de práctica y nivel del practicante.

Canonical correlation between body-posture deviations and gait disorders in children with cerebral palsy.

Children with Cerebral Palsy (CP) show the postural constraints while standing, and gait disorders, resulting from both primary and secondary impairments of brain injury. In our previous studies, several characteristic postural and gait patterns in children with unilateral as well as with bilateral CP were defined, and the relationship between these patterns was demonstrated. The purpose of present study was to identify which features of body posture deviation during standing were strongly related to gait deviations in independently ambulatory children with CP. For this aim we explored the cross—relationship between features of body posture while standing examined by surface topography and the selected gait parameters from three-dimensional instrumented gait analysis in one hundred twenty children with cerebral palsy, aged between 7 and 13 years, who were able to walk independently. First, our study documented that that sagittal misalignment of the spine curvature was significantly related to kinematic deviations such as deviations of pelvic tilt, inadequate swing phase and knee flexion, and peak dorsiflexion in stance. Second, the study shows that the static asymmetry of pelvis and trunk was significantly associated with kinematic deviations during gait cycle such as pelvic rotation, hip abduction in swing, ROM of knee flexion, peak dorsiflexion in stance. Based on obtained results and referring to our previous findings it can be assumed that the first model of the relationship between postural deviation and gait disturbances, called ‘postural and gait complex of disorders in sagittal plane’, is related to children with bilateral CP, whereas the second model ‘postural and gait complex of disorders in coronal plane’ to children with unilateral CP. The clinical applications of this study relate to the early recognition of particular features of postural deviation using surface topography, instead of more difficult and demanding expensive tools 3-D gait analysis.

Is there a relationship between body mass index and postural deviations in overweight and obese powerlifting athletes?

Is there a relationship between body mass index and postural deviations in overweight and obese powerlifting athletes?

Sağlıklı Bireylerde Depresyona Yatkınlık Durumunun Postüre Etkisinin İncelenmesi

The aim of the study was to investigate the effect of depression tendency status on posture disorder and to see if it differs according to gender in healthy individuals. Depression tendency statuses of healthy individuals were evaluated by the Beck Depression Scale (BDS). Posture evaluation was performed by experienced physiotherapist from three directions: anterior (anterior), lateral (lateral) and posterior (posterior). A total of 151 healthy people who volunteered to participate in the study were divided into two groups according to the score they got from the BDS. Participants with BDS >10 refer depressed individuals, Group I (n = 79); participants with BDS <10 refer normal individuals, Group II (n = 72). In Group I individuals, anterior tilt of the head (p=0.04), lateral flexion of the head (p=0.01), shoulder protraction (p=0.02), scapula alata (p=0.02), kyphotic posture (p=0.02), increased lumbar lordosis (p=0.03) and pes planus (p=0.03) were found to be significantly more frequent than Group II individuals. Postural disorders such as; lateral flexion of the head (p=0.04), right shoulder depression (p=0.022), shoulder protraction (p=0.01), kyphotic posture (p=0.003) and scapula alata (p=0.01) in women of Group I were found to be statistically more frequent than in women of Group II. In men of Group I, it was found that only pes planus (p=0.04) was statistically more common than in men of Group II. According to the findings obtained in our study, depression tendency status in healthy individuals causes more common postural disorders such as anterior tilt of the head, lateral flexion of the head, shoulder protraction, kyphotic posture, scapula alata and pes planus. It was seen that the depression tendency status caused more postural deviations in women than men.

Functional parameters, wrist posture deviations and comfort: A comparison between a computer mouse and a touch pen as input devices.

Performing common computer tasks such as pointing, clicking, and dragging requires repetitive movements that cause musculoskeletal disorders in the wrists and hands. Given the growing use of touch screens and touch pens, further studies on the ergonomics of these devices are needed. This study aimed to compare a touch pen and an ordinary computer mouse in terms of movement time, error rate, wrist posture, and comfort of use. Performance parameters (movement time and error rate), wrist postures, and comfort when using a mouse and a touch pen were measured based on ISO 9241-9 standard with the help of 27 participants. For data analysis, paired t test was performed using SPSS version 22. Using the touch pen resulted in better performance parameters than using the mouse (p < 0.05). Wrist extension and flexion were lower when performing the task with the computer mouse than with the touch pen (p < 0.05). When using the touch pen to perform the task, ulnar deviation and radial deviation were lower (p < 0.05). The overall comfort was higher when using the mouse than the touch pen. Our results showed that the touch pen had better performance parameters than the ordinary mouse and also resulted in lower ulnar and radial deviations. Given the impact of habit and proficiency on users' comfort in using input devices, it is reasonable to expect users becoming more comfortable by using touch pens on the long term.

Can human posture and range of motion be measured automatically by smart mobile applications?

Human posture and Range of Motion (ROM) are important components of a physical assessment and, from the collected data, it is possible to identify postural deviations such as scoliosis or joint and muscle limitations, hence identifying risks of more serious injuries. Posture assessment and ROM measures are also necessary metrics to monitor the effect of treatments used in the motor rehabilitation of patients, as well as to monitor their clinical progress. These evaluation processes are more frequently performed through visual inspection and manual palpation, which are simple and low cost methods. These methods, however, can be optimized with the use of tools such as photogrammetry and goniometry. Mobile solutions have also been developed to help health professionals to capture more objective data and with less risk of bias. Although there are already several systems proposed for assessing human posture and ROM in the literature, they have not been able to automatically identify and mark Anatomical and Segment Points (ASPs). The hypothesis presented here considers the development of a mobile application for automatic identification of ASPs by using machine learning algorithms and computer vision models associated with technologies embedded in smartphones. From ASPs identification, it will be possible to identify changes in postural alignment and ROM. In this context, our view is that an application derived from the hypothesis will serve as an additional tool to assist in the physical assessment process and, consequently, in the diagnosis of disorders related to postural and movement changes.

The effectiveness of a comprehensive corrective exercises program and subsequent detraining on alignment, muscle activation, and movement pattern in men with upper crossed syndrome: protocol for a parallel-group randomized controlled trial

BackgroundUpper crossed syndrome (UCS) refers to specific altered muscle activation and changed movement patterns along with some postural deviations in the upper quarter of the body. This syndrome might contribute to the dysfunction of the cervicothoracic and glenohumeral joints.ObjectivesThe present study will aim to investigate the effectiveness of a comprehensive corrective exercises program (CCEP) and subsequent detraining on alignment, muscle activation and movement pattern in men with UCS.Methods/designThis is a parallel-group randomized controlled trial. Participants will be 22 men aged 18 to 28 years who are suffering from UCS. Participants in the intervention group will conduct CCEP (three times a week for 8 weeks), followed by 4 weeks of detraining. The control group will do their daily activities. Participants will be randomized (1:1) into the intervention or the control group. The primary outcome will be upper trapezius activations. Secondary outcomes consist of electromyography of middle and lower trapezius and serratus anterior muscles, scapular dyskinesis test, forward head and shoulder angles, thoracic kyphosis angle, and neck flexion pattern test.DiscussionWe propose to evaluate the effectiveness of a randomized controlled trial of a CCEP in men with UCS on their alignment, selected muscle activations, and relevant movement patterns. Results from our trial may provide new insights into the effects of exercise not only on the alignment but also on muscle activation and movement patterns that are important outcomes for people with postural malalignments and, if successful, could assist therapists in evidence-based clinical decision-making.Trial registrationIranian Registry of Clinical Trials, IRCT20181004041232N1. Registered on 26 October 2018.

Standard reference values of the upper body posture in healthy male adults aged between 41 and 50 years in Germany

Background: Classifications of posture deviations are possible when they can be compared to the standard values for healthy persons. Standard values for healthy male adults aged between 41 and 50 years are currently missing. Methods: 100 healthy volunteers (41–50 years old; 45.37 ± 3.06 years) were included in the study. Their body weight ranged from 68 to 132 kg (88.76 ± 15.93 kg), their heights from 1.64 to 2.0 m (1.81 ± 0.07 m) and the Body Mass Index (BMI) ranged from 19.0 kg/m² to 37.7 kg/m² (26.2 ± 3.96 kg/m²). A three-dimensional back scan was performed to quantify the upper back posture during habitual standing. The upper and lower limit for 95% of the tolerance regions and the left and right limit of the confidence interval were calculated. Results: The upper body posture of the subjects was close to the symmetry, or 0°, axis. There was a moderate ventral upper body inclination with a slight left lateral axial deviation and rotation of the spine to the right. An enhanced kyphotic posture was observed in the sagittal plane in the area of the thoracic spine. The shoulder and pelvis areas were almost balanced. Conclusion: Healthy males between 41 and 50 years were found to have an almost balanced posture with minimal ventral body inclination and a marginal scoliotic deviation. These values allow a comparison with other studies for control and patient data and may serve as basis in both clinical practice and scientific studies.

Quantitative assessment of posture in healthy controls and patients with Parkinson's disease

IntroductionA stooped posture is a main clinical feature of Parkinson's disease (PD). The assessment of posture is important to measure treatment effects. The aim of this study was to investigate the reliability of a standardized postural rating tool, to calculate minimal detectable change scores and to assess the role of gender and age. MethodsTwo independent raters assessed total camptocormia (TCC), upper camptocormia (UCC) and Pisa angles of 192 PD patients and 78 healthy controls (HC) with the free NeuroPostureApp©(http://www.neuroimaging.uni-kiel.de/NeuroPostureApp). Reliabilities and linear models were calculated for different effects. Three subgroups were defined based on two thresholds (mean+2SD of HC and PD): A) normal, B) presumed stooped/lateral bended posture and C) postural disorder. ResultsIntraclass correlation coefficients ranged between 0.71 and 0.95 for the interrater and test-retest reliability of the three angles. The minimal detectable change values in the PD patients were 3.7°, 6.7° and 2.1° for the TCC, UCC and Pisa angles, respectively. Men had a more stooped posture than women (p < 0.05). Patients with PD had a worse posture than HC (p < 0.001) in all three angles. For the TCC angle, 39.1% of the patients had a normal posture (<17.4°), 47.9% a presumed stooped posture (>17.4°, <30.2°) and 6.3° had camptocormia (>30.2°). ConclusionsThe NeuroPostureApp© is reliable. Our results confirmed gender differences and the progression of postural deviation in PD patients with age and empirically support the ≥30° TCC angle as a defining criterium for camptocormia. Diagnostic criteria for UCC and Pisa syndrome should be further explored in future studies.

Prevalence of Symptoms of Temporomandibular Disorders among Dental Patients- A KAP Survey among Dental Practitioners

Temporomandibular disorders (TMD) are a group of conditions affecting the temporomandibular joint, the muscles of mastication and its associated structures. Temporomandibular disorders are multifactorial in nature with associated dental, psychological and medical conditions. The most commonly associated factors are emotional tension, postural deviation, masticatory muscular dysfunction, occlusal interferences, teeth loss, internal and external changes in TMJ. To determine the Prevalence of symptoms of Temporomandibular Disorders among Dental Patients - A KAP survey among dental practioners. A questionnaire with eight questions regarding the prevalence of symptoms of temporomandibular disorders among dental patients in their dental practice was prepared and sent to dental practioners. The data was analysed statistically for significance and correlations. Statistical analysis was performed using the SPSS software. The dental practioners reported among their patients 12 % had pain very often during jaw opening, 37 % had headaches frequently, 15 % accounting for habit of clenching, 19% with difficulty in mouth opening and 9 % pain during mastication. The dental practitioners who participated in the survey found that most of the dental patients had one or more symptoms of TMD. Among these symptoms, the most commonly occurring are the headaches followed by pain on jaw opening and difficulty in mouth opening. On assessing the results of the survey, the dental practioners had observed that most of the patients with dental issues were unaware of having TMJ disorders and adverse effects they could experience in future if left untreated.

A study to identify any relationship between hand dominance and restrictions in range of motion in the protracted shoulder

BackgroundShoulder disorders are considered to be the most common musculoskeletal disorders. Shoulder pain is often linked to movement repetition, uncomfortable postures, prolonged maintenance of static postures and muscular fatigue. Excessive or abnormal muscle tension, are adapted when inefficient or abnormal postures are maintained over time, can lead to musculoskeletal dysfunction causing pain or movement restriction. Hence this study intent to identify movement dysfunction in the shoulder having postural deviation and relationship of the dysfunction to the functional dominance of the extremity.The aim is to identify any relationship between hand dominance and restrictions in range of motion in the protracted shoulder.ObjectiveTo find the restrictions in the range of motion in protracted shoulder and its impact in shoulder function and to find a relationship between altered posture of the shoulder and the hand dominance.Methods60 subjects with altered shoulder posture were selected based on the inclusion and exclusion criteria.Outcome MeasuresThe outcome measures used were scapular protraction formula and shoulder joint mobility using goniometer.Statistical AnalysisThe collected data was tabulated and analysed using descriptive and inferential statistics. To all parameters mean and standard deviation (SD) were used. Independent t-test was used to analyse significant changes between dominant and non-dominant shoulder.ResultsStatistical analysis of scapular protraction and range of motion (ROM) of shoulder flexion and abduction revealed that there is a High statistical significant difference of p&lt;0.0001 seen between dominant and non-dominant upper extremity.In this study there is a significant difference in the end range shoulder flexion and abduction range of motion between dominant and non- dominant upper extremity, while measuring scapular protraction, which is clinically useful to the therapist to diagnose the altered posture of the shoulder.

Correction of Posture Deviations in the Sagittal Plane Using the Pilates Method

Posture is commonly perceived as the relationship between the segments of the human body upright. Certain parts of the body such as the cephalic extremity, neck, torso, upper and lower limbs are involved in the final posture of the body. Musculoskeletal instabilities and reduced postural control lead to the installation of nonstructural posture deviations in all 3 anatomical planes. When we talk about the sagittal plane, it was concluded that there are 4 main types of posture deviation: hyperlordotic posture, kyphotic posture, rectitude and "sway-back" posture.Pilates method has become in the last decade a much more popular formof exercise used in rehabilitation. The Pilates method is frequently prescribed to people with low back pain due to their orientation on the stabilizing muscles of the pelvis. Pilates exercise is thus theorized to help reactivate the muscles and, by doingso, increases lumbar support, reduces pain, and improves body alignment.

Limited evidence of physical therapy on balance after stroke: A systematic review and meta-analysis.

BackgroundStroke results in balance disorders and these directly affect autonomy and quality of life. The purpose of this systematic review and meta-analysis was to determine the efficacy of physical therapy (PT) on balance and postural control after stroke.MethodsWe included all randomized controlled trials assessing the efficacy of PT on balance and postural control in adult patients after stroke without language restriction. Medline, Embase/Scopus, Cochrane Central Register of Controlled Trials, PEDro, Pascal, and Francis databases were searched until January 2019. Primary outcomes were balance (Berg Balance scale and Postural Assessment Scale for Stroke) and postural control with postural deviation or stability measurement in sitting or standing static evaluation. A pair of independent reviewers selected studies, extracted data, and assessed risk of bias. Meta-analyses with subgroups (categories of PT, time post-stroke, and lesion location) and meta-regression (duration of PT) were conducted.ResultsA total of 145 studies (n = 5912) were selected from the 13,123 records identified. For balance, evidence was found in favor of the efficacy of functional task-training alone (standardized mean difference 0.39, 95% confidence interval [0.09; 0.68], heterogeneity I2 = 63%) or associated with musculoskeletal intervention and/or cardiopulmonary intervention (0.37, [0.19; 0.55], I2 = 48%), electrostimulation (0.91, [0.49; 1.34], I2 = 52%) immediately after intervention, compared to sham treatment or usual care (ST/UC). For postural deviation eyes open, assistive devices were more effective than no treatment (-0.21, [-0.37; -0.05], I2 = 0%) immediately after intervention; for postural stability eyes open, functional task-training and sensory interventions were more effective than ST/UC (0.97, [0.35; 1.59], I2 = 65% and 0.80, [0.46; 1.13], I2 = 37% respectively) immediately after intervention.ConclusionsFunctional task-training associated with musculoskeletal intervention and/or cardiopulmonary intervention and sensory interventions seem to be immediately effective in improving balance and postural stability, respectively. The heterogeneity of PT and the weak methodological quality of studies limited the interpretation and the confidence in findings.

A laser scanning posture optimization method to reduce the measurement uncertainty of large complex surface parts

Non-contact laser scanning is widely used in aircraft parts inspection and components assembly, especially for the dimensional error of complex structural parts. Careful scan path planning can greatly improve the measurement accuracy and efficiency of scanning. This paper presents a methodology to solve the design and optimization problems of scanning posture. The scanning quality is improved by reducing measurement uncertainty to obtain the optimum posture angle and spatial position for scanning. A posture coordinate system is established to obtain the posture angle deviation between the current scanning posture and the principal direction of all points in the corresponding measuring area, which quantifies the measurement uncertainty of the scanning area. The posture adjustment interval is defined according to the limit scanning envelope to search for the feasible direction and position of the scanner, and the measurement uncertainty of the scanning area is reduced by optimizing the posture angles iteratively. We demonstrate the effectiveness of the proposed method by comparing it with other posture planning algorithms.

Posture of rugby league players and its relationship to non-contact lower limb injury: A prospective cohort study

ObjectiveThis study aimed to identify posture deviations in rugby league players, and to observe relationships between posture and the incidence of non-contact lower limb injury. DesignProspective cohort. SettingLaboratory and on-field. ParticipantsJunior representative, semi-professional and professional rugby league players (n = 207). Main outcome measuresStatic posture scores from photographs (Watson and MacDonncha tool) in pre-season; non-contact lower limb injury surveillance and exposure data. MethodsChi-square and logistic regression analyses were used to observe relationships between postural components and the incidence of non-contact lower limb injury. Results8.7% of players sustained a quadriceps injury; 7.2% sustained a calf injury. Semi-professional and professional players had the highest injury rates. The most common posture deviations were having a forward shoulder position (46.9%), a forward head position (33.3%), a varus knee interspace (32.9%) or a lumbar lordosis (30.9%). A moderate C-scoliosis deviation was associated with a decrease in injury risk (OR 1.57 95% CI 1.00-2.46 p = 0.052). Included in the model was player weight, which was associated with an increased risk of injury (OR 1.04 95% CI 1.01-1.07 p = 0.010). ConclusionsAlthough postural deviations are common in rugby league players, given the lack of association with injury, they may not warrant intervention.

Is the manual following response an attempt to compensate for inferred self-motion?

If the surrounding of a visual target unexpectedly starts to move during a fast goal-directed hand movement, the hand reflexively moves along with it. This is known as the ‘manual following response’. One explanation for this response is that it is a compensation for inferred self-motion in space. Previous studies have shown that background motion gives rise to both postural responses and deviations in goal-directed hand movements. To evaluate whether compensation for inferred self-motion is responsible for the manual responses we examined whether galvanic stimulation of the vestibular system would give rise to similar deviations in hand movements. Standing participants tried to quickly tap on targets that were presented on a horizontal screen. Participants could infer self-motion on some of the trials, either from galvanic vestibular stimulation or from background motion. Both perturbations took place during the hand movement. It took both the head and hand about 45 ms longer to respond to background motion than to respond to galvanic stimulation. The head responded in a similar manner to both types of perturbations. The hand responded about as expected to galvanic stimulation, but much more vigorously to background motion. Thus, the manual response to background motion is probably not a direct consequence of trying to compensate for inferred self-motion. Perhaps the manual following response is a consequence of an error in binding motion information to objects.

Lower limb rehabilitation using multimodal measurement of sit-to-stand and stand-to-sit task

Purpose Assistive and rehabilitation devices are dependent upon detecting the user intent through physiological and kinematics changes. Rising from a chair and vice-versa have been less investigated for the purpose of rehabilitation-aids. This study investigates the muscle activation along with trunk and knee biomechanics in sagittal plane during sit-to-stand and stand-to-sit transfer. Method Nine healthy participants (age 25.67 ± 3.27 years) were measured for flexion/extension of knee and trunk, and for surface electromyography (EMG) of vastus lateralis (VL) and biceps femoris (BF) of both the legs at a speed of 100 beats per minute while performing sit-to-stand and stand-to-sit task. Results The knee flexion angles at peak EMG-RMS (root mean square envelope of EMG) were significantly different for the two tasks (p = 0.002). Also, for each muscle, EMG-RMS peak was obtained at significantly different knee angle within the same task (p = 0.046). EMG work done (WD) was also found to be significantly different for the intervened muscles (p = 0.002). Conclusions Trunk flexion together with VL showed an earlier onset in sit-to-stand task, which might form an important modality for detecting human intention to perform the activity. However, for stand-to-sit task, some other muscle group in conjunction to BF may be useful for detecting the human intention. The understanding from the study could be used as a first step in devising multimodal control for assistive devices aiding sit-to-stand and stand-to-sit transfers. That would be a novel approach to fuse the data of postural deviation into the EMG signal to achieve lower limb rehabilitation or in prosthetic control. Implications for rehabilitation Multi-modal sensor fusion can be used for realtime monitoring of patient biomechanics. Development of control algorithms for assistive devices aiding sit-stand transfers. Sensor fusion will help in achieving greater robotic compliance rehabilitation.

O PADRÃO POSTURAL ENTRE OS ALUNOS ATIVOS E SEDENTÁRIOS NO ENSINO FUNDAMENTAL

The postural pattern of kids must be essentially preserved, because it is in this phase that they develop the most, and at the same time, their bodies are in structural accommodations. Nowadays, due to technological advance, majority of children have become sedentary, which affects their anatomical composition, impairing their health. Therefore, the goal of this study was to identify the postural of active kids and sedentary kids in elementary school. Were used is students at Professora Hilda RomaziniMeloSchool, União da Vitória – PR, in the year 2018. The sample was composed of kids of both sexes, between the ages of 8 to 10 years old. The data collection instrument used was Pate’s formulary, published by Mota, 2012. In order to do the postural assessment, it was used a simetograph. At the end of the study, it was observed that more than 70 percent of the students had any kind of postural deviation; as the amount of physical activity increased among the students, it was possible to notice that the development of their postural patterns became better. All of the alterations that were found are predisposed to correction by a muscular strengthening and stretching program properly accompanied and oriented by a Physical Education professional.

Review of Forward-Head Posture and Vestibular Deficits in Older Adults

Forward-head posture (FHP) is a common postural deviation associated with older age, cervical muscle weakness, poor balance, anteriorly displaced center of mass, increased postural sway and fall risk, impaired cervical proprioception, and possibly vestibular dysfunction. Studies have found increased fall risk in older adults with FHP but have not identified a casual reason for this relationship. This review aims to examine the links between (FHP) and vestibular deficits. While assessment of overall posture, including FHP, is a common component of a physical therapy evaluation, a standardized method of clinical measurement for FHP is lacking. The craniovertebral angle (CVA) appears to be the most reliable method, with FHP defined as less than or equal to 44–53 degrees. Studies where FHP is measured using the CVA appear to be more accurate in identifying associations between this postural deviation and factors that impact postural control in older adults, such as balance and cervical proprioception. Limited studies have found FHP to be associated with duration of clinical symptoms of vestibular disease. FHP also heightens age-related increases in anterior-posterior postural sway. Compelling evidence exists that links FHP with vestibular deficits, increased fall risk, and impaired cervical proprioception. Further research using CVA and a consistent definition of FHP is needed to answer this question and develop clinical practice guidelines.