Evaluation of Forward Head Posture in School-Going Students and its Association with Shoulder Pain
DOI:
https://doi.org/10.51253/pafmj.v76iSUPPL-1.12722Keywords:
Disability, Posture, Shoulder Pain, StudentsAbstract
Objective: To determine the frequency of forward head posture (FHP) and its association with shoulder pain in school-going students.
Study Design: Cross-sectional study.
Place and Duration of Study: University of Lahore with fieldwork in government and private schools in Sialkot, Pakistan from Jan to Jun 2024.
Methodology: The sample of one hundred and eleven participants was selected by convenient sampling and consent was taken before the study. The students of 10 to 14 years of age, both genders, 5th to 8th class, were included in the study. Those with recent injuries in the neck or shoulder region or having any congenital abnormality were excluded. Forward head posture was evaluated using a meter scale by measuring the distance from the tragus of the ear to a point 25cm away from the plumb line. Shoulder pain was assessed using the Shoulder Pain and Disability Index (SPADI). Pearson’s chi-square test was used to find the association between forward head posture and shoulder pain.
Results: The mean age of participants was 12.42±1.44 years. About 64(57.65%) had a forward head posture, and 42(37.8%) had a moderate level of FHP. Around 39(35.1%) had mild shoulder pain and disability. Forward head posture was found to be significantly associated with shoulder pain (p<0.001).
Conclusion: The forward head posture is common among school-going children, and it is associated with shoulder pain and related disability.
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References
1. Mahmoud NF, Hassan KA, Abdelmajeed SF, Moustafa IM, Silva AG. The Relationship Between Forward Head Posture and Neck Pain: a Systematic Review and Meta-Analysis. Curr Rev Musculoskelet Med 2019; 12(4): 562–77.
https://doi.org/10.1007/s12178-019-09594-y 1
2. Verma S, Shaikh J, Mahato R, Sheth M. Prevalence of forward head posture among 12-16-year-old school going students - A cross-sectional study. Appl Med Res 2018; 4(1): 1-4.
https://doi.org/10.5455/amr.20180805064752
3. Lee KJ, Han HY, Cheon SH, Park SH, Yong MS. The effect of forward head posture on muscle activity during neck protraction and retraction. J Phys Ther Sci 2015; 27(3): 977–979.
https://doi.org/10.1589/jpts.27.977
4. Kim HJ, Lee D. The study of the correlation between forward head posture and shoulder pain: A STROBE-compliant cross-sectional study. Phys Ther Rehabil Sci 2021; 30; 10(3): 251–256.
https://doi.org/10.14474/ptrs.2021.10.3.251
5. Cuschieri SJSjoa. The STROBE guidelines. 2019; 13(Suppl 1): S31-S4.
6. Chandoliya H, Chorsiya V, Kaushik D. Prevalence and Levels of Forward Head Posture among School Going Children. Am J Epidemiol 2021; 5(1): 022–025.
https://doi.org/10.37871/ajeph.id44
7. Zehra H, Tariq A, Raja AJ. Prevalence of Forward Head Posture among School Children Using Smartphones in Rawalpindi: Forward Head Posture and Smartphone Use. J Modern Health Rehabil Sci 2024; 1(2): 12.
8. Gheysvandi E, Dianat I, Heidarimoghadam R, Tapak L, Karimi-Shahanjarini A, Rezapur-Shahkolai F et al. Neck and shoulder pain among elementary school students: prevalence and its risk factors. BMC Public Health 2019; 19(1): 1299.
https://doi.org/10.1186/s12889-019-7706-0
9. Karthik V, Arulpragassame S, Felix A, Parkavi K. Prevalence of forward head posture and its association with gender, BMI and neck pain among college-going students–A cross-sectional study. J Positive School Psychol 2022; 6(9): 5084-5090.
10. Glinianaia SV, McLean A, Moffat M, Shenfine R, Armaroli A, Rankin J et al. Academic achievement and needs of school‐aged children born with selected congenital anomalies: A systematic review and meta‐analysis. Birth Defects Res 2021; 113(20): 1431–1462. https://doi.org/10.1002/bdr2.1961
11. Anwer S, Alghadir AH, Al-Eisa ES, Iqbal ZA. The relationships between shoulder pain, range of motion, and disability in patients with shoulder dysfunction. J Back Musculoskelet Rehabil 2018; 31(1): 163–167.
https://doi.org/10.3233/BMR-169762
12. Christensen KB, Thorborg K, Hölmich P, Clausen MB. Rasch validation of the Danish version of the shoulder pain and disability index (SPADI) in patients with rotator cuff-related disorders. Qual Life Res 2019; 28(3): 795–800.
https://doi.org/10.1007/s11136-018-2052-8
13. Rezaei M, Salahzadeh Z, Karimipour B, Reza Azghani M, Sarbakhsh P, Adigozali H, et al. Postural Analysis of The Trunk, Pelvic Girdle and Lower Extremities in The Sagittal Plane in People with and without Forward Head Posture. Muscles Ligament Tendon J 2022; 12(02): 253-260.
https://doi.org/10.32098/mltj.02.2022.21
14. Szczygieł E, Waśniowski D, Chmiel J, Golec J. Is the forward head posture a health problem affecting children and adolescents? J Kinesiol Exerc Sci 2022; 17; 32(97): 37–44.
https://doi.org/10.5604/01.3001.0015.8788
15. Vaghela NP, Parekh SK, Padsala D, Patel D. Effect of backpack loading on cervical and sagittal shoulder posture in standing and after dynamic activity in school-going children. J Family Med Prim Care 2019; 8(3): 1076–1081.
https://doi.org/10.4103/jfmpc.jfmpc_367_18
16. Torres-Cusihuaman L, Bravo-Cucci S. Association between Thoracic Kyphosis and Forward Head Posture in Teenagers: An Analytical Cross-Sectional Study. Middle East J Rehabil Health Stud 2023; 10(4): e134579.
https://doi.org/10.5812/mejrh-134579
17. Wiguna NP, Wahyuni N, Indrayani AW, Wibawa A, Thanaya S. The relationship between smartphone addiction and forward head posture in junior high school students in North Denpasar. J Epidemiol Kesehatan Komunitas 2019; 4(2): 84-89.
https://doi.org/10.14710/jekk.v4i2.5268
18. Akbari M, Zohreh Maghsoomi M. Screening of vertebral column deviations in 7 to 9-year-old students in southern Tehran: a cross-sectional study. Razi J Med Sci 2019; 26(2): 93-100.
19. Mandrekar S, Chavhan D, Shyam AK, Sancheti PK. Effects of carrying school bags on cervical and shoulder posture in static and dynamic conditions in adolescent students. Int J Adolesc Health 2022; 34(1): 20190073.
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