A comparison between estimated and registered natural head posture

Using tracings of facial profiles, four observers made two independent, subjective estimations of natural head posture (NHP) in 28 adults. The results of these estimations were compared with recordings of NHP obtained through photographic registration of the same subjects. Only minor average differences (between 0 and 1.4 degrees) were found between the two methods. The differences between estimated and registered head posture found at the first and second observation, were positively correlated for both intra- and inter-observer registrations (r = 0.59-0.80 and r = 0.50-0.71, respectively). The inclination of the basion-nasion line was measured; first, in relation to the photographically registered horizontal line and, secondly, in relation to the horizontal line derived from the estimation of NHP. Both methods of measurement gave similar mean values and standard deviations. A panel comprising 18 persons was asked to compare the head orientations of two subjects in whom a marked difference between estimated and registered NHP had been recorded. In the majority of these comparisons, the profiles orientated according to the subjective estimation were judged to have a more 'natural posture' than those orientated by the photographic method. This unexpected finding is discussed.