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Validity of a qualitative visual method for diagnosing forward head posture.

Shohei Shibasaki1, Tomonori Kishino2, Yoriko Sei1

  • 1Department of Medical Technology, Kyorin University Faculty of Health Sciences, Tokyo, Japan.

Musculoskeletal Science & Practice
|February 19, 2025
PubMed
Summary

A new visual method for diagnosing forward head posture (FHP) showed similar detection rates to the craniovertebral angle (CVA) method. However, the visual method

Keywords:
Craniovertebral angle (CVA)Forward head posture (FHP)MethodValidity

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Area of Science:

  • Biomechanics
  • Posture Analysis
  • Human Movement Science

Background:

  • Forward head posture (FHP) is typically diagnosed using the quantitative craniovertebral angle (CVA) measurement.
  • A novel qualitative visual method for FHP assessment has been proposed, but its diagnostic validity requires confirmation.
  • This study validates a visual FHP assessment against established CVA measurement standards.

Purpose of the Study:

  • To determine the validity of a new visual method for diagnosing forward head posture (FHP).
  • To compare the diagnostic accuracy of the visual method against quantitative craniovertebral angle (CVA) measurements.
  • To assess the positive predictive values of the visual method in relation to CVA criteria.

Main Methods:

  • Forward head posture (FHP) was assessed using both photographic craniovertebral angle (CVA) measurements (criteria <53° or <55°) and a visual wall test.
  • The visual method identified FHP if the participant's head did not touch the wall when standing in a specific posture.
  • Prevalence rates and positive predictive values were calculated and compared between the visual and CVA methods in healthy young adults.

Main Results:

  • The visual method identified FHP in 41% of participants, closely approximating CVA methods (34% at 53°, 50% at 55°).
  • Positive predictive values for the visual method were 0.42 (for CVA <53°) and 0.61 (for CVA <55°).
  • The visual method showed a higher FHP detection rate in males with higher body mass index (BMI).

Conclusions:

  • While the visual method's detection rates align with CVA measurements, its relatively low positive predictive values indicate lower diagnostic accuracy.
  • The visual method's inferiority may be partly attributed to its increased sensitivity to FHP in males with elevated BMI.
  • Craniovertebral angle (CVA) measurements remain a more reliable standard for diagnosing forward head posture (FHP).