Cervical and shoulder postural assessment of adolescents between 15 and 17 years old and association with upper quadrant pain
Open accessAbstract
BACKGROUND: There is sparse literature that provides evidence of cervical and shoulder postural alignment of 15 to 17-year-old adolescents and that analyzes sex differences. OBJECTIVES: To characterize the postural alignment of the head and shoulder in the sagittal plane of 15 to 17-year-old Portuguese adolescents in natural erect standing and explore the relationships between three postural angles and presence of neck and shoulder pain. METHOD: This cross-sectional study was conducted in two secondary schools in Portugal. 275 adolescent students (153 females and 122 males) aged 15 to 17 were evaluated. Sagittal head, cervical, and shoulder angles were measured with photogrammetry and PAS software. The American Shoulder and Elbow Surgeons Shoulder Assessment (ASES) was used to assess shoulder pain, whereas neck pain was self-reported with a single question. RESULTS: Mean values of sagittal head, cervical, and shoulder angles were 17.2±5.7, 47.4±5.2, and 51.4±8.5º, respectively. 68% of the participants revealed protraction of the head, whereas 58% of them had protraction of the shoulder. The boys showed a significantly higher mean cervical angle, and adolescents with neck pain revealed lower mean cervical angle than adolescents without neck pain. 53% of the girls self-reported regular neck pain, contrasting with 19% of the boys. CONCLUSIONS: This data shows that forward head and protracted shoulder are common postural disorders in adolescents, especially in girls. Neck pain is prevalent in adolescents, especially girls, and it is associated with forward head posture.
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The age group (adolescents) and the unequal sample size between groups might have had an effect on the results of one study.
“However, the age group (adolescents) and the unequal sample size between groups might have had an effect on the results of this study [35].”
From The Relationship Between Forward Head Posture and Neck Pain: a Systematic Review and Meta-Analysis (2019) · cites this paper as [35]
The Methods (Participants) identify the participants as adolescents aged 15–17, and Results (Table 2) show unequal group sizes, including 170 without neck pain versus 105 with neck pain. The paper does not say that age or unequal group sizes affected its results; its Limitations section discusses other constraints instead. Page numbers are unavailable in our copy. (LLM, conf=0.82)
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- Authors
- Ruivo, R. M., Pezarat-Correia, P., & Carita, A. I.
- Affiliations
- University of Lisbon (PT)
- Venue
- Brazilian Journal of Physical Therapy
- Publisher
- FapUNIFESP (SciELO)
- Published
- 2014-08
- Volume
- 18
- Issue
- 4
- Pages
- 364-371
- ISSN
- 1413-3555 (ISSN-L)
- PMC
- PMC4183261
- OpenAlex
- W2068934288
- Cited by
- 168
- References
- 36
- Citations by year
- 2026: 17 · 2025: 18 · 2024: 13 · 2023: 15 · 2022: 25 · 2021: 21 · 2020: 11 · 2019: 19 · 2018: 7 · 2017: 10 · 2016: 4 · 2015: 8
- FWCI
- 10.88
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- cc-by-nc
- Locations
- Brazilian Journal of Physical Therapy (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- LA Referencia (Red Federada de Repositorios Institucionales de Publicaciones Científicas) (publishedVersion, other-oa)
- Americanae (AECID Library) (submittedVersion, cc-by-nc)
- Redalyc (Universidad Autónoma del Estado de México) (submittedVersion)
- Topics
- Social Sciences › Psychology › Social Psychology › Ergonomics and Musculoskeletal Disorders
- Health Sciences › Medicine › Surgery › Shoulder Injury and Treatment
- Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
- Keywords
- cervical posture, shoulder posture, forward head posture, adolescents, neck pain, shoulder pain, sex differences, sagittal plane, postural angles, photogrammetry, ASES
- MeSH terms
- Adolescent, Cross-Sectional Studies, Female, Humans, Male, Neck, Posture, Sex Factors, Shoulder, Neck Pain, Shoulder Pain
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