There is great interest in thoracic kyphosis as it is thought to be a contributor to neck pain, neck disability, and sensorimotor control measures; though this has not been completely inves-tigated in treatment or case control studies. This case control design investigated participants with non-specific chronic neck pain. Eighty participants with a defined hyper-kyphosis (> 55°) were compared to 80 matched participants with normal thoracic kyphosis (< 55°). Participants were matched for age and neck pain duration. Hyper-kyphosis was further categorized into two distinct types: postural kyphosis (PK) and Scheuermann’s kyphosis (SK). Posture measures included formetric thoracic kyphosis and the craniovertebral angle (CVA) to assess forward head posture. Sensorimotor control was assessed by the following measures: smooth pursuit neck torsion test (SPNT), overall stability index (OSI) and left and right rotation repositioning accuracy. A measure of autonomic nervous system function included the amplitude and latency of skin sympathetic response (SSR). Differences in variable measures were examined using the Student’s t-test to compare the means of continuous variables between the two groups. Pearson correlation was used to evaluate the relationship between participant’s thoracic kyphosis magnitude (in each group separately and as an entire population) and their CVA, SPNT, OSI, head repositioning ac-curacy, and SSR latency and amplitude. Hyper-kyphosis participants had a significantly greater neck disability index compared to the normal kyphosis group (p < 0.001) with the SK group having greatest disability (p < 0.001). Statistically significant differences between the two kyphosis groups and the normal kyphosis group for all the sensorimotor measured variables were identified with the SK group having the most decreased efficiency of the measures in the hyper-kyphosis group, including: SPNT, OSI and left and right rotation repositioning accuracy. Also, there was a signif-icant difference in neurophysiological findings for SSR amplitude (entire sample of kyphosis vs. normal kyphosis, p < 0.001), but there was no significant difference for SSR latency (p = .07). The CVA was significantly greater in the hyper-kyphosis group (p < 0.001). The magnitude of the thoracic kyphosis correlated with worsening CVA (with the SK group having the smallest CVA; p < 0.001) and the magnitude of the decreased efficiency of the sensorimotor control measures and the amplitude and latency of the SSR. The PK group, overall, showed the greatest correlations between thoracic kyphosis and measured variables. Participants with hyper-thoracic kyphosis exhibited abnormal sensorimotor control and autonomic nervous system dysfunction compared to those with normal thoracic kyphosis.

This study assessed the relationship between body posture displacements and cardiopulmonary function test (CPET) and skill related physical fitness tests. One hundred male (60%) and female collegiate athletes (22.2 ± 4yrs) with a normal body mass index (BMI up to 24.9) were assessed via the PostureScreen Mobile app to quantify postural displacements as head, thorax and pelvis rotations and translations. CPET and physical performance tests including the agility T-test, the vertical jump test, the stork static balance test (SSBT) and the dynamic Y-balance test (YBT) were performed. Spearman correlation (r) and p-values are reported. Postural parameters were found to have moderate-to-high associations with CPET and the agility test, moderate correlations with the vertical jump test and the SSBT (head and pelvic postures only), and weak correlations with the YBT. As postural parameters were more asymmetric, both CPET and performance skills scores were worse. For examples: 1) a medium positive correlation was found between cranio-vertebral angle (CVA) and vertical jump test (r = 0.54; p-value &lt; 0.001) and SSBT (r = 0.57; p-value &lt; 0.001), while a strong negative correlation was found between CVA and agility test (r = -0.86; p-value &lt; 0.001). 2) A strong positive correlation was found between CVA and oxygen uptake efficiency slope, load watts VO2 at VT, VO2 / kg, load watts at respiratory compensation point (RCP), (r = 0.65 and r = 0.71; p &lt; 0.001). Conversely, a significant negative correlation was found between CVA and VE / VO2 at VT (r = -0.61; p &lt; 0.001). Postural rotations and translations of the head, thorax and pelvis were statistically correlated with physical performance skills and CPET in young collegiate athletes. There were moderate-to-high associations with cardiopulmonary functions and agility tests, moderate correlations with the vertical jump test, and weak correlations with the YBT. Postural alignment may be important for optimal physical performance and optimal cardiopulmonary function. Further research is necessary to elucidate reasons for these correlations as found in our sample of young and healthy athletes.

This study assessed the relationship between head posture displacements and biomechanical parameters in three different tasks. One hundred male and female students (20 ± 3yrs) were assessed via the PostureScreen Mobile app to quantify postural displacements of head rotations and translations including: 1) the cranio-vertebral angle (CVA) (°), 2) anterior head translation (AHT) (cm), 3) lateral head translation in the coronal plane (cm), and 4) lateral head side bending (°). Biomechanical parameters during gait and jumping were measured using the G-Walk sensor. The assessed gait spatiotemporal parameters were cadence (steps / min), speed (m / s), symmetry index, % left and right stride length (% height), and right and left propulsion index. The pelvic movement parameters were: 1) tilt symmetry index, 2) tilt left and right range, 3) obliquity symmetry index, 4) obliquity left and right range, 5) rotation symmetry index, and 6) rotation left and right range. The jump parameters measured were: 1) flight height (cm), 2) take off force (kN), 3) impact Force (kN), 4) take off speed (m / s), 5) peak speed (m / s), 6) average speed concentric phase (m / s), 7) maximum concentric power (kW), 8) average concentric power (kW) during the counter movement jump (CMJ), and 9) CMJ with arms thrust (CMJAT). At a significance-level of p ≤ 0.001, moderate to high correlations (0.4 &lt; r &lt; 0.8) were found between CVA, AHT, lateral translation head and all the gait and jump parameters. Weak correlations (0.2 &lt; r &lt;  0.4) were ascertained for lateral head bending and all the gait and jump parameters except for gait symmetry index and pelvic symmetry index, where moderate correlations were identified (0.4 &lt; r &lt; 0.6). The findings indicate moderate to high correlations between specific head posture displacements, such as CVA, lateral head translation and AHT with the various gait and jump parameters. These findings highlight the importance of considering head posture in the assessment and optimization of movement patterns during gait and jumping. Our findings contribute to the existing body of knowledge and may have implications for clinical practice and sports performance training. Further research is warranted to elucidate the underlying mechanisms and establish causality in these relationships, which could potentially lead to the development of targeted interventions for improving movement patterns and preventing injuries.

A multicenter, prospective cohort study conducted in 5 physiotherapy clinics in the UAE from January 2021 to March 2023 to assess coronal lumbar spine radiographic parameters as a predictor of conservative therapy outcomes in patients suffering from low back and leg pain due to lumbar disc herniation (HNP). Ninety patients (mean age 44 yrs., 54% male) with lumbar HNP underwent conservative therapy. All participants received lumbar spine MRI and radiography to assess spine alignment. Interventions included specific exercises, diathermy, traction, education, a home-based exercise pro-gram, and medications. Detailed demographic data was collected. Follow-up was 6-months after discharge. A successful outcome was based on a minimum of the following four outcomes: (1) reduction of pain by 17.5 points (0–100 NRS); (2) fatigue reduction by 7.5 points; (3) distress reduction by 5 points; and (4) interference reduction by 9.5 points. At 6-month follow-up it was found that patient age, education, and radio-graphic determined lumbosacral angle measures significantly affected the odds of a successful outcome. Increasing age 1-year significantly decreased the odds of success of improving pain, fatigue (OR = 0.85, p = 0.016) and interference scores (OR = 0.89, p = 0.042) by 15%, 15%, and 11% respectively. Lower education significantly increased the odds of success for improving pain, fatigue, and interference by 26.18, 26.18, and 7.5 (p = 0.006, = 0.006, and = 0.029 respectively). Increasing (worsening) the radiographic lumbosacral angle by each 1° significantly reduced the odds of success for improving pain, fatigue, distress, and interference by 3.52, 3.52, 27.99, and 2.55, respectively (p < 0.001, < 0.001, = 0.003, = 0.001). Our findings indicate that younger age, less education, and better coronal radiological lumbar spine alignment all had a substantial impact on the likelihood of success of 6-month outcomes in patients suffering from chronic lower back pain and radiculopathy due to HNP.

Background: Previous investigations have found a correlation between abnormal curvatures and a variety of patient complaints such as cervical pain and disability. However, no study has shown that loss of the cervical curve is a direct result of exposure to a motor vehicle collision (MVC). This investigation presents a retrospective consecutive case series of patients with both a pre-injury cervical lateral radiograph (CLR) and a post-injury CLR after exposure to a MVC. Computer analysis of digitized vertebral body corners on CLRs was performed to investigate the possible alterations in the geometric alignment of the sagittal cervical curve. Methods: Three spine clinic records were reviewed, over a 2-year period, looking for patients where both an initial lateral cervical x-ray and an examination were performed prior to the patient being exposed to a MVC; afterwards an additional exam and radiographic analysis were required. A total of 41 patients met the inclusion criteria. Examination records of pain intensity on numerical pain rating scores (NPRS) and neck disability index (NDI), if available, were analyzed. The CLRs were digitized and modeled in the sagittal plane using curve fitting and the least squares error approach. Radiographic variables included total cervical curve (ARA C2-C7), Chamberlain’s line to horizontal (skull flexion), horizontal translation of C2 relative to C7, segmental translations (retrolisthesis and anterolisthesis), and circular modelling radii. Results: There were 15 males and 26 females with an age range of 8-65 years. Most participants were drivers (28) involved in rear end impacts (30). The pre-injury NPRS was 2.7 while the post injury was 5.0; p &lt; 0.001. The NDI was available on 24 /41 (58.5%) patients and was found to increase following exposure to the MVC: 15.7% to 32.8%, p &lt; 0.001. An altered cervical curvature was identified following exposure to MVC, characterized by an increase in radius of curvature and an approximate 8° reduction of lordosis from C2-C7; p &lt; 0.001. The mid cervical spine (C3-C5) showed the greatest curve reduction with localized mild kyphosis at these levels on average. Several participants developed segmental translations that approached the instability value of translation &gt; 3.5mm. Conclusions: Abnormalities of cervical lordosis occurred following exposure to a MVC. The average loss of cervical curvature was 8° from C2-C7, with mild flexion of the mid cervical segments. Snap through type or dynamic buckling during the MVC may explain our findings. The primary contribution of this study to the motor vehicle collision literature is that altered cervical lordosis may result from MVC exposures and the consequences of an altered cervical alignment, in turn, may lead to future pain, disability and decreased health-related quality of life.