Authors: Gabriela Natália Ferracini, PT, MD
Study Design
Case-control study.
Background
Previous studies have assessed forward head posture in patients with migraine using photographs. To date, no study has compared postural differences using both radiographs and photographs.
Objective
To determine the differences in head extension posture between women with migraine and healthy women assessed with radiographic and photographic measures.
Methods
Thirty-three women (mean ± SD age, 32 ± 11.3 years) with migraine and 33 matched controls (age, 33 ± 12.6 years) participated. Radiographs were used to measure the high cervical angle (HCA), the angle between the most inferior line from the occipital surface to the posterior portion of C1 and the posterior surface of the odontoid process of C2, and the vertical distance between C0 and C1 (C0–C1). Photographs and commercially available software were used to assess the craniovertebral angle (CVA).
Results
None of the outcomes differed significantly between women with migraine and control participants. Outcomes for women with migraine were HCA, 66.1° (95% confidence interval [CI]: 64.2°, 68.1°); CVA, 46.1° (95% CI: 45.0°, 47.1°); and C0–C1, 8.5 mm (95% CI: 7.7, 9.2). Outcomes for the control group were HCA, 67.9° (95% CI: 66.5°, 69.3°); CVA, 44.5° (95% CI: 43.2°, 45.7°); and C0–C1, 8.7 mm (95% CI: 7.9, 9.4). Relationships between the frequency (r = −0.42, P = .01, R2 = 10%) of migraine and the HCA were found.
Conclusion
This study demonstrated that women with migraine did not exhibit forward head posture compared to women with no history of headache in either radiographic or photographic postural analysis. However, there was a weak association of the frequency of migraine attacks with a variation in the HCA as assessed by radiographs.
Level of Evidence
Differential diagnosis/symptom prevalence, level 4. J Orthop Sports Phys Ther 2016;46(4):251–257. Epub 8 Mar 2016. doi:10.2519/jospt.2016.6166