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J Back Musculoskelet Rehabil. 2014;27(2):131-9. doi: 10.3233/BMR-130426.

Assessment of forward head posture in females: observational and photogrammetry methods.

Author information

  • 1School of Rehabilitation Science, Tehran University of Medical Sciences, Tehran, Iran.
  • 2School of Medical Science, Tehran University of Medical Sciences, Tehran, Iran.
  • 3Department of Civil Engineering, Clemson University, Clemson, SC, USA.
  • 4School of Health Management and Information Sciences, Tehran University of Medical Sciences, Tehran, Iran.
  • 5School of Mechanical Engineering, Sharif University of Technology, Tehran, Iran.



There are different methods to assess forward head posture (FHP) but the accuracy and discrimination ability of these methods are not clear.


Here, we want to compare three postural angles for FHP assessment and also study the discrimination accuracy of three photogrammetric methods to differentiate groups categorized based on observational method.


All Seventy-eight healthy female participants (23 ± 2.63 years), were classified into three groups: moderate-severe FHP, slight FHP and non FHP based on observational postural assessment rules. Applying three photogrammetric methods - craniovertebral angle, head title angle and head position angle - to measure FHP objectively.


One - way ANOVA test showed a significant difference in three categorized group's craniovertebral angle (P< 0.05, F=83.07). There was no dramatic difference in head tilt angle and head position angle methods in three groups. According to Linear Discriminate Analysis (LDA) results, the canonical discriminant function (Wilks'Lambda) was 0.311 for craniovertebral angle with 79.5% of cross-validated grouped cases correctly classified.


Our results showed that, craniovertebral angle method may discriminate the females with moderate-severe and non FHP more accurate than head position angle and head tilt angle. The photogrammetric method had excellent inter and intra rater reliability to assess the head and cervical posture.


Observational assessment; forward head posture; photogrammetry

[PubMed - indexed for MEDLINE]
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