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Title: An investigation into the role of forward head posture as an associated factor in the presentation of episodic tension-type and cervicogenic headaches
Authors: Duani, Victor 
Keywords: Forward head posture;Craniovertebral angle;C7 spinous process;Episodic tension-type headache;Cervicogenic headaches;EAM;Plumbline and cervical range of motion
Issue Date: 2010
Forward head posture (FHP) is a common postural abnormality, often
associated with myofascial trigger points which can result in head and neck pain. The
craniovertebral (CV) angle lies between a horizontal line running through C7 spinous
process and a line connecting C7 spinous process to the tragus of the ear. The
smaller the angle the greater the FHP. Cervical musculoskeletal abnormalities have
often been linked to headache types, most especially episodic tension-type
headache (ETTH) and cervicogenic headaches (CGH). Objectives: To determine
whether an association exists between FHP, distance of the external auditory meatus
(EAM) from the plumbline and cervical range of motion and the presentation of ETTH
and CGH. Method: This was a quantitative comparative study (n=60) comparing
three equal groups, one with ETTH, CGH and healthy controls. The FHP of the
Subjects FHP was assessed by measuring the CV angle. A lateral digital photograph
was taken to assess the distance of the external auditory meatus from the plumbline.
Lastly, cervical range of motion was measured. The two symptomatic groups also
received a headache diary for a fourteen day period monitoring frequency, intensity
and duration of their headaches. Result: The two symptomatic groups had a smaller
CV angle and a greater distance from the plumbline (p<0.05) than the asymptomatic
group. The asymptomatic group had a significantly greater flexion (p=0.009),
extension (p=0.038) and left rotation (p=0.018) range of motion than the two
symptomatic groups. The CGH group had a significant positive correlation between
the distance of the EAM from the plumbline and the intensity of headaches. The
ETTH group had a significant positive correlation between the right craniovertebral
angle and the mean duration of headaches. Conclusion: Therefore, it can be
concluded that patients presenting with ETTH and/or CGH may have associated
postural abnormalities that may act as a trigger or a contributory factor to the
presenting headache.
Dissertation submitted in partial compliance with the requirements for a Master's Degree in Technology: Chiropractic, Durban University of Technology, Durban, South Africa, 2010.
Appears in Collections:Theses and dissertations (Health Sciences)

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