Craniovertebral angle: Difference between revisions
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==Introduction== | ==Introduction== | ||
The craniovertebral angle is identified as the intersection of a horizontal line passing through the C7 spinous process and a line joining the midpoint of the tragus of the ear to the skin overlying the C7 spinous process<ref>Wilmarth M, Hilliard T. Measuring head posture via the craniovertebral angle.</ref> | [[File:Trajus.jpeg|right|frameless]] | ||
The craniovertebral angle is identified as the intersection of a horizontal line passing through the [[Vertebra Prominens|C7 spinous process]] and a line joining the midpoint of the [[Tragus to Wall Test|tragus]] of the ear to the skin overlying the C7 spinous process<ref>Wilmarth M, Hilliard T. Measuring head posture via the craniovertebral angle.</ref>. | |||
Craniovertebral angle is also referred to as cervical angle and [[Forward Head Posture|forward head]] angle.<ref name=":0">Sheikhhoseini R, Shahrbanian S, Sayyadi P, O’Sullivan K. Effectiveness of therapeutic exercise on forward head posture: a systematic review and meta-analysis. Journal of manipulative and physiological therapeutics. 2018 Jul 1;41(6):530-9.</ref> | Image 1: Shows Tragus, part of external ear | ||
* Measurement of craniovertebral angle, (CVA) is one of the common methods in assessing head posture. | |||
* Craniovertebral angle is also referred to as cervical angle and [[Forward Head Posture|forward head]] angle.<ref name=":0">Sheikhhoseini R, Shahrbanian S, Sayyadi P, O’Sullivan K. Effectiveness of therapeutic exercise on forward head posture: a systematic review and meta-analysis. Journal of manipulative and physiological therapeutics. 2018 Jul 1;41(6):530-9.</ref> | |||
== Measuring == | |||
[[File:C7 animation (1).gif|right|frameless]] | |||
Craniovertebral angle is measured by taking 2 lateral photographs of the subject in a relaxed seated position without a back support. Spinous process of C7 and the tragus of ear are marked with a body marker. A horizontal line is drawn passing through C7 making a right angle with the vertical. Then, the angle between the line connecting C7 spinous process with the tragus of the ear and the horizontal line, is measured using eg. Goniometer<ref name=":1">Abbasi AH, Aslam M, Ashraf T, Malik AN. [https://www.bibliomed.org/?mno=259964 Evaluation of the Forward Head Posture, its association with Neck Pain & Quality of life of Female DPT Students]: JRCRS. 2016; 4 (2): 59-64. Journal Riphah College of Rehabilitation Sciences. 2016 Nov 1;4(2):59-64. Available: https://www.bibliomed.org/?mno=259964 (accessed 2.11.2021)</ref> or Image J Software.<ref>International Journal of Applied Research 2020 Effects of suboccipital muscle energy technique (MET) versus suboccipital release technique (SOR) on craniovertebral angle, cervical range of motion and chronic neck pain in medical students with upper cross syndrome at the end of 6 weeks: A comparative study Available:https://www.allresearchjournal.com/archives/2020/vol6issue7/PartC/6-6-73-486.pdf (accessed 2.11.21)</ref> | |||
A study by B. Shaghayegh fard et al, compared the craniovertebral angle in sitting and standing positions. There is a clear link between the thoraco-lumbar spine posture and cervical spine posture which depends on different sitting and standing positions. The study concluded that it is recommended to measure CVA in standing posture as the postural muscles activity decrease in slump sitting compared to standing. <ref name=":2">ShaghayeghFard B, Ahmadi A, Maroufi N, Sarrafzadeh J. Evaluation of forward head posture in sitting and standing positions. European spine journal. 2016 Nov;25(11):3577-82.</ref> | |||
Image 2: C7 animation gif | |||
== Clinically Relevant Anatomy == | == Clinically Relevant Anatomy == | ||
Vertebra prominens is the name of the seventh [[Cervical Anatomy|cervical]] vertebra. The most distinctive characteristic of this vertebra is the existence of a long and prominent spinous process which is palpable from the [[skin]] surface, hence the name. The spinous process is thick, nearly horizontal in direction, not bifurcated, but terminating in a tubercle to which the lower end of the [[ligamentum nuchae]] is attached.<ref>Physiopedia [[Vertebra Prominens|Vertebra prominens]] Available: [[Vertebra Prominens]](accessed 2.11.2021)</ref> | |||
== Craniovertebral Angle and Neck Pain == | == Craniovertebral Angle and Neck Pain == | ||
[[File:Chris-benson-yx-iJFybOBQ-unsplash.jpg|right|frameless]] | |||
Craniovertebral angle is the landmark for assessment of head and neck [[posture]]<nowiki/>s. | |||
* The angle is significantly smaller in subjects with [[Mechanical Neck Pain|neck pain]]. | |||
* The decrease in the values of craniovertebral angle is associated with the greater incidence of forward head posture, and a greater level of disability among the subjects with neck pain.<ref name=":1" /> | |||
A smaller craniovertebral angle (CVA) indicate a greater forwards head posture. A CVA less than 48–50 is defined as Forward head posture.<ref name=":2" /> | |||
In a study conducted by Kim et al, it was reported that forward head posture measurement according CVA can be used as a significant index in determining the resulting functional disability of the neck.<ref>Kim EK, Kim JS. [https://pubmed.ncbi.nlm.nih.gov/27821964/ Correlation between rounded shoulder posture, neck disability indices, and degree of forward head posture.] Journal of physical therapy science. 2016;28(10):2929-32.</ref> | * In a study conducted by Kim et al, it was reported that forward head posture measurement according CVA can be used as a significant index in determining the resulting functional disability of the neck.<ref>Kim EK, Kim JS. [https://pubmed.ncbi.nlm.nih.gov/27821964/ Correlation between rounded shoulder posture, neck disability indices, and degree of forward head posture.] Journal of physical therapy science. 2016;28(10):2929-32.</ref> | ||
* The CVA angle reliability and validity has been confirmed in previous studies.<ref>Salahzadeh Z, Maroufi N, Ahmadi A, Behtash H, Razmjoo A, Gohari M, Parnianpour M. Assessment of forward head posture in females: observational and photogrammetry methods. Journal of back and musculoskeletal rehabilitation. 2014 Jan 1;27(2):131-9.</ref> | |||
== References == | == References == | ||
Latest revision as of 10:28, 2 November 2021
Original Editor - Ashiyat Kehinde Akodu Top Contributors - Kim Jackson, Lilian Ashraf, Ashiyat Kehinde Akodu and Lucinda hampton
Introduction[edit | edit source]
The craniovertebral angle is identified as the intersection of a horizontal line passing through the C7 spinous process and a line joining the midpoint of the tragus of the ear to the skin overlying the C7 spinous process[1].
Image 1: Shows Tragus, part of external ear
- Measurement of craniovertebral angle, (CVA) is one of the common methods in assessing head posture.
- Craniovertebral angle is also referred to as cervical angle and forward head angle.[2]
Measuring[edit | edit source]
.gif)
Craniovertebral angle is measured by taking 2 lateral photographs of the subject in a relaxed seated position without a back support. Spinous process of C7 and the tragus of ear are marked with a body marker. A horizontal line is drawn passing through C7 making a right angle with the vertical. Then, the angle between the line connecting C7 spinous process with the tragus of the ear and the horizontal line, is measured using eg. Goniometer[3] or Image J Software.[4]
A study by B. Shaghayegh fard et al, compared the craniovertebral angle in sitting and standing positions. There is a clear link between the thoraco-lumbar spine posture and cervical spine posture which depends on different sitting and standing positions. The study concluded that it is recommended to measure CVA in standing posture as the postural muscles activity decrease in slump sitting compared to standing. [5]
Image 2: C7 animation gif
Clinically Relevant Anatomy[edit | edit source]
Vertebra prominens is the name of the seventh cervical vertebra. The most distinctive characteristic of this vertebra is the existence of a long and prominent spinous process which is palpable from the skin surface, hence the name. The spinous process is thick, nearly horizontal in direction, not bifurcated, but terminating in a tubercle to which the lower end of the ligamentum nuchae is attached.[6]
Craniovertebral Angle and Neck Pain[edit | edit source]
Craniovertebral angle is the landmark for assessment of head and neck postures.
- The angle is significantly smaller in subjects with neck pain.
- The decrease in the values of craniovertebral angle is associated with the greater incidence of forward head posture, and a greater level of disability among the subjects with neck pain.[3]
A smaller craniovertebral angle (CVA) indicate a greater forwards head posture. A CVA less than 48–50 is defined as Forward head posture.[5]
- In a study conducted by Kim et al, it was reported that forward head posture measurement according CVA can be used as a significant index in determining the resulting functional disability of the neck.[7]
- The CVA angle reliability and validity has been confirmed in previous studies.[8]
References[edit | edit source]
- ↑ Wilmarth M, Hilliard T. Measuring head posture via the craniovertebral angle.
- ↑ Sheikhhoseini R, Shahrbanian S, Sayyadi P, O’Sullivan K. Effectiveness of therapeutic exercise on forward head posture: a systematic review and meta-analysis. Journal of manipulative and physiological therapeutics. 2018 Jul 1;41(6):530-9.
- ↑ 3.0 3.1 Abbasi AH, Aslam M, Ashraf T, Malik AN. Evaluation of the Forward Head Posture, its association with Neck Pain & Quality of life of Female DPT Students: JRCRS. 2016; 4 (2): 59-64. Journal Riphah College of Rehabilitation Sciences. 2016 Nov 1;4(2):59-64. Available: https://www.bibliomed.org/?mno=259964 (accessed 2.11.2021)
- ↑ International Journal of Applied Research 2020 Effects of suboccipital muscle energy technique (MET) versus suboccipital release technique (SOR) on craniovertebral angle, cervical range of motion and chronic neck pain in medical students with upper cross syndrome at the end of 6 weeks: A comparative study Available:https://www.allresearchjournal.com/archives/2020/vol6issue7/PartC/6-6-73-486.pdf (accessed 2.11.21)
- ↑ 5.0 5.1 ShaghayeghFard B, Ahmadi A, Maroufi N, Sarrafzadeh J. Evaluation of forward head posture in sitting and standing positions. European spine journal. 2016 Nov;25(11):3577-82.
- ↑ Physiopedia Vertebra prominens Available: Vertebra Prominens(accessed 2.11.2021)
- ↑ Kim EK, Kim JS. Correlation between rounded shoulder posture, neck disability indices, and degree of forward head posture. Journal of physical therapy science. 2016;28(10):2929-32.
- ↑ Salahzadeh Z, Maroufi N, Ahmadi A, Behtash H, Razmjoo A, Gohari M, Parnianpour M. Assessment of forward head posture in females: observational and photogrammetry methods. Journal of back and musculoskeletal rehabilitation. 2014 Jan 1;27(2):131-9.
