Differences in Forward Head Posture and Cervical Function According to Physical Activity Level and Correlations Among Forward Head Posture, Physical Activity Level, and Cervical Function

PURPOSE: This study aimed to examine the associations among forward head posture (FHP), physical activity (PA) level, and neck function indicators in undergraduate and graduate students.METHODS: A total of 102 undergraduate and graduate students were included. PA level was assessed using the International Physical Activity Questionnaire-Short Form. Cervical sagittal alignment was evaluated using the craniovertebral angle (CVA), and neck function indicators included cervical range of motion (ROM), joint position error (JPE), neck muscle strength, and neck muscle endurance.RESULTS: Between-group comparisons indicated that the PA-sufficient group exhibited significantly greater CVA, neck flexor strength (NFS), neck extensor strength (NES), and neck flexor endurance (NFE) than the PA-insufficient group. Correlation analysis showed that CVA was significantly associated with PA level, cervical ROM, and JPE. Stepwise regression analysis indicated that cervical flexion and extension ROM, as well as JPE during extension and left and right rotation, were significantly associated with CVA.CONCLUSIONS: These findings suggest that physical activity level may be associated with cervical alignment and neck muscle function in this population. In addition, cervical range of motion and joint position error may represent relevant functional characteristics related to forward head posture and should be considered in its evaluation.