Measurement of craniovertebral angle by the Modified Head Posture Spinal Curvature Instrument: A reliability and validity study

ABSTRACT

The Modified Head Posture Spinal Curvature Instrument (MHPSCI) is an extension of the Head Posture Spinal Curvature Instrument. Two specific modifications were made in the original design by adding a third arm projecting horizontally from the protractor to objectively fix the pivot exactly over the C7 vertebra and the addition of a spirit-level to properly align the instrument. In order to demonstrate reliability and validity, this study was conducted using patients with postural neck pain (N = 65) and healthy subjects (N = 20). All the subjects were working at a selected Information Technology Industry in India and had been recruited using a criterion-based sampling approach. The craniovertebral (CV) angle of each subject was evaluated by two raters consecutively. The measurements were taken by using both MHPSCI and the standard photographic method in a standardized sitting posture for the purpose of establishing criterion-validity of the instrument. The results of this study indicate a good inter-rater reliability (ICC = 0.76; CI = 0.65–0.84) as well as intra-rater reliability (ICC = 0.87; CI = 0.82–0.91) between three successive CV angle measurements (with 2 minutes interval between each measurement) through MHPSCI. While keeping the digital photographic measurement as a standard, this study established that the MHPSCI is a valid tool for measuring the CV angle as shown by non-significant difference (p > 0.01) and high correlation between the two methods (r = 0.79–0.84). This study demonstrates that the MHPSCI is a reliable and valid instrument for measuring CV angle in subjects with or without postural neck pain.

KEYWORDS:

• Craniovertebral angle
• neck pain
• posture
• reliability
• validity

Acknowledgments

The author expresses his thankfulness to Dr. S. Alagasen, Professor and Head, Ramakrishna Mission Vivekananda University, India for proving technical input in completing this research work. The author thanks Chris Ho Ting Yip for providing permission to use the basic design of Head Posture Spinal Curvature Instrument and allowing me to make necessary changes to improve the clinical utility of this apparatus. The author also acknowledges the work of Design Engineers, Mr. R. Manoharan and Mr. Balaji Srenivas, who helped in designing the Modified Head Posture Spinal Curvature Instrument used in this study. The author also expresses his gratitude to both University of Dammam [UOD] and KG Group of Institutions, for providing the opportunity to complete this research. The author expresses his sincere thanks to Mr. Shyam Sundar, Director, HRD, KGISL Information Systems, Coimbatore, India, for providing permission to carry out this research. Finally, the author expresses his special thanks to all the Information Technology Professionals who participated in this study.

Declaration of interest

The author reports no declarations of interest.