Relationships between craniocervical posture and pain-related disability in patients with cervico-craniofacial pain

Figures & data

Figure 1 Flowchart of the study.

Figure 2 Craniocervical posture measurements.

Notes: (A) Placement of cervical range of motion device with the head arm for the measure of head posture with the vertebra locator. (B) Evaluator taking measure from the jugular notch of the sternum to the chin protuberance to quantitative the sternomental distance.

Table 1 Demographic characteristics for the asymptomatic subjects’ and chronic CCFP patients’ samples

	Asymptomatic subjects	CCFP patients	P-value
Age years	38.1±10.5	41.7±11.7	0.099#
Sex (female)	30 (60)	32 (53.3)	0.483‡
Height (cm)	169.6±8.1	167±8.7	0.102#
Weight (kg)	69±13.3	71.2±10.5	0.336#

Notes: Values are mean ± standard deviation and n (%).

# Independent t-test.

‡ Pearson’s chi-squared.

Abbreviation: CCFP, cervico-craniofacial pain.

Figure 3 Scatter diagram showing correlation between head posture and the sternomental distance.

Notes: (A) Scatter diagram for chronic CCFP patients (n=60). (B) Scatter diagram for asymptomatic subjects (n=53). Graphic lines represent the 95% confidence interval.
Abbreviation: CCFP, cervico-craniofacial pain.

Table 2 Comparison between the asymptomatic subjects’ and chronic CCFP patients’ samples for measurements

	Asymptomatic subjects (mean ± SD)	CCFP patients (mean ± SD)	Mean differences (95% CI)	Cohen’s d
HP (cm)	18.87±2.24	20.32±1.49	–1.44 (–2.15 to –0.74)**	0.76
SMD (mm)	106.31±14.25	112.55±11.46	–6.24 (–11.1 to –1.38)*	0.38

Notes:

* P<0.05;

** P<0.001.

Abbreviations: CCFP, cervico-craniofacial pain; CI, confidence interval; HP, head posture; SD, standard deviation; SMD, sternomental distance.

Table 3 Intrarater reliability and descriptive statistics for measurements in chronic CCFP patients and asymptomatic subjects

Groups	Measures	Trial 1 (mean ± SD)	Trial 2 (mean ± SD)	Trial 3 (mean ± SD)	48 hours between trials (trial 1–trial 2)				9 days between trials (trial 2–trial 3)
					ICC3,1	95% CI for ICC	SEM	MDC90	ICC3,1	95% CI for ICC	SEM	MDC90
CCFP patients	HP (cm)	20.40±1.50	20.23±1.58	20.03±1.84	0.88	0.80–0.92	0.54	1.27	0.81	0.70–0.88	0.75	1.74
	SMD (mm)	111.53±12.41	113.57±11.83	112.73±13.78	0.79	0.67–0.87	5.60	13.07	0.76	0.63–0.85	6.24	14.55
Asymptomatic subjects	HP (cm)	18.77±2.35	18.96±2.19	–	0.93	0.89–0.96	0.55	1.30	–	–	–	–
	SMD (mm)	105.07±14.55	107.54±14.21	–	0.95	0.85–0.97	2.75	6.42	–	–	–	–

Abbreviations: CCFP, cervico-craniofacial pain; CI, confidence interval; HP, head posture; ICC_3,1, intraclass correlation coefficient, model 3,1; MDC₉₀, minimal detectable change at the 90% confidence level; SD, standard deviation; SEM, standard error of the measurement; SMD, sternomental distance.

Table 4 Statistical metrics from Bland–Altman analysis of the intrarater measurements in chronic CCFP patients and asymptomatic subjects

Groups	Measures	48 hours (trial 1–trial 2)			9 days (trial 2–trial 3)
		Mean differences ± SD	95% CI for mean differences	LOA (lower limit–upper limit)	Mean differences ± SD	95% CI for mean differences	LOA (lower limit–upper limit)
CCFP patients	HP (cm)	0.17±0.77	−0.03 to 0.37	–1.34 to 1.67	0.21±1.06	−0.06 to 0.48	−1.86 to 2.28
	SMD (mm)	−2.03±7.92	−4.08 to 0.01	−17.56 to 13.49	0.83±8.82	−1.45 to 3.11	−16.46 to 18.12
Asymptomatic subjects	HP (cm)	−0.19±0.79	−0.41 to 0.04	−1.73 to 1.36	–	–	–
	SMD (mm)	−2.47±3.89	−3.58 to –1.37	−10.10 to 5.16	–	–	–

Abbreviations: CCFP, cervico-craniofacial pain; CI, confidence interval; HP, head posture; LOA, limits of agreement; SD, standard deviation; SMD, sternomental distance.