Frequency of Cephalic Antepulsion in Medicine Students, associated factors and symptoms
Abstract
Introduction: Cephalic antepulsion is defined as a biomechanic alteration of the frontal plane where the head is anteriorized in respect to the trunk and there is hypotonia of the posterior cervical muscles and hyperextension of the upper cervical spine. It is the result of poor posture while doing activities such as sitting down for long periods of time during studying.
Materials and methods: Observational, transversal and analytic study. Sample size was 118 medical students from Universidad Nacional de Asunción, selected using non-probability sampling. The study was based on a survey and kinesiologic evaluation: Kendall’s posture evaluation technique for the diagnosis of cephalic antepulsion. Means, standard deviation, frequencies and percentages were used for the descriptive statistical analysis. For the association study between the presence of cephalic antepulsion and associated factors, X2 test and OR with its respective CI were used. A statistically significant p was considered at values lower than 0.05.
Results: 55.1% were men, mean age was 21.25 (±1.40 years). 30.5% of students have assured that they adopt this position while studying for more than 3 hours a day. When applying Kendall’s evaluation technique, it was found that 78% presents cephalic antepulsion, 57% being male students. Regarding most frequent symptoms, 77.1% had back pain; followed by headache (57.6%) and shoulder pain (55.7%). Association analysis showed that antepulsion is associated to study hours (p=0.001), with an OR 1.6 (1.1-2.6). The association increases with study time. However, when conducting an association analysis with symptoms, a relationship between antepulsion and symptoms referred by students could not be proven.
Discussion: We found a high frequency of cephalic antepulsion in medical students and a strong correlation between the amount of time spent studying in poor posture and cephalic antepulsion.
Downloads
References
(1) Casas S, Aminta S, Patiño S, María S. Prevalencia y factores asociados con el dolor de espalda y cuello en estudiantes universitarios [Internet]. Revista de la Universidad Industrial de Santander. Salud. 2012;44(2):45-55. Disponible en: https://www.redalyc.org/articulo.oa?id=343835705007
(2) Brito-Hernández L, Espinoza-Navarro O, Gamboa JD, Lizana PA. Evaluación postural y prevalencia de hipercifosis e hiperlordosis en estudiantes de enseñanza básica. Int J Morphol. 2018;36(1):290-6.
(3) Zafar H, Alghadir AH, Iqbal ZA. Effect of different head-neck-jaw postures on cervicocephalic kinesthetic sense [Internet]. J Musculoskelet Neuronal Interact. 2017 Dec 1;17(4) [cited 21 Abr 2019]. Available from: https://pubmed.ncbi.nlm.nih.gov/29199196/
(4) Capurso U, Garino GB, Rotolo L, Verna CA. Parametri posturali cefalometrici e malocclusioni dentarie [Cephalometric postural parameters and dental malocclusion]. Mondo Ortod. 1989;14(3):345‐349.
(5) Kendall FP, Mcreary EK, Provance PG. Muscles: Testing and Function with Posture and Pain [Internet]. Lippincott Williams & Wilkins; 2005. Available from: https://books.google.com.py/books?id=AgRkvidspkMC
(6) Gamboa Torres J. “Incidencia de la cervicalgia en posturas de antepulsión de cabeza en los estudiantes de la carrera de Terapia Física de la universidad técnica de Ambato” [Internet]. Repositorio.uta.edu.ec. 2019 [cited 22 Apr 2019]. Available from: https://repositorio.uta.edu.ec/jspui/handle/123456789/25254
(7) Cheong S, Park S. Changes in neck and upper trunk muscle activities according to the angle of movement of the neck in subjects with forward head posture [Internet]. J-State. 2017 [cited 22 Apr 2019]. Available from: https://www.jstage.jst.go.jp/article/jpts/29/2/29_jpts-2016-833/_article/-char/ja/
(8) Vakili L, Halabchi F, Mansournia MA, Khami MR, Irandoost S, et al. Prevalencia de trastornos posturales comunes entre el personal académico [Internet]. Asian J Sports Med. 2016; 7 (2) [cited 27 Apr 2019]. Available from: https://sites.kowsarpub.com/asjsm/articles/21651.html
(9) Ariëns GA, Bongers PM, Douwes M, Miedema MC, Hoogendoorn WE, van der Wal G, et al. Are Neck Flexion, Neck Rotation, and Sitting at Work Risk Factors for Neck Pain? Results of a Prospective Cohort Study [Internet]. Occupational and environmental medicine. U.S. National Library of Medicine; [cited 2019 May 18]. Available from: https://pubmed.ncbi.nlm.nih.gov/11171934/
(10) Ruivo RM, Pezarat-Correia P, Carita AI. Cervical and shoulder postural assessment of adolescents between 15 and 17 years old and association with upper quadrant pain [Internet]. Braz J Phys Ther. 2014;18(4) [cited 2019 May 19]. Available from: https://pubmed.ncbi.nlm.nih.gov/25054381/
(11) Singla D, Veqar Z, Hussain ME. Photogrammetric Assessment of Upper Body Posture Using Postural Angles: A Literature Review [Internet]. J Chiropr Med. 2017;16(2) [cited 2019 May 19]. Available from: https://pubmed.ncbi.nlm.nih.gov/28559753/
(12) Guan X, Fan G, Wu X, Zeng Y, Su H, Gu G, et al. Photographic measurement of head and cervical posture when viewing mobile phone: a pilot study. Eur Spine J. 2015 Dec 1;24(12):2892–2898.
(13) Brink Y, Louw Q, Grimmer K, Jordaan E. The spinal posture of computing adolescents in a real-life setting [Internet]. BMC Musculoskelet Disord. 2014; 212 (15). [cited 2019 May 20]. Available from: https://pubmed.ncbi.nlm.nih.gov/24950887/
(14) Straker LM, O’Sullivan PB, Smith A, Perry M. Computer use and habitual spinal posture in Australian adolescents. Public Health Rep [Internet]. 2007;122(5). [cited 2019 May 20]. Available from: http://www.ncbi.nlm.nih.gov/pubmed/17877311
(15) Kim MS, Cha YJ, Choi JD. Correlation between forward head posture, respiratory functions, and respiratory accessory muscles in young adults [Internet]. J Back Musculoskelet Rehabil. 2017;30(4) [cited 2019 May 20]. Available from: https://pubmed.ncbi.nlm.nih.gov/28453447/?from_term=forward+head+posture
Copyright (c) 2020 Paraguayan Journal of Rheumatology

This work is licensed under a Creative Commons Attribution 4.0 International License.