The Relationship Between Postural Stability and Forward Head Posture
,
Abstract
Background: Musculoskeletal disorders of the neck and shoulders are the most commonly reported complaints in sedentary occupations such as dentistry. These disorders not only cause pain but can also impair postural control mechanisms. The aim of this study was to investigate the relationship between postural stability disorders and forward head posture (FHP) in dentists.
Materials & Methods: In this cross-sectional study, 70 dentists from two dental centers in Tehran were investigated. Individual and job characteristics were collected via questionnaire. The head position was examined using clinical testing for forward head posture. The Romberg equilibrium test and its three modified versions were used to evaluate static stability, and the stepping test was applied to evaluate dynamic stability. Pearson’s correlation coefficient and the independent t-test were used to examine the relationship between variables and to investigate the difference in stability variables between the FHP and healthy groups.
Results: Based on the results, 57.1% of the studied dentists were diagnosed with forward head posture. According to the results of the independent t-test, there were significant differences in the average holding time in the static stability tests and the deviation degrees from the normal range in the dynamic equilibrium test between the FHP and healthy groups (p= 0.013).
Conclusion: FHP could negatively affect the postural equilibrium of dentists. Suitable interventions such as ergonomic redesign of workstations and/or corrective exercises are strongly recommended.
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2. Widanarko B, Legg S, Stevenson M, Devereux J, Eng A, Mannetje A. Prevalence of musculoskeletal symptoms in relation to gender, age, and occupational/industrial group. Int J Ind Ergon. 2011;41:561-572.
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15. Finsen L, Christensen H, Bakke M. Musculoskeletal disorders among dentists and variation in dental work. Appl Ergon. 1997;29(2):119-125.
16. Milerad E, Ericson M, Niseli R, Kilbom A. An electromyographic study of dental work. Ergonomics. 1991;34(7):953-962.
17. Salehi S, Hedayati R, Bakhtiary AH, Ghorbani R, Sanjari MA, Aminianfar A. The relationship between forward head deviation and balance parameters in young females. J Koomesh. 2012;14(1):76-85. [Persian]
18. Kang J, Park RY, Lee SJ, Kim JY, Yoon SR, Jung KI. The effect of the forward head posture on postural balance in long time computer based workers. Ann Rehabil Med. 2012;36(1):98-104.
19. Paloski WH, Wood SJ, Feiveson AH, Black O, Hwang EY, Reschke MF. Destabilization of human balance control by static and dynamic head tilts. Gait Posture. 2006;23:315-323.
20. Manchester D, Woollacott M, Zederbuer-Hylton N, Marin O. Visual, vestibular and somatosensory contributions to balance control in the older adult. J Gerontol. 1989;44:118-127.
21. Weeks DL, Forget R, Mouchnino L. Interaction between attention demanding motor and cognitive tasks and static postural stability. Gerontology. 2003;49:225-232.
22. Paulus W, Straube A, Brandt T. Visual postural performance after loss of somatosensory and vestibular function. J Neurol Neurosurg Psychiatry. 1987;50:1542-1545.
23. Peterka RJ. Sensorimotor integration in human postural control. J Neurophysiol. 2002;88:1097-1187.
24. Weeks DL, Forget R, Mouchnino L. Interaction between attention demanding motor and cognitive tasks and static postural stability. Gerontology. 2003;49:225-232.
25. Kuo AD, Donelan JM. Dynamic principles of gait and their clinical implications. Phys Ther. 2010;90:157-174.
26. Horak FB, MacPherson JM. Postural orientation and equilibrium. In: Rowell LB, Sheperd JT, editors. Handbook of physiology. New York: Oxford University Press; 1996. p. 255-292.
27. Treleaven J. Sensorimotor disturbances in neck disorders affecting postural stability, head and eye movement control. Man Ther. 2008;13:2-11.
28. Saadat M, Shaterzadeh Yazdi MJ, Arastoo AA, Zahednegad Sh, Negahban Seuki H, Bigdeli AH. Indicators of Changes in Postural Stability with Chronic Nonspecific Neck Pain. Jundishapur Sci Med J. 2012;11(3):277-283. [Persian]
29. Smetanin BN, Popov KY, Shlykov VY. Postural responses to vibrostimulation of the neck muscle proprioceptors in man. Neurophysiology. 1993;25(2):86-92.
30. Hertling D, Kessler RM. Management of Common Musculoskeletal Disorders. 4th ed. Philadelphia: Lippincott Williams & Wilkins; 2006. p. 638-640.
31. Mostamand J, Lotfi H, Safi N. Evaluating the head posture of dentists with no neck pain. J Bodyw Mov Ther. 2013 Oct;17(4):430-3.
32. Rocabado M. Advanced upper quarter manual. Tacoma, WA: Rocabado Institute; 1981.
33. Black FO, Wall C, Rockette H, Kitch R. Normal subject postural sway during the Romberg test. Am J Otolaryngol. 1982;3:309-318.
34. Newton R. Review of tests of standing balance abilities. Br J Sports Med. 1989;3(4):335-343.
35. O’Loughllin J. Incidence of and risk factors for falls and injurious falls among the community-dwelling elderly. Am J Epidemiol. 1993;137:342-354.
36. Vellas BJ, Wayne S, Romero L, et al. One-leg balance is an important predictor of injurious falls in older persons. J Am Geriatr Soc. 1997;45:735-738.
37. Bohannon R, Larkin P, Cook A, Gear J, Singer J. Decrease in timed balance test scores with aging. Phys Ther. 1984;64(7):1067-1070.
38. Murphy DR. Conservative management of cervical spine syndrome. 3rd ed. New York: McGraw-Hill; 2000. p. 307-327.
39. Alexandrov AV, Frolov AA, Horak FB, Carlson-Kuhta P, Park S. Feedback equilibrium control during human standing. Biol Cybern. 2005;93(5):309-322.
40. Nejati P, Lotfian S, Moezy A, Nejati M. The Relationship of Forward Head Posture and Rounded Shoulders with Neck Pain in Iranian Office Workers. Med J Islam Repub Iran. 2014;28(26):1-7.
41. Chiu TTW, Ku WY, Lee MH, et al. Study on the Prevalence of and Risk Factors for Neck Pain Among University Academic Staff in Hong Kong. J Occup Rehabil. 2002;12(2):77-91.
42. Moen BE, Bjorvatn K. Musculoskeletal symptoms among dentists in a dental school. Occup Med (Lond). 1996;46(1):65-68.
43. Gosavi SS, Gosavi SY, Jawade RS. Posturedontics: reducing the stress in dentistry. World J Dent. 2012;3(4):335-330.
44. Nasl Saaraji J, Hosseini MH, Shahtaheri SJ, Golbabaei F, Ghasemkhani M. Evaluation of ergonomic postures of dental professions by REBA, in Birjand, Iran. J Dent. 2005;18(1):61-67. [Persian]
45. Choobineh AR, Soleimani S, Daneshmandi H. Prevalence of Musculoskeletal disorders and evaluation of posture by RULA among dentists of Shiraz. J Dent. 2011;24(4):310-317. [Persian]
46. Poor Abas R, Shakoori SK, Haji Dizaji R. Prevalence and Risk Factors of Musculoskeletal Disorders among Dentists in Tabriz. Med J Tabriz Univ Med Sci. 2005;64:34-39. [Persian]
47. Ezoddini Ardakani F, Haerian Ardakani A, Akhavan Karbasi MH, Dehghan Tezerjani KH. Assessment of musculoskeletal disorders prevalence among dentists. J Dent Med. 2004;17(4):52-60. [Persian]
48. Eivazi M, Rezaei M, Eteraf Oskuei MA, Zolghadr M, Parand Avar H, Sadeghi N, Nouruzi M. Prevalence of Musculoskeletal Disorders and Related Risk Factors among Dentists. Med J Tabriz Univ Med Sci. 2011;34(3):81-87. [Persian]
49. Donatelli R, Carp K, Pagnacco G, Adam J. Skill level and balance in golf. Lower Extremity Rev. 2011.
2. Widanarko B, Legg S, Stevenson M, Devereux J, Eng A, Mannetje A. Prevalence of musculoskeletal symptoms in relation to gender, age, and occupational/industrial group. Int J Ind Ergon. 2011;41:561-572.
3. Bhattacharya A. Costs of occupational musculoskeletal disorders (MSDs) in the United States. Int J Ind Ergon. 2014;44:448-454.
4. Rundcrantz BL, Johnsson B, Moritz U. Cervical pain and discomfort among dentists. Epidemiological, clinical and therapeutic aspects: A survey of pain and discomfort. Swed Dent J. 1990;14:71-80.
5. Alexopoulos EC, Stathi IC, Charizani F. Prevalence of musculoskeletal disorders in dentists. BMC Musculoskelet Disord. 2004 Jun 9;5:16..
6. Marshall ED, Robinson RQ, Duncombe LM, Kllbreatb SL. Musculoskeletal dysfunction involving the trunk in Australian dentists. In: Proceedings of the 12th Triennial Congress of the International Ergonomics Association. 1994;2:108-110.
7. Shugars D, Miller D, Williams D, Fishburne C, Strickland D. Musculoskeletal pain among general dentists. Gen Dent. 1987;4:272-276.
8. Leggat PA, Kedjarune U, Smith DR. Occupational health problems in modern dentistry: a review. Ind Health. 2007;45(5):611-621.
9. Lindfors P, Von Thiele U, Lundberg U. Work characteristics and upper extremities in female dental health workers. J Occup Health. 2006;1:192-197.
10. Saremi M, Lahmi MA, Faqihzadeh S. The effects of ergonomic intervention on musculoskeletal disorders among dentists. Daneshvar. 2006;64:55-62. [Persian]
11. Donatelli R, Wooden MJ. Orthopedic physical therapy. 5th ed. New York: Churchill Livingstone; 2001. p. 46-61.
12. Hertling D, Kessler RM. Management of Common Musculoskeletal Disorders. 4th ed. Philadelphia: Lippincott Williams & Wilkins; 2006. p. 456-480.
13. Kendal FP, Provance PG, McCreary EK, Rodgers MM, Romani WA. Muscle Testing and Function. 4th ed. Philadelphia: Lippincott Williams & Wilkins; 2005. p. 124-153.
14. McNee C, Kieser JK, Antoun JS, Bennani H, Gallo LM, Farella M. Neck and shoulder muscle activity of orthodontists in natural environments. J Electromyogr Kinesiol. 2013 Jun;23(3):600-7.
15. Finsen L, Christensen H, Bakke M. Musculoskeletal disorders among dentists and variation in dental work. Appl Ergon. 1997;29(2):119-125.
16. Milerad E, Ericson M, Niseli R, Kilbom A. An electromyographic study of dental work. Ergonomics. 1991;34(7):953-962.
17. Salehi S, Hedayati R, Bakhtiary AH, Ghorbani R, Sanjari MA, Aminianfar A. The relationship between forward head deviation and balance parameters in young females. J Koomesh. 2012;14(1):76-85. [Persian]
18. Kang J, Park RY, Lee SJ, Kim JY, Yoon SR, Jung KI. The effect of the forward head posture on postural balance in long time computer based workers. Ann Rehabil Med. 2012;36(1):98-104.
19. Paloski WH, Wood SJ, Feiveson AH, Black O, Hwang EY, Reschke MF. Destabilization of human balance control by static and dynamic head tilts. Gait Posture. 2006;23:315-323.
20. Manchester D, Woollacott M, Zederbuer-Hylton N, Marin O. Visual, vestibular and somatosensory contributions to balance control in the older adult. J Gerontol. 1989;44:118-127.
21. Weeks DL, Forget R, Mouchnino L. Interaction between attention demanding motor and cognitive tasks and static postural stability. Gerontology. 2003;49:225-232.
22. Paulus W, Straube A, Brandt T. Visual postural performance after loss of somatosensory and vestibular function. J Neurol Neurosurg Psychiatry. 1987;50:1542-1545.
23. Peterka RJ. Sensorimotor integration in human postural control. J Neurophysiol. 2002;88:1097-1187.
24. Weeks DL, Forget R, Mouchnino L. Interaction between attention demanding motor and cognitive tasks and static postural stability. Gerontology. 2003;49:225-232.
25. Kuo AD, Donelan JM. Dynamic principles of gait and their clinical implications. Phys Ther. 2010;90:157-174.
26. Horak FB, MacPherson JM. Postural orientation and equilibrium. In: Rowell LB, Sheperd JT, editors. Handbook of physiology. New York: Oxford University Press; 1996. p. 255-292.
27. Treleaven J. Sensorimotor disturbances in neck disorders affecting postural stability, head and eye movement control. Man Ther. 2008;13:2-11.
28. Saadat M, Shaterzadeh Yazdi MJ, Arastoo AA, Zahednegad Sh, Negahban Seuki H, Bigdeli AH. Indicators of Changes in Postural Stability with Chronic Nonspecific Neck Pain. Jundishapur Sci Med J. 2012;11(3):277-283. [Persian]
29. Smetanin BN, Popov KY, Shlykov VY. Postural responses to vibrostimulation of the neck muscle proprioceptors in man. Neurophysiology. 1993;25(2):86-92.
30. Hertling D, Kessler RM. Management of Common Musculoskeletal Disorders. 4th ed. Philadelphia: Lippincott Williams & Wilkins; 2006. p. 638-640.
31. Mostamand J, Lotfi H, Safi N. Evaluating the head posture of dentists with no neck pain. J Bodyw Mov Ther. 2013 Oct;17(4):430-3.
32. Rocabado M. Advanced upper quarter manual. Tacoma, WA: Rocabado Institute; 1981.
33. Black FO, Wall C, Rockette H, Kitch R. Normal subject postural sway during the Romberg test. Am J Otolaryngol. 1982;3:309-318.
34. Newton R. Review of tests of standing balance abilities. Br J Sports Med. 1989;3(4):335-343.
35. O’Loughllin J. Incidence of and risk factors for falls and injurious falls among the community-dwelling elderly. Am J Epidemiol. 1993;137:342-354.
36. Vellas BJ, Wayne S, Romero L, et al. One-leg balance is an important predictor of injurious falls in older persons. J Am Geriatr Soc. 1997;45:735-738.
37. Bohannon R, Larkin P, Cook A, Gear J, Singer J. Decrease in timed balance test scores with aging. Phys Ther. 1984;64(7):1067-1070.
38. Murphy DR. Conservative management of cervical spine syndrome. 3rd ed. New York: McGraw-Hill; 2000. p. 307-327.
39. Alexandrov AV, Frolov AA, Horak FB, Carlson-Kuhta P, Park S. Feedback equilibrium control during human standing. Biol Cybern. 2005;93(5):309-322.
40. Nejati P, Lotfian S, Moezy A, Nejati M. The Relationship of Forward Head Posture and Rounded Shoulders with Neck Pain in Iranian Office Workers. Med J Islam Repub Iran. 2014;28(26):1-7.
41. Chiu TTW, Ku WY, Lee MH, et al. Study on the Prevalence of and Risk Factors for Neck Pain Among University Academic Staff in Hong Kong. J Occup Rehabil. 2002;12(2):77-91.
42. Moen BE, Bjorvatn K. Musculoskeletal symptoms among dentists in a dental school. Occup Med (Lond). 1996;46(1):65-68.
43. Gosavi SS, Gosavi SY, Jawade RS. Posturedontics: reducing the stress in dentistry. World J Dent. 2012;3(4):335-330.
44. Nasl Saaraji J, Hosseini MH, Shahtaheri SJ, Golbabaei F, Ghasemkhani M. Evaluation of ergonomic postures of dental professions by REBA, in Birjand, Iran. J Dent. 2005;18(1):61-67. [Persian]
45. Choobineh AR, Soleimani S, Daneshmandi H. Prevalence of Musculoskeletal disorders and evaluation of posture by RULA among dentists of Shiraz. J Dent. 2011;24(4):310-317. [Persian]
46. Poor Abas R, Shakoori SK, Haji Dizaji R. Prevalence and Risk Factors of Musculoskeletal Disorders among Dentists in Tabriz. Med J Tabriz Univ Med Sci. 2005;64:34-39. [Persian]
47. Ezoddini Ardakani F, Haerian Ardakani A, Akhavan Karbasi MH, Dehghan Tezerjani KH. Assessment of musculoskeletal disorders prevalence among dentists. J Dent Med. 2004;17(4):52-60. [Persian]
48. Eivazi M, Rezaei M, Eteraf Oskuei MA, Zolghadr M, Parand Avar H, Sadeghi N, Nouruzi M. Prevalence of Musculoskeletal Disorders and Related Risk Factors among Dentists. Med J Tabriz Univ Med Sci. 2011;34(3):81-87. [Persian]
49. Donatelli R, Carp K, Pagnacco G, Adam J. Skill level and balance in golf. Lower Extremity Rev. 2011.
| Files | ||
| Issue | Vol 17 No 1 (2025) | |
| Section | Original Article(s) | |
| Published | 2025-03-03 | |
| Keywords | ||
| Forward head posture static stability dynamic stability dentists ergonomics | ||
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How to Cite
1.
Khayati F, Saremi M, Firoozeh M, Kavousi A. The Relationship Between Postural Stability and Forward Head Posture. Int J Occup Hyg. 2025;17(1):55-60.
