Cervico-occipital Posture in Women With Migraine: A Case-Control Study
Authors: Gabriela Natália Ferracini, PT, MD
Published: Journal of Orthopaedic & Sports Physical Therapy, 2016 Volume:0 Issue:0 Pages:1–25
Study Design
Case-control study.
Background
Previous studies have assessed forward head posture in patients with migraine using photographs. To date no study has compared postural differences using both radiographs and photographs.
Objective
To determine the differences in head extension posture between women with migraine and healthy women assessed by radiographic and photographic measures.
Methods
Thirty-three women (age 32±11.3 years) with migraine and 33 matched controls (age 33±12.6) years old participated. High cervical angle (HCA: the angle formed between the most inferior line from the occipital surface to the posterior portion of C1 and the posterior surface of the odontoid process of C2) and the vertical distance between C0 and C1 (C0-C1) were measured with radiographs, whereas the cranio-vertebral (CV) angle was assessed with photographs using K-Pacs® and Corporis Pro 3.1® software, respectively.
Results
None of the outcomes differed significantly between women with migraine (HCA: 66.8°, 95%CI 64.2-68.1; CV: 46.1°, 95%CI 45.0-47.1; C0-C1: 8.6mm 95%CI 7.7-9.2) and controls (HCA: 67.9°, 95%CI 66.5-69.3; CV: 44.5°, 95%CI 43.2-45.7; C0-C1: 8.7mm, 95%CI 7.9-9.4). Different relationships between the frequency (r=-0.42; P=0.01, R2= 10%) of migraine and the HCA were found.
Conclusion
This study demonstrated that women with migraine did not exhibit forward head posture compared to women with no history of headache in either radiographic or photographic postural analysis. However, there was a weak association of the frequency of migraine attacks with a variation in the high cervical angle as assessed by radiographs.
Level of Evidence
Differential diagnosis/symptom prevalence, Level 4. J Orthop Sports Phys Ther, Epub 8 Mar 2016. doi:10.2519/jospt.2016.6166