Effects of a postural cueing for head and neck posture on lumbar lordosis angles in healthy young and older adults: a preliminary study.

ABSTRACT

BACKGROUND: Postural rehabilitation plays an important role in the treatment of non-specific low back pain. Although pelvic inclination has been widely used to improve lumbar lordosis, the effect of cervical anterior inclination on lumbar lordosis in young and older adults in sitting and standing posture is still unclear. This preliminary study was designed to examine the influence of changing the cervical anterior angle on the lumbar lordosis angle, through alterations of the head position under the natural sitting and standing conditions, aiming to provide a basis for establishing a new postural rehabilitation strategy. METHODS: Thirty-six young (24.0 ± 2.2 years, 14 females and 22 males) and 38 older (68.4 ± 5.9 years, 36 females and 2 males) healthy adults participated in this study. The four spinal regional angles-cervical anterior angle, thoracic kyphosis angle, lumbar lordosis angle, and pelvic forward inclination angle, were measured in standing and relaxed sitting postures to determine the effects of a postural cueing for the head and neck posture, "inclining head backward and performing chin tuck," on lumbar lordosis angle. RESULTS: In the standing posture, the pelvic forward inclination angle in the older adult group was significantly smaller (P < 0.001, by ANOVA) than that in the young adult group and increased significantly (P < 0.001) in response to the postural cueing. In addition, the thoracic kyphosis angle in the standing (P = 0.001) and sitting (P = 0.003) positions was significantly reduced in response to the postural cueing. However, the lumbar lordosis angle in response to the postural cueing increased significantly in both the standing position (P < 0.001) and sitting position (P < 0.001). CONCLUSION: The results suggest that increasing the cervical anterior angle can increase the lumbar lordosis angle, and the cervical anterior inclination can be used as an alternative to pelvic forward inclination to improve the lumbar lordosis angle. Furthermore, the change in head and neck posture can reduce the thoracic kyphosis angle, making it possible to establish a new noninvasive body posture rehabilitation strategy.