Prevalence, risk factors of forward head posture and its health consequences on physical outcomes among the adult population in Saudi Arabia
DOI:
https://doi.org/10.6018/sportk.667611Keywords:
Cervical Spine, Craniovertebral Angle, Risk Factors, Side Effects, Upper Crossed SyndromeAbstract
This study investigated the prevalence, risk factors, and health consequences associated with forward head posture (FHP) among Saudi Arabia's adult population. The authors screened 533 adult males using a photographic technique to calculate the craniovertebral angle (CVA), and used direct questions to determine the average screen time per day, the existence of neck pain, and the average number of pain attacks. Body composition was indicated by body mass index (BMI). The numeric pain rating scale (NPRS) assessed the average neck pain intensity. Of the 533 participants, 211 (39%) demonstrated a CVA of 48° or less, indicating FHP. There was a statistically significant negative correlation between screen time exposure and the value of CVA (r=-.651; p<.001). Similarly, a statistically significant positive correlation existed between BMI and FHP (r= -.470; p<.001). The existence of pain, its intensity, and the average number of attacks were statistically significantly correlated with the CVA (Rpb= -.692; p<.001). (r=-.621; p<.001). (r=-.801; p<.001), respectively. In conclusion, FHP is a common neck problem among adult males in Saudi Arabia. Reducing exposure to smart screens and optimizing body composition could reduce the incidence of FHP and subsequent neck pain.
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1. Abbasi, H., Alizadeh, M. H., Rajabi, R., & Mohammadi, F. (2020). Research Paper: Comparison of Static and Dynamic Postural Stability Between Individuals With and Without Forward Head Posture. Physical Treatments, 10(3), 127–134. https://doi.org/10.32598/ptj.10.3.364.3
2. Abu Halimah, J., Mojiri, M., Hakami, S., Mobarki, O., Alanazi, S., Alharbi, A., Khalban, F., Al Sheef, A., Alnujaidi, S., Almalawi, M., Nasser, F., Kreshan, A., Almarwani, R., & Ayyashi, S. (2024). Musculoskeletal Health Risks Associated With Smartphone Use: A Retrospective Study from Riyadh, Saudi Arabia. Cureus, 16(6), 1-10. https://doi.org/10.7759/cureus.63446
3. Annarumma, G., Spinelli, A., Serio, A., Di Fraia, T., Gallinoro, C. M., Caoduro, L., Tarantino, D., Demeco, A., Keeling, E., Palermi, S., Biffi, A., & Sirico, F. (2023). Forward head posture and neck disability: what is the effect on lung function? Exploration of Medicine, 4(4), 207–214. https://doi.org/10.37349/emed.2023.00134
4. Bustam, I., & Herdayanti, D. (2023). Forward Head Posture (FHP) Condition: Reliability of Cranio Vertebral Angle (CVA) Testing. Journal of Physical Education, Sport, Health and Recreations, 13(3), 421–426.
5. Chandoliya, H., Chorsiya, V., & Kaushik, D. (2021). Prevalence and Levels of Forward Head Posture among School Going Children. American Journal of Epidemiology & Public Health, 5(1), 22–25. https://doi.org/10.37871/ajeph.id44
6. Cheng, C., Lau, Y., Chan, L., & Luk, J. W. (2021). Prevalence of social media addiction across 32 nations: Meta-analysis with subgroup analysis of classification schemes and cultural values. Addictive Behaviors, 117(2), 1-8. https://doi.org/10.1016/j.addbeh.2021.106845
7. Dawood, R. S., Abdelraouf, O. R., Mehmed, S., Moubarak, E. Els., & Elborady, A. A. (2023). Assessment of core endurance and shoulder proprioception in dental students with and without forward head posture. Bulletin of Faculty of Physical Therapy, 28(19), 1–7. https://doi.org/10.1186/s43161-023-00131-0
8. Fiebert, I., Kistner, F., Gissendanner, C., & Dasilva, C. (2021). Text neck: An adverse postural phenomenon. Work, 69(4), 1261–1270. https://doi.org/10.3233/WOR-213547
9. Hussein, H. M., Abu El Kasem, S. T., Kamel, R. M., Said, S. M., Mohamed, A. S., Farrag, Y. F., Ibrahim, A. A., & Elerian, A. E. (2023). Anthropometric Profile of Adult Egyptian Population: Establishment of Normative Data. Rehabilitacja Medyczna, 27(3), 34–39. https://doi.org/10.5604/01.3001.0053.9681
10. Hussien, H., Almishaal, A., Alrawaili, S., Ahmed, A., & Kamel, E. (2021). Prevalence and risk factors of obesity among school-age female children in Ha’il, Saudi Arabia Medical Science Prevalence and risk factors of obesity among school-age female children in Ha’il, Saudi Arabia Prevalence and risk factors of obesity among scho. Medical Science, 2021(107), 7–15. https://www.researchgate.net/publication/348185853
11. Kang, K. (2024). Correlation between cranio-vertebral angle and muscle activity according to body movements in forward head posture. WSEAS Transactions on Biology and Biomedicine, 21, 272–280. https://doi.org/10.37394/23208.2024.21.28
12. Kim, D. H., Kim, C. J., & Son, S. M. (2018). Neck pain in adults with forward head posture: Effects of craniovertebral angle and cervical range of motion. Osong Public Health and Research Perspectives, 9(6), 309–313. https://doi.org/10.24171/j.phrp.2018.9.6.04
13. Kim, E. K., & Kim, J. S. (2016). Correlation between rounded shoulder posture, neck disability indices, and degree of forward head posture. Journal of Physical Therapy Science, 28(10), 2929–2932. https://doi.org/10.1589/jpts.28.2929
14. Kim, H.-J., & Lee, D. (2021). The study of correlation between forward head posture and shoulder pain: A STROBE-compliant cross-sectional study. Physical Therapy Rehabilitation Science, 10(3), 251–256. https://doi.org/10.14474/ptrs.2021.10.3.251
15. Kulwal, P., & Sakharwade, A. (2024). Prevalence of Forward Head Posture in Goldsmith Workers. Indian Journal of Physiotherapy & Occupational Therapy - An International Journal, 18(2), 80–84. https://doi.org/10.37506/5bd7z790
16. Liu, J., Lee, Y., Micha, R., Li, Y., & Mozaffarian, D. (2021). Trends in junk food consumption among US children and adults, 2001–2018. The American Journal of Clinical Nutrition, 114(3), 1039–1048. https://doi.org/10.1093/ajcn/nqab129
17. Mosaad, D. M., Abdel-aziem, A. A., Mohamed, G. I., Abd-Elaty, E. A., & Mohammed, K. S. (2020). Effect of forward head and rounded shoulder posture on hand grip strength in asymptomatic young adults: a cross-sectional study. Bulletin of Faculty of Physical Therapy, 25(1), 1–8. https://doi.org/10.1186/s43161-020-00001-z
18. Moustafa, I. M., Youssef, A., Ahbouch, A., Tamim, M., & Harrison, D. E. (2020). Is forward head posture relevant to autonomic nervous system function and cervical sensorimotor control? Cross sectional study. Gait and Posture, 77, 29–35. https://doi.org/10.1016/j.gaitpost.2020.01.004
19. Nawal, A., Perwaiz, S., Alam, M. M., Bhatti, Z. M., Irfan, H., Shaukat, F., Ramzan, A., & Touqeer, R. (2025). Screening of Forward Head Posture Through Measurement of Craniovertebral Angle in Medical Students. Journal of Health, Wellness and Community Research, 3(1), 1–5. https://doi.org/10.61919/6jwz7h39
20. Naz, A., Bashir, M. S., & Noor, R. (2018). Prevalance of forward head posture among university students. Rawal Medical Journal, 43(2), 260–262.
21. Nejati, P., Lotfian, S., Moezy, A., & Nejati, M. (2015). The study of correlation between forward head posture and neck pain in Iranian office workers. International Journal of Occupational Medicine and Environmental Health, 28(2), 295–303. https://doi.org/10.13075/ijomeh.1896.00352
22. Saeed, A., Shahid, A., Liaqat, M., Farhat, R., Khursheed, R., Ahmed, S., Rafique, N., & Rafique, A. (2024). Prevalence of Forward Head Posture and Its Association with Smartphone Use among University Students. Pakistan BioMedical Journal, 7(10), 13–18. https://doi.org/10.54393/pbmj.v7i10.1141
23. Singh, S., Kaushal, K., & Jasrotia, S. (2020). Prevalence of forward head posture and its impact on the activity of daily living among students of Adesh University – A cross-sectional study. Adesh University Journal of Medical Sciences & Research, 2(2), 99–102. https://doi.org/10.25259/aujmsr_18_2020
24. Tasmeer, R., Asad Ullah Arslan, S., Ahmad, A., & Amjad, F. (2022). Effect Of Forward Head Posture with Neck Disability and Quality of Life in Freelancer. Pakistan BioMedical Journal, 5(5), 288–292. https://doi.org/10.54393/pbmj.v5i5.472
25. Verma, S., Shaikh, J., Mahato, R., & Sheth, M. (2018). Prevalence of forward head posture among 12-16 year old school going students - A cross sectional study. Applied Medical Research, 4(1), 18–21. https://doi.org/10.5455/amr.20180805064752
26. Youssef, H., Aydoǧdu, O., & Yildiz, A. (2025). Altered body balance and plantar pressure distribution in young adults with forward head posture. Journal of Orthopaedics, 59, 68–75. https://doi.org/10.1016/j.jor.2024.07.016
27. Zehra, H., Tariq, A., & Jamil, A. (2024). Prevalence of Forward Head Posture among School Children Using Smartphones in Rawalpindi. Journal of Modern Health and Rehabilitation Sciences, 1(2), 1–4.
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