The clinical examination of patients with cervical spine pathology includes measures of posture, mobility, strength, and stability. The forward head position as measured by craniovertebral angle (CVA) has been suggested as a risk factor for cervical spine pathology. The purpose of this study was to describe CVA reference values in healthy adults and assess the relationship with age and sex. This prospective cross-sectional observational study measured the CVA in 122 healthy adults using digital analysis of a lateral view photograph. To facilitate this analysis, a marker was placed at the level of the C7 vertebra, with the tragus of the ear visible in the photograph. The CVA was measured using Kinovea 0.8.15 software, where the CVA was calculated using the intersection of a horizontal line with a line joining the spinous process of C7 and the tragus of the ear. Mean CVA values were 48.76° (6.77) across all participants, 50.07° (6.63) for females, and 47.46° (6.71) for males. Linear regression analysis indicated significant relationships with age and with sex. The study established CVA reference values in healthy adults and identified a significant difference in head position between males and females and a 1.6° decrease in CVA per decade of increased age.

Active motion examination of patients with cervical spine-related pathologies is necessary to establish baseline function, set physical therapy goals, and choose interventions. This study investigated the sagittal plane active range of motion (ROM) of the global (GCS) and upper cervical spine (UCS) in relation to age and sex in healthy volunteers. One hundred twenty-two volunteers aged 18 to 75 years participated. Volunteers were excluded if they displayed any characteristic that could affect cervical spine ROM. GCS and UCS flexion and extension were each measured three times using a CROM device. Linear regression models (LRMs) were developed to explore the relationships between age and sex and GCS and UCS ROM. The LRM for age showed a decrease in GCS flexion (−2.01°), GCS extension (−3.33°), and UCS extension (−1.87°) for every decade of increasing age. The LRM for sex showed that men displayed less ROM than women in GCS extension (−6.52°) and UCS extension (−2.43°). These results suggest an age-related loss of sagittal plane GCS ROM and UCS extension ROM, and sex-related differences in GCS and UCS extension with women having greater motion than men.

The purpose of this study was to establish reference values for the Craniocervical Flexion Test (CCFT) in healthy volunteers and to explore the relationship between age and sex on the CCFT. This prospective, observational, cross-sectional study was developed in the assessment room of the Physiotherapy department at the Universitat Internacional de Catalunya. The study included healthy subjects between 18 and 75 years old. CCFT and sociodemographic variables, such as pain or physical activity, were collected. Linear regression models were developed with age and sex as the only predictor variables. Adjusted models were developed factoring in the sociodemographic information. A total of 122 volunteers (61 males, 61 females) between 18 and 75 years old participated in the study. The mean CCFT for the sample was 25.48 (3.3) mm Hg. Linear regression model by sex showed a coefficient of 1.11 mm Hg (CI 95%: -0.06, 2.29; p = .062) with men demonstrating 1.11 mm Hg more than women. Linear regression models by age strata showed a coefficient of -0.17 mm Hg (CI 95%: -0.51, 0.18 p = .347) for each decade of age. Variables related to sociodemographic information showed no significant effect. Gender and age have no relationship with the results of CCFT in healthy volunteers. The reference value for the Craniocervical flexion test in 122 healthy adults was 25.48 (3.30) mm Hg. This value may help therapists examine/set goals for patients with head/neck pain.