Lin Guohao, Zhao Xiong, Tao Zhihao, Wang Weijie
The Third School of Clinical Medicine (School of Rehabilitation Medicine), Zhejiang Chinese Medical University, Hangzhou, China.
School of Science and Engineering, University of Dundee, Dundee, UK.
BMC Musculoskelet Disord. 2025 Aug 7;26(1):754. doi: 10.1186/s12891-025-08882-8.
Forward head posture (FHP) is a common postural deviation in the sagittal plane. Despite the growing interest in FHP, research on gait biomechanics in individuals with FHP remains scarce. This study aimed to investigate gait biomechanics in FHP, with a gait performance-based craniovertebral angle (CVA) cut-off.
Forty-eight participants were included in the study, with CVA measurements used to assess head-and-neck posture. Three-dimensional kinematic and kinetic data were collected using a motion capture system during three walking trials at preferred speeds. Spatiotemporal gait parameters, joint angles, joint moments, joint powers, joint forces, center of mass (COM) trajectories, and COM-to-joint (knee and ankle) angles were analyzed. Time-series data were compared between the two groups using statistical parametric mapping to identify potential changes during the gait cycle.
Forty-eight participants were divided into control ( = 26) and FHP ( = 22) groups based on a CVA cut-off of 44 degrees determined by K-means clustering. There were no significant differences in spatiotemporal gait parameters between the control and FHP groups. However, the FHP group exhibited significantly increased trunk flexion during the loading response and initial midstance (2.21–14.50%, = 0.047), as well as pre-swing and initial swing phases of the gait cycle (46.45–68.86%, = 0.039). The COM-to-knee angle was significantly reduced during mid-swing in the FHP group (71.26–87.92%, = 0.007). Additionally, significant differences in sagittal knee joint power and longitudinal joint forces at the knee and ankle were observed in the final stages of the gait cycle ( < 0.05). No significant differences were found in COM trajectories or other gait parameters.
This study identified phase-specific compensatory trunk flexion in individuals with FHP, despite preserved overall gait characteristics. A CVA cut-off of 44 degrees was proposed as a criterion for diagnosing FHP based on walking performance. These findings suggest that individuals with FHP employ specific biomechanical adaptations to maintain gait stability and underscore the importance of considering biomechanical adaptations in FHP diagnosis.
The online version contains supplementary material available at 10.1186/s12891-025-08882-8.
头部前倾姿势（FHP）是矢状面常见的姿势偏差。尽管对FHP的关注日益增加，但关于FHP个体的步态生物力学研究仍然匮乏。本研究旨在通过基于步态表现的颅椎角（CVA）临界值来研究FHP患者的步态生物力学。
48名参与者纳入本研究，通过测量CVA评估头颈部姿势。在以首选速度进行的三次步行试验中，使用运动捕捉系统收集三维运动学和动力学数据。分析时空步态参数、关节角度、关节力矩、关节功率、关节力、质心（COM）轨迹以及COM与关节（膝关节和踝关节）的角度。使用统计参数映射比较两组的时间序列数据，以识别步态周期中的潜在变化。
根据K均值聚类确定的44度CVA临界值，48名参与者被分为对照组（n = 26）和FHP组（n = 22）。对照组和FHP组在时空步态参数上无显著差异。然而，FHP组在负重反应和初始支撑中期（2.21 - 14.50%，P = 0.047）以及步态周期的摆动前期和初始摆动期（46.45 - 68.86%，P = 0.039）躯干前屈显著增加。FHP组在摆动中期COM与膝关节角度显著减小（71.26 - 87.92%，P = 0.007）。此外，在步态周期的最后阶段，矢状面膝关节功率以及膝关节和踝关节的纵向关节力存在显著差异（P < 0.05）。在COM轨迹或其他步态参数方面未发现显著差异。
本研究发现FHP个体存在特定阶段的代偿性躯干前屈，尽管整体步态特征保持不变。提出44度的CVA临界值作为基于步行表现诊断FHP的标准。这些发现表明FHP个体采用特定的生物力学适应来维持步态稳定性，并强调在FHP诊断中考虑生物力学适应的重要性。
在线版本包含可在10.1186/s12891 - 025 - 08882 - 8获取的补充材料。
