Exploring the relationship between neck flexion and neck problems in occupational populations: a systematic review of the literature

Hamid Norasi, Emmanuel Tetteh, Pramiti Sarker, Gary A. Mirka, M. Susan Hallbeck

Research output: Contribution to journalReview articlepeer-review

Abstract

A systematic review was conducted to evaluate the relationship between occupational neck flexion angles and neck problems. The synthesised findings were used to answer three research questions: (1) Is there a positive/negative relationship between neck flexion and neck problems? (2) What is the appropriate angular threshold for neck flexion as a risk factor for neck problems? (3) What are the gaps in our current knowledge? A review of 21 papers revealed (1) a consistent positive correlation between neck flexion and neck problems, and (2) a neck flexion angle of 20° as the most evidence-based (not necessarily the best) cut-off angle separating high- and low-risk neck flexion postures. Future research should focus on the (1) continuous collection of three-dimensional neck postures through longitudinal studies to quantify cumulative exposures of neck postures, and (2) development of standard descriptions of ‘neck problems’ and ‘neck flexion’ to facilitate the development of a dose-response relationship. Practitioner summary: Practitioners depend on thresholds for evaluating neck postural exposure using work assessment tools; however, the scientific basis for this is unclear. This systematic review investigated the angular threshold for neck flexion and found 20° of neck flexion with the greatest evidence-based support as the threshold for high-risk neck postural exposure.

Original languageEnglish (US)
JournalErgonomics
DOIs
StateAccepted/In press - 2021

Keywords

  • cervical spine
  • neck musculoskeletal disorders
  • neck pain
  • Neck postural exposure

ASJC Scopus subject areas

  • Human Factors and Ergonomics
  • Physical Therapy, Sports Therapy and Rehabilitation

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