Prevalence of Forward Head Posture among School Children Using Smartphones in Rawalpindi

Forward Head Posture and Smartphone Use

Abstract

Background: Forward head posture (FHP) is a postural dysfunction characterized by the anterior displacement of the head relative to the vertical midline. The increasing use of smartphones has been implicated in the rising prevalence of FHP among schoolchildren.

Objectives: This study aimed to determine the prevalence of forward head posture among school going children in Rawalpindi, Pakistan, and to assess its association with smartphone usage patterns.

Methods: A descriptive cross-sectional study was conducted in private schools in Rawalpindi from September 2023 to March 2024. A total of 270 participants, aged 10–15 years, were selected using non-probability convenience sampling. Craniovertebral angle (CVA) was measured using Kinovea software for forward head posture measurement after marking the C7 vertebra and capturing lateral-view images. Smartphone usage patterns were assessed through a semi-structured questionnaire. Data were analyzed using SPSS version 25, with results presented as frequencies, percentages, and mean ± SD.

Results: The prevalence of forward head posture (CVA < 48°) was 88.5% (n=239), with males (88.5%) and females (88.6%) equally affected. Most participants (73%) used smartphones more than five days per week, and 91.5% had over two years of usage history.

Conclusion: Forward head posture was highly prevalent among school children in Rawalpindi, strongly associated with prolonged smartphone use. Interventions targeting posture education are urgently needed.

Keywords: Cervical Vertebrae, Craniovertebral Angle, Forward Head Posture, Mobile Phones, Posture, School Children, Smartphone Usage