Body mass index, craniovertebral angle, and pectoralis major and upper trapezius muscle length in young adults with neck pain: a cross-sectional observational study
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Abstract
Background: Neck pain is a common musculoskeletal complaint in young adults, and postural change, muscle shortening and body composition are frequently implicated in its development. Whether body mass index (BMI), craniovertebral angle (CVA), pectoralis major (PM) length and upper trapezius (UT) length act together, rather than in isolation, to influence pain intensity in this age group has rarely been examined.
Objective: To determine the correlation of BMI, CVA, PM length and UT length with neck pain intensity in young adults.
Methods: In this cross-sectional observational study, 96 college students (70 men, 26 women; mean age 21.16 ± 1.81 years) with mild-to-moderate neck pain (Numeric Pain Rating Scale [NPRS] score 1–6) were recruited from colleges in Meerut, Uttar Pradesh, India. BMI was calculated from measured height and weight. CVA was assessed photogrammetrically using Kinovea software. PM and UT muscle lengths were measured bilaterally with a standard tape technique and averaged across sides. Because NPRS and BMI departed from a normal distribution on the Shapiro-Wilk test, Spearman’s rank-order correlation was used throughout.
Results: PM length correlated negatively with NPRS (ρ = -0.210, p = 0.040). CVA (ρ = -0.185, p = 0.071) and UT length (ρ = -0.195, p = 0.057) showed negative trends that approached but did not reach significance. BMI was not directly associated with NPRS (ρ = +0.151, p = 0.143), but correlated significantly with CVA (ρ = -0.483, p < 0.001) and PM length (ρ = +0.376, p < 0.001).
Conclusion: Pectoralis major tightness was the only parameter independently and significantly associated with neck pain intensity in this sample. CVA and upper trapezius length showed clinically relevant marginal trends, and BMI appears to influence neck pain indirectly, through posture and muscle length, rather than as a direct predictor. A multimodal physiotherapy approach that prioritises pectoralis major stretching alongside postural correction may benefit young adults with neck pain.
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