# Spinal Posture, Mobility, and Muscle Endurance in Women With Tension‐Type Headache: A Case‐Control Study

## TL;DR

Women with tension-type headache have reduced cervical mobility and muscle endurance compared to those without the condition.

## Contribution

This study identifies biomechanical differences in spinal posture and muscle endurance in women with tension-type headache.

## Key findings

- Women with TTH had significantly lower cervical flexion and extension mobility.
- Cervical flexor and deep neck flexor muscle endurance were reduced in TTH patients.
- Trunk muscle endurance and core stability were also lower in the TTH group.

## Abstract

Tension‐type headache (TTH), a prevalent form of primary headache, has been linked to alterations in spinal biomechanics.

This study aimed to compare spinal posture, mobility, and muscle endurance between women with and without TTH.

This case‐control study included 68 women aged 18–55 years with (n = 34, age = 20.51 ± 1.73 years, BMI = 22.03 ± 2.90 kg/m2) and without (n = 34, age = 19.91 ± 0.99 years, BMI = 21.38 ± 2.99 kg/ m2) TTH. Posture (craniovertebral angle) and mobility (range of motion) of the cervical region were evaluated with a goniometer and posture and mobility of the thoracic and lumbar and sacral regions in the sagittal plane were evaluated with the Spinal Mouse device (IDIAG M360, Fehraltorf, Switzerland), cervical region muscle endurance was evaluated with cervical flexion and extension endurance tests and the craniocervical flexion test, and trunk muscle endurance was evaluated with McGill’s trunk muscle endurance tests and the Sahrmann test.

Cervical flexion (95% CI: −1.38 to −0.40, d = 0.90, p ≤ 0.001) and extension (95% CI: −2.02 to −0.97, d = 1.50, p ≤ 0.001) mobility and cervical flexor (95% CI: −1.49 to −0.49, d = 0.99, p ≤ 0.001) and deep neck flexor muscle endurance (95% CI: −1.64 to −0.61, d = 1.13, p ≤ 0.001) scores were lower in women with TTH compared to the healthy controls. It was also observed that the thoracic angle (95% CI: 0.11 to 1.08, d = 0.60, p = 0.015) was higher in the sagittal plane and trunk flexor (95% CI: −1.33 to −0.35, d = 0.84, p = 0.001) and trunk right/left lateral flexor muscle endurance (95% CI: −1.75 to −0.73, d = 1.24, p ≤ 0.001)/(95% CI: −1.76 to −0.73, d = 1.25, p ≤ 0.001) and trunk core stability (p = 0.003) scores were lower.

Cervical mobility was less and cervical muscle endurance was lower in women with TTH, but their cervical postures were similar. It was also observed that thoracic angle was higher in sagittal plane and trunk muscle endurance was lower.