Review of Forward-Head Posture and Vestibular Deficits in Older Adults

  • Sara MigliareseEmail author
  • Emma White
Surgical Care (F Luchette and R Gonzalez, Section Editors)
Part of the following topical collections:
  1. Topical Collection on Surgical Care


Purpose of Review

Forward-head posture (FHP) is a common postural deviation associated with older age, cervical muscle weakness, poor balance, anteriorly displaced center of mass, increased postural sway and fall risk, impaired cervical proprioception, and possibly vestibular dysfunction. Studies have found increased fall risk in older adults with FHP but have not identified a casual reason for this relationship. This review aims to examine the links between (FHP) and vestibular deficits.

Recent Findings

While assessment of overall posture, including FHP, is a common component of a physical therapy evaluation, a standardized method of clinical measurement for FHP is lacking. The craniovertebral angle (CVA) appears to be the most reliable method, with FHP defined as less than or equal to 44–53 degrees. Studies where FHP is measured using the CVA appear to be more accurate in identifying associations between this postural deviation and factors that impact postural control in older adults, such as balance and cervical proprioception. Limited studies have found FHP to be associated with duration of clinical symptoms of vestibular disease. FHP also heightens age-related increases in anterior-posterior postural sway.


Compelling evidence exists that links FHP with vestibular deficits, increased fall risk, and impaired cervical proprioception. Further research using CVA and a consistent definition of FHP is needed to answer this question and develop clinical practice guidelines.


Forward head posture Elderly Vestibular deficits Fall risk 


Compliance with Ethical Standards

Conflict of Interest

Sara Migliarese and Emma White each declare that they have no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.


Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Physical TherapyWinston-Salem State UniversityWinston-SalemUSA

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