| Summary: | Background: Head posture (HP) assessment of patients with neck pain (NP) is claimed to be useful in aiding diagnosis, determining treatment strategies and monitoring patient progress. It is assumed that patients with NP have poorer HP than asymptomatic individuals. Objectives: To determine whether there are differences in angles or linear distances between anatomical landmarks used as surrogates for HP between individuals with and without NP. Methods: Studies were sought from PubMed, CINAHL, Physiotherapy Evidence Database, Sports Discus, Web of Science, Academic Search Premier and The Cochrane Library. Two reviewers screened titles and abstracts, and assessed full reports for potentially eligible studies. Data extraction and synthesis: Two reviewers independently extracted information on participants' characteristics, study methods and study quality. Discrepancies were resolved using a third reviewer as arbiter. Study heterogeneity prevented meta-analysis so a tally of study outcome was performed. Results: Seven of 13 included studies found no statistically significant differences in measurements of components of HP between participants with NP and asymptomatic participants. When compared to asymptomatic individuals NP patients were found to have greater forward HP in 4 of 19 comparisons (11 studies), greater head extension/flexion in two of nine comparisons (six studies) and less side-flexion and less rotation in one of one comparison (one study). Conclusion: There is insufficient good quality evidence to determine whether forward HP, head extension, side-flexion and rotation differ between participants with NP and asymptomatic participants.
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