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Revista Paraguaya de Reumatología

On-line version ISSN 2413-4341


BENEGAS, Eric et al. Frequency of Cephalic Antepulsion in Medicine Students, associated factors and symptoms. Rev. parag. reumatol. [online]. 2020, vol.6, n.1, pp.17-21. ISSN 2413-4341.


Cephalic antepulsion is defined as a biomechanic alteration of the frontal plane where the head is anteriorized in respect to the trunk and there is hypotonia of the poste- rior cervical muscles and hyperextension of the upper cervical spine. It is the result of poor posture while doing activities such as sitting down for long periods of time during studying.

Materials and methods:

Observational, transversal and analytic study. Sample size was 118 medical students from Universidad Nacional de Asunción, selected using non-probability sampling. The study was based on a survey and kinesiologic evaluation: Kendall’s posture evaluation technique for the diagnosis of cephalic antepulsion. Means, standard deviation, frequencies and percentages were used for the descriptive statistical analysis. For the association study between the presence of cephalic antepulsion and associated factors, X2 test and OR with its respective CI were used. A statistically significant p was considered at values lower than 0.05.


55.1% were men, mean age was 21.25 (±1.40 years). 30.5% of students have assured that they adopt this position while studying for more than 3 hours a day. When applying Kendall’s evaluation technique, it was found that 78% presents cephalic antepulsion, 57% being male students. Regarding most frequent symptoms, 77.1% had back pain; followed by headache (57.6%) and shoulder pain (55.7%). Association analysis showed that antepulsion is associated to study hours (p=0.001), with an OR 1.6 (1.1-2.6). The association increases with study time. However, when conducting an association analysis with symptoms, a relationship between antepulsion and symptoms referred by students could not be proven.


We found a high frequency of cephalic antepulsion in medical students and a strong correlation between the amount of time spent studying in poor posture and cephalic antepulsion.

Keywords : Cephalic Antepulsion; Study Time; Students; back pain.

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