The relationship between lumbar core stability, neck pain, functional disability, and forward head posture in patients with chronic nonspecific neck pain: a cross-sectional study

Background. Posture depends on coordinated spinal interactions between musculoskeletal and neuromuscular mechanisms to produce optimal function. Although the cervical and lumbar are biomechanically connected, the relationship between spinal core stability, endurance and posture in neck pain remains unclear. Purpose. To investigate the correlation between lumbar core endurance, neck pain and function, forward head posture, and cervical activation and endurance in chronic nonspecific neck pain patients (CNSNP). Methods. Sixty-six participants with CNSNP were recruited for this cross-sectional study. Plank tests evaluated core endurance. Cervical pain and function were assessed by VAS and Neck Disability Index. Forward head posture was evaluated by craniovertebral angle (CVA) and cervical endurance was assessed by craniocervical flexion test and neck flexor endurance tests. Results. Significant moderate positive correlations were found between left plank endurance and both neck flexor endurance and CVA (r = 0.441, p < 0.001, r = 0.290, p = 0.018, respectively). A weak positive significant correlation was observed between trunk extension endurance and CVA (r = 0.288, p = 0.019). Conclusion. Lateral and posterior core endurance appears to be associated with cervical posture and muscle performance, supporting the concept of regional interdependence. Incorporating trunk stability exercises may enhance rehabilitation outcomes in patients with FHP and chronic neck pain.