Shoulder Mobility and Cervical Postural Alignment in Regular Versus Irregular Salah Performers: A Comparative Cross-Sectional Study

Abstract

Background: Habitual physical inactivity is a recognised contributor to progressive shoulder stiffness and forward head posture, two of the most prevalent upper quadrant musculoskeletal presentations in contemporary adults. Daily Islamic prayer (Salah) imposes a structured sequence of upper limb elevation, cervical flexion and extension, and bilateral trunk rotation that may exert biomechanically meaningful stimuli on glenohumeral mobility and cervicocranial alignment. No comparative investigation has previously used validated clinical instruments to quantify these outcomes between adults who differ systematically in their Salah observance.

Objectives: To compare shoulder flexion and abduction range of motion and craniovertebral angle between adult males categorised as regular or irregular Salah performers, using standardised clinical measurement instruments.

Methods: Forty adult males (aged 18-45 years) were enrolled in a comparative cross-sectional study and stratified into Group A (regular performers, n=20; all five daily prayers for ≥1 year) or Group B (irregular performers, n=20; <3 prayers daily). Bilateral shoulder flexion and abduction were measured using a universal goniometer. Cervical postural alignment was quantified by the Cranio Vertebral Angle (CVA) measured from standardised lateral digital photographs. Between-group comparisons were conducted using independent-samples t-tests (α=0.05), with effect magnitude expressed as Cohen’s d.

Results: Regular Salah performers demonstrated significantly greater shoulder flexion (166.8±4.3° vs. 154.2±5.7°; p<0.001; d=2.51) and abduction (170.4±4.8° vs. 158.1±6.2°; p<0.001; d=2.26) than irregular performers. CVA was significantly larger in Group A (51.4±2.9° vs. 42.7±3.6°; p<0.001; d=2.69), indicating substantially less forward head posture. All effect sizes were very large.

Conclusion: Regular Salah practice is independently associated with superior glenohumeral mobility and superior cervical postural alignment in adult males. The magnitude of group differences is large and clinically meaningful, supporting the consideration of Salah-based movement as a culturally congruent framework for upper quadrant health promotion and preventive physiotherapy in Muslim communities.

Keywords: Salah; Islamic Prayer; Shoulder Mobility; Cervical Posture; Craniovertebral Angle; Goniometry; Glenohumeral Range of Motion; Forward Head Posture; Musculoskeletal Health; Neuromuscular Adaptation

Citation

Raffiq Ali S, Muthukrishnan P. Shoulder Mobility and Cervical Postural Alignment in Regular Versus Irregular Salah Performers: A Comparative Cross-Sectional Study. WebLog J Phys Ther Rehabil. wjptr.2026.h1007. https://doi.org/10.5281/zenodo.22068950