Immediate Effects of Atlanto-Occipital Mobilization on Head Posture, Respiratory Function, and Neck Mobility in Forward Head Posture

March 11, 2026 updated by: Mesut Arslan, Bitlis Eren University

An Investigation Into the Immediate Effects of Atlanto-Occipital Joint Mobilization on Head Posture, Respiratory Function, and Cervical Range of Motion in Individuals With Forward Head Posture

The purpose of this study is to investigate the immediate effects of atlanto-occipital joint mobilization on head posture, respiratory function, and cervical range of motion in healthy individuals with forward head posture.

Study Overview

Status

Status

Indicates the current recruitment status or the expanded access status.
Completed

Conditions

Conditions

The disease, disorder, syndrome, illness, or injury that is being studied. On ClinicalTrials.gov, conditions may also include other health-related issues, such as lifespan, quality of life, and health risks.

Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.

Detailed Description

Forward head posture (FHP) is a common postural disorder characterized by the anterior displacement of the head relative to the shoulders. The estimated prevalence of FHP among individuals who use electronic devices frequently is reported to be high, affecting a significant portion of the general population. While postural correction exercises and ergonomic education are generally the first-line management strategies for FHP, manual therapy techniques (such as joint mobilizations and soft tissue therapy) are often recommended as an adjunct treatment. Additionally, various physiotherapy approaches, including stretching of the posterior cervical muscles, strengthening of the deep neck flexors, and respiratory exercises, can also be utilized. Specific mobilization of the atlanto-occipital joint is theorized to normalize arthrokinematics and reduce fascial restrictions in the suboccipital region. This is said to decrease neuromuscular tension, improve proprioceptive input, and restore optimal alignment, resulting in positive effects on head posture, cervical mobility, and respiratory function.

Study Type

Study Type

Describes the nature of a clinical study. Study types include interventional studies (also called clinical trials), observational studies (including patient registries), and expanded access.
Interventional

Enrollment (Actual)

Enrollment

The number of participants in a clinical study. The "anticipated" enrollment is the target number of participants that the researchers need for the study.
54

Phase

Phase

The stage of a clinical trial studying a drug or biological product, based on definitions developed by the U.S. Food and Drug Administration (FDA). The phase is based on the study's objective, the number of participants, and other characteristics. There are five phases: Early Phase 1 (formerly listed as Phase 0), Phase 1, Phase 2, Phase 3, and Phase 4. Not Applicable is used to describe trials without FDA-defined phases, including trials of devices or behavioral interventions.
  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Contact

The name and contact information for the person who can answer enrollment questions for a clinical study. Each location where the study is being conducted may also have a specific contact, who may be better able to answer those questions.

Study Locations

  • Turkey (Türkiye)
      • Ankara, Turkey (Türkiye), 06000
        • Department of Physiotherapy and Rehabilitation, Ankara Yıldırım Beyazıt University

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Eligibility Criteria

The key requirements that people who want to participate in a clinical study must meet or the characteristics they must have. Eligibility criteria consist of both inclusion criteria (which are required for a person to participate in the study) and exclusion criteria (which prevent a person from participating). Types of eligibility criteria include whether a study accepts healthy volunteers, has age or age group requirements, or is limited by sex.

Ages Eligible for Study

  • Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • Volunteering to participate in the study.
  • Being between the ages of 18 and 45.
  • Having forward head posture according to craniovertebral angle measurement.

Exclusion Criteria:

  • History of cervical surgery or trauma.
  • Diagnosed cervical disc herniation or cervical stenosis.
  • Presence of a diagnosed neurological and/or rheumatological disorder.
  • Pregnancy.
  • Presence of malignancy.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Single

Arms and Interventions

Participant Group / Arm

Participant Group / Arm

A group or subgroup of participants in a clinical trial that receives a specific intervention/treatment, or no intervention, according to the trial's protocol.
Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.
Experimental: Mobilization group
The intervention group will receive atlanto-occipital joint mobilization.
Other: Atlanto-occipital joint mobilization
The intervention group will receive a single session of atlanto-occipital joint mobilization.
Sham Comparator: Sham group
The control group will receive the sham application.
Other: Sham application
The control group will receive a single session of sham intervention.

What is the study measuring?

Primary Outcome Measures

Primary Outcome Measures

In a clinical study's protocol, the planned outcome measure that is the most important for evaluating the effect of an intervention/treatment. Most clinical studies have one primary outcome measure, but some have more than one.
Outcome Measure
Measure Description
Time Frame
Craniovertebral Angle (CVA) for Forward Head Posture
Time Frame: Assessments will be performed at baseline (before the application) and immediately following the single-session intervention.
Forward head posture will be assessed by measuring the craniovertebral angle (CVA) using a goniometer. The CVA is the angle between the horizontal line passing through the C7 spinous process and the line from the tragus of the ear to the C7 spinous process.
Assessments will be performed at baseline (before the application) and immediately following the single-session intervention.
Respiratory Function assessed by Spirometry (FVC, FEV1, FEV1/FVC, PEF, FEF25-75%)
Time Frame: Assessments will be performed at baseline (before the application) and immediately following the single-session intervention.
Respiratory function will be assessed using a spirometry device. The following parameters will be recorded and analyzed: Forced Vital Capacity (FVC), Forced Expiratory Volume in one second (FEV1), the FEV1/FVC ratio, Peak Expiratory Flow (PEF), and Forced Expiratory Flow at 25-75% of FVC (FEF25-75%).
Assessments will be performed at baseline (before the application) and immediately following the single-session intervention.
Cervical mobility (Cervical Range of Motion (CROM)) assessed by Bubble Inclinometer
Time Frame: Assessments will be performed at baseline (before the application) and immediately following the single-session intervention.
Cervical mobility (range of motion) will be assessed using a bubble inclinometer. Active range of motion will be measured in degrees for the movements of flexion, extension, lateral flexion (left/right), and rotation (left/right).
Assessments will be performed at baseline (before the application) and immediately following the single-session intervention.

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Sponsor

The organization or person who initiates the study and who has authority and control over the study.
Bitlis Eren University

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

Study Start

The actual date on which the first participant was enrolled in a clinical study. The "anticipated" study start date is the date that the researchers think will be the study start date.
December 5, 2025

Primary Completion (Actual)

Primary Completion

The date on which the last participant in a clinical study was examined or received an intervention to collect final data for the primary outcome measure. Whether the clinical study ended according to the protocol or was terminated does not affect this date. For clinical studies with more than one primary outcome measure with different completion dates, this term refers to the date on which data collection is completed for all the primary outcome measures. The "anticipated" primary completion date is the date that the researchers think will be the primary completion date for the study.
March 1, 2026

Study Completion (Actual)

Study Completion

The date on which the last participant in a clinical study was examined or received an intervention/treatment to collect final data for the primary outcome measures, secondary outcome measures, and adverse events (that is, the last participant's last visit). The "anticipated" study completion date is the date that the researchers think will be the study completion date.
March 1, 2026

Study Registration Dates

First Submitted

First Submitted

The date on which the study sponsor or investigator first submitted a study record to ClinicalTrials.gov. There is typically a delay of a few days between the first submitted date and the record's availability on ClinicalTrials.gov (the first posted date).
December 5, 2025

First Submitted That Met QC Criteria

First Submitted That Met QC Criteria

The date on which the study sponsor or investigator first submits a study record that is consistent with National Library of Medicine (NLM) quality control (QC) review criteria. The sponsor or investigator may need to revise and submit a study record one or more times before NLM's QC review criteria are met. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
December 17, 2025

First Posted (Actual)

First Posted

The date on which the study record was first available on ClinicalTrials.gov after National Library of Medicine (NLM) quality control (QC) review has concluded. There is typically a delay of a few days between the date the study sponsor or investigator submitted the study record and the first posted date.
December 23, 2025

Study Record Updates

Last Update Posted (Actual)

Last Update Posted

The most recent date on which changes to a study record were made available on ClinicalTrials.gov. There may be a delay between when the changes were submitted to ClinicalTrials.gov by the study's sponsor or investigator (the last update submitted date) and the last update posted date.
March 12, 2026

Last Update Submitted That Met QC Criteria

Last Update Submitted That Met QC Criteria

The most recent date on which the study sponsor or investigator submitted changes to a study record that are consistent with National Library of Medicine (NLM) quality control (QC) review criteria. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
March 11, 2026

Last Verified

Last Verified

The most recent date on which the study sponsor or investigator confirmed the information about a clinical study on ClinicalTrials.gov as accurate and current. If a study with a recruitment status of recruiting; not yet recruiting; or active, not recruiting has not been confirmed within the past 2 years, the study's recruitment status is shown as unknown.
March 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

Other Study ID Numbers

Identifiers or ID numbers other than the NCT number that are assigned to a clinical study by the study's sponsor, funders, or others. These numbers may include unique identifiers from other trial registries and National Institutes of Health grant numbers.
  • BP-M

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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