Effects of Global Postural Reeducation on Forward Head Posture

Effect of Global Postural Reeducation on Functional Abilities, Stability of Sense of Position, Cognitive Abilities and Treatment Satisfaction in Patients With Forward Head Posture

This study aims at investigating the effects of application of twelve sessions of Global Postural Re-education Technique (GPR) and Kendall Exercises (KE) on Craniovertebral angle (CVA), Gaze Angle (GA), Shoulders Angle (SA), Pain, functional abilities, Range of Motion, stability of sense of position, cervical muscle strength and endurance, Spinal mobility, and Chest Expansion.

Study Overview

• Status: Completed
• Conditions: Forward Head Posture
• Intervention / Treatment: Other: Global Postural Re-education; Other: Kendall exercises

Detailed Description

A sample of 43 participants with a CVA less than 50 degrees will be randomly assigned to one of the two groups either receiving global postural reeducation added to traditional Kendall exercises or a group that receives Kendall Exercises only. Treatment sessions will be continued for a total of 12 sessions with a rate of 3 sessions per week. The effect of these two treatments will be assessed by various variables including: forward head angle, Gaze Angle and Shoulder angle via photogrammetry and Kinovea App, Pain intensity (VAS), functional abilities via neck disability index (NDI), cervical Range of motion and sense of position stability by Cervical Range of Motion instrument (CROM), Spinal mobility and chest expansion by tape measurement.

• Study Type: Interventional
• Enrollment (Actual): 43
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Egypt
  • Damietta, Egypt, 34518
    • Horus University

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years to 30 years (Adult)
• Accepts Healthy Volunteers: Yes

Description

Inclusion Criteria:

• Patients suffering from forward head Posture (CVA less than 50 degrees)
• All subjects are medically stable and do not suffer from any other diseases which might affect the trial results.
• BMI (18-24)
• Patients willing and able to participate in this treatment program.
• At least a moderate user of English.

Exclusion Criteria:

• History of whiplash injury.
• Patients who have undergone spinal surgeries or spinal fixations.
• Patients with a neurologic deficit in their upper limbs, such as hypertonia, hypotonia, hyporeflexia, absence of reflex, and vertebral instability.

The patient underwent other physical therapy programs in the last three months.

- Excessive use of smart technology

Study Plan

How is the study designed?

Design Details

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

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: GPR; participants in this group receive global postural reeducation technique+ Kendall exercises	Other: Global Postural Re-education; treatment techniques include corrective exercises both local and global to correct forward head posture. first session will be to educate participants on the treatment sequence. This will be a session of Kendall's exercises as described below. This will followed be by performing GPR techniques of Anterior Chain stretch in the supine frog-like position for 20 minutes followed by posterior chain stretch against the wall for another 20 minutes. This is repeated in the first 6 sessions. Starting from the seventh session the time of holding each position is decreased to 15 minutes and a third position (standing against the wall) is introduced and performed for 15 minutes. Starting from the eighth session fourth position of sitting on the floor position is introduced and performed for another 15 minutes. total of a session will then take about 90 minutes. Pre-treatment diaphragmatic release and deep breathing exercises are applied at the beginning of each session; Other: Kendall exercises; exercises that correct upper crossed syndrome: The treatment sequence will be: a) Strengthen deep Cervical Flexors via Chin tucks. Repetition will be repeated 10 times for 5 sets. (b) Stretching the cervical extensors. This is held for 1 minute and repeated 5 times. (c) Strengthening shoulder retraction. Repetition will be repeated 10 times for 5 sets. (d) Stretching the pectoralis muscle. This is held for 1 minute and repeated 5 times. Exercises will be progressed as the sessions develop.
Active Comparator: Kendall; Kendall exercises	Other: Kendall exercises; exercises that correct upper crossed syndrome: The treatment sequence will be: a) Strengthen deep Cervical Flexors via Chin tucks. Repetition will be repeated 10 times for 5 sets. (b) Stretching the cervical extensors. This is held for 1 minute and repeated 5 times. (c) Strengthening shoulder retraction. Repetition will be repeated 10 times for 5 sets. (d) Stretching the pectoralis muscle. This is held for 1 minute and repeated 5 times. Exercises will be progressed as the sessions develop.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
craniovertebral angle	the angle formed between a horizontal line and a line extending from ear meatus and C7	before and after 12 sessions

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Gaze Angle	the angle formed between the line extending from the tragus of the ear to the canthus of the eye.	before and after 12 sessions
Shoulder Angle	the angle formed between the line extending from C7 to acromion with horizontal line	before and after 12 sessions
Proprioceptive stability test	By utilizing CROM testing the patients' sense of location precision	before and after 12 sessions
Spinal mobility	Fingers to floor test using a tape measurement	before and after 12 sessions
Chest expansion	Axillary and Xyphoid chest expansion by the tape measurement	before and after 12 sessions
Cervical muscle strength and endurance	Biofeedback stabiliser is used to measure the maximum time the muscles could hold in addition to time the contraction of 50% maximum muscle contractionis maintained.	before and after 12 sessions
Neck disability index	a scale that tests the effect of treatment on functional abilities of patients.	before and after 12 sessions
Pain intensity	Visual analogue scale is given to participants to select their pain scale level.	before and after 12 sessions

Collaborators and Investigators

• Sponsor: Horus University
• Collaborators: Cairo University
• Investigators: Principal Investigator: Walaa Abu-Taleb, MSc, Cairo University

Study record dates

Study Major Dates

• Study Start (Actual): February 6, 2021
• Primary Completion (Actual): October 4, 2021
• Study Completion (Actual): October 14, 2021

Study Registration Dates

• First Submitted: January 15, 2021
• First Submitted That Met QC Criteria: January 22, 2021
• First Posted (Actual): January 25, 2021

Study Record Updates

• Last Update Posted (Actual): August 7, 2024
• Last Update Submitted That Met QC Criteria: August 5, 2024
• Last Verified: August 1, 2024

More Information

Terms related to this study

• Keywords: Forward Head Posture; Global Postural Re-education; Kendall Exercises; Rounded Shoulders; Postural Correction; Myofascial chains
• Other Study ID Numbers: P.T.REC/012/002671

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO
• IPD Plan Description: These data are case sensitive and considered confidential regarding my supervisors' opinion and participants' request , So, upon their request I prefer to not share individual participant data (IPD) with other researchers

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No