Pilates Mat Versus Cervical Stabilization Exercises on Myoelectric Activity of Cervical Muscles in Forward Head Posture (FHP)

Pilates Mat Versus Cervical Stabilization Exercises on Myoelectric Activity of Cervical Muscles, Craniovertebral Angle, Pain and Function in Young Adults With Forward Head Posture: Randomized Controlled Trial

see if there is no statistical significant difference between the effects of Pilates mat versus cervical stabilization exercises on myoelectric activity of cervical muscles in young adults with forward head posture.

Study Overview

• Status: Completed
• Conditions: Musculoskeletal Diseases
• Intervention / Treatment: Other: Pilates mat exercises; Other: conventional physiotherapy; Other: cervical stabilization exercises

Detailed Description

Forward head posture (FHP) increases extension of the atlanto-occipital joint and the upper cervical vertebrae as well as flexion of the lower cervical and upper thoracic vertebrae. Furthermore, this posture causes persistent and abnormal contraction of the suboccipital, neck, and shoulder muscles. Additionally, the muscles around the head and shoulders, including the trapezius, sternocleidomastoid, suboccipital, and temporal, are affected by FHP, which further worsens postural deformity. FHP is the most common deviation from ideal head posture and is characterized by the head projecting forward into the sagittal plane such that it is anterior to the trunk. Head in forward posture can add up to thirty pounds of abnormal leverage on the cervical spine, which pull the entire spine out of alignment, in addition, loss of the physiological lordosis could be a possible cause of pain due to muscular imbalance.

• Study Type: Interventional
• Enrollment (Actual): 60
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Egypt
  • Giza, Egypt, 12511
    • Faculty of Physical Therapy-Cairo University

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years to 25 years (Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• Subjects of both genders aged 18-25 years old with forward head posture will be included in this study
• Subjects have forward head posture if craniovertebral angle ≤ 50.
• Subjects complain non- specific neck pain for at least 3 months or at least two episodes of non-specific neck pain during the last three months.
• Normal body mass index

Exclusion Criteria:

• Subjects with any spinal problems
• Subjects with experience in Pilates exercises through the last 3 months of the start of intervention will be excluded from the study
• Previous surgery in the neck and shoulder regions
• Current participation in a structured exercises program
• Neurological symptoms of the upper extremities during screening tests (e.g., Spurling test and upper limb tension tests)
• Red flags suggesting of cancer, infection, vascular insufficiency
• Cervical radiculopathy or myelopathy

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Other
• Allocation: Randomized
• Interventional Model: Factorial Assignment
• Masking: None (Open Label)

Number of Arms

3

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Pilates mat exercises; one hour Pilates exercises with 10 min warm up and 5-10 min cooling down	Other: Pilates mat exercises; Pilates mat exercises: Each Pilates session will last for one hour and commence with a 10 minute warm up and finish with a 10 min cool down. The subjects will be taught the 5 key elements of Pilates (lateral costal breathing, centring which is a neutral position of the lumbar spine with activation of the core muscles, ribcage placement, shoulder blade placement and neutral position of the cervical spine with slight upper cervical flexion at the cranio-cervical junction). Pilates exercise program will consist of warm up exercises, main treatment program (10 level) and cooling down exercises.; Other: conventional physiotherapy; 10 min hot pack on cervical area range of motion exercises and isometric neck exercises as a home program 3 days/week for 12 weeks
Experimental: cervical stabilization exercises; training of deep cervical flexor muscles with pressure biofeedback unit	Other: conventional physiotherapy; 10 min hot pack on cervical area range of motion exercises and isometric neck exercises as a home program 3 days/week for 12 weeks; Other: cervical stabilization exercises; training of deep cervical flexor muscles with pressure biofeedback unit, 20 min/day, 3 days/week for 12 weeks.
Active Comparator: conventional physiotherapy; 10 min hot pack on cervical area range of motion exercises and isometric neck exercises as a home program	Other: conventional physiotherapy; 10 min hot pack on cervical area range of motion exercises and isometric neck exercises as a home program 3 days/week for 12 weeks

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Myoelectric activity of cervical muscles	by surface electromyography (EMG)	up to twelve weeks
Craniocervical angle	by photogrammetric method.	up to twelve weeks

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Pain intensity of neck area	by visual analogue scale 10 cm line with 2 ends, 0 and 10 ends 0 end means no pain 10 end means the worst pain	up to twelve weeks
function of daily life	by neck disability index	up to twelve weeks

Collaborators and Investigators

• Sponsor: Cairo University
• Investigators: Study Director: Haytham M Elhafez, Professor, professor of physical therapy- cairo university

Study record dates

Study Major Dates

• Study Start (Actual): October 1, 2021
• Primary Completion (Actual): December 30, 2021
• Study Completion (Actual): February 1, 2022

Study Registration Dates

• First Submitted: September 16, 2021
• First Submitted That Met QC Criteria: September 25, 2021
• First Posted (Actual): October 6, 2021

Study Record Updates

• Last Update Posted (Actual): October 28, 2022
• Last Update Submitted That Met QC Criteria: October 26, 2022
• Last Verified: October 1, 2022

More Information

Terms related to this study

• Keywords: Craniovertebral angle; Forward head posture; Pilates mat exercises
• Additional Relevant MeSH Terms: Musculoskeletal Diseases
• Other Study ID Numbers: P.T.REC/012/003349

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: Yes
• IPD Plan Description: we will share the results of the trial 1-craniovertebral angle 2-myoelevtric activity of cervical muscles 3-pain of neck area 4-function and neck disability
• IPD Sharing Time Frame: one year
• IPD Sharing Access Criteria: the criteria will be accessed by the publication of trials in international journal
• IPD Sharing Supporting Information Type: Study Protocol

Drug and device information, study documents

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