Efficacy of Deep Cervical Training Combined With Mobilization Techniques on Forward Head Posture

Efficacy of Deep Cervical Training Combined With Mobilization Techniques on Forward Head

To investigate the efficacy of adding cervical & thoracic spinal mobilization techniques to deep cervical training compared to deep cervical training alone on Pain, Neck functional ability, Craniovertebral angle.

Study Overview

• Status: Recruiting
• Conditions: Forward Head Posture
• Intervention / Treatment: Other: Deep Cervical Training; Other: Deep cervical training + Upper cervical mobilization group; Other: Deep cervical training + Upper thoracic mobilization group

• Study Type: Interventional
• Enrollment (Anticipated): 66
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Ahmed Ma Hamed, M.Sc.; Phone Number: +2 01064123606; Email: ahmedmahmoudbusiness@gmail.com

Study Locations

• Egypt
  • Cairo, Egypt, 00202
    • Recruiting
    • The Egyptian Chinese University
    • Contact: Ahmed Ma Hamed, M.Sc.; Phone Number: +2 01064123606; Email: ahmedmahmoudbusiness@gmail.com

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:

• The craniovertebral angle is less than 50 degrees.
• Age ranges from 18 to 25 years old.
• Forward head is associated with neck pain.

Exclusion Criteria:

A history of any of the following conditions:

• Previous surgery regarding the spine or shoulders.
• Vertebral fractures regarding the cervical spine or the skull.
• Positive neurological signs or evidence of spinal compression
• headaches prior to the onset of neck pain and without cervical origin
• Inner ear or vestibular Problems
• Whiplash Injuries

Study Plan

How is the study designed?

Design Details

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

Number of Arms

3

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Active Comparator: Control Group ( Deep Cervical Training )	Other: Deep Cervical Training; The Cranio cervical flexion exercise will be performed with the patient in supine crook lying with the neck in a neutral position (no pillow) such that the line of the face is horizontal and a line bisecting the neck longitudinally is horizontal to the testing surface. The uninflated pressure sensor will be placed behind the neck so that it abutted the occiput and is inflated to a stable baseline pressure of 20 mm Hg, a standard pressure sufficient to fill the space between the testing surface and the neck but not push the neck into a lordosis. the patient attempted to sequentially target five, 2-mm Hg progressive pressure increases from the baseline of 20 mm Hg to a maximum of 30 mm Hg as well as to maintain a isometric contraction at the progressive pressures as an endurance task.
Experimental: Experimental group I (Deep cervical training + Upper cervical mobilization group)	Other: Deep Cervical Training; The Cranio cervical flexion exercise will be performed with the patient in supine crook lying with the neck in a neutral position (no pillow) such that the line of the face is horizontal and a line bisecting the neck longitudinally is horizontal to the testing surface. The uninflated pressure sensor will be placed behind the neck so that it abutted the occiput and is inflated to a stable baseline pressure of 20 mm Hg, a standard pressure sufficient to fill the space between the testing surface and the neck but not push the neck into a lordosis. the patient attempted to sequentially target five, 2-mm Hg progressive pressure increases from the baseline of 20 mm Hg to a maximum of 30 mm Hg as well as to maintain a isometric contraction at the progressive pressures as an endurance task.; Other: Deep cervical training + Upper cervical mobilization group; the patient in supine crook lying with the neck in a neutral position.The uninflated pressure sensor will be placed behind the neck so that it abutted the occiput and is inflated to a stable baseline pressure of 20 mm Hg, a standard pressure sufficient to fill the space between the testing surface and the neck but not push the neck into a lordosis. the patient attempted to sequentially target five, 2-mm Hg progressive pressure increases from the baseline of 20 mm Hg to a maximum of 30 mm Hg; The therapist will cover the rear of the cervical part of the participant with his right hand for stabilization, and will place his thumb and index fingers on the atlas of the participant. To conduct the atlanto-occipital mobilization, the therapist will place his left hand at the right side of the participant and at the same time will place his fifth finger under the occipital area and will pull the participant's head toward his trunk.
Experimental: Experimental group II (Deep cervical training + Upper thoracic mobilization group)	Other: Deep Cervical Training; The Cranio cervical flexion exercise will be performed with the patient in supine crook lying with the neck in a neutral position (no pillow) such that the line of the face is horizontal and a line bisecting the neck longitudinally is horizontal to the testing surface. The uninflated pressure sensor will be placed behind the neck so that it abutted the occiput and is inflated to a stable baseline pressure of 20 mm Hg, a standard pressure sufficient to fill the space between the testing surface and the neck but not push the neck into a lordosis. the patient attempted to sequentially target five, 2-mm Hg progressive pressure increases from the baseline of 20 mm Hg to a maximum of 30 mm Hg as well as to maintain a isometric contraction at the progressive pressures as an endurance task.; Other: Deep cervical training + Upper thoracic mobilization group; The Cranio cervical flexion exercise will be performed with the patient in supine crook lying with the neck in a neutral position (no pillow) such that the line of the face is horizontal and a line bisecting the neck longitudinally is horizontal to the testing surface. The uninflated pressure sensor will be placed behind the neck so that it abutted the occiput and is inflated to a stable baseline pressure of 20 mm Hg, a standard pressure sufficient to fill the space between the testing surface and the neck but not push the neck into a lordosis. the patient attempted to sequentially target five, 2-mm Hg progressive pressure increases from the baseline of 20 mm Hg to a maximum of 30 mm Hg as well as to maintain a isometric contraction at the progressive pressures as an endurance task.; The participants will be placed in the prone position and the therapist will stand facing the joint where the mobilization will be applied to improve the extension of the upper thoracic spine (T1-2).

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Craniovertebral Angle	The CVA was formed at the intersection of the horizontal line, which passed through the back and the line, which joined the tragus of the ear and the back. The Patient Will Be In Standing Position and the image will be taken from the lateral view then the image will be inserted to IMAGEJ Software To Measure The Angle	One Month
Deep Neck Core Strength	The the patient in supine crook lying with the neck in a neutral position. The uninflated pressure sensor will be placed behind the neck so that it abutted the occiput and is inflated to a stable baseline pressure of 20 mm Hg.The movement will perform gently and slowly as a head nodding action (as if saying "yes"). The Cranio cervical flexion exercise the activation and endurance of the deep cervical flexors in progressive inner range positions as the patient attempted to sequentially target five, 2-mm Hg progressive pressure increases from the baseline of 20 mm Hg to a maximum of 30 mm Hg as well as to maintain a isometric contraction at the progressive pressures as an endurance task.	One Month

Collaborators and Investigators

• Sponsor: Egyptian Chinese University

Study record dates

Study Major Dates

• Study Start (Anticipated): January 10, 2023
• Primary Completion (Anticipated): February 20, 2023
• Study Completion (Anticipated): February 20, 2023

Study Registration Dates

• First Submitted: November 23, 2022
• First Submitted That Met QC Criteria: December 4, 2022
• First Posted (Actual): December 14, 2022

Study Record Updates

• Last Update Posted (Estimate): January 10, 2023
• Last Update Submitted That Met QC Criteria: January 9, 2023
• Last Verified: January 1, 2023

More Information

Terms related to this study

• Other Study ID Numbers: P.T.REC/012/003524

Drug and device information, study documents

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