Effects of Corrective Exercises and Postural Education on Forward Head Posture

Effects of Corrective Exercises and Postural Education on Forward Head Posture- A Randomized Controlled Trial

Forward head posture is one of the most common postural problems that we face today. Sitting for long periods in poor posture and the excessive use of electronic devices has become a high risk for this postural abnormality.

The goal of this [interventional study] is to [provide the participants with simple and easy corrective exercises for this abnormal posture which they can do anywhere at any time and to provide postural education and awareness on the matter.

Study Overview

• Status: Completed
• Conditions: Musculoskeletal Deformity
• Intervention / Treatment: Other: Corrective Exercises; Other: Postural Education

Detailed Description

Forward head posture is one of the most common postural problems that we face today. Sitting for long periods in poor posture and the excessive use of electronic devices has become a high risk for this postural abnormality.

The goal of this [interventional study] is to [provide the participants with simple and easy corrective exercises for this abnormal posture which they can do anywhere at any time and to provide postural education and awareness on the matter. Also, this study aims in comparing both the treatment and education.] in [the people who have forward head posture or are more likely to develop it]. The main question[s] it aims to answer are:

• Does corrective exercises have any effect on improving forward head posture?
• Does postural education has any effect on improving forward head posture?

Participants in [-Exercise group will perform corrective exercises for 6 weeks

• Postural Education group will follow postural guidelines while doing daily tasks for 6 weeks
• Control group will do nothing in 6 weeks]. Researchers will compare [Corrective Exercise group with Postural Education group and control group] to see if [corrective exercise group or postural education group has any effect on forward head posture and compare the results with the control group].

• Study Type: Interventional
• Enrollment (Actual): 46
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Turkey
  • Atasehir
    • Istanbul, Atasehir, Turkey
      • Yeditepe University

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult
• Accepts Healthy Volunteers: Yes

Description

Inclusion Criteria:

1. Consent to participate in the study.
2. Young & Middle-aged Adults between the ages of 20-40 years
3. Craniovertebral angle less than or equal to 50°
4. Shoulder Angle less than or equal to 52°

Exclusion Criteria:

1. History of Trauma
2. Acute Neck Injuries e.g., Whiplash
3. Surgical history

Study Plan

How is the study designed?

Design Details

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

Number of Arms

3

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Active Comparator: Corrective Exercises Group; The researcher will teach a total of 6 evidence-based corrective exercises and stretches. The participants will perform this for the prescribed time for a minimum of 3 and 5 times a week for a total of 6 weeks of the trial.	Other: Corrective Exercises; A total of 6 evidence-based exercises and stretches namely; Upper trapezius stretch, Sternocleidomastoid stretch, pectoral stretch; Chin tuck exercise, YTWL exercise, and resisted/isometric neck extension exercise will be prescribed to the exercise group while the postural education group will follow the guidelines provided by National Institutes of Health (NIH) for using computers and other sources. The control group will receive no intervention.
Active Comparator: Postural Education Group; Postural guidelines for doing daily activity especially sitting for prolonged periods and using electronic devices like computers and other electronic devices.	Other: Postural Education; Postural guidelines for doing daily activity especially sitting for prolonged periods and using electronic devices like computers and other electronic devices.
No Intervention: Control Group; This group will not receive either of the above mentioned treatments.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Craniovertebral Angle	The CVA is obtained by measuring the angle formed by the intersection of two lines drawn through particular anatomical landmarks and can be obtained using an image of the sagittal view of a person's head and neck. The first line is drawn from the tragus of the ear to the spinous process of the C7 vertebrae, and the second line is drawn through the spinous process of the C7 vertebrae horizontally. Although, there is no clear cut-off point threshold, identifying FHP for craniovertebral angle, in general, subjects with smaller craniovertebral angle i.e. less than 50 degrees have more Forward head posture	6 weeks
Shoulder Angle	It is considered as the angle between a horizontal line through the spinous process of the C7 vertebra and a line passes from the midpoint of the shoulder joint through the spinous process of the seventh cervical vertebra.	6 weeks

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Short Survey 36 Questionnaire	The 36-Item Short Form Survey (SF-36) is an outcome measure instrument that is often used, a well-researched, self-reported measure of health. The SF-36 is often used as a measure of a person or population's quality of life (QOL).	6 weeks
Numeric Pain Rating Scale	The Numeric Pain Rating Scale (NPRS) (an outcome measure) is a unidimensional measure of adult pain intensity. This 11-point numeric scale ranges from '0' representing one pain extreme (e.g., "no pain") to '10' representing the worst pain imaginable.	6 weeks

Collaborators and Investigators

• Sponsor: Yeditepe University
• Investigators: Principal Investigator: Ebru Akbuga, Assistant Professor

Publications and helpful links

General Publications

• Sheikhhoseini R, Shahrbanian S, Sayyadi P, O'Sullivan K. Effectiveness of Therapeutic Exercise on Forward Head Posture: A Systematic Review and Meta-analysis. J Manipulative Physiol Ther. 2018 Jul-Aug;41(6):530-539. doi: 10.1016/j.jmpt.2018.02.002. Epub 2018 Aug 11.
• Ruivo RM, Pezarat-Correia P, Carita AI. Effects of a Resistance and Stretching Training Program on Forward Head and Protracted Shoulder Posture in Adolescents. J Manipulative Physiol Ther. 2017 Jan;40(1):1-10. doi: 10.1016/j.jmpt.2016.10.005. Epub 2016 Nov 11.
• Heydari Z, Sheikhhoseini R, Shahrbanian S, Piri H. Establishing minimal clinically important difference for effectiveness of corrective exercises on craniovertebral and shoulder angles among students with forward head posture: a clinical trial study. BMC Pediatr. 2022 Apr 27;22(1):230. doi: 10.1186/s12887-022-03300-7. Erratum In: BMC Pediatr. 2022 Sep 28;22(1):564.

Study record dates

Study Major Dates

• Study Start (Actual): May 12, 2023
• Primary Completion (Actual): June 30, 2023
• Study Completion (Actual): July 10, 2023

Study Registration Dates

• First Submitted: May 11, 2023
• First Submitted That Met QC Criteria: May 31, 2023
• First Posted (Actual): June 8, 2023

Study Record Updates

• Last Update Posted (Actual): August 1, 2023
• Last Update Submitted That Met QC Criteria: July 31, 2023
• Last Verified: July 1, 2023

More Information

Terms related to this study

• Keywords: Posture; Musculoskeletal; Postural Education; Forward head Posture; Corrective Exercises; Craniovertebral and Shoulder angles
• Additional Relevant MeSH Terms: Congenital Abnormalities
• Other Study ID Numbers: Forward Head Posture

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO
• IPD Plan Description: The participant data contains sensitive information like their contact and photographs. That is why this information will not be shared.

Drug and device information, study documents

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