Comparative Effects of Visual and Pressure Biofeedback in Symptomatic Forward Head Posture.

November 22, 2023 updated by: Riphah International University

Comparative Effects of Visual and Pressure Biofeedback on Pain, Range of Motion and Disability in Symptomatic Forward Head Posture.

This study aims to determined the comparative effect of visual and pressure biofeedback on Pain,Disability and Range of Motion in young and middle aged adults diagnosed with forward head posture.

Study Overview

Status

Recruiting

Conditions

Intervention / Treatment

Detailed Description

Forward head posture describes the shifting of the head forward with the chin poking out. It is caused by increased flexion of the lower cervical spine and upper thoracic.

Forward head posture is the most frequently observed postural deviations and is said to be associated with shortening of posterior cervical extensors and weakening of the anterior deep cervical flexors. In this randomized control trial participants showing forward head posture will be randomly assigned into two intervention groups. 28 subjects were divided equally into two groups 14 each containing both genders. Group A (Experimental group) will be given isometric strengthening and stretching training guided pressure biofeedback.

Group B (Experimental group) will be given isometric strengthening and stretching training of deep cervical flexor (DCF) muscle guided through visual biofeedback .

Each participant will be receive a total of twelve treatment sessions over a four-week period. The efficacy of the interventions will be assessed at the beginning (first session) and conclusion (last session) of the treatment period. The assessment will encompass various outcome measures. Pain intensity will be evaluated using the Numeric Pain Rating Scale (NPRS), while disability levels will be measured using the Neck Disability Index (NDI). The cervical active range of motions (CAROMs) will be assessed by goniometry. Finally, the visual feedback referred as indicator of measuring forward head posture by evaluating these outcome measures insights will be gained into the impact of the interventions on the participants' symptoms and postural alignment through light. The randomized design of the trial provide valuable information to healthcare professionals on how to manage symptomatic forward head posture and may contribute to the development of future research in this area.

Study Type

Interventional

Enrollment (Estimated)

28

Phase

  • 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 Backup

Study Locations

  • Pakistan
    • Punjab
      • Bahawalpur, Punjab, Pakistan, 63100
        • Recruiting
        • Bahawal Victoria Hospital QAMC Bahawalpur
        • Contact:
        • Principal Investigator:
          • Nusrat Prveen
      • Bahāwalpur, Punjab, Pakistan, 63100
        • Recruiting
        • Bahawal Victoria Hospital QAMC Bahawalpur
        • Principal Investigator:
          • Nusrat Prveen
        • Contact:
        • Contact:

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

Ages Eligible for Study

  • Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

1. Participants would be complaining of neck pain as a primary complain and age of 20- 35 year was recruited in the study .

2 . Male and female both gender are included in the study.

3. patient with Craniovertebral angle (CVA)<53 degree were included in the study .

4. Score more than 3 on NPRS and more than 10 on NDI.

Exclusion Criteria:

Participant failing to fall in this category would be excluded of the study.

  1. Neurogenic findings like cervical trauma, myopathy, vestibular pathology, dizziness, visual problem, spinal Fracture, dislocation and hypertension will not include in the study.
  2. History of sever metabolic diseases.
  3. History of recurrent surgery in upper thoracic and lumber vertebrae
  4. History of recent fractures in shoulder and neck region.
  5. History of tumor. -

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
Intervention / Treatment
Experimental: Group A
Movement control training of Neck flexor muscles with Pressure Biofeedback along with baseline treatment
Other: Cervical Stabilization
Isometric stretching and strengthening exercises of Neck flexor muscle including suboccipitalis, levator scapulae,scalnae anterior and upper trapezius. Each exercise hold for 6 second and then release and repeated 10 times respectively 3 times in a week for 4 weeks. Therefore, the total exercise time will be 5-10 mints.
Device: Pressure Biofeedback

In this method patients in supine position. Sphygmomanometer is used and 100 mmHg pressure will be maintained before the treatment start then cuff will be placed under the occiopit of spine and patient will be asked to press the cuff against the occiopit until gauze show target pressure then hold this position for 6 second and release. Repeated this pressure to 10 times, 3 times in a week for 4 weeks. Therefore, the total exercise time will be 5-10 mints.

Baseline Treatment

Before starting the session participants received moist heat pack and soft tissue massage on cervical for 10 to 15 mints followed by movement control training.
Experimental: Group B
Movement control training of Neck flexor muscles with Visual Biofeedback along with baseline treatment
Other: Cervical Stabilization
Isometric stretching and strengthening exercises of Neck flexor muscle including suboccipitalis, levator scapulae,scalnae anterior and upper trapezius. Each exercise hold for 6 second and then release and repeated 10 times respectively 3 times in a week for 4 weeks. Therefore, the total exercise time will be 5-10 mints.
Device: Visual Biofeedback

In this method Led Head Band light will be used as a visual feedback. Patients in sitting or standing position with neck straight with the alignment of front wall marking followed by control movement training. Patient will be asked to follow the marking through head band light while performing motion control training. Each exercise hold for 6 second and then release and repeated 10 times respectively 3 times in a week for 4 weeks. Therefore, the total exercise time will be 5-10 mints.

Baseline Treatment

Before starting the session participants received moist heat pack and soft tissue massage on cervical for 10 to 15 mints followed by movement control training.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Numeric Pain Rating Scale (NPRS)
Time Frame: 4 weeks
The NPRS is a subjective pain rating scale using an 11-point scale from 0 to 10, where 0 means 'no pain' and 10 means 'intolerable pain'. Participants select the whole number that best represents their level of pain. The reliability is >0.95 with ICC values 0.86- 0.95
4 weeks
Neck Disability Index (NDI)
Time Frame: 4 weeks
NDI is a self-reported questionnaire which is formulated to assess pain that restricts the activities of daily living (ADL); it also helps to determine self-assessed disability. NDI has 10 domains covering pain intensity, personal care, lifting, reading, headaches, concentration, work, driving, sleeping, and recreation. Scores range from 0 to 50, with 50 being the greatest levels of dysfunction. It is a valid and reliable tool with ICC=0.98
4 weeks
Pressure Biofeedback (Simple Sphygmomanometer)
Time Frame: 4 weeks
It is used to measure the neck muscle strength. It was consisting of 3 chamber air filled pressure bag, a catheter & sphygmomanometer gauze. To measure the strength, cuff is placed under occipital in supine position for Neck flexor and under forehead in prone position for neck extensor muscle. After setting pressure with the baseline Pressure of 100 mmHg, patient was asked to put maximum effort on cuff by giving 6 seconds hold for 3 repetitions. After taking the mean value, it is compared with the normal extensor flexor.
4 weeks

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Visual Biofeedback (LED Headband light)
Time Frame: 4 weeks
This light is known as light panel that contain rectangular shape light focusing panel that maintain the focus through manual adjustment.
4 weeks
goniometry
Time Frame: 4 weeks
A goniometer is a device that measures an angle or permits the rotation of an object to a definite position. In orthopedics, the former description applies more. It is valid and reliable tool for measuring range of motion.
4 weeks

Collaborators and Investigators

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

Sponsor

Riphah International University

Investigators

  • Principal Investigator: Ali Raza, Riphah International University
  • Principal Investigator: Nusrat Prveen, Riphah International 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)

May 10, 2023

Primary Completion (Estimated)

December 10, 2023

Study Completion (Estimated)

January 10, 2024

Study Registration Dates

First Submitted

November 22, 2023

First Submitted That Met QC Criteria

November 22, 2023

First Posted (Actual)

November 30, 2023

Study Record Updates

Last Update Posted (Actual)

November 30, 2023

Last Update Submitted That Met QC Criteria

November 22, 2023

Last Verified

November 1, 2023

More Information

Terms related to this study

Keywords

Other Study ID Numbers

  • REC/RCR&AHS/23/0154

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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