Effectiveness of the Suboccipital Inhibition Technique in Forward Head Posture.

Effectiveness of the Suboccipital Inhibition Technique in Individuals With Forward Head Posture: Randomized Controlled Trial

In this randomized controlled experimental trial, it is aimed to verify the effectiveness of applying the suboccipital inhibition technique in altering forward head posture, increasing the craniovertebral angle and decreasing the angle between the chin, the external acoustic meatus and the sternal angle.

Study Overview

• Status: Not yet recruiting
• Conditions: Individuals With Forward Head Posture
• Intervention / Treatment: Other: Suboccipital Inhibition Technique; Other: Sham Technique

Detailed Description

Forward head posture (FHP) is defined as misalignment of the head caused by anterior translation of the head in relation to the trunk, The incidence rate of this postural alteration is 66% in individuals between the ages of 20 and 50.

In order to diagnose this alteration, two angles are used: the craniovertebral angle (CVA) and the angle between the chin, the external acoustic meatus and the sternal angle (AMME), with the CVA being the reference angle for diagnosing a FHP. According to the literature, when the CVA is less than 49.9º, there is a FHP.

We decided to use the suboccipital inhibition technique, which according to Eileen DiGiovanna et al (2005), causes a decrease in muscle tension leading to their relaxation. This relaxation, according to Heredia Rizo et al (2012), has significant effects on increasing CVA, which in turn will decrease AMME, resulting in a positive change in FHP.

• Study Type: Interventional
• Enrollment (Estimated): 50
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Natália MO Campelo, PhD; Phone Number: 22 206 1000; Email: nmc@ess.ipp.pt

Study Locations

• Portugal
  • Porto, Portugal, 4200-072
    • Escola Superior de Saúde do Porto
    • Contact: Natália MO Campelo, PhD; Phone Number: +35122 206 1000; Email: nmc@ess.ipp.pt

Participation Criteria

Eligibility Criteria

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

Description

Inclusion Criteria:

• male and female;
• be over 18 years old;
• have a craniovertebral angle of less than 49.9º.

Exclusion Criteria:

• have a craniovertebral angle greater than 49.9º;
• be a 3rd or 4th year osteopathy student;
• be an osteopath.

Study Plan

How is the study designed?

Design Details

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

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Placebo Comparator: Sham Technique; Placebo Comparator: Sham Technique	Other: Sham Technique; The participant is instructed to lie down in the supine position while the mediator assumes a position at the head of the table and places their hands on the participant's shoulders. This technique is performed for 4 minutes.
Experimental: Suboccipital Inhibition Technique; Experimental: Suboccipital Inhibition Technique	Other: Suboccipital Inhibition Technique; The researcher will place their palms under the patient's head and use their fingers to contact the occipital condyles. Next, the researcher will place the 3rd and 4th fingers of each hand in the space between the occiput and the spinous process of C2. The metacarpophalangeal joints are at 90º flexion, with the base of the skull resting on their hands while they apply constant, non-painful pressure in a postero-anterior direction, keeping the 2nd, 3rd and 4th fingers together in extension. Afterwards, the researcher applies a light and gentle traction in a cephalad direction in order to relieve the suboccipital area. Once the suboccipital muscles have relaxed, the researcher gently removes the contact, leaving the participant's head resting on the table. This technique is performed for 4 minutes.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Craniovertebral angle	To obtain the craniovertebral angle, the SAPO postural assessment software will be used. This angle will be measured in the sagittal plane, with the participant sitting on a chair with their feet shoulder-width apart, resting on the floor, forearms relaxed over their legs, looking at a fixed point positioned on the wall 1 meter in front of their eyes. The SAPO software will determine the angle measurement. This procedure will be carried out 3 times in order to minimize the reading error.	Immediately after the intervention.
Angle between the chin, external acoustic meatus and the sternal angle.	To obtain this angle, the SAPO postural assessment software will be used. This angle will be measured in the sagittal plane, with the participant sitting on a chair with their feet shoulder-width apart, resting on the floor, forearms relaxed over their legs, looking at a fixed point positioned on the wall 1 meter in front of their eyes. The SAPO software will determine the angle measurement. This procedure will be carried out 3 times in order to minimize the reading error.	Immediately after the intervention.

Collaborators and Investigators

• Sponsor: Escola Superior de Tecnologia da Saúde do Porto
• Investigators: Principal Investigator: Natália MO Campelo, PhD, Escola Superior de Saúde do Porto

Publications and helpful links

General Publications

• Aggarwal, A., Nair, A., Palekar, TJ e Bhamare, D. (2022). Efeito da técnica de liberação suboccipital na postura anterior da cabeça: um estudo comparativo. Jornal Médico da Universidade Dr. DY Patil , 15 (4), 534-537.
• Contractor, ES, Shah, S. e Dave, P. (2019). Estudar o efeito imediato da técnica de energia muscular suboccipital no ângulo craniovertebral e no ângulo crânio-horizontal em indivíduos com postura de cabeça anteriorizada. Int J Health Sci Res , 9 (3), 83.
• Kim, BB, Lee, JH, Jeong, HJ e Cynn, HS (2016). Efeitos da liberação suboccipital com exercício de flexão craniocervical no alinhamento craniocervical e na atividade muscular cervical extrínseca em indivíduos com postura anterior da cabeça. Jornal de Eletromiografia e Cinesiologia , 30 , 31-37.
• Weber, P., Corrêa, ECR, Milanesi, JM, Soares, JC, & Trevisan, ME (2012). Postura craniocervical: análise cefalométrica e biofotogramétrica. Revista Brasileira de Ciências Orais , 11 (3), 416-421.
• DiGiovanna, E. L., Schiowitz, S., Dowling, D. J. (2005). Uma abordagem osteopática para diagnóstico e tratamento. Lippincott Williams & Wilkins.

Study record dates

Study Major Dates

• Study Start (Estimated): September 1, 2024
• Primary Completion (Estimated): December 1, 2024
• Study Completion (Estimated): December 1, 2024

Study Registration Dates

• First Submitted: May 28, 2024
• First Submitted That Met QC Criteria: May 28, 2024
• First Posted (Actual): June 3, 2024

Study Record Updates

• Last Update Posted (Estimated): June 4, 2024
• Last Update Submitted That Met QC Criteria: June 2, 2024
• Last Verified: June 1, 2024

More Information

Terms related to this study

• Keywords: Forward head posture; Craniovertebral angle; Suboccipital muscles; Osteopathy.
• Other Study ID Numbers: OST1_016

Drug and device information, study documents

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