Comparison of Prefrontal Hemodynamic Responses and Balance Control Differences Based on Head Posture and Task Difficulty in Cognitive-Balance Tasks

• Recent studies have shown that individuals with forward head posture (FHP) experience not only impaired balance control but also cognitive deficits.
• Using a balance-cognitive dual-task paradigm, this study aims to explore the relationship between balance ability and Prefrontal cortex(PFC) oxygenation levels(△HbO2) in individuals with FHP compared to those with normal head posture(NHP).
• By analyzing differences in frontal lobe activation based on task difficulty, this study is expected to provide practical data for designing balance training and cognitive-motor intervention programs tailored to individuals with FHP.

Study Overview

• Status: Completed
• Conditions: Forward Head Posture; Normal Head Posture
• Intervention / Treatment: Behavioral: Cognitive-Balance dual task

Detailed Description

- This study is a cross-sectional study aiming to investigate the differences in balance ability between individuals with forward head posture (FHP) and those with normal head posture (NHP), as well as the differences in frontal lobe oxygenation levels during a balance-cognitive dual task.

Study participants will be assigned to receive two groups: (a) Forward head posture (b) Normal head posture. Each group will perform three balance tasks while simultaneously completing three cognitive tasks. To determine the differences, the primary outcome will assess prefrontal cortex (PFC) hemodynamic response, and the secondary outcome will assess balance ability.

• Study Type: Observational
• Enrollment (Actual): 38

Contacts and Locations

Study Locations

• South Korea
  • 노원구
    • Seoul, 노원구, South Korea, 01759
      • Sahmyook University

Participation Criteria

Eligibility Criteria

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

• Sampling Method: Non-Probability Sample

Study Population

Participants will be recruited from Samyook University(Seoul, South Korea) or local communities in Daegu or Seoul, South Korea. Recruitment will primarily target individuals who regularly engage in academic or sedentary activities. The study population will consist of individuals classified based on postural characteristics, specifically Forward Head Posture (FHP) or Normal Head Posture (NHP), assessed using craniovertebral angle (CVA) measurements. Recruitment will take place through campus advertisements, online postings, and word-of-mouth referrals.

Description

Inclusion Criteria:

• Healthy adults aged 20 to 39 years
• Classified as having Forward Head Posture (FHP) or Normal Head Posture (NHP) based on Craniovertebral Angle (CVA) measurement

Exclusion Criteria:

• Individuals with a history of spinal or musculoskeletal trauma or surgery
• Individuals who have reported recent neck or shoulder pain

Study Plan

How is the study designed?

Number of groups / cohorts

2

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
Forward head posture group; The experiment will be conducted for approximately 30 minutes. It will comprise cognitive tasks with three levels of difficulty and balance tasks, with task difficulty adjusted according to each participant's cognitive and balance abilities. During the experiment, changes in cerebral blood flow, cognitive performance, and balance ability will be assessed and analyzed.	Behavioral: Cognitive-Balance dual task; The cognitive-balance dual task consists of three levels of difficulty and is performed simultaneously. The cognitive tasks include the N-back test, while the balance tasks consist of static balance tasks.
Normal head posture group; The experiment will be conducted for approximately 30 minutes. It will comprise cognitive tasks with three levels of difficulty and balance tasks, with task difficulty adjusted according to each participant's cognitive and balance abilities. During the experiment, changes in cerebral blood flow, cognitive performance, and balance ability will be assessed and analyzed.	Behavioral: Cognitive-Balance dual task; The cognitive-balance dual task consists of three levels of difficulty and is performed simultaneously. The cognitive tasks include the N-back test, while the balance tasks consist of static balance tasks.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
The degree of hemodynamic response in the prefrontal cortex (PFC)	Hemodynamic response changes in the prefrontal cortex (PFC) will be assessed by measuring variations in oxyhemoglobin (HbO) concentration using functional near-infrared spectroscopy (fNIRS). The study will compare HbO concentration changes between the control and experimental groups during cognitive-balance task performance.	From enrollment to 2 days

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Balance performance	Static and dynamic balance performance will be assessed using the Good Balance system (Metitur, Finland). The assessment will be conducted on a triangular platform by measuring changes in the center of pressure (COP), regardless of foot position. The results will be reported as variations in COP displacement and velocity. Dynamic balance performance will be assessed using the Four Square Step Test (FSST). Participants will step in four quadrants formed by rods or tape arranged in a cross pattern. The time taken to complete the FSST will be recorded in seconds.	From enrollment to 2 days

Collaborators and Investigators

• Sponsor: Sahmyook University

Study record dates

Study Major Dates

• Study Start (Actual): April 27, 2025
• Primary Completion (Actual): October 20, 2025
• Study Completion (Actual): October 20, 2025

Study Registration Dates

• First Submitted: February 18, 2025
• First Submitted That Met QC Criteria: February 23, 2025
• First Posted (Actual): February 27, 2025

Study Record Updates

• Last Update Posted (Actual): January 7, 2026
• Last Update Submitted That Met QC Criteria: January 5, 2026
• Last Verified: September 1, 2025

More Information

Terms related to this study

• Keywords: cognition; dual task; forward head posture; prefrontal cortex
• Other Study ID Numbers: SYU 2025-01-017-003

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: YES
• IPD Plan Description: all collected IPD
• IPD Sharing Time Frame: Beginning 3 months and ending 3 years after the publication of results
• IPD Sharing Supporting Information Type: STUDY_PROTOCOL; SAP

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No
• product manufactured in and exported from the U.S.: No