Immediate Effects of Atlanto-Occipital Mobilization on Head Posture, Respiratory Function, and Neck Mobility in Forward Head Posture

March 11, 2026 updated by: Mesut Arslan, Bitlis Eren University

An Investigation Into the Immediate Effects of Atlanto-Occipital Joint Mobilization on Head Posture, Respiratory Function, and Cervical Range of Motion in Individuals With Forward Head Posture

The purpose of this study is to investigate the immediate effects of atlanto-occipital joint mobilization on head posture, respiratory function, and cervical range of motion in healthy individuals with forward head posture.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

Forward head posture (FHP) is a common postural disorder characterized by the anterior displacement of the head relative to the shoulders. The estimated prevalence of FHP among individuals who use electronic devices frequently is reported to be high, affecting a significant portion of the general population. While postural correction exercises and ergonomic education are generally the first-line management strategies for FHP, manual therapy techniques (such as joint mobilizations and soft tissue therapy) are often recommended as an adjunct treatment. Additionally, various physiotherapy approaches, including stretching of the posterior cervical muscles, strengthening of the deep neck flexors, and respiratory exercises, can also be utilized. Specific mobilization of the atlanto-occipital joint is theorized to normalize arthrokinematics and reduce fascial restrictions in the suboccipital region. This is said to decrease neuromuscular tension, improve proprioceptive input, and restore optimal alignment, resulting in positive effects on head posture, cervical mobility, and respiratory function.

Study Type

Interventional

Enrollment (Actual)

54

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 Locations

  • Turkey (Türkiye)
      • Ankara, Turkey (Türkiye), 06000
        • Department of Physiotherapy and Rehabilitation, Ankara Yıldırım Beyazıt University

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:

  • Volunteering to participate in the study.
  • Being between the ages of 18 and 45.
  • Having forward head posture according to craniovertebral angle measurement.

Exclusion Criteria:

  • History of cervical surgery or trauma.
  • Diagnosed cervical disc herniation or cervical stenosis.
  • Presence of a diagnosed neurological and/or rheumatological disorder.
  • Pregnancy.
  • Presence of malignancy.

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: Mobilization group
The intervention group will receive atlanto-occipital joint mobilization.
Other: Atlanto-occipital joint mobilization
The intervention group will receive a single session of atlanto-occipital joint mobilization.
Sham Comparator: Sham group
The control group will receive the sham application.
Other: Sham application
The control group will receive a single session of sham intervention.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Craniovertebral Angle (CVA) for Forward Head Posture
Time Frame: Assessments will be performed at baseline (before the application) and immediately following the single-session intervention.
Forward head posture will be assessed by measuring the craniovertebral angle (CVA) using a goniometer. The CVA is the angle between the horizontal line passing through the C7 spinous process and the line from the tragus of the ear to the C7 spinous process.
Assessments will be performed at baseline (before the application) and immediately following the single-session intervention.
Respiratory Function assessed by Spirometry (FVC, FEV1, FEV1/FVC, PEF, FEF25-75%)
Time Frame: Assessments will be performed at baseline (before the application) and immediately following the single-session intervention.
Respiratory function will be assessed using a spirometry device. The following parameters will be recorded and analyzed: Forced Vital Capacity (FVC), Forced Expiratory Volume in one second (FEV1), the FEV1/FVC ratio, Peak Expiratory Flow (PEF), and Forced Expiratory Flow at 25-75% of FVC (FEF25-75%).
Assessments will be performed at baseline (before the application) and immediately following the single-session intervention.
Cervical mobility (Cervical Range of Motion (CROM)) assessed by Bubble Inclinometer
Time Frame: Assessments will be performed at baseline (before the application) and immediately following the single-session intervention.
Cervical mobility (range of motion) will be assessed using a bubble inclinometer. Active range of motion will be measured in degrees for the movements of flexion, extension, lateral flexion (left/right), and rotation (left/right).
Assessments will be performed at baseline (before the application) and immediately following the single-session intervention.

Collaborators and Investigators

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

Sponsor

Bitlis Eren 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)

December 5, 2025

Primary Completion (Actual)

March 1, 2026

Study Completion (Actual)

March 1, 2026

Study Registration Dates

First Submitted

December 5, 2025

First Submitted That Met QC Criteria

December 17, 2025

First Posted (Actual)

December 23, 2025

Study Record Updates

Last Update Posted (Actual)

March 12, 2026

Last Update Submitted That Met QC Criteria

March 11, 2026

Last Verified

March 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • BP-M

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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