Effects of Forward Head Posture on Cervical Proprioception, Muscle Endurance, and Cardiopulmonary Function During Cognitive-Motor Tasks Among University Students

Effects of Forward Head Posture on Cervical Proprioception, Muscle Endurance, and Cardiopulmonary Function During Cognitive-Motor Tasks Among University Students: A Cross-Sectional Study

Forward head posture is commonly observed among university students and may influence cervical sensorimotor function and physiological responses during functional activities. The purpose of this observational cross-sectional study is to examine the association between forward head posture and cervical proprioception, deep cervical muscle endurance, and cardiopulmonary responses during a cognitive-motor task in university students.

Study Overview

• Status: Completed
• Conditions: Forward Head Posture
• Intervention / Treatment: Other: No intervention

Detailed Description

This is an observational cross-sectional study conducted among healthy university students aged 18 to 26 years. The study aims to investigate the relationship between forward head posture and cervical joint position sense, deep cervical muscle endurance, and cardiopulmonary responses during a combined cognitive-motor task. No therapeutic intervention or treatment is applied.

• Study Type: Observational
• Enrollment (Actual): 80

Contacts and Locations

Study Locations

• Jordan
  • Aqaba, Jordan
    • Faculty of physical therapy

Participation Criteria

Eligibility Criteria

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

• Sampling Method: Non-Probability Sample

Study Population

The study population consists of healthy male and female university students aged 18 to 26 years, recruited from the university campus. Participants represent a young adult population without known neurological, musculoskeletal, or cardiopulmonary conditions that could influence cervical posture or sensorimotor performance.

Description

Inclusion Criteria:

• University students aged 18 to 26 years
• Both male and female participants
• Apparently healthy individuals
• Ability to understand and follow study instructions
• Willingness to participate and provide written informed consent

Exclusion Criteria:

• Age below 18 years or above 26 years
• History of cervical spine surgery or cervical fracture
• Presence of neurological disorders affecting the cervical spine or balance
• Chronic cardiopulmonary diseases
• Current or recent neck or shoulder pain within the past 6 months
• Any musculoskeletal condition that may affect cervical posture or movement

Study Plan

How is the study designed?

Number of groups / cohorts

2

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
Group / Cohort 1 Group Name: Forward Head Posture Group; This cohort includes participants diagnosed with forward head posture based on standardized postural assessment criteria.	Other: No intervention; No intervention
Group / Cohort 2 Group Name: Normal Head Posture (Control) Group; This cohort includes participants with normal head and neck posture and no musculoskeletal or neurological disorders.	Other: No intervention; No intervention

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Cervical joint position error measured using a smartphone-based inclinometer	Cervical proprioception will be assessed by measuring joint position error (JPE) during cervical flexion, extension, and rotation using a smartphone-based inclinometer. Participants will attempt to reposition their head to a neutral target position with eyes closed. The absolute repositioning error (in degrees) will be calculated, and the mean JPE will be used for analysis.	At baseline

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Deep cervical flexor endurance measured by the craniocervical flexion endurance test	Deep cervical flexor endurance will be assessed using the craniocervical flexion endurance test. Participants will perform a chin-tuck head lift in the supine position and hold the position as long as possible. Endurance time will be recorded in seconds.	At baseline
Cervical extensor endurance measured by a cervical extensor endurance test	Cervical extensor muscle endurance will be assessed using a cervical extensor endurance test in the prone position. Participants will maintain the head in a neutral horizontal position for as long as possible. Endurance time will be recorded in seconds.	At baseline
Heart rate measured during a cognitive-motor dual-task using a chest-strap heart rate monitor	Heart rate will be recorded during a combined stepping and cognitive subtraction task using a validated chest-strap heart rate monitor. The mean heart rate during the task will be used for analysis.	During a single 3-minute cognitive-motor task session
Respiratory rate measured during a cognitive-motor dual-task	Respiratory rate will be measured during the same cognitive-motor dual-task by counting breaths per minute. The mean respiratory rate during the task will be used for analysis	During a single 3-minute cognitive-motor task session

Collaborators and Investigators

• Sponsor: Abeer Abdrabo

Study record dates

Study Major Dates

• Study Start (Actual): November 14, 2025
• Primary Completion (Actual): January 7, 2026
• Study Completion (Actual): January 10, 2026

Study Registration Dates

• First Submitted: January 18, 2026
• First Submitted That Met QC Criteria: February 4, 2026
• First Posted (Actual): February 11, 2026

Study Record Updates

• Last Update Posted (Actual): February 11, 2026
• Last Update Submitted That Met QC Criteria: February 4, 2026
• Last Verified: January 1, 2026

More Information

Terms related to this study

• Other Study ID Numbers: [NO.P.T/REC/230010/4/12/2023]]

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO
• IPD Plan Description: "Individual participant data (IPD) will not be shared to protect the privacy and confidentiality of university students. The data include sensitive health and physical measurements, and sharing them could risk identification of participants despite de-identification efforts. Additionally, no formal data-sharing agreements are in place."

Drug and device information, study documents

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