Postural Rehabilitation for Visual Dysfunction in Forward Head Posture

Postural Rehabilitation Through Motor Control Versus Sensor-based Biofeedback Training for Visual Dysfunction in Forward Head Posture

This assessor-blinded randomized controlled trial aims to compare the effects of motor control training, sensor-based biofeedback training using a wearable inertial measurement unit (IMU), and standardized postural correction exercises on mild visual dysfunction in university students with forward head posture (FHP). The trial seeks to establish whether targeted postural rehabilitation can produce measurable improvements in validated visual and sensorimotor outcomes.

Study Overview

• Status: Not yet recruiting
• Conditions: Forward Head Posture
• Intervention / Treatment: Other: motor control training; Device: Sensor development training group; Other: conventional posture training

Detailed Description

Forward head posture is highly prevalent among young adults due to prolonged screen exposure and sustained cervical flexion. Emerging neurophysiological evidence suggests that cervical alignment influences visual stability through altered proprioceptive input, cervico-ocular reflex mechanisms, and sensorimotor integration. However, no randomized controlled trials have investigated whether correcting FHP leads to measurable improvements in validated visual parameters.

• Study Type: Interventional
• Enrollment (Estimated): 72
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Qamar Mehmood, PHD; Phone Number: 03335151063; Email: qamar.mehmood@riphah.edu.pk

Study Locations

• Pakistan
  • Capital
    • Islamabad, Capital, Pakistan, 46000
      • Post-graduate research Lab, Riphah international university, gulberg greens campus, islamabad

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• 18-30 years Both genders BMI 17.5-27.99 CVA <50° Mild visual impairment log Mar 0.1-0.5

Exclusion Criteria:

• • Head and neck trauma or surgical history, Neurological disorders

  • Vestibular disorders, Benign paroxysmal positional vertigo (BPPV)
  • Congenital head and neck postural abnormality
  • Diagnosed oculomotor pathology (strabismus, nystagmus)
  • Diagnosed congenital ocular defects (corneal dystrophies)
  • Diagnosed glaucoma, cataract, uncorrected refractive errors
  • Diagnosed diabetes

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Single

Number of Arms

4

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: motor control training group; the motor control training is done in the stationary and in motion conditions with and without inertia and with and without object manipulations for the forward head posture participants.	Other: motor control training; the intervention will be a progressive training starting from the stationary, no inertia and no object manipulation to in motion with inertia and with object manipulation taking help of sitting standing and stepping stairs like activities keep the head in normal position with the help of a laser gun. the intervention duration is 45 minutes/day, with three sessions per week for 4 weeks.
Experimental: Sensor biofeedback training group; Real time biofeedback training is being done through the sensor being applied to cervical spine during normal day activities.	Device: Sensor development training group; the sensor will be being placed at C7 measuring current craniovertebral angle with the threshold being set at 50 degrees. the real time feedback will be shown on the mobile app. and the data will be recorded for whole intervention time. the intervention duration is 45 minutes/day, with three sessions per week for 4 weeks.
Experimental: conventional postural training; this program consists on strengthening of deep cervical flexors and scapular retractors and stretching of cervical extensors and pectoralis major muscles	Other: conventional posture training; the strengthening of deep neck flexors and retractors and stretching of pectoralis major and cervical extensors will be done using intervention duration is 45 minutes/day, with three sessions per week for 4 weeks.
No Intervention: control group; postural education about proper ergonomics is being shared to the participants

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
visual impairment	The mild visual impairment will be measured by LogMar chart. the smallest line that person can read will be recorded as reading of visual impairment. the score is generally in form of fractions.	baseline to 8th week
oculomotor function	this will be measured by the near point convergence test. the point at which blurring stated by participant will be measured in cms.	baseline to 8th week
visual reaction time	this will be measured on visual reaction time app on phone. the person has to click the screen when the stimulus arrives on screen. The average of 3 readings will be recorded as the visual reaction time	baseline to 8th week
visual fatigue	The visual fatigue will be measured by 17 item asthenopia questionnaire (ASQ-17). the score will be marked on 5 point likert scale with greater score shows more severity	baseline to 8th week
craniovertebral angle	this will be measured by mobile app specified for said purpose. sideways picture will be taken and CVA will be noted from the app.	baseline to 8th week

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
flexor muscle endurance	this will be measure by flexor endurance test as the end of couch in supine lying with head lift in chin tuck in position. the time of hold in seconds will be noted.	baseline to 8th week
extensor muscle endurance	the test will be done in prone lying holding the head in static position at the end of couch. the time of hold will be measured in seconds.	baseline to 8th weeks
pelvic tilt	the pelvic tilt will be measured by the pelvic inclinometer in degrees by place its both ends at anterior superior iliac spine.	baseline to 8th week
static balance	the static balance will be measured by Balance Error Scoring System test. the readings in double foot stance, single leg stance and tandem stance will be done on firm and foam surface and the composite score will be used. the no. of wrrors in adopting position will be marked as points. total score is 60. lower score indicate good balance.	baseline to 8th week
dynamic balance	The dynamic balance will be measured by the Y-balance test in anterior, postero-medial and postero-latertal positions. the composite score according to formula will be taken as final score. the higher score indicates good balance.	baseline to 8th week

Collaborators and Investigators

• Sponsor: Riphah International University
• Investigators: Principal Investigator: Qamar Mehmood, PHD, Riphah internatioal university

Study record dates

Study Major Dates

• Study Start (Estimated): March 1, 2026
• Primary Completion (Estimated): November 30, 2026
• Study Completion (Estimated): February 25, 2027

Study Registration Dates

• First Submitted: March 16, 2026
• First Submitted That Met QC Criteria: March 16, 2026
• First Posted (Actual): March 20, 2026

Study Record Updates

• Last Update Posted (Actual): March 20, 2026
• Last Update Submitted That Met QC Criteria: March 16, 2026
• Last Verified: March 1, 2026

More Information

Terms related to this study

• Keywords: Balance; posture; Motor control training; Muscle endurance; Sensors; Visual impairment
• Additional Relevant MeSH Terms: Neurologic Manifestations; Nervous System Diseases; Eye Diseases; Sensation Disorders; Pathological Conditions, Signs and Symptoms; Signs and Symptoms; Vision Disorders
• Other Study ID Numbers: RiphahIU Aisha Razzaq

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