Comparative Effects of Posture Correction Exercises and Papworth Technique in Asthmatic Forward Head Posture

Comparative Effects of Posture Correction Exercises and Papworth Technique on Dyspnea, Chest Expansion, and Quality of Life in Asthmatic Patients With Forward Head Posture.

This study aims to evaluating and contrasting the effects of posture correction and papworth technique on dyspnea, chest expansion and quality of life in asthmatic patients with forward head.

Study Overview

• Status: Completed
• Conditions: Asthma (Diagnosis) With Forward Head Posture
• Intervention / Treatment: Other: posture correction exercises; Other: papworth teachnique

Detailed Description

Asthma is a chronic inflammatory airway disease characterized by airway hyperresponsiveness, reversible air flow obstruction , and bronchial inflammation, resulting in episodic symptoms such as dyspnea, wheezing, chest tightness and cough. In addition to airway pathology, respiratory mechanics and postural deviations can significantly influence disease severity and functional capacity. Forward head posture is a common postural dysfunction that alters cervical- thoracic alignment, increase upper chest dominance during breathing, reduces rib cage mobility and compromises diaphragmatic efficiency. Correction of forward head posture is expected to improve thoracic expansion, optimize musculoskeletal alignment, and facilitate more efficient breathing mechanics, thereby reducing the work of breathing and improving ventilatory efficiency in asthmatic individuals. The papworth breathing technique is a structured respiratory retraining approach that emphasizes diaphragmatic breathing, nasal breathing, and relaxation strategies to reduce dysfunctional breathing patterns and hyperventilation. it has been shown to improve ventilatory control and may enhance expiratory efficiency, potenitally improving physiological parameters such as positive end expiratory pressure. This study will compare the effects of these two interventions on pulmonary function, asthma control , and postural alignment in asthmatic patients with forward head posture , aiming to determine their relative efficacy in improving respiratory mechanics and functional outcomes.

• Study Type: Interventional
• Enrollment (Actual): 38
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Pakistan
  • Punjab Province
    • Lahore, Punjab Province, Pakistan, 54000
      • Sheikh Zaid Hospital Lahore

Participation Criteria

Eligibility Criteria

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

Description

Inclusion Criteria:

• Male and female patients 35 to 50 years
• No history of recent thoracic or cervical spine surgery
• Patients diagnosed with mild to moderate asthma
• Stable asthma condition at the time of recruitment.
• Non smokers
• Experiencing mild to moderate dyspnea during daily activities presence of forward head posture
• FEV/FVC ratio < 0.75 with FEV between 60 to 80 percent of predicted values indicating mild to moderate asthma.

Exclusion Criteria:

• Patients with inflammatory lesion in cervical region.
• Patients with neurological impairments and cognitive impairments will be excluded.
• Patients with tendinopathy
• History of cervical trauma, cervical spine surgery and vertebral fracture.

Study Plan

How is the study designed?

Design Details

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

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Posture correction; posture correction exercises	Other: posture correction exercises; posture correction exercises three sessions per week 30-40 minutes Mckenzie exercises three sets of ten repetitions scapular retraction exercises three sets of ten repetitions thoracic extension exercises pectoral muscle stetching 20-30 seconds upper trapezius and Levator scapulae stretching three times per sessions
Experimental: Papwoth technique; papworth technique	Other: papworth teachnique; papworth three sessions per week approximately 30 minutes diaphragmatic breathing 10 minutes per session sow breathing practice 1-2 minutes breath control and breath holding muscle relaxation techniques

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Universal goniometer	Forward head posture was assessed using a universal goniometer by measuring the craniovertebral angle .The CVA is defined as the angle formed between a horizontal line passing through the spinous process of the seventh cervical vertebra(c7) and a line connecting to the tragus of the ear. A smaller CVA reflects increased anterior head displacement and reduced cervical lordosis. A CVA of >50 considered normal , values between 40 to 49 considered mild forward head posture while a CVA <40 represents moderate to severe forward head posture.	1st day

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Borg dyspnea scale	The borg dyspnea scale is a subjective tool for assessing the intensity of breathessness in patients, often used in fields like pulmonology, cardiology and sport medicine. it ranges from 0 to 10. 0 very slight and 10 very severe.this scale helps clinicians mointor a patients respiratory symptoms during activities like exercises or rehabilitation and adjust treatment plans accordingly.	1st day
Asthma control questionnaire	The asthma control questionnaire is a widely used tool for assessing asthma control in patients. It measures various aspects of asthma, including symptoms, frequency of rescue inhaler use, and lung function over the past week. the ACQ includes questions rated on a 7 point scale, with higher scores indicating proorer asthma control. this questionnaire helps clinicians guage treatment effectiveness, track symptom progression and adjust care strategies to improve patient quality of life.	1st day

Collaborators and Investigators

• Sponsor: Riphah International University
• Investigators: Principal Investigator: Qurat ul Ain, MS, Riphah International University

Publications and helpful links

General Publications

• Tian QS, Zhou XH kim T-HJAS the effects of combined cervical and scapular stabilization exercises on muscle tone, pain and cervical range of motion in cervical extension type A controlled experimental study 2025
• Oakley PA, Moustafa IM, Haas JW, Betz JW, Harrison DEJJoCM two methods of forward head posture assessment radiography vs posture and their clinical comparison 2024
• Maddah T, Daneshmandi H, Alizade MH, Rahmati MBJBp the investigation of relationship between allergic rhinitis with forward head posture and anxiety in childern 2025
• Dongare S, Rathi K, Rathi GJPM,Journal P. Inhaled coticosteroids its evolution and step wise phramacological treatment strategies for all levels of asthma 2024
• Plichta J, Kuna P, Panek MJFIL.biologic drugs in thr treatment of chronic inflammatory pulmonary diseases recent developments and future perspectives 2023
• 1. padem N, Salton C, editors. classification of asthma.Allergy and Asthma proceedings 2019

Study record dates

Study Major Dates

• Study Start (Actual): August 15, 2025
• Primary Completion (Actual): December 17, 2025
• Study Completion (Actual): December 17, 2025

Study Registration Dates

• First Submitted: March 16, 2026
• First Submitted That Met QC Criteria: May 4, 2026
• First Posted (Actual): May 7, 2026

Study Record Updates

• Last Update Posted (Actual): May 7, 2026
• Last Update Submitted That Met QC Criteria: May 4, 2026
• Last Verified: May 1, 2026

More Information

Terms related to this study

• Keywords: Asthma; Dyspnea; Breathing exercises; Posture rehabilitation
• Additional Relevant MeSH Terms: Pathologic Processes; Immune System Diseases; Respiratory Tract Diseases; Lung Diseases; Respiration Disorders; Bronchial Diseases; Lung Diseases, Obstructive; Respiratory Hypersensitivity; Hypersensitivity, Immediate; Hypersensitivity; Signs and Symptoms, Respiratory; Pathological Conditions, Signs and Symptoms; Signs and Symptoms; Asthma; Disease; Dyspnea
• Other Study ID Numbers: S24C14G36028 nosheen

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