Forward Head Posture Differences in Tension Headaches

July 22, 2026 updated by: Amira saad mohamed, Cairo University

Scapular Kinematics and Forward Head Posture Differences in Tension Headaches

it evaluates forward head posture (craniovertebral angle), resting scapular alignment (upward rotation, anterior tilt, protraction, depression), and dynamic scapular kinematics (upward rotation, anterior-posterior tilt) between tension-type headache and controls.

Study Overview

Status

Active, not recruiting

Conditions

Intervention / Treatment

Detailed Description

This study was conducted at the outpatient clinic, faculty of physical therapy, Sinai University, it evaluates forward head posture (craniovertebral angle), resting scapular alignment (upward rotation, anterior tilt, protraction, depression), and dynamic scapular kinematics (upward rotation, anterior-posterior tilt) between tension-type headache and controls.

Study Type

Observational

Enrollment (Actual)

50

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

  • Egypt
      • Giza, Egypt
        • Cairo 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

Yes

Sampling Method

Non-Probability Sample

Study Population

Participants will be recruited using a non-probability convenience sampling method at the outpatient clinic, faculty of physical therapy, Sinai University, Egypt. Cases are consisting of individuals diagnosed with tension-type headache. Controls are healthy individuals without a history of tension-type headache. Eligible participants who meet the inclusion and exclusion criteria and provide informed consent will be enrolled during the study period.

Description

Inclusion Criteria:

  • Inclusion Criteria for TTH group:

    1. Patients will be included if they meet the diagnostic criteria of the International Headache Society for Tension-Type Headache
    2. Score of 8 in screening questionnaire of TTH
    3. Patients' age ranges from 20 to 40 years
    4. BMI will range from 18.5- 29.9 kg/m2
    5. Chronic and frequent episodic Tension-Type Headache as duration of patient's symptoms is more than three months
  • Inclusion Criteria for the control group Asymptomatic tension-type headaches will be included if they are matched in age, gender, and BMI

Exclusion criteria:

  1. Abnormal neurological symptoms (cervical radiculopathy-motor manifestation)
  2. Vertebrobasilar Insufficiency
  3. Systemic diseases e.g., Multiple sclerosis
  4. Diabetes and hypertension
  5. History of head trauma
  6. History of epileptic fits
  7. History of previous head or neck surgery
  8. History of Shoulder

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

Cohorts and Interventions

Group / Cohort
Intervention / Treatment
Tension-type headache (TTH) group
evaluates forward head posture (craniovertebral angle), resting scapular alignment (upward rotation, anterior tilt, protraction, depression), and dynamic scapular kinematics (upward rotation, anterior-posterior tilt) in tension-type headache subjects
Diagnostic test: forward head posture , resting scapular alignment and dynamic scapular kinematics
forward head posture using the Smartphone application AI Posture Evaluation and Correction System (APECS), resting scapular alignment using a modified digital inclinometer and dynamic scapular kinematics using The digital inclinometer
control group
evaluates forward head posture (craniovertebral angle), resting scapular alignment (upward rotation, anterior tilt, protraction, depression), and dynamic scapular kinematics (upward rotation, anterior-posterior tilt) in asymptomatic subjects.
Diagnostic test: forward head posture , resting scapular alignment and dynamic scapular kinematics
forward head posture using the Smartphone application AI Posture Evaluation and Correction System (APECS), resting scapular alignment using a modified digital inclinometer and dynamic scapular kinematics using The digital inclinometer

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
forward head posture (craniovertebral angle)
Time Frame: at baseline

forward head posture (craniovertebral angle) Using the Smartphone application AI Posture Evaluation and Correction System (APECS), CVA will be measured. Patients or subjects will stand on the right lateral view, while an adjustable tripod will hold the mobile phone (iPhone 11) camera at shoulder height, positioned 1.5 meters from the patient for standardization.

craniovertebral angle (CVA) is measured in degrees (°).
at baseline
resting scapular alignment
Time Frame: at baseline
resting scapular alignment (upward rotation, anterior tilt, protraction, depression) is assessed using a modified digital inclinometer and recorded in degrees (°). The subject's resting scapular alignment of protraction, upward rotation, anterior tilt, and depression in a standing posture. Markers will be positioned on the inferior angle of the scapula, the posterolateral side of the acromion, and the scapular spine's root before scapular position measurements
at baseline
Dynamic scapular kinematics
Time Frame: at baseline
Dynamic scapular kinematics is assessed using digital inclinometer and recorded in degrees (°). The subject's scapular position will be measured during upward rotation, anterior tilt, and posterior tilt in a standing posture. Before the test, the landmarks will be determined before the measurement (scapula inferior angle, posterior lateral of the acromion, and scapula spine) and markers will be attached
at baseline

Collaborators and Investigators

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

Sponsor

Cairo 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)

January 16, 2025

Primary Completion (Estimated)

July 25, 2026

Study Completion (Estimated)

July 30, 2026

Study Registration Dates

First Submitted

July 20, 2026

First Submitted That Met QC Criteria

July 22, 2026

First Posted (Actual)

July 24, 2026

Study Record Updates

Last Update Posted (Actual)

July 24, 2026

Last Update Submitted That Met QC Criteria

July 22, 2026

Last Verified

July 1, 2026

More Information

Terms related to this study

Additional Relevant MeSH Terms

Other Study ID Numbers

  • P.T.REC/012/006297

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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