Electromyographic Effects of Postural Correction Exercises in Individuals With Forward Head Posture
Electromyographic Changes in Masticatory and Cervical Muscles Following a Structured 10-week Postural Correction Exercise Program in Individuals With Asymptomatic Forward Head Posture: A Randomized Controlled Trial
This study investigates the effects of specific corrective exercises on EMG of masticatory and cervical muscles in individuals with forward head posture. The study's design will be a retrospective, double- blinded, randomized controlled trial. The participants will be randomly allocated to one of two groups: the exercise group and the control group. The training groups will perform a program consisting of two strengthening (deep cervical flexors and shoulder retractors) and two stretchings (cervical extensors and pectoral muscles) exercises. This exercise program will be repeated 4 times per week for 10 weeks, and each session lasted 30 minutes.
The pre/post assessment of forward head posture will measure by using craniovertebral angle CVA. While the muscle activity EMG of the masseter, temporalis, splenius, upper trapezius, and SCM will measure pre and post-assessment using a biopic data acquisition system.
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Forward head posture (FHD) is a common habitual faulty posture exists in the surrounding that can alter the resting position of the mandible and may affect the masticatory muscle activity.
The aim of this study is to investigate the effect of postural correction on masticatory and cervical muscle activity and mandibular opening in forward-head posture patients.
Materials and Methods:
Cranio-vertebral angle measurement CVA EMG activity of masseter, temporalis, splenius, upper trapezius and SCM BAU - Institutional Review Board (Form H-II) | BEIRUT ARAB UNIVERSITY
-Electrodes will be placed on the muscle belly parallel to the direction of muscle fibers. The distance between the two electrodes was 2 cm. The subjects will be instructed to complete maximum voluntary contraction (MVC) of clenching the teeth for 3 s and repeating twice. The average of the two trials of MVC will be used for further analysis. The subjects will be seated comfortably in a chair.
Study Type
Enrollment (Estimated)
Phase
- Not Applicable
Contacts and Locations
Study Contact
- Name: Ahmed M Elsayed, PhD
- Phone Number: 00201027943622
- Email: ahmed.elmelhat@cu.edu.eg
Study Contact Backup
- Name: Ahmed El-Melhat, PhD
- Phone Number: 0096181437072
- Email: a.melhat@bau.edu.lb
Study Locations
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Beirut, Lebanon
- Recruiting
- Physical therapy outpatient clinic
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Contact:
- Ahmed ElMelhat, PhD
- Phone Number: 00201027943622
- Email: ahmed.elmelhat@cu.edu.eg
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
- Adult
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- 1. Participants aged 18- 30 years. 2. Presence of forward head posture, defined as CVA of less than 50° with no symptoms of neck pain [18, 19]. 3. No treatment for TMD or cervical symptoms (e.g., medication, physical therapy, or intra-articular injection) within the previous 2 weeks.
Exclusion Criteria:
1. Current or previous diagnosis of temporomandibular disorder (TMD), or the presence of TMD-related signs or symptoms (e.g., joint sounds, restricted mouth opening, or orofacial pain) during screening.
2. History of TMJ subluxation or dislocation that could interfere with mouth opening.
3. History of recent head or neck trauma. 4. Angle Class II or Class III malocclusion. 5. Postural abnormalities secondary to structural spinal deformities (e.g., scoliosis or kyphosis), rheumatic diseases, or other medical conditions affecting posture.
6. Missing posterior teeth, recent orthodontic treatment (within the previous 12 months), or dental restorations that altered occlusion.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Double
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
|---|---|
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Experimental: Specific strengthening and stretching exercise
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The program consisted of two strengthening (deep cervical flexors and shoulder retractors) and two stretching (cervical extensors and pectoral muscles) exercises based on Harman and Mostafa et al's approach.
This exercise program will be repeated 4 times per week for 10 weeks, and each session lasted for 30 minutes.
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Active Comparator: General exercises
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The program will consist of regular general postural exercises such as postural awareness exercises as well as general strengthening exercises such as range of motion exercises for the upper quadrant.
The program will also be repeated 4 times per week for 10 weeks, with each session lasting 30 minutes
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
EMG activity
Time Frame: 10 weeks
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Electrodes will be placed on the muscle belly parallel to the direction of muscle fibers. The distance between the two electrodes was 2 cm. The subjects will be instructed to complete maximum voluntary contraction (MVC) of clenching the teeth for a period of 3 s and repeated twice. The average of the two trials of MVC will be used for further analysis. The subjects will be seated comfortably in a chair (---cm height). |
10 weeks
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
craniovertebral angle
Time Frame: 10 weeks
|
Forward head posture will be assess by the craniovertebral angle, one of the most reliable tool for evaluating the FHP. The examiner takes 2 lateral photographs of the subject in standing position, according to Shaghayegh fard et al. A digital camera will be positioned on a tripod at a distance of 0.8m from the subject at shoulder height. Two land mark will be taken, the spinous process of C7 and the tragus of ear. A horizontal line will be drawn passing through C7 making a right angle with the vertical. Then, the angle between the line connecting C7 spinous process with the tragus of the ear and the horizontal line. |
10 weeks
|
Collaborators and Investigators
Sponsor
Publications and helpful links
General Publications
- Lee SM, Lee CH, O'Sullivan D, Jung JH, Park JJ. Clinical effectiveness of a Pilates treatment for forward head posture. J Phys Ther Sci. 2016 Jul;28(7):2009-13. doi: 10.1589/jpts.28.2009. Epub 2016 Jul 29.
- Kim SD. Effects of yoga exercises for headaches: a systematic review of randomized controlled trials. J Phys Ther Sci. 2015 Jul;27(7):2377-80. doi: 10.1589/jpts.27.2377. Epub 2015 Jul 22.
- Quek J, Pua YH, Clark RA, Bryant AL. Effects of thoracic kyphosis and forward head posture on cervical range of motion in older adults. Man Ther. 2013 Feb;18(1):65-71. doi: 10.1016/j.math.2012.07.005. Epub 2012 Sep 5.
- Lee KJ, Han HY, Cheon SH, Park SH, Yong MS. The effect of forward head posture on muscle activity during neck protraction and retraction. J Phys Ther Sci. 2015 Mar;27(3):977-9. doi: 10.1589/jpts.27.977. Epub 2015 Mar 31.
- Zabihhosseinian M, Holmes MW, Ferguson B, Murphy B. Neck muscle fatigue alters the cervical flexion relaxation ratio in sub-clinical neck pain patients. Clin Biomech (Bristol). 2015 Jun;30(5):397-404. doi: 10.1016/j.clinbiomech.2015.03.020. Epub 2015 Mar 27.
- Shaghayegh Fard B, Ahmadi A, Maroufi N, Sarrafzadeh J. Evaluation of forward head posture in sitting and standing positions. Eur Spine J. 2016 Nov;25(11):3577-3582. doi: 10.1007/s00586-015-4254-x. Epub 2015 Oct 17.
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Estimated)
Study Completion (Estimated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Other Study ID Numbers
- 2023-H-0145-HS-R-0505
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Plan Description
Any study records that identify patient will be kept confidential. The records from the participation may be reviewed by people responsible for making sure that research is done properly, including members of the BAU Institutional Review Board. All of these people are required to keep their identities confidential. Otherwise, records that identify patients will be available only to people working on the study.
• The investigators will use a code of numbers and alphabets rather than participants' names on data sheets, keeping records in a safe place.
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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