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Relationship of Forward Head Posture With Burnout and Quality of Life

sunnuntai 1. marraskuuta 2026 päivittänyt: Ahmed Mossaed hussein, Cairo University

Relationship of Forward Head Posture With Burnout and Quality of Life in Patients With Mechanical Neck Pain

The goal of this observational study is to investigate the relationship of forward head posture with burnout and quality of life in patients with mechanical neck pain.

The main questions the study aims to answer are:

Is there a significant correlation between the severity of forward head posture (measured by Kinovea software) and psychological burnout (evaluated by the Maslach Burnout Inventory, MBI)?

How do different degrees of forward head posture impact pain intensity, pressure pain threshold, cervical proprioception, and cognitive function (assessed via CogniFit application)?

comparison groups:

Researchers will compare different degrees of forward head posture to see if varying degrees of forward head posture lead to different levels of physical, cognitive, and psychological impairments.

Participants will:

Undergo posture assessment using Kinovea software to determine their forward head posture angle and be allocated into their respective study groups.

pain intensity and pressure pain threshold measured using the Visual Analogue Scale (VAS) and pressure algometry.

Perform a cervical proprioception test using a pointer laser device.

Complete cognitive evaluations using the Montreal Cognitive Assessment (MoCA) and the CogniFit digital application.

Fill out standardized questionnaire, the Maslach Burnout Inventory (MBI) ,to assess burnout .

quality of life will be measured using Arabic- WHOQOL-BREF

Tutkimuksen yleiskatsaus

Yksityiskohtainen kuvaus

Background and Rationale:

Mechanical neck pain is a widespread musculoskeletal disorder frequently linked to postural abnormalities, most notably Forward Head Posture (FHP). Prolonged exposure to poor ergonomic habits and forward head alignment creates continuous biomechanical stress on the cervical spine's musculature and joints. Beyond physical pain and restricted mobility, chronic musculoskeletal discomfort can exert significant strain on the central nervous system, sensorimotor control, and psychological well-being, potentially triggering burnout and diminishing the overall quality of life.

Study Design and Group Allocation:

This observational/cross-sectional (or comparative) study is designed to evaluate and correlate the degree of forward head posture with psychological burnout and quality of life parameters among patients with mechanical neck pain. Participants diagnosed with mechanical neck pain and exhibiting forward head posture will be assessed using the Kinovea software to measure the craniovertebral angle (CVA) .

Outcome Measures and Assessment Protocols:

To comprehensively examine the physiological, sensorimotor, cognitive, and psychological impacts across participant, a battery of standardized and objective evaluation tools will be administered:

Pain Assessment and Pressure Pain Threshold:

Pain intensity will be quantified using the Visual Analogue Scale (VAS). Pressure pain thresholds over cervical and upper quarter trigger points will be evaluated using pressure algometry.

Cervical Proprioception:

Cervical position sense and repositioning accuracy will be measured using a pointer laser device attached to the participant's head, assessing joint position error.

Cognitive Function:

Global cognitive screening will be performed using the Montreal Cognitive Assessment (MoCA).

Detailed, computerized cognitive domains will be assessed via the CogniFit digital application.

Burnout:

Psychological burnout will be thoroughly evaluated using the Maslach Burnout Inventory (MBI), addressing dimensions such as emotional exhaustion, depersonalization, and reduced personal accomplishment.

Quality of life:

The Arabic version of the WHOQOL-BREF will be used to assess health-related quality of life among patients with mechanical neck pain. It evaluates four domains: physical health, psychological health, social relationships, and environment, allowing assessment of the relationship between forward head posture and quality of life.

Clinical Significance:

By assessing forward head posture using precise Kinovea-derived craniovertebral angle measurements and examining its relationship with multidimensional outcomes (pain, proprioception, and MBI-measured burnout), alongside quality of life, this study aims to clarify the potential impact of forward head posture on the physical and psychological well-being of patients with mechanical neck pain. The findings may contribute to a better understanding of these relationships and help guide physical therapy assessment and rehabilitation strategies.

Opintotyyppi

Havainnollistava

Ilmoittautuminen (Arvioitu)

50

Yhteystiedot ja paikat

Tässä osiossa on tutkimuksen suorittajien yhteystiedot ja tiedot siitä, missä tämä tutkimus suoritetaan.

Opiskeluyhteys

  • Nimi: Ahmed Mossaed, Demonstrator/ M.Sc. researcher
  • Puhelinnumero: 00201069062868
  • Sähköposti: amosaed79@gmail.com

Tutki yhteystietojen varmuuskopiointi

  • Nimi: Marwa Mostafa abdel moneim, lecturer of physical therapy
  • Puhelinnumero: 00201005661591
  • Sähköposti: marwa.mostafa@cu.edu.eg

Osallistumiskriteerit

Tutkijat etsivät ihmisiä, jotka sopivat tiettyyn kuvaukseen, jota kutsutaan kelpoisuuskriteereiksi. Joitakin esimerkkejä näistä kriteereistä ovat henkilön yleinen terveydentila tai aiemmat hoidot.

Kelpoisuusvaatimukset

Opintokelpoiset iät

35 vuotta - 50 vuotta (Aikuinen)

Hyväksyy terveitä vapaaehtoisia

Ei

Sukupuolet, jotka voivat opiskella

Kaikki

Näytteenottomenetelmä

Ei-todennäköisyysnäyte

Tutkimusväestö

A total of 50 patients of both sexes (aged 35-50 years) with mild to moderate mechanical neck pain and forward head posture will be recruited from the outpatient clinic of the Faculty of Physical Therapy, Cairo University, following diagnosis and referral by a neurologist.

Eligibility Criteria:

Age between 35 and 50 years. Mild to moderate mechanical neck pain (assessed by VAS) with symptom duration from 6 months up to 2 years.

Cooperative patients with sufficient cognitive abilities to understand and follow instructions.

Group Allocation:

Based on the Craniovertebral Angle (CVA) measured via Kinovea software, participants will be divided into two groups:

Group 1: CVA between 40° and 45°. Group 2: CVA between 45° and 50°.

Ethical Consideration:

All participants will sign an informed consent form after receiving full details regarding study purpose, procedures, benefits, data privacy, and their right to withdraw

Kuvaus

Inclusion Criteria:

  • 50 patients of both sexes diagnosed with mild to moderate mechanical neck pain with forward head.
  • Patient's age 35-50 years
  • Patients with mild to moderate mechanical neck pain by VAS
  • Duration of symptoms will be more than 6 months up to 2 years
  • Co-operative patients with sufficient cognitive abilities that enables them to understand and follow instructions
  • MOCA score equal to or more than 26

Exclusion Criteria:

  • Any neurological disease that causes mechanical neck pain rather than forward head posture, especially radiculopathy.
  • Depressed patients
  • History of cervical surgery , trauma or Severe neurological deficits (e.g., motor paralysis
  • Sever mechanical neck pain
  • Patients with visual or auditory impairment affecting their ability to complete the testing
  • Patients with cognitive impairment

Opintosuunnitelma

Tässä osiossa on tietoja tutkimussuunnitelmasta, mukaan lukien kuinka tutkimus on suunniteltu ja mitä tutkimuksella mitataan.

Miten tutkimus on suunniteltu?

Suunnittelun yksityiskohdat

  • Havaintomallit: OTHER
  • Aikanäkymät: CROSS_SECTIONAL

Kohortit ja interventiot

Ryhmä/Kohortti
Interventio / Hoito
forward head posture group 1

patients with mechanical neck pain who have forward head posture angle ranging from 40:50 degrees measured by kinovea software

no therapeutic intervention is provided. Participants only undergo postural evaluation (Kinovea), pain assessment (VAS and Algometry), proprioception testing, and cognitive/psychological evaluations (MoCA, CogniFit, and MBI).

Mitä tutkimuksessa mitataan?

Ensisijaiset tulostoimenpiteet

Tulosmittaus
Toimenpiteen kuvaus
Aikaikkuna
Craniovertebral Angle (CVA) Measured Using Kinovea Software
Aikaikkuna: Baseline (at the initial assessment)

Forward head posture will be assessed using digital lateral photographs analyzed with Kinovea software. The craniovertebral angle (CVA) will be measured in degrees using the angle formed between the horizontal line passing through the C7 spinous process and the line connecting C7 to the tragus. Lower CVA values indicate greater forward head posture.

Baseline (at the initial assessment)

Toissijaiset tulostoimenpiteet

Tulosmittaus
Toimenpiteen kuvaus
Aikaikkuna
pain intensity assessed using visual analog scale.
Aikaikkuna: Baseline (at the initial assessment)

Pain intensity will be assessed using the Visual Analog Scale (VAS), a 10-cm horizontal line anchored by "no pain" (0 cm) at one end and "worst imaginable pain" (10 cm) at the other end. Participants will be instructed to mark the point on the line that best represents their current neck pain intensity. The score will be determined by measuring the distance from the "no pain" anchor to the participant's mark. The minimum value is 0, indicating no pain, and the maximum value is 10, indicating the worst imaginable pain. Higher scores indicate greater pain intensity and worse outcomes, whereas lower scores indicate lower pain intensity and better outcomes

Baseline (at the initial assessment)
neck proprioception assessed using joint position error test
Aikaikkuna: Baseline (at the initial assessment)

Cervical proprioception will be assessed using the Joint Position Error (JPE) test with a laser pointer. Participants will be instructed to perform active cervical movements with their eyes closed and return their head to the initial neutral position. The distance between the laser pointer's final position and the original target position will be measured in centimeters (cm). The minimum value is 0 cm, indicating no repositioning error. Lower scores indicate better cervical proprioceptive accuracy, whereas higher scores indicate greater repositioning error and poorer cervical proprioception.

Baseline (at the initial assessment)
cognition (cognitive function) assessed using cognifit application
Aikaikkuna: Baseline (at the initial assessment)

CogniFit is a computerized cognitive assessment platform used to evaluate multiple cognitive abilities, including attention, memory, reasoning, and other cognitive functions. Each cognitive ability is assessed separately, and scores are generated according to the platform's scoring system. Each score ranges from 0 to 800 points, where 0 represents the minimum score and 800 represents the maximum score. Higher scores indicate better cognitive performance, whereas lower scores indicate poorer cognitive performance.

Baseline (at the initial assessment)
pressure pain threshold assessed using pressure algometry.
Aikaikkuna: Baseline (at the initial assessment)

Pressure pain threshold (PPT) will be assessed using a pressure algometer applied over the C6 and C7 cervical vertebral levels and the surrounding cervical soft tissues at predetermined assessment sites. The algometer probe will be applied perpendicularly to the skin, and pressure will be gradually increased at a constant rate until the participant first perceives the pressure as painful. The force at the onset of pain will be recorded in kilograms (kg). Three measurements will be performed at each assessment site, with 30-second intervals between trials, and the mean value will be calculated for analysis. The minimum value is 0 kg, while the maximum value depends on the measurement capacity of the algometer. Higher values indicate a higher pressure pain threshold and lower pressure sensitivity, representing better outcomes, whereas lower values indicate greater pressure sensitivity and worse outcomes.

Baseline (at the initial assessment)
Burnout Measured Using the Maslach Burnout Inventory
Aikaikkuna: Baseline (at the initial assessment)

Burnout will be assessed using the Arabic version of the Maslach Burnout Inventory (MBI-MR). The questionnaire evaluates burnout-related dimensions, including emotional exhaustion, depersonalization, and personal accomplishment. Scores will be calculated according to the scoring instructions of the instrument, with higher scores indicating greater burnout in the relevant burnout dimensions.

Baseline (at the initial assessment)
Quality of Life Measured Using the Arabic Version of WHOQOL-BREF
Aikaikkuna: Baseline (at the initial assessment)

Quality of life will be assessed using the Arabic version of the World Health Organization Quality of Life-BREF (WHOQOL-BREF). The questionnaire evaluates four domains: physical health, psychological health, social relationships, and environment. Domain scores will be calculated according to the instrument's scoring guidelines and transformed to a scale ranging from 0 to 100, with higher scores indicating better quality of life.

Baseline (at the initial assessment)

Yhteistyökumppanit ja tutkijat

Täältä löydät tähän tutkimukseen osallistuvat ihmiset ja organisaatiot.

Sponsori

Opintojen ennätyspäivät

Nämä päivämäärät seuraavat ClinicalTrials.gov-sivustolle lähetettyjen tutkimustietueiden ja yhteenvetojen edistymistä. National Library of Medicine (NLM) tarkistaa tutkimustiedot ja raportoidut tulokset varmistaakseen, että ne täyttävät tietyt laadunvalvontastandardit, ennen kuin ne julkaistaan ​​julkisella verkkosivustolla.

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