Upper thoracic spine mobilization and mobility exercise versus upper cervical spine mobilization and stabilization exercise in individuals with forward head posture: a randomized clinical trial

Juchul Cho, Eunsang Lee, Seungwon Lee, Juchul Cho, Eunsang Lee, Seungwon Lee

Abstract

Background: Although upper cervical and upper thoracic spine mobilization plus therapeutic exercises are common interventions for the management of forward head posture (FHP), no study has directly compared the effectiveness of cervical spine mobilization and stabilization exercise with that of thoracic spine mobilization and mobility exercise in individuals with FHP.

Methods: Thirty-two participants with FHP were randomized into the cervical group or the thoracic group. The treatment period was 4 weeks, with follow-up assessment at 4 and 6 weeks after the initial examination. Outcome measures including the craniovertebral angle (CVA), cervical range of motion, numeric pain rating scale (NPRS), pressure pain threshold, neck disability index (NDI), and global rating of change (GRC) were collected. Data were examined with a two-way repeated-measures analysis of variance (group × time).

Results: Participants in the thoracic group demonstrated significant improvements (p < .05) in CVA, cervical extension, NPRS, and NDI at the 6-week follow-up compared with those in the cervical group. In addition, 11 of 15 (68.8%) participants in the thoracic group compared with 8 of 16 participants (50%) in the cervical group showed a GRC score of +4 or higher at the 4-week follow-up.

Conclusions: The combination of upper thoracic spine mobilization and mobility exercise demonstrated better overall short-term outcomes in CVA (standing position), cervical extension, NPRS, NDI, and GRC compared with upper cervical spine mobilization and stabilization exercise in individuals with FHP.

Trial registration: KCT0002307 , April 11, 2017 (retrospectively registered).

Keywords: Forward head posture; Mobilization; Neck pain; Therapeutic exercises.

Conflict of interest statement

Authors’ information

Juchul Cho: bbangil11@hanmail.net

Juchul Cho was received the M.S. degrees from Konyang University, Daejeon, Korea. He is currently a doctoral student at Sahmyook University. His main areas of research interest are musculoskeletal disorders and balance disorders.

Eunsang Lee: Lespt0430@gmail.com

Eunsang Lee was received the M.S. degrees from Sahmyook University, Seoul, Korea. He is currently a doctoral student at Sahmyook University. His main areas of research interest are sport physical therapy and human movement analysis.

Seungwon Lee: swlee@syu.ac.kr

Seungwon Lee was received the Ph.D. degrees from Sahmyook University, Seoul, Korea. Since 2008, he has been with Department of Physical Therapy, Sahmyook University, where he is currently an Associate Professor. His main areas of research interest are therapeutic exercise, geriatric physical therapy, and physical agents.

Ethics approval and consent to participate

The protocol for the study was approved by the Institutional Review Board of Sahmyook University. Each author certifies that all investigations were conducted in conformity with ethical principles. All participants provided informed consent before their participation in the study and written were obtained from all participants.

Consent for publication

The authors have received written consent from participants to publish individual patient data (images).

Competing interests

The authors declare that they have no financial or non-financial competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Flowchart of the recruitment, randomization, and follow-up of participants
Fig. 2
Fig. 2
Upper cervical (C1–2) spine mobilization and stabilization exercise used in this study
Fig. 3
Fig. 3
Upper thoracic (T1–2) spine mobilization and mobility exercise used in this study

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