Immediate Effect of Cervico-thoracic Mobilization on Deep Neck Flexors Strength in Individuals with Forward Head Posture: A Randomized Controlled Trial

Gauri Milind Ghan, V Sarath Babu, Gauri Milind Ghan, V Sarath Babu

Abstract

Introduction: Forward head posture is the most frequently observed postural deviations and is said to be associated with shortening of posterior cervical extensors and weakening of the anterior deep cervical flexors. Manual therapy has the potential to achieve reflexogenic changes in muscle and enhance the motor activity and strength.

Purpose of the study: To evaluate the immediate effect of grade IV cervicothoracic Maitland mobilization on deep neck flexors strength in individuals with forward head posture.

Study design: A Single-blinded randomized placebo-controlled trial.

Method: Sixty individuals were randomly divided into two groups. Placebo-controlled (PBO) group (n = 30) received the grade I and experimental (EXP) group (n = 30) received grade IV posteroanterior central and unilateral Maitland mobilization from the upper cervical to the upper thoracic spine. Outcome measure: Clinical Cranio-cervical flexion test (CCFT) was used to measure the motor activity and the strength of deep neck flexors.

Results: The strength of deep neck flexors effectively increased (p = <0.0001) after advocating grade IV mobilization.

Conclusion: This study concluded that grade IV central and unilateral posteroanterior Maitland mobilization demonstrated significant increase in the deep neck flexors strength in individuals with forward head posture.

Keywords: Maitland mobilization; arthrokinetic reflex (AKR); deep neck flexors (DNF), craniocervical flexion test (CCFT).; forward Head Posture (FHP).

Conflict of interest statement

The authors have no conflicts of interest to declare.

Figures

Figure 1.
Figure 1.
Cranio-vertebral Angle (CVA) using KINOVEA angle-measuring software
Figure 1.
Figure 1.
Cranio-vertebral Angle (CVA) using KINOVEA angle-measuring software
Figure 2.
Figure 2.
Craniocervical flexion test (CCFT) with the Chattanooga pressure biofeedback unit (PBU) TM
Figure 2.
Figure 2.
Craniocervical flexion test (CCFT) with the Chattanooga pressure biofeedback unit (PBU) TM
Figure 3.
Figure 3.
Central PA mobilization and ⇩ indicates mobilization pressure
Figure 3.
Figure 3.
Central PA mobilization and ⇩ indicates mobilization pressure
Figure 4.
Figure 4.
Unilateral PA mobilization and the symbol ⇩ indicate mobilization pressure directed postero-anteriorly and slightly medially for the cervical spine
Figure 4.
Figure 4.
Unilateral PA mobilization and the symbol ⇩ indicate mobilization pressure directed postero-anteriorly and slightly medially for the cervical spine
Figure 5.
Figure 5.
CONSORT flow diagram of participant enrollment, allocation, follow-up & analysis
Figure 5.
Figure 5.
CONSORT flow diagram of participant enrollment, allocation, follow-up & analysis
Figure 6.
Figure 6.
Changes in the pre and post-interventional mean values before and immediately after the intervention (95% confidence interval) of the activation score (mm Hg)
Figure 6.
Figure 6.
Changes in the pre and post-interventional mean values before and immediately after the intervention (95% confidence interval) of the activation score (mm Hg)
Figure 7.
Figure 7.
Changes in the pre and post-interventional mean values before and immediately after the intervention (95% confidence interval) of the performance index
Figure 7.
Figure 7.
Changes in the pre and post-interventional mean values before and immediately after the intervention (95% confidence interval) of the performance index

Source: PubMed

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