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Comparative Effects of Blackburn and Egoscue Exercises to Improve CVA in Individuals With Forward Head Posture

1 giugno 2026 aggiornato da: Maryam Safdar, University of Faisalabad

Comparative Effects of Blackburn and Egoscue Exercises to Improve Craniovertebral Angle in Individuals With Forward Head Posture

The trial aims to evaluate and compare the therapeutic outcomes of Blackburn and Egoscue exercise interventions in managing forward head posture. The study will be conducted as a Randomized Clinical Trial enrolling subjects diagnosed with forward head posture. Participants of both sexes will be eligible provided they present with a Craniovertebral Angle (CVA) ranging between 30 and 45 degrees, a Neck Disability Index (NDI) score indicating moderate to severe impairment, and pain levels rated as moderate to severe on the Numeric Pain Rating Scale (NPRS). Individuals currently wearing orthotic devices or having a history of recent trauma or fractures will be ineligible for participation. Written as well as verbal informed consent shall be obtained from each participant prior to enrollment. A total of 28 subjects will be distributed across 2 groups, each comprising 14 individuals, with allocation performed through randomization. Group A will undertake Blackburn exercise protocols while Group B will follow Egoscue method exercises. Transcutaneous Electrical Nerve Stimulation (TENS), isometric exercises, and thermotherapy via hot pack will serve as baseline interventions for both cohorts alongside cervical isometrics. The complete intervention protocol will span 24 sessions administered across 3 sessions weekly on alternate days. The principal outcomes assessed will include pain severity, craniovertebral alignment, and functional disability. Assessment instruments will comprise the Craniovertebral Angle measurement, Neck Disability Index, and Numeric Pain Rating Scale. Baseline measurements will be recorded at the start, pain will be documented before and after every treatment session, whereas forward head posture assessment and neck disability evaluations will be conducted both at baseline and upon completion of the 8-week protocol. Statistical processing of data will utilize SPSS version 23.

Panoramica dello studio

Stato

Non ancora reclutamento

Condizioni

Intervento / Trattamento

Descrizione dettagliata

Forward head posture represents a common cervical spinal deviation characterized by hyperextension of the upper cervical vertebrae combined with hyperflexion of the lower cervical region, ultimately producing excessive lordosis within the cervical spine. As a consequence, affected individuals experience difficulties performing their routine daily functions due to premature muscular fatigue in the neck region, diminished cervical stability, cervicogenic headache, and compromised postural regulation. The trial aims to evaluate and compare the therapeutic outcomes of Blackburn and Egoscue exercise interventions in managing forward head posture.The study will be conducted as a Randomized Clinical Trial enrolling subjects diagnosed with forward head posture. Participants of both sexes will be eligible provided they present with a Craniovertebral Angle (CVA) ranging between 30 and 45 degrees, a Neck Disability Index (NDI) score indicating moderate to severe impairment, and pain levels rated as moderate to severe on the Numeric Pain Rating Scale (NPRS). Individuals currently wearing orthotic devices or having a history of recent trauma or fractures will be ineligible for participation. Written as well as verbal informed consent shall be obtained from each participant prior to enrollment. A total of 28 subjects will be distributed across 2 groups, each comprising 14 individuals, with allocation performed through randomization. Group A will undertake Blackburn exercise protocols while Group B will follow Egoscue method exercises. Transcutaneous Electrical Nerve Stimulation (TENS), isometric exercises, and thermotherapy via hot pack will serve as baseline interventions for both cohorts alongside cervical isometrics. The complete intervention protocol will span 24 sessions administered across 3 sessions weekly on alternate days. The principal outcomes assessed will include pain severity, craniovertebral alignment, and functional disability. Assessment instruments will comprise the Craniovertebral Angle measurement, Neck Disability Index, and Numeric Pain Rating Scale. Baseline measurements will be recorded at the start, pain will be documented before and after every treatment session, whereas forward head posture assessment and neck disability evaluations will be conducted both at baseline and upon completion of the 8-week protocol. Statistical processing of data will utilize SPSS version 23.

Tipo di studio

Interventistico

Iscrizione (Stimato)

28

Fase

  • Non applicabile

Contatti e Sedi

Questa sezione fornisce i recapiti di coloro che conducono lo studio e informazioni su dove viene condotto lo studio.

Contatto studio

Backup dei contatti dello studio

Luoghi di studio

  • Pakistan
    • Punjab Province
      • Faisalābad, Punjab Province, Pakistan, 38000
        • Anas Iqbal Physiotherapy and Rehabilitation Centre, Khadija tul Zahra Physiotherapy Centre
        • Contatto:
        • Contatto:

Criteri di partecipazione

I ricercatori cercano persone che corrispondano a una certa descrizione, chiamata criteri di ammissibilità. Alcuni esempi di questi criteri sono le condizioni generali di salute di una persona o trattamenti precedenti.

Criteri di ammissibilità

Età idonea allo studio

  • Adulto

Accetta volontari sani

No

Descrizione

Inclusion Criteria:

  • Age range: 25 to 45 years (Mahmoud et al., 2019).
  • Individuals demonstrating a Craniovertebral Angle between 30 and 45 degrees.
  • Individuals reporting pain levels classified as moderate to severe on the NPRS.
  • Individuals demonstrating moderate to severe disability as measured by the Neck Disability Index.
  • Both male and female participants will be considered eligible.

Exclusion Criteria:

  • Individuals currently receiving any physical therapy intervention targeting the neck or shoulder regions.
  • Individuals utilizing cervical or lumbar orthotic devices.
  • Individuals taking prescribed pain medications.
  • Individuals with a formally diagnosed psychological condition.
  • Any recent bone fracture.
  • Any recently sustained trauma or injury.
  • Formally diagnosed neurological signs or symptoms.
  • Burns or open wounds.
  • Formally diagnosed vestibular pathology.

Piano di studio

Questa sezione fornisce i dettagli del piano di studio, compreso il modo in cui lo studio è progettato e ciò che lo studio sta misurando.

Come è strutturato lo studio?

Dettagli di progettazione

  • Scopo principale: Trattamento
  • Assegnazione: Randomizzato
  • Modello interventistico: Assegnazione parallela
  • Mascheramento: Separare

Armi e interventi

Gruppo di partecipanti / Arm
Intervento / Trattamento
Sperimentale: Group A (Blackburn exercises)
The protocol includes prone shoulder exercises to improve scapular stability and posture. Prone horizontal abduction (neutral) is performed by lifting arms laterally from a prone position until parallel to the floor. In full external rotation, thumbs are turned upward to increase rotator cuff activation. Prone horizontal scaption is done ~30° anterior to abduction, while its external rotation variant enhances posterior shoulder activation. Prone horizontal external rotation is performed with shoulders abducted 90° and elbows flexed 90°, rotating forearms upward. Prone horizontal extension involves lifting arms backward in line with the trunk. Exercises are performed 3 times/week, 10 reps with 5-second hold. After 5 days, progression increases hold to 10 seconds per repetition. Baseline care includes hot pack application to neck and shoulders for 15 minutes, and TENS in burst mode (200 µs pulse width, 100 Hz carrier, 2 Hz burst) for 10 minutes and also Cervical isometric exercises
Altro: Group A (Blackburn Exercises)
Prone exercises include horizontal abduction (neutral) where arms are lifted sideways from a prone position until parallel to floor, and in full external rotation with thumbs up for greater rotator cuff activation. Prone horizontal scaption is performed ~30° anterior to abduction, with its external rotation variant enhancing posterior shoulder control. Prone horizontal external rotation is done at 90° shoulder abduction with elbow flexion, rotating forearms upward. Prone horizontal extension lifts arms backward in line with trunk. Exercises are done 3×/week, 10 reps with 5-second hold, progressing to 10-second hold after 5 days. Baseline care includes hot pack for 15 min, TENS (200 µs, 100 Hz, 2 Hz burst) for 10 min, and cervical isometrics for stability and pain control.
Comparatore attivo: Group B (Egoscue exercises)
Egoscue exercises will be performed 3 times/week with 10 repetitions and a 5-second hold, progressing after 5 days to a 10-second hold. Exercises include static back (supine with legs supported at 90°), elbow curls (hands at temples, elbows moving together and apart with head stable), upper floor spinal twist (side lying trunk rotation with knees bent), cats and dogs (quadruped alternating spinal flexion/extension), and arm circles (standing, arms at shoulder level with scapular retraction and controlled rotations). Baseline care includes hot pack application to neck and shoulders for 15 minutes, and TENS in burst mode (200 µs pulse width, 100 Hz carrier, 2 Hz burst) for 10 minutes. Cervical isometric exercises are also included for strengthening and postural stability.
Altro: Group B (Egoscue Exercises)
Egoscue exercises will be performed 3×/week with 10 repetitions and a 5-second hold, progressing after 5 days to a 10-second hold. Exercises include static back (supine with legs supported at 90°), elbow curls (hands at temples, elbows moving together/apart with head stable), upper floor spinal twist (side-lying trunk rotation), cats and dogs (quadruped spinal flexion/extension), and arm circles (standing with scapular control and arm rotations). Baseline care includes hot pack applied to neck/shoulder for 15 minutes, and TENS in burst mode (200 µs, 100 Hz carrier, 2 Hz burst) for 10 minutes before sessions. Cervical isometric exercises are also included to improve strength and postural stability.

Cosa sta misurando lo studio?

Misure di risultato primarie

Misura del risultato
Misura Descrizione
Lasso di tempo
Neck Pain
Lasso di tempo: Baseline and Week 8th
The NPRS consists of an 11-point measurement scale with values ranging from 0, representing complete absence of pain, to 10, representing the most intense pain conceivable. It is a highly valid and reliable instrument for assessing pain intensity and permits precise patient-reported responses
Baseline and Week 8th
Craniovertebral Angle
Lasso di tempo: Baseline and Week 8
The CVA represents an acute angle formed between a horizontal reference line passing through the spinous process of the seventh cervical vertebra and a line connecting the midpoint of the tragus of the ear to the spinous process of the seventh cervical vertebra. This tool is recognized as a valid instrument for quantifying the degree of forward head posture
Baseline and Week 8

Misure di risultato secondarie

Misura del risultato
Misura Descrizione
Lasso di tempo
Neck Disability Index
Lasso di tempo: Baseline and Week 8
Originally developed in 1991, this instrument remains widely adopted for evaluating disability in individuals with neck pain. It comprises 10 items, each scored on a 6-point scale from 0 to 5, where 0 denotes no disability and 5 represents total disability. Item scores are aggregated to yield a total ranging from 0 to 50. Some investigators opt to multiply the total score by 2, thereby converting it to a percentage-based scale ranging from 0 to 100%
Baseline and Week 8

Collaboratori e investigatori

Qui è dove troverai le persone e le organizzazioni coinvolte in questo studio.

Sponsor

University of Faisalabad

Investigatori

  • Cattedra di studio: Dr Muhammad Ateeb, PhD Public Health, The University of Faisalabad

Pubblicazioni e link utili

La persona responsabile dell'inserimento delle informazioni sullo studio fornisce volontariamente queste pubblicazioni. Questi possono riguardare qualsiasi cosa relativa allo studio.

Pubblicazioni generali

Studiare le date dei record

Queste date tengono traccia dell'avanzamento della registrazione dello studio e dell'invio dei risultati di sintesi a ClinicalTrials.gov. I record degli studi e i risultati riportati vengono esaminati dalla National Library of Medicine (NLM) per assicurarsi che soddisfino specifici standard di controllo della qualità prima di essere pubblicati sul sito Web pubblico.

Studia le date principali

Inizio studio (Stimato)

20 maggio 2026

Completamento primario (Stimato)

20 settembre 2026

Completamento dello studio (Stimato)

20 settembre 2026

Date di iscrizione allo studio

Primo inviato

13 maggio 2026

Primo inviato che soddisfa i criteri di controllo qualità

1 giugno 2026

Primo Inserito (Effettivo)

3 giugno 2026

Aggiornamenti dei record di studio

Ultimo aggiornamento pubblicato (Effettivo)

3 giugno 2026

Ultimo aggiornamento inviato che soddisfa i criteri QC

1 giugno 2026

Ultimo verificato

1 giugno 2026

Maggiori informazioni

Termini relativi a questo studio

Parole chiave

Altri numeri di identificazione dello studio

  • TUF/EIRB/178/26

Piano per i dati dei singoli partecipanti (IPD)

Hai intenzione di condividere i dati dei singoli partecipanti (IPD)?

NO

Informazioni su farmaci e dispositivi, documenti di studio

Studia un prodotto farmaceutico regolamentato dalla FDA degli Stati Uniti

No

Studia un dispositivo regolamentato dalla FDA degli Stati Uniti

No

Queste informazioni sono state recuperate direttamente dal sito web clinicaltrials.gov senza alcuna modifica. In caso di richieste di modifica, rimozione o aggiornamento dei dettagli dello studio, contattare register@clinicaltrials.gov. Non appena verrà implementata una modifica su clinicaltrials.gov, questa verrà aggiornata automaticamente anche sul nostro sito web .

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