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Relationship of Forward Head Posture With Burnout and Quality of Life

1 november 2026 bijgewerkt door: 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

Studie Overzicht

Toestand

Nog niet aan het werven

Gedetailleerde beschrijving

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.

Studietype

Observationeel

Inschrijving (Geschat)

50

Contacten en locaties

In dit gedeelte vindt u de contactgegevens van degenen die het onderzoek uitvoeren en informatie over waar dit onderzoek wordt uitgevoerd.

Studiecontact

  • Naam: Ahmed Mossaed, Demonstrator/ M.Sc. researcher
  • Telefoonnummer: 00201069062868
  • E-mail: amosaed79@gmail.com

Studie Contact Back-up

  • Naam: Marwa Mostafa abdel moneim, lecturer of physical therapy
  • Telefoonnummer: 00201005661591
  • E-mail: marwa.mostafa@cu.edu.eg

Deelname Criteria

Onderzoekers zoeken naar mensen die aan een bepaalde beschrijving voldoen, de zogenaamde geschiktheidscriteria. Enkele voorbeelden van deze criteria zijn iemands algemene gezondheidstoestand of eerdere behandelingen.

Geschiktheidscriteria

Leeftijden die in aanmerking komen voor studie

35 jaar tot 50 jaar (Volwassen)

Accepteert gezonde vrijwilligers

Nee

Geslachten die in aanmerking komen voor studie

Allemaal

Bemonsteringsmethode

Niet-waarschijnlijkheidssteekproef

Studie Bevolking

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

Beschrijving

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

Studie plan

Dit gedeelte bevat details van het studieplan, inclusief hoe de studie is opgezet en wat de studie meet.

Hoe is de studie opgezet?

Ontwerpdetails

  • Observatiemodellen: OTHER
  • Tijdsperspectieven: CROSS_SECTIONAL

Cohorten en interventies

Groep / Cohort
Interventie / Behandeling
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).

Wat meet het onderzoek?

Primaire uitkomstmaten

Uitkomstmaat
Maatregel Beschrijving
Tijdsspanne
Craniovertebral Angle (CVA) Measured Using Kinovea Software
Tijdsspanne: 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)

Secundaire uitkomstmaten

Uitkomstmaat
Maatregel Beschrijving
Tijdsspanne
pain intensity assessed using visual analog scale.
Tijdsspanne: 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
Tijdsspanne: 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
Tijdsspanne: 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.
Tijdsspanne: 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
Tijdsspanne: 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
Tijdsspanne: 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)

Medewerkers en onderzoekers

Hier vindt u mensen en organisaties die betrokken zijn bij dit onderzoek.

Studie record data

Deze datums volgen de voortgang van het onderzoeksdossier en de samenvatting van de ingediende resultaten bij ClinicalTrials.gov. Studieverslagen en gerapporteerde resultaten worden beoordeeld door de National Library of Medicine (NLM) om er zeker van te zijn dat ze voldoen aan specifieke kwaliteitscontrolenormen voordat ze op de openbare website worden geplaatst.

Bestudeer belangrijke data

Studie start (Geschat)

20 november 2026

Primaire voltooiing (Geschat)

20 februari 2027

Studie voltooiing (Geschat)

1 maart 2027

Studieregistratiedata

Eerst ingediend

8 oktober 2026

Eerst ingediend dat voldeed aan de QC-criteria

16 oktober 2026

Eerst geplaatst (Werkelijk)

23 oktober 2026

Updates van studierecords

Laatste update geplaatst (Werkelijk)

4 november 2026

Laatste update ingediend die voldeed aan QC-criteria

1 november 2026

Laatst geverifieerd

1 oktober 2026

Meer informatie

Termen gerelateerd aan deze studie

Plan Individuele Deelnemersgegevens (IPD)

Bent u van plan om gegevens van individuele deelnemers (IPD) te delen?

NEE

Beschrijving IPD-plan

Data is available with corresponding author on reasonable request

Informatie over medicijnen en apparaten, studiedocumenten

Bestudeert een door de Amerikaanse FDA gereguleerd geneesmiddel

Nee

Bestudeert een door de Amerikaanse FDA gereguleerd apparaatproduct

Nee

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