Forward Head Posture
Conditions
Keywords
Instrument-assisted soft tissue mobilization, Postural corrective exercise, Craniovertebral angle, Cervical proprioception, Muscle endurance, Physiotherapy
Brief summary
This study investigated the acute effects of instrument-assisted soft tissue mobilization added to postural corrective exercises in young adults with forward head posture. Participants were randomly allocated to one of three groups: instrument-assisted soft tissue mobilization plus postural corrective exercises, postural corrective exercises only, or control. The primary outcome was craniovertebral angle. Secondary outcomes included cervical joint repositioning error, deep cervical flexor muscle endurance, and scapular muscle endurance. All outcomes were assessed at baseline and 1 hour after the intervention by a blinded outcome assessor.
Detailed description
Forward head posture is a common postural deviation in young adults and may be associated with altered cervicothoracic alignment, impaired cervical proprioception, and reduced cervical and scapular muscle endurance. Postural corrective exercises are commonly used in physiotherapy practice to improve head-neck posture and related neuromuscular control. Instrument-assisted soft tissue mobilization may provide additional acute effects through mechanical stimulation of soft tissues and proprioceptive input. This single-blind randomized controlled trial evaluated the acute effects of instrument-assisted soft tissue mobilization added to postural corrective exercises in young adults with forward head posture. Eligible participants were randomly allocated in a 1:1:1 ratio to one of three groups: instrument-assisted soft tissue mobilization plus postural corrective exercises, postural corrective exercises only, or control. The control group received no intervention and was assessed at the same time intervals as the intervention groups. Outcome assessments were conducted by a blinded assessor at baseline and 1 hour after the intervention. The primary outcome was craniovertebral angle, used as an indicator of forward head posture. Secondary outcomes included cervical joint repositioning error, deep cervical flexor muscle endurance, and scapular muscle endurance.
Interventions
OTHERInstrument-Assisted Soft Tissue Mobilization Plus Postural Corrective Exercises
Participants received a single-session postural corrective exercise program and postural education in addition to instrument-assisted soft tissue mobilization. The exercise program included deep cervical flexor activation using the chin tuck exercise, active cervical range-of-motion exercises, scapular exercises, and pectoral stretching. Instrument-assisted soft tissue mobilization was applied bilaterally to the cervicothoracic region, including the upper and middle trapezius, sternocleidomastoid, levator scapulae, scalene, suboccipital, and cervical erector spinae muscles. The mobilization was applied for approximately 10 minutes using appropriate instruments.
OTHERPostural Corrective Exercises
Participants received a single-session postural corrective exercise program and postural education. The exercise program included deep cervical flexor activation using the chin tuck exercise, active cervical flexion, extension, lateral flexion and rotation exercises, scapular exercises, and pectoral stretching.
Sponsors
Dokuz Eylul University
The Scientific and Technological Research Council of Turkey
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Outcomes Assessor)
Masking description
Outcome assessments were conducted by an assessor who was blinded to group allocation. Due to the nature of the interventions, participants and the treating therapist could not be blinded.
Eligibility
Sex/Gender
ALL
Age
18 Years to 25 Years
Healthy volunteers
Yes
Inclusion criteria
* Individuals aged 18-25 years * Presence of forward head posture * Provision of written informed consent
Exclusion criteria
* History of any disease or surgical procedure affecting cervical or thoracic posture * Any health condition preventing completion of the assessments
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Craniovertebral Angle | Baseline and 1 hour after the intervention | Craniovertebral angle was assessed using digital photographic postural analysis. Markers were placed on the tragus of the ear and the spinous process of C7, and the angle was calculated from a lateral-view photograph. Higher values indicate a more upright head posture. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Cervical Joint Repositioning Error | Baseline and 1 hour after the intervention | Cervical joint repositioning error was assessed using a laser pointer system during cervical flexion, extension, right and left rotation, and right and left lateral flexion. Absolute repositioning error was calculated for each movement direction. Lower values indicate better cervical joint position sense. |
| Deep Cervical Flexor Muscle Endurance | Baseline and 1 hour after the intervention | Deep cervical flexor muscle endurance was assessed using the cervical flexor endurance test. The duration for which the participant could maintain the test position was recorded in seconds. Higher values indicate greater muscle endurance. |
| Scapular Muscle Endurance | Baseline and 1 hour after the intervention | Scapular muscle endurance was assessed using the scapular muscle endurance test. The duration for which the participant could maintain the required test position and resistance was recorded in seconds. Higher values indicate greater muscle endurance. |
Countries
Turkey (Türkiye)
Contacts
STUDY_CHAIRNihal Gelecek, Professor
Dokuz Eylul University
Outcome results
None listed