Forward Head Posture
Conditions
Keywords
Forward Head Posture, Dynamic Neuromuscular Stabilization, Myofascial Release, Conventional Therapy, Neck Pain, Cervical Spine
Brief summary
Forward Head Posture (FHP) is a common postural dysfunction characterized by the anterior displacement of the head relative to the shoulders, leading to cervical spine misalignment, increased muscle strain, and neck pain. It is highly prevalent in university students (63-66%), largely due to prolonged sedentary behaviors and the use of smartphones, laptops, and tablets in poor ergonomic postures . This randomized controlled trial aims to evaluate the effectiveness of three intervention strategies for managing FHP in university students: Dynamic Neuromuscular Stabilization (DNS) Breathing + Conventional Exercises: DNS breathing will emphasize diaphragmatic activation and postural stabilization, combined with stretching, strengthening, and postural education. Myofascial Release (MFR) + Conventional Exercises: Suboccipital MFR to release fascial tension, combined with the same conventional exercise program. Conventional Exercises Alone (Control Group): A standard rehabilitation protocol of stretching, strengthening, and postural correction. All interventions will be delivered three times per week for six weeks, with each session lasting 45 minutes. Assessments will be conducted at baseline, week 4, and week 6: Craniovertebral Angle (CVA) and Forward Shoulder Angle (FSA) measured using smartphone photographic analysis. Wall Test to assess forward head and rounded shoulder posture. Visual Analog Scale (VAS) to measure subjective pain intensity. SF-36 Health Survey to evaluate quality of life across eight health domains. The study will compare the relative effectiveness of DNS breathing and MFR, each combined with conventional therapy, against conventional therapy alone. Findings are expected to contribute to evidence-based postural rehabilitation, particularly for young adults with sedentary lifestyles.
Interventions
OTHERDynamic neuromuscular stabilisation breathing
Diaphragmatic breathing exercises performed in supine, side-lying, and quadruped positions, 3 sets of 1 minute each.
OTHERMyofascial Release
Manual sustained pressure applied to the suboccipital region, upper trapezius, and levator scapulae, 2-3 minutes per site, to reduce myofascial stiffness and improve tissue extensibility
OTHERConvetional Exercises
Standardized exercise protocol including head rotation, neck/upper back extension, swimmer exercise, head retraction with resistance band, and upper trapezius/levator scapulae stretches.
Sponsors
Istinye University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to 28 Years
Healthy volunteers
Yes
Inclusion criteria
University student aged 18 to 28 years Presence of forward head posture confirmed by photogrammetric assessment Mild to moderate cervical pain (VAS score between 0 and 6) Voluntary agreement to participate in the study
Exclusion criteria
History of cervical spine surgery Presence of neurological disorders Diagnosis of cervical disc herniation Severe musculoskeletal pain (VAS ≥ 7)
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Craniovertebral Angle (CVA) | 4 weeks, and 8 weeks | The craniovertebral angle (CVA) will be measured using digital photogrammetry to assess the degree of forward head posture. A marker will be placed on the tragus of the ear and the spinous process of C7, and the angle formed between a horizontal line through C7 and the line connecting C7 to the tragus will be calculated. Smaller angles indicate a greater degree of forward head posture. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Visual Analogue Scale (VAS) | Baseline, 4 weeks, and 8 weeks | Pain intensity will be assessed using a 10 cm Visual Analogue Scale (VAS), where 0 indicates no pain and 10 indicates worst imaginable pain. Participants will mark their perceived pain level at rest and during activity. |
Countries
Turkey (Türkiye)
Contacts
CONTACTProf.Dr. H. Habibe serap INAL, doctor of physical therapy
CONTACTPT Rami M.osama Ramdoun, Bachelor of physical therapy
PRINCIPAL_INVESTIGATORProf.Dr. Habibe. Serap İnal, doctor of physical therapy
istinye university, faculty of health sciences , Department of physical therapy and rehabilitation
Outcome results
None listed