Forward Head Posture
Conditions
Keywords
Forward head posture, Craniovertebral angle, Electrotherapy, Therapeutic ultrasound, Interferential current, TENS, myotonometry, muscle stiffness, cervical muscles
Brief summary
This randomized controlled trial investigates the acute effects of three electrotherapy modalities (therapeutic ultrasound, interferential current, and TENS) on the mechanical and viscoelastic properties of neck muscles in young adults with forward head posture. Seventy-five participants will be randomly allocated to one of three groups. Muscle stiffness, oscillation frequency, and craniovertebral angle will be assessed before and immediately after a single treatment session.
Detailed description
Forward head posture (FHP) is a common postural deviation associated with increased mechanical loading of the cervical spine and altered muscle length-tension relationships. While electrotherapy modalities are widely used clinically to manage neck pain, their acute effects on the biomechanical and viscoelastic properties of cervical muscles remain insufficiently characterized. This study will evaluate the acute effects of therapeutic ultrasound, interferential current, and TENS on the dynamic stiffness, oscillation frequency, elasticity, and pain of the upper trapezius, splenius capitis, sternocleidomastoid, and cervical erector spinae muscles, measured using myotonometry (MyotonPRO) immediately before (T0) and after (T1) a single treatment session.
Interventions
DEVICETherapeutic Ultrasound (Chattanooga Intelect® Vet)
Pulsed therapeutic ultrasound applied to the cervical region at 1-3 MHz frequency and 0.1-3 W/cm² intensity for 8-10 minutes in prone position, using circular head movements.
DEVICEInterferential Current (Chattanooga Intelect® Vet)
Bipolar interferential current applied via two electrodes covering the target muscles, \~2500 Hz carrier frequency, 100 Hz amplitude modulation frequency, for 15 minutes, at an intensity producing a clear but painless paresthesia sensation, in prone position.
DEVICEConventional TENS
Conventional TENS applied via surface electrodes covering the target muscles, 60-120 Hz frequency, 50-100 µsec pulse duration, for 15 minutes, at an intensity producing a clear but painless paresthesia sensation, in prone position.
Sponsors
Medipol University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to 30 Years
Healthy volunteers
Yes
Inclusion criteria
* Aged 18-30 years * Craniovertebral angle (CVA) \< 55° * Male and female * Voluntary participation
Exclusion criteria
* Cervical instability * Diagnosed inflammatory joint disease * History of accident, trauma, or surgery * Cervical pain treatment within the last 6 months * Presence of cervical implant * Skin irritation at measurement/electrode sites * Diagnosed epilepsy * Presence of cardiac/brain pacemaker * Unwillingness to participate
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in Dynamic Stiffness (N/m) | Baseline (T0) and immediately after single intervention session (T1) | Dynamic stiffness reflects the resistance of the muscle to an external deforming force. It will be measured using MyotonPRO on the upper trapezius, splenius capitis, sternocleidomastoid, and cervical erector spinae muscles. The normative reference range for stiffness (S) is 220-380 N/m. |
| Change in Oscillation Frequency (Hz) | Baseline (T0) and immediately after single intervention session (T1) | Oscillation frequency reflects the resting muscle tone. It will be measured using MyotonPRO on the same muscle groups. The normative reference range for oscillation frequency (F) is 12.0-18.0 Hz. |
| Change in Craniovertebral Angle (degrees) | Baseline (T0) and immediately after single intervention session (T1) | The craniovertebral angle (CVA) is the angle between a horizontal line passing through the tragus of the ear and a line connecting the tragus to the spinous process of C7, and it is used to assess forward head posture. It will be measured from photographs using the Kinovea 2D motion analysis software. According to Salahzadeh et al. (2014), the mean CVA value in individuals without forward head posture is 55 degrees. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Change in Muscle Elasticity (Logarithmic Decrement) | Baseline (T0) and immediately after single intervention session (T1) | The logarithmic decrement reflects muscle elasticity, describing how quickly the natural oscillation of the muscle decays after mechanical perturbation. It will be measured using MyotonPRO on the same muscle groups. The normative reference range for logarithmic decrement (D) is 1.00-1.60. |
| Change in Mechanical Stress Relaxation Time | Baseline (T0) and immediately after single intervention session (T1) | Mechanical stress relaxation time reflects the viscoelastic properties of the muscle, specifically the time required for the muscle to relax after removal of an applied mechanical load. It will be measured using MyotonPRO on the same muscle groups. The normative reference range for relaxation time (R) is 14.0-30.0 ms. |
| Change in Creep (Deformation/Relaxation Ratio) | Baseline (T0) and immediately after single intervention session (T1) | Creep reflects the ratio between the deformation time and the relaxation time of the muscle and is used as an indicator of its viscoelastic behavior. It will be measured using MyotonPRO on the same muscle groups. The normative reference range for creep (C) is 1.00-2.00. |
| Change in Pain (Numeric Pain Rating Scale, 0-10) | Baseline (T0) and immediately after single intervention session (T1) | Pain will be assessed using the Numeric Pain Rating Scale, an 11-point scale ranging from 0 to 10, where 0 indicates no pain and 10 indicates the worst pain imaginable. Participants who report pain will rate its severity using this scale. |
Contacts
CONTACTFatma Dilge AŞIK BOZDEMİR
CONTACTHande TUNÇ
PRINCIPAL_INVESTIGATORFatma Dilge AŞIK BOZDEMİR
Medipol University
STUDY_DIRECTORHande TUNÇ
Medipol University
STUDY_CHAIRAyşe Nur TUNALI
Medipol University
Outcome results
None listed