Forward Head Posture
Conditions
Keywords
Nordic Pole Walking, Forward Head Posture, Neck Pain, Pulmonary Function, Respiratory Muscle Strength, Craniovertebral Angle
Brief summary
This randomized controlled trial aims to investigate the effects of Nordic pole walking on pain, neck-related disability, pulmonary function, respiratory muscle strength, and postural alignment in adults with forward head posture and neck pain. Participants will be randomly assigned to either a Nordic pole walking group or a general walking group. Both groups will participate in a 6-week walking program, three times per week, with each session lasting 40 minutes. Neck-related disability and pain will be assessed using the Neck Disability Index (NDI) and Visual Analog Scale (VAS). Pulmonary function will be assessed using forced vital capacity (FVC), forced expiratory volume in one second (FEV1), and the FEV1/FVC ratio. Respiratory muscle strength will be evaluated using maximal inspiratory pressure (MIP) and maximal expiratory pressure (MEP), and postural alignment will be assessed using the craniovertebral angle (CVA). Measurements will be performed before and after the 6-week intervention.
Interventions
Participants will perform Nordic pole walking using Nordic walking poles for 6 weeks, 3 sessions per week, with each session lasting 40 minutes. Participants will walk with coordinated upper- and lower-extremity movements while actively planting and pushing the poles during walking.
Participants will perform general walking for 6 weeks, 3 sessions per week, with each session lasting 40 minutes.
Sponsors
Study design
Intervention model description
Participants will be randomly assigned to either a Nordic pole walking group or a general walking group.
Eligibility
Inclusion criteria
* Adults aged 20 years or older * Craniovertebral angle (CVA) \< 50° * Neck pain lasting at least 3 months * Visual Analog Scale (VAS) score \> 4
Exclusion criteria
* Individuals currently participating in an exercise program related to neck pain management or postural correction * Individuals with musculoskeletal disorders that limit the ability to perform the exercise intervention * Individuals with respiratory diseases such as asthma, chronic obstructive pulmonary disease (COPD), bronchiectasis, or pneumonia * Individuals who have been regular smokers within the past 6 months
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Visual Analog Scale (VAS) for Neck Pain | Baseline and 6 weeks | Neck pain intensity will be assessed using a 10-cm horizontal Visual Analog Scale (VAS). The left end of the line represents no pain (0), and the right end represents very severe pain (10). To minimize bias, numerical values will not be displayed on the line. Participants will mark the point that best represents their perceived pain intensity, and the distance from the left end to the marked point will be measured with a ruler. Higher scores indicate greater pain intensity. |
| Neck Disability Index (NDI) | Baseline and 6 weeks | Neck-related disability will be assessed using the Neck Disability Index (NDI), a 10-item self-reported questionnaire. Each item is scored from 0 to 5, resulting in a raw total score ranging from 0 to 50. The raw total score will be multiplied by 2 and converted to a 0-100 scale, with higher scores indicating greater neck-related disability. The change in NDI score from baseline to 6 weeks will be evaluated. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Forced Vital Capacity (FVC) | Baseline and 6 weeks | Pulmonary function will be assessed using a MicroLab 3300 spirometer. Participants will be seated upright and perform forced expiratory maneuvers through a mouthpiece following maximal inspiration. FVC will be measured over three trials. |
| Forced Expiratory Volume in One Second (FEV1) | Baseline and 6 weeks | FEV1 will be measured using a MicroLab 3300 spirometer with participants seated upright. Participants will perform forced expiratory maneuvers following maximal inspiration. FEV1 will be measured three times, and the mean of the three measurements will be used for analysis. |
| FEV1/FVC Ratio | Baseline and 6 weeks | The FEV1/FVC ratio will be calculated from the measured forced expiratory volume in one second (FEV1) and forced vital capacity (FVC) values obtained using a MicroLab 3300 spirometer. Higher values indicate a greater proportion of the vital capacity exhaled during the first second of forced expiration. |
| Maximal Inspiratory Pressure (MIP) | Baseline and 6 weeks | Respiratory muscle strength will be assessed using a MicroRPM device with participants in a seated position. Maximal inspiratory pressure (MIP) will be measured from residual volume (RV). At least three and up to eight measurements will be performed. The highest value among measurements showing variability within 10% will be used for analysis. |
| Maximal Expiratory Pressure (MEP) | Baseline and 6 weeks | Respiratory muscle strength will be assessed using a MicroRPM device with participants in a seated position. Maximal expiratory pressure (MEP) will be measured from total lung capacity (TLC). At least three and up to eight measurements will be performed. The highest value among measurements showing variability within 10% will be used for analysis. |
| Craniovertebral Angle (CVA) | Baseline and 6 weeks | Postural alignment will be assessed using the craniovertebral angle (CVA). A camera will be positioned 104 inches from the participant at a height of 33 inches. Participants will stand upright in a comfortable posture with their arms at their sides after performing three consecutive maximal cervical flexion and extension movements. The CVA will be defined as the angle between a horizontal line passing through the C7 spinous process and a line connecting the tragus of the ear to the C7 spinous process. Three photographs will be taken, and the mean CVA value will be used for analysis. Lower CVA values indicate a greater degree of forward head posture. |
Countries
South Korea