Effect of Posture and Breathing Exercises in Forward Head Posture

Forward Head Posture Clinical Trial

Official title:

Effects of Posture Exercises With and Without Breathing Exercises in Forward Head Posture

Clinical Trial Details — Status: Recruiting

Administrative data

• NCT number: NCT06197919
• Other study ID #: REC/RCR &AHS/23/0169
• Status: Recruiting
• Phase: N/A
• Start date: May 10, 2023
• Est. completion date: January 10, 2024

Study information

• Verified date: December 2023
• Source: Riphah International University
• Contact: imran amjad, PhD
• Phone: 03324390125
• Email: imran.amjad[@]ripha.edu.pk
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

This study aims to compare the effects of postural exercises with and without breathing exercises in the subjects having forward head posture.

Description:

Forward head posture (FHP) is a prevalent postural deviation that can occur in individuals of various age groups, spanning from childhood to old age. It manifests as an anterior positioning of the head in relation to the neck in the sagittal plane. . FHP is commonly associated with the excessive extension of the upper cervical spine (C1-C3) and flexion of the lower cervical spine (C4-C7). A common method to diagnose forward head posture is by measuring craniovertebral angle i.e. if CVA<49 than FHP is positive. In many cases faulty postures are linked with different musculoskeletal conditions as well as breathing difficulties. Forward head posture specifically impairs the mobility and functionality of the diaphragm, resulting in inefficient contraction of abdominal muscles and reduced lung capacity. A randomized clinical trial will be conducted so that we can rule out proper treatment protocol for forward head posture.

For this randomized clinical trial, 36 participants having forward head posture will be recruited from Sehat medical complex and shalamar hospitals Lahore by nonprobability convenient sampling. Participants will divide in two groups A and B by randomization. Group A will be given both exercise regimes of postural exercises and breathing exercises while group B will be given with only postural exercise protocol. Pain, ROM and craniovertebral angle will be assessment before the treatment start, after 5 weeks and at the end of treatment after 10 weeks. After the collection of data in 8 months, Statistical analysis using SPSS version 21, will be done to summarize the results.

Recruitment information / eligibility

• Status: Recruiting
• Enrollment: 36
• Est. completion date: January 10, 2024
• Est. primary completion date: January 10, 2024
• Accepts healthy volunteers: Accepts Healthy Volunteers
• Gender: All
• Age group: 20 Years to 35 Years

Eligibility

Inclusion Criteria:

• Individuals with 20 to 35 years of age, both male and female

• Individuals with CVA <49.

Exclusion Criteria:

• History of Surgery of thorax or spine or both.

• Traumatic neck injury.

• Acute or chronic neuro-muscular pain.

• Clinical deformity present in thoracic cage or spine

Related Conditions & MeSH terms

• Forward Head Posture
• Respiratory Aspiration

Intervention

Other:
• postural exercises
In this study forward head posture will be defined as CVA<49°, which was diagnosed by photogrammetry method. The postural exercise program consisted of two strengthening (deep cervical flexors and shoulder retractors) and two stretching (cervical extensors and pectoral muscles) exercises based on Kendall et al's approach. The exercises involved chin tucks ins a chin drop in sitting shoulder retraction unilateral and bilateral pectoralis stretches Participants were instructed to complete 3 sets of 12 repetitions of the strengthening exercises and 3 stretching exercises held for 30 seconds each. This program was to be repeated 4 times per week. They also returned for a consultation every 2 weeks to be checked for exercise technique and progression, if appropriate. Progress to the next exercise level was indicated if the participant could complete 12 repetitions, 3 times easily with correct form
• postural exercises with breathing exercises
The postural exercise program consisted the exercises i.e chin tucks in, a chin drop in sitting, shoulder retraction. Participants were instructed to complete 3sets of 12repetitions of these exercises. This program was to be repeated 4times per week. They also returned for a consultation every 2weeks to be checked for exercise technique and progression, if appropriate. Progress to the next exercise level was indicated if the participant could complete 12repetitions, 3times easily with correct form. For the breathing exercises in experimental group, breathing program includes respiratory muscle training, relaxation techniques, breathing techniques, e.g., deep breathing, hand controlled diaphragmatic breathing, relaxation technique, deep breathing, controlled diaphragmatic breathing, slow relaxed exhalation with pursed lips technique, and segmental breathing techniques. exercise protocol will be continued for 6 weeks with and initial, after 3weeks and final assessment of pain and CVA.

Locations

Country	Name	City	State
Pakistan	Sehat Medical Complex	Lahore	Punjab
Pakistan	Shalamar Hospital	Lahore	Punjab

Sponsors (1)

Lead Sponsor	Collaborator
Riphah International University

Country where clinical trial is conducted

Pakistan, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	photogrammetry for CVA and cervical range of motion(ROM) (image j)	CVA, can be measured using the lateral photo exposing C7 and the ear. The participants will maintain the natural head posture through the measurement method of self balance posture.It is the angle made by the line that connects the seventh cervical spine with the tragus and the horizontal line of 7th cervical spine in the standing position. A CVA is of ,49 is characterized as Forward head posture.; image j is an image processing and analysis program that can read both image file formats and raw formats. it has been introduces as a reliable assessment tool used to measure cervical angle in several studies on forward head posture.	6 weeks
Secondary	Numeric pain rating scale (NPRS):	The NPRS is a subjective pain rating scale using an 11 point scale from 0 to 10, where 0 means "no pain" and 10 means "intolerable pain". Participants select the whole number that best represent their level of pain. The reliability is>0.95 with ICC value 0.86-0.95	6 weeks
Secondary	Goniometer	Goniometer is an objective tool to measure range of motion of different joints of body. it has good reliability (r = .70)	6 weeks