High Intensity Laser Therapy Versus Scapular Stabilization Exercises on Ventilatory Function in Forward Head Posture

Not Applicable

Completed

• Conditions: Forward Head Posture
• Interventions: Other: Postural advice; Other: Traditional exercise treatment; Other: Scapular stabilization exercises; Other: High intensity Laser therapy

• Registration Number: NCT06270563
• Lead Sponsor: Cairo University

Brief Summary

The purpose of the study is to compare between the efficacy of high intensity LASER therapy and scapular stabilization exercises on ventilatory functions in forward head posture patients

Detailed Description

Neck pain is a common complaint in the population, with a considerable impact on individuals and their families, communities, health-care systems and businesses. The estimated 1-year incidence of neck pain ranges between 10.4 and 21.3%, and the overall prevalence of neck pain in general population can be as high as 86.8%.

The photothermic and the photochemical effects of high intensity LASER therapy may increase blood flow and stimulate collagen production within tendons; in addition, high intensity LASER therapy may increase vascular permeability and has an anti-inflammatory effect, thus removing the pain stimulus.

Scapular stabilization exercise is used as an effective way to recover the imbalance in posture and the muscles. It is also effective in increasing muscle activation in the serratus anterior and lower trapezius, through decreasing the compensatory movement, which is caused by the forward head posture, and in decreasing muscle activation on the upper trapezius. Furthermore, it brings about a spinal curve change and upper crossed syndrome improvement.

Therefore, this study will compare the difference between the effect of high intensity laser therapy and scapular stabilization as a modality of treatment on ventilatory function in forward head posture patients.

Study Timeline

• Study Start: 2022-10-01
• Primary Completion: 2023-12-01
• Study Completion: 2023-12-01
• Status Verified: 2024-02
• Study First Submitted: 2024-02-13
• Study First Submitted QC: 2024-02-19
• Last Update Submitted: 2024-02-19
• Study First Posted: 2024-02-21
• Last Update Posted: 2024-02-21

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 60

Inclusion Criteria

1. Their ages ranged from 30 -40 years.
2. All patients were diagnosed with forward head posture. - Diagnostic criteria for forward head posture by craniovertebral angle that detected by radiography and was less than 49° using specific goniometer.
3. Patients with abnormal values of decreased Forced vital capacity (FVC), forced expiratory volume at one second (FEV1), FEV1/FVC, MVV and TLC due to forward head posture.
4. All patients are medically and psychologically stable
5. They had a score more than 40% at neck disability index.

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Exclusion Criteria

1. Patients who had congenital anomalies in the neck and the thoracic cage.
2. Patients with pulmonary diseases (with restrictive lung disease or with obstructive lung disease).
3. Patients with BMI > 30 kg/m2.
4. patients with Contraindications for HILT: malignancies and potential precancerous growths, patients with cochlear implants, endocrine glands disease, patients with febrile conditions, epilepsy, pregnancy, freckles or tattoos, photosensitive medication.
5. Uncontrolled diabetes.

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Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Group A	Postural advice	They received postural advice and traditional exercise treatment (stretching and strengthening exercises) for 3 times per week for 12 weeks.
Group C	Traditional exercise treatment	They received postural advice, traditional exercise treatment (stretching and strengthening exercises), and high intensity laser therapy 3 times per week for 12 weeks.
Group B	Postural advice	They received postural advice, traditional exercise treatment (stretching and strengthening exercises), and scapular stabilization exercises 3 times per week for 12 weeks.
Group A	Traditional exercise treatment	They received postural advice and traditional exercise treatment (stretching and strengthening exercises) for 3 times per week for 12 weeks.
Group B	Traditional exercise treatment	They received postural advice, traditional exercise treatment (stretching and strengthening exercises), and scapular stabilization exercises 3 times per week for 12 weeks.
Group C	Postural advice	They received postural advice, traditional exercise treatment (stretching and strengthening exercises), and high intensity laser therapy 3 times per week for 12 weeks.
Group B	Scapular stabilization exercises	They received postural advice, traditional exercise treatment (stretching and strengthening exercises), and scapular stabilization exercises 3 times per week for 12 weeks.
Group C	High intensity Laser therapy	They received postural advice, traditional exercise treatment (stretching and strengthening exercises), and high intensity laser therapy 3 times per week for 12 weeks.

Primary Outcome Measures

Name	Time	Method
Forced vital capacity (FVC)	12 weeks	It was assessed by a spirometer before and after treatment. The patient was asked to breath 3 tidal breaths then fully expire, then take a deep inspiration to expire forcefully and rapidly as much as possible through the mouthpiece, the procedure was repeated 3 times and the best record was taken.
Forced expiratory volume at one second (FEV1)	12 weeks	It was assessed by a spirometer before and after treatment. The patient was asked to breath 3 tidal breaths then fully expire, then take a deep inspiration to expire forcefully and rapidly as much as possible through the mouthpiece, the procedure was repeated 3 times and the best record was taken.
FEV1/FVC	12 weeks	The ratio between the forced expiratory volume at one second (FEV1) and forced vital capacity (FVC) was calculated before and after treatment.
Maximum voluntary ventilation (MVV)	12 weeks	It was assessed by a spirometer before and after treatment. The patients were instructed to breathe rapidly and deeply for 15 to 30 seconds, ventilatory volumes were recorded, and the maximal volume achieved over 15 consecutive seconds was expressed in liters per minute.
Neck Disability Index (NDI)	12 weeks	It is a ten-item questionnaire that was used to assess disability associated with neck pain and whiplash. There are four items that relate to subjective symptomatology (pain intensity, headache, concentration, sleeping) and six items that relate to activities of daily living (lifting, work, driving, recreation, personal care, reading).
Craniovertebral angle (CVA)	12 weeks	It was measured by a specific goniometer that was positioned parallel to the C7 Spinous process and the goniometer's movable arm on the anterior cartilage of the ear. The angle between the movable arm and the perpendicular line passing through the C7 vertebrae was recorded.

Secondary Outcome Measures

Name	Time	Method
Upper thoracic chest expansion	12 weeks	It was measured using a tape measure at the axillary level before and after treatment.
Visual analogue scale (VAS)	12 weeks	It was used to assess neck pain intensity; it is graded scale from 10 to 0 at one point along the length of a 10-cm line that represents a continuum between the two ends of the scale "no pain" on the left end (0 cm) of the scale and the "worst pain" on the right end of the scale (10 cm).
Middle thoracic chest expansion	12 weeks	It was measured using a tape measure at the nipple level before and after treatment.
Lower thoracic chest expansion	12 weeks	It was measured using a tape measure at the level of the tip of the xiphoid process before and after treatment.

Trial Locations

Locations (1)

Cairo University; 🇪🇬 Giza, Egypt