Effect of scapular stabilization and thoracic extension on craniovertebral angle, single breath count test and hand dexterity in young adults with forward head posture.

Forward head posture (FHP) is characterised by displacement of the head anteriorly with respect to the line of gravity. FHP results in excessive flexion at the lower cervical spine (C4C7) and extension at the upper cervical spine (C1-C3). FHP produces imbalance of several neck muscles, inhibition of mid scapular retractors thereby altering both scapular position and kinematics. Failure of the head to align with the vertical axis of the body can cause other malalignments throughout the body, such as rounded shoulders and increased thoracic kyphosis to compensate for the altered location of the LOG, resulting in further impairments. Thus to rectify head and neck posture, it is necessary to work on the thoracic spine as well. Nowadays, smartphones and other touch-screen portable devices play a big part in people’s daily lives because they are utilised for gaming, internet surfing, education and communication especially by the younger population. This usage pattern compels the user to assume an uncomfortable position, including forward neck flexion, which is frequently sustained for extended periods of time which is the primary cause of postural disorders like FHP. Hence it is important to work on the FHP developing in young adults as early as possible to prevent its complications from developing. 32 participants will be recruited based on inclusion and exclusion criteria. Informed consent will be taken and if they agree to participate, they will be included in the study. The participants will be called for 30 mins thrice a week for 3 weeks during the study. They will be asked about their demographic data. An intervention protocol including 4 exercises for scapular stabilization targeting rhomboids, middle trapezius, lower trapezius, serratus anterior and 3 exercises for thoracic extension will be given to the participants during these sessions. Craniovertebral angle, single breath count test and nine-hole peg test will be the outcome measures taken before and after the intervention. The horizontal line through C7 and the line joining C7 to the tragus constitute the cranio-vertebral angle. It will be measured using the photographic method through the computer program MB- Ruler software. The camera that will be used to take pictures of the participants will be set up on a tripod 1.5 meters from the individuals, with a height of 115 cm from the camera. The single breath count  will be measured by asking subjects to take a deep breath and count as far as possible in their normal voice at an approximate rate of 2 counts per second. The better of 2 attempts will be recorded. The Nine Hole Peg test will be used to assess the hand dexterity. The total time required by the participants to insert and remove the pegs from the peg board will be measured in seconds. After the data collection, it will be analysed using the statistical tests. Depending upon normality of the data, Paired t test or Wilcoxon signed rank test will be used.