Effect of Thoracic SNAGS on Vitals Among Individuals With Forward Head Posture

Not Applicable

Completed

Interventions: Other: Thoracic SNAGs with conventional therapy
Other: conventional therapy

Brief Summary: To determine how vitals (heart rate, blood pressure, respiratory rate, oxygen saturation) and craniovertebral angle will be affected by thoracic SNAGs in individuals with forward head posture.

Detailed Description: Forward head posture (FHP) leads to abnormal activation of neck muscles. This leads to respiratory complications and changes in blood pressure. Due to regional interdependence Upper thoracic spine can restrict the movement of cervical spine Thoracic spine is is closely related to Sympathetic nervous system. T1-T5 spinal sympathetic neurons provide sympathetic innervation to the vessels that supply to the heart tissues and upper portion of the body. Thus, thoracic mobilization can regulate main body vitals as well as other visceral activities that maintain homeostasis

There is a manual therapy technique called sustained natural apophyseal glides (SNAGs) in which patient performs active movements along with the passive movements performed by the physiotherapist. It not only has biomechanical efficacy which includes pain reduction and improvement in ROM, but it also has neurophysiologic effects. Previous studies lack to provide how thoracic SNAGs can affect vitals. Thus, this study aims to determine the effect of thoracic SNAGs on vital signs, including heart rate, blood pressure, respiratory rate, and oxygen saturation . Furthermore, this research will add to growing body of knowledge that how thoracic SNAGs can influence the correction of forward head posture

Recruitment & Eligibility

Inclusion Criteria

Exclusion Criteria

Arm && Interventions

Group	Intervention	Description
Thoracic SNAGs with conventional therapy	Thoracic SNAGs with conventional therapy	Thoracic (T1- T5) SNAGs 3 repetitions x 1 set, 2 days/week Hot pack for 10 minutes Stretching of upper trapezius, levator scapulae, 5 reps x 1 set x 15 sec hold 2 days/week and Pectoralis Major 10 reps x 1 set x 10 sec hold Strengthening of deep neck flexors and shoulder retractors (rhomboids) 10 reps x 1 set x 10 sec hold 2 days/week 2 days/week
Conventional therapy	conventional therapy	Hot pack for 10 minutes Stretching of upper trapezius, levator scapulae, 5 reps x 1 set x 15 sec hold 2 days/week and Pectoralis Major 10 reps x 1 set x 10 sec hold Strengthening of deep neck flexors and shoulder retractors (rhomboids) 10 reps x 1 set x 10 sec hold 2 days/week 2 days/week

Primary Outcome Measures

Name	Time	Method
Aneroid sphygmomanometer	4 weeks	Aneroid sphygmomanometer has more sensitivity and specificity (86.7% and 98.7%) than a digital device (80% and 67.7%) in the measurement of blood pressure, so it is considered to be more precise than a digital one
Pulse oximeter	4 weeks	Hypoxemia can be ruled out by pulse oximeter. It has high reliability and validity for heart rate calculation with ICC\> 0.93 in healthy individuals.
Respiratory rate	4 weeks	Respiratory rate or the number of breaths per minute is defined as one breath to each movement of air in and out of the lungs. In general, the respiratory rate for an adult sits between 12 and 20 breaths per min. 60second count is more accurate than short duration i.e 15 and 30 second

Secondary Outcome Measures

Name	Time	Method
Inclinometer	4 weeks	An inclinometer is used to measure the range of motion (ROM) of joints. It has a housing that contains a sensor. The sensor is sensitive to gravity and measures the angle of the housing. The angle is then displayed on a digital display or a dial. It is placed on the joint and then move the joint through its range of motion. The angle of the inclinometer will change as the joint moves. The maximum angle reached is the ROM of the joint. ICC values of inclinometer range between 0.89-0.94 in measuring cervical range of motion including flexion, extension, lateral flexion, and rotation; making it a reliable tool.
NPRS (Numeric Pain Rating Scale)	4 weeks	Numeric Pain Rating Scale (NPRS) measures the subjective intensity of pain. The NPRS is an eleven-point scale from 0 to 10. "0" = no pain and "10" = the most intense pain imaginable while the NPRS exhibited moderate reliability (ICC = 0.27-0.84)
Photogrammetric method for craniovertebral angle	4 weeks	FHP can be measured by craniovertebral angle which measures natural head neck posture in the sagittal plane and is determined by the intersection of a line extending from tragus of ear to C7 and horizontal line passing through C7. Kinovea software will be used for measurement of Cranio vertebral angle. Inter-rater reliability ranged from an intraclass correlation coefficient value of 0.95 to 0.98, whereas the intrarater reliability ranged from an intraclass correlation coefficient value of 0.98 to 0.99