Effects of Exercise on Alignment and Muscle Parameters in Forward Head Posture

Not Applicable

Completed

• Conditions: Forward Head Posture
• Interventions: Other: Corrective exercise program

• Registration Number: NCT05619094
• Lead Sponsor: Cukurova University

Brief Summary

It is aimed to investigate the effect of corrective exercise program on alignment, muscle activation and biomechanical properties of muscles in medical students with forward head posture.

Detailed Description

Forward head posture (FHP) is a common postural abnormality that can be seen in all age groups. It is characterized by the head position being forward relative to the neck in the sagittal plane. The anterior displacement of the head is mainly assessed through examination of the craniovertebral angle (CVA) and a CVA of ˂50° is described as a FHP. Therapeutic exercises have shown to be effective in FHP and related symptoms in many studies. One of the exercise programs applied is the corrective exercise program. Within the scope of this program, deep cervical flexor muscles and shoulder retractors are strengthened, cervical extensors and pectoral muscles are stretched. This exercise protocol has been reported to provide relief in neck pain, improvement in CVA and shoulder angle. However, the number of studies examining the effect of corrective exercise program for the affected muscle groups in FHP on muscle activation parameters is limited, and there is no study examining the effect on the biomechanical properties of the muscles.

In this study, it is aimed to investigate the effect of corrective exercise program on alignment, muscle activation and biomechanical properties of muscles in medical students with forward head posture.

Study Timeline

• Study Start: 2022-10-01
• Study First Submitted: 2022-10-27
• Study First Submitted QC: 2022-11-11
• Study First Posted: 2022-11-16
• Primary Completion: 2023-06-30
• Study Completion: 2023-10-01
• Status Verified: 2023-11
• Last Update Submitted: 2023-11-27
• Last Update Posted: 2023-11-28

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 36

Inclusion Criteria

• Medical students with a Craniovertebral angle ˂ 50°

Exclusion Criteria

• History of chronic pain in cervical region
• Presence of spinal deformity and malalignment
• Disease, fracture or surgery affecting the spine-shoulder-pelvic region
• Presence of malignancy
• BMI outside the normal range
• Presence of medical condition that prevents participation in physical exercise program
• Presence of neuromuscular disease
• Involvement in regular and professional sports activities

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Corrective Exercise	Corrective exercise program	Selective corrective exercise program, 8 weeks

Primary Outcome Measures

Name	Time	Method
Craniovertebral angle	Week 8	The angle between the line connecting the seventh cervical vertebra and the tragus of right ear, and the horizontal line.; running in the sagittal place through the C7 process

Secondary Outcome Measures

Name	Time	Method
Surface electromyography (EMG) amplitude (RMS)	Week 8	The activity levels of trapezius, sternocleidomastoid and pectoralis muscles will be measured with a wireless EMG system (Delsys, Inc, Boston, MA). The electrodes will be positioned on the belly of the muscle. The signals will be amplified and band-pass filtered (20-450 Hz) before being record digitally at 2000 samples per second, and then the root mean square (RMS) will be calculated. To normalize individual muscle contraction levels, we will use maneuvers of voluntary contractions.
Myotonometer measures (Muscle tone)	Week 8	The state of tension and biomechanical properties will be measured with a hand-held device (MyotonPro®, Myoton AS, Tallinn, Estonia). MyotonPro® displays the muscle mechanical properties by analyzing the oscillations of the myofascial tissue in response to the 10 short (15 ms) impulses, at 0.56 N force and frequency of 1Hz applied by the probe of the device.; The superficial muscles (trapezius, sternocleidomastoid and pectoralis muscle) will be evaluated.; The device measures (computes simultaneously) the following parameters: Oscillation frequency (Hz), dynamic stiffness (N/m) and logarithmic decrement.; Ossilation Frequency \[Hz\]: Characterises the tone (intrinsic tension) of a muscle in its passive or resting state.
Myotonometer measures (Muscle stiffness)	Week 8	The state of tension and biomechanical properties will be measured with a hand-held device (MyotonPro®, Myoton AS, Tallinn, Estonia). MyotonPro® displays the muscle mechanical properties by analyzing the oscillations of the myofascial tissue in response to the 10 short (15 ms) impulses, at 0.56 N force and frequency of 1Hz applied by the probe of the device.; The superficial muscles (trapezius, sternocleidomastoid and pectoralis muscle) will be evaluated.; The device measures (computes simultaneously) the following parameters: Oscillation frequency (Hz), dynamic stiffness (N/m) and logarithmic decrement.; Dynamic Stiffness \[N/m\]: Characterises the resistance to a contraction or to an external force that deforms its initial shape.
Myotonometer measures (Muscle elasticity)	Week 8	The state of tension and biomechanical properties will be measured with a hand-held device (MyotonPro®, Myoton AS, Tallinn, Estonia). MyotonPro® displays the muscle mechanical properties by analyzing the oscillations of the myofascial tissue in response to the 10 short (15 ms) impulses, at 0.56 N and frequency of 1Hz applied by the probe of the device.; The superficial muscles (trapezius, sternocleidomastoid and pectoralis muscle) will be evaluated.; The device measures (computes simultaneously) the following parameters: Oscillation frequency (Hz), dynamic stiffness (N/m) and logarithmic decrement.; Logarithmic Decrement: Characterises elasticity.

Trial Locations

Locations (1)

Cukurova University; 🇹🇷 Adana, Turkey