Efficacy of Combined Manual Diaphragm Release Technique and Neck Exercises in Adolescents With Forward Head Posture

Not Applicable

Active, not recruiting

• Conditions: Forward Head Posture

• Registration Number: NCT07039565
• Lead Sponsor: Pharos University in Alexandria

Brief Summary

* Due to the heavy use of smartphones among adolescents the cervical spine destabilizes and moves forward, so do the vital structures (nerves, arteries, veins) within the neck undergo torsion, stretch and compression including the autonomic nervous system nerves (which can cause dysfunction in heart rate, digestion, breathing among other symptoms).

* Forward head posture (FHP) puts more compressive strain on the cervical spine's tissues, especially the ligaments and facet joints. Because FHP weakens the respiratory muscles, it has a significant impact on respiratory function. Static balance may be negatively impacted by FHP.

* FHP is effectively treated by a proper and suitable physical therapy program.

Detailed Description

In the past few years, the number of smart phone users has progressively increased worldwide. With the growing use of smart phones, concerns have also increased about musculoskeletal problems associated with the prolonged use of smart phones.

Concerns have also increased about musculoskeletal problems associated with the prolonged use of smartphones. Recent investigations have shown that smartphone users tend to report pain in the neck, shoulder, and thumb, and the severity of the symptoms as the total time spent using the smartphone increases.

One of the most overspread postural abnormalities is forward head posture (FHP) and it is described as head projection anteriorly in relation to the trunk which appears mainly in sagittal plane. When using a smartphone, people usually flex their neck downwards to stare at the lowered object and maintain the head in a forward position for long periods of time, the maintenance of a head-forward posture decreases cervical lordosis of the lower cervical vertebrae and creates a posterior curve in the upper thoracic vertebrae to maintain balance; this is known as the forward head posture (FHP) that causes shortening of the extensors of the neck and producing chronic neck pain.

The weight supported by the spine dramatically increases when flexing the head forward at varying degrees. An adult head weighs 10-12 pounds in the neutral position. As the head tilts forward, the forces felt by the neck surge to 27 pounds at 15 degrees, 40 pounds at 30 degrees, 49 pounds at 45 degrees, and 60 pounds at 60 degrees. At 90 degrees, the model prediction was not reliable.

Study Timeline

• Study First Submitted: 2025-06-09
• Study First Submitted QC: 2025-06-17
• Study First Posted: 2025-06-26
• Study Start: 2025-06-28
• Primary Completion: 2025-06-30
• Status Verified: 2025-07
• Last Update Submitted: 2025-07-04
• Last Update Posted: 2025-07-09
• Study Completion: 2025-09-30

Recruitment & Eligibility

• Status: ACTIVE_NOT_RECRUITING
• Sex: Male
• Target Recruitment: 100

Inclusion Criteria

• Male students their age ranged from 17 to 18 years.

• Has Body Mass Index (BMI) = 5th percentile to less than the 85th percentile.

  _ has forward head posture

• Studying at any faculty at Pharos University in Alexandria.

• Cooperative and followed the instructions.

Exclusion Criteria

• • Subjects were excluded from the study if the student had visual or hearing defects.
• Overweight, obese or cachexic students.
• Had any neurological disorders.
• Had musculoskeletal problems.
• Had any congenital abnormalities that might affect the study.

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Primary Outcome Measures

Name	Time	Method
Vertical head alignment (VHA)	12 weeks	Angle between right tragus, right acromion and vertical.
craniovertebral angle (CVA) Forward head posture	12 weeks	The angle formed by a horizontal line crossing c7 and a line crossing c7 to the tragus of the ear is known as the CVA

Trial Locations

Locations (1)

Pharos University in Alexandria; 🇪🇬 Alexandria, Egypt