Effect of Electromyography Biofeedback Training to Deep Neck Flexor in Mechanical Neck Pain Patients with Forward Head Posture

Effect of Electromyography Biofeedback Training to Deep Neck Flexor in Mechanical Neck Pain Patients with Forward Head Posture – A Prospective Interventional Study

Background & Rationale:

Mechanical neck pain and forward head posture (FHP) are increasingly common among individuals with sedentary lifestyles, especially those engaged in prolonged screen-based activities. FHP alters cervical spine mechanics, weakens deep cervical flexors (DCF), and leads to muscle imbalances and chronic pain. While chin tuck exercises are standard in rehabilitation, many patients struggle with proprioceptive awareness, limiting the effectiveness of conventional training. Electromyography (EMG) biofeedback offers real-time visual and auditory cues to enhance muscle activation and motor control, potentially improving postural correction and reducing symptoms.

Objective:

To assess the clinical efficacy of EMG biofeedback-assisted Deep Cervical Flexors (DCF) training versus conventional Deep Cervical Flexion exercises in individuals with mechanical neck pain and FHP.

Methodology:

Patients aged 20–50 years with diagnosed mechanical neck pain and CVA <50° will be recruited and randomly allocated to either an EMG biofeedback group or a control group. Both groups will perform identical DCF exercises daily for four weeks. Outcome measures will include Craniovertebral Angle (CVA), Visual Analog Scale (VAS) for pain, Neck Disability Index (NDI), and cervical Active Range of Motion (AROM), assessed pre and post-intervention.

Clinical Significance:

This study aims to generate evidence for the integration of EMG biofeedback into routine physiotherapy practice. If proven effective, it can offer a low-risk, accessible, and efficient intervention to improve posture, alleviate pain, and restore function in patients with cervical dysfunctions, particularly FHP. Findings from this study may inform future guidelines on cervical rehabilitation protocols.