Comparison of Deep Neck Flexor Strengthening and Motor Learning-Based Neuroplasticity Training for Forward Head Posture

Forward head posture is a prevalent postural abnormality characterized by anterior translation of the head relative to the cervical spine. It is commonly observed among university students and young adults due to prolonged smartphone use, computer work, and sedentary lifestyles. Persistent FHP leads to muscular imbalance, weakness of the deep neck flexors, altered proprioception, and impaired neuromuscular control, often resulting in neck pain and functional limitations.

Deep neck flexor strengthening targets the longus colli and longus capitis muscles to restore cervical alignment and improve segmental stability. These exercises aim to correct muscular imbalances by enhancing endurance and motor control of the cervical stabilizers.

Motor learning-based neuroplasticity training is an emerging rehabilitation approach that emphasizes sensorimotor integration, task-specific training, and multisensory feedback. This approach facilitates cortical reorganization and re-establishment of disrupted cortico-spinal and cortico-subcortical pathways through repetitive, goal-oriented motor tasks. By integrating visual, auditory, and proprioceptive feedback, neuroplasticity-based training enhances postural awareness, motor planning, and long-term postural correction.

Despite evidence supporting both interventions individually, limited research has directly compared their effectiveness across postural, neuromuscular, and proprioceptive outcomes, particularly with respect to symptom recurrence. This study seeks to address this gap.

Previous studies have demonstrated that deep neck flexor strengthening significantly improves craniovertebral angle, reduces neck pain, and enhances cervical stability in individuals with forward head posture. Cervical stabilization programs have also shown positive effects on proprioception and neck repositioning accuracy.