Forward Head PostureNCT05274711
The Effect of Whole Body Vibration on Neck Disability and Proprioception in Patients With Forward Head Posture
A study testing Whole body vibration training and Conventional physical treatment in people with Forward Head Posture, run by Cairo University at 1 site in Egypt.
Trial summary
To investigate if the Whole-body vibration affect cervical function cervical, proprioception, pain intensity level and ROM and in subjects with forward head posture? Read more about this study
- Who is it for?
- Ages 18 to 23 years
- Conditions the study is for
- Forward Head Posture
- What is being tested?
- Whole body vibration training and Conventional physical treatment
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 40 participants
- Where
- 1 siteEgypt
- Study dates
- 1 Jul 2022to 28 Feb 2023
- Phase
- Interventional
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 to 23 years
- All sexes
- No healthy volunteers
- Adult
Who may be able to join
- Adolescent physical therapy students of both gender between 18-23 years old
- BMI between 18.5-25 kg/m²
- Symptomatic forward head posture with CVA 49° or less.
Who cannot join
- Cervical disc
- Myelopathy or cervical radiculopathy
- Cervical spine surgery in the past
- Having received physical therapy in the three months prior to the study
Trial locations and contacts
1 site in 1 country.
About this study
To investigate if the Whole-body vibration affect cervical function cervical, proprioception, pain intensity level and ROM and in subjects with forward head posture?
Read the detailed description
Forward head posture (FHP) is one of the most common types of postural abnormality, and it is generally described as an anterior position of the head in relation to the vertical line of the body's center of gravity. Many researchers have reported that several factors, including headache, neck pain, and musculoskeletal disorders such as temporomandibular disorders or rounded shoulders, are related to FHP In forward head posture (FHP) lower cervical vertebrae are bent and upper cervical vertebrae are extended, and the weight of the head supported by the neck is increased. The bending moment of the head applies pressure on muscles and joints around the cervical vertebrae, in addition to active myofascial trigger points of the suboccipital muscle which may induce tension type headaches, neck pain and cervical headaches, while reducing the mobility of the neck Furthermore, FHP was associated with shortening of the upper trapezius, the posterior cervical extensor muscles, the sternocleidomastoid muscle and the levator scapulae muscle Recently studies have reported impaired proprioception to be one of the results of prolonged FHP. The cervical spine proprioceptive system is responsible for head orientation in space and in relation to the trunk and it is known for its role in maintaining head and neck stability It was concluded that the craniovertebral angle (CVA) is negatively correlated with the disability of patients with neck pain. So, patients with small CVA have a greater forward head posture, and the greater the forward head posture, the greater the disability.
Neck pain is a common complaint in the population. It has an episodic occurrence with variable recovery between episodes, and it is considered the most persistent musculoskeletal pain syndrome. Regarding physical work factors, neck pain was significantly associated with holding the neck in a forward bent posture for a prolonged time and making repetitive movements Despite claims that FHP may be related to neck pain, existing evidence seems controversial, since some previous studies have reported no significant associations between neck pain and FHP whereas other studies have reported an association between FHP and neck pain. It was showed that adults with neck pain have significantly more FHP than asymptomatic adults. Greater FHP has been associated with greater deficits in cervical range of motion, particularly neck rotation and flexion. Also, FHP seems to have a negative impact on static balance control in asymptomatic adults.
Corrective exercise is one of the interventional methods that had been suggested for treatment of FHP, including stretching, strengthening, and movement control exercises. Moreover, there may be advantages in exercising adjacent body segments to the cervical spine, such as the thoracic spine, to enhance the effectiveness of exercise training on FHP. Several studies have shown that corrective exercise regimes can improve FHP and potentially related symptoms. For example, exercise training protocols have resulted in improvement of CVA, head tilt, cranial or cervical range of motion neck disability and pain
Whole-body vibration exercise (WBV) may enhance muscle strength adaptations associated with traditional neuromuscular training or rehabilitation. The potentially beneficial effects of WBV are caused by the transmission of mechanical, sinusoidal vibrations throughout the body via the feet WBV is a neuromuscular training method that has recently been developed. In WBV training, the subject stands on a platform that generates vertical sinusoidal vibration at a frequency between 35 and 40 Hz. These mechanical stimuli are transmitted to the body where they stimulate in turn sensory receptors, most likely muscle spindles. This leads to the activation of the alpha-motoneurons and initiates muscle contractions comparable to the earlier described "tonic vibration reflex" Whole-body vibration (WBV) has become increasingly popular with reports of improved strength, power, movement velocity as well as balance and flexibility (Pollock et al., 2010). WBV exercises are performed while standing on a motor driven oscillating platform device. The mechanical vibration stimulus applied to the muscles and tendons during WBV exercise is characterized by a cyclic transition between eccentric and concentric muscle contractions and leads to a neuromuscular response
- Conditions
- Forward Head Posture
- Being tested
- Whole body vibration training, Conventional physical treatment
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Whole body vibration trainingOther
The participants will be instructed to stand on the vibration platform bare footed and distribute their weight evenly on both feet (fig 3). Next, they will be asked to do a head and neck retraction while looking forward with their knees at 30 degrees of flexion. In order to prevent fatigue in the subject's cervical area due to holding their head and neck in retraction, they will be asked to hold this position for 15 seconds then rest for 5 seconds. Since each set will last 60 second this allowed the subjects to do 3 retractions in each set. In total each subject will perform 15 retractions during the training. The subjects will experience a vertical vibration at a frequency and amplitude of 30 Hz and 4 mm during the sets (Salami et al., 2018).
Conventional physical treatmentOther
Posturalcorrectionexercisesintheformofstretchingandstrengthening exercise. Manual stretching exercises as passive stretch to (upper trapezius, levator scapulae, sub occipitalis, scalene, sternocleidomastoid, and pectoralis major muscles), 30 seconds of 3-5 repetitions for each muscle, followed by 30 seconds of rest, as well as isotonic exercises (to strength deep neck flexors and scapular retractor muscles) 3 sets of 12 repetitions each with a 6 second hold in between, with a 1-2-minute rest between sets (Kisner. and Colby 2012).
| Study group | Role | What they receive |
|---|---|---|
| Conventional treatment | Active comparator | will receive conventional physical therapy prograM Receives: Other: Conventional physical treatment |
| Experimental treatment | Experimental | will receive conventional physical therapy program and whole body vibration training Receives: Other: Whole body vibration training; Other: Conventional physical treatment |
What is being measured
The primary outcome is the main question the study is designed to answer.
The change in Neck disability
Neck disability will be measured by English neck disability index (NDI) questionnaire is composed of a total of 10 questions. Each question has 6 answer options which pertain to a level of severity (0-5) With total score of 50 , when NDI is high the neck function is the worst
Measured: immediately after the treatment
The change in Neck proprioception
Neck proprioception will be measured by clinometer application
Measured: immediately after the treatment
Secondary outcomes (2)
Neck pain
Neck pain will be measured be visual analogue scale (VAS). When responding to a VAS item, patients make marks along the 100 mm line at the point they feel represents their current pain state. With 100 mm means high level of pain and 0 means no pain
Measured: Before and immediately after the treatment
Cervical ROM
Cervical ROM will be measured by clinometer application
Measured: Before and immediately after the treatment
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted10 Mar 2022
- Study start1 Jul 2022
- Primary completion1 Feb 2023
- Study completion28 Feb 2023
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Forward Head PostureStudies of the same condition, open and under way.
- More trials run by Cairo UniversityThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Model description
- This trail has 2 groups one control and one experimental
- Masking
- Double blind
- Who is masked
- Investigator, Outcomes assessor
- Enrolment
- 40 participants (actual)
Sponsor and investigators
- Lead sponsor
- Cairo University
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Aya Ali Saaid Mahmoed, Cairo University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT05274711
- Sponsor's protocol ID
- P.T.REC/012/003408
- Status last verified
- May 2023
- First submitted
- 2 Mar 2022
- Last updated
- 26 May 2023
- Results posted
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
Study at a glance
From the registry record, last updated by the sponsor on 26 May 2023. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- The Effect of Whole Body Vibration on Neck Disability and Proprioception in Patients With Forward Head Posture
- ClinicalTrials.gov ID
- NCT05274711
- Acronym / sponsor ID
- P.T.REC/012/003408
- Conditions
- Forward Head Posture
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 40 participants (actual)
- Lead sponsor
- Cairo UniversityUniversity, hospital or other
- Study start
- 1 Jul 2022 (actual)
- Primary completion
- 1 Feb 2023 (actual)
- Study completion
- 28 Feb 2023 (actual)
- First posted
- 10 Mar 2022 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
To investigate if the Whole-body vibration affect cervical function cervical, proprioception, pain intensity level and ROM and in subjects with forward head posture?
Detailed description
Forward head posture (FHP) is one of the most common types of postural abnormality, and it is generally described as an anterior position of the head in relation to the vertical line of the body's center of gravity. Many researchers have reported that several factors, including headache, neck pain, and musculoskeletal disorders such as temporomandibular disorders or rounded shoulders, are related to FHP In forward head posture (FHP) lower cervical vertebrae are bent and upper cervical vertebrae are extended, and the weight of the head supported by the neck is increased. The bending moment of the head applies pressure on muscles and joints around the cervical vertebrae, in addition to active myofascial trigger points of the suboccipital muscle which may induce tension type headaches, neck pain and cervical headaches, while reducing the mobility of the neck Furthermore, FHP was associated with shortening of the upper trapezius, the posterior cervical extensor muscles, the sternocleidomastoid muscle and the levator scapulae muscle Recently studies have reported impaired proprioception to be one of the results of prolonged FHP. The cervical spine proprioceptive system is responsible for head orientation in space and in relation to the trunk and it is known for its role in maintaining head and neck stability It was concluded that the craniovertebral angle (CVA) is negatively correlated with the disability of patients with neck pain. So, patients with small CVA have a greater forward head posture, and the greater the forward head posture, the greater the disability.
Neck pain is a common complaint in the population. It has an episodic occurrence with variable recovery between episodes, and it is considered the most persistent musculoskeletal pain syndrome. Regarding physical work factors, neck pain was significantly associated with holding the neck in a forward bent posture for a prolonged time and making repetitive movements Despite claims that FHP may be related to neck pain, existing evidence seems controversial, since some previous studies have reported no significant associations between neck pain and FHP whereas other studies have reported an association between FHP and neck pain. It was showed that adults with neck pain have significantly more FHP than asymptomatic adults. Greater FHP has been associated with greater deficits in cervical range of motion, particularly neck rotation and flexion. Also, FHP seems to have a negative impact on static balance control in asymptomatic adults.
Corrective exercise is one of the interventional methods that had been suggested for treatment of FHP, including stretching, strengthening, and movement control exercises. Moreover, there may be advantages in exercising adjacent body segments to the cervical spine, such as the thoracic spine, to enhance the effectiveness of exercise training on FHP. Several studies have shown that corrective exercise regimes can improve FHP and potentially related symptoms. For example, exercise training protocols have resulted in improvement of CVA, head tilt, cranial or cervical range of motion neck disability and pain
Whole-body vibration exercise (WBV) may enhance muscle strength adaptations associated with traditional neuromuscular training or rehabilitation. The potentially beneficial effects of WBV are caused by the transmission of mechanical, sinusoidal vibrations throughout the body via the feet WBV is a neuromuscular training method that has recently been developed. In WBV training, the subject stands on a platform that generates vertical sinusoidal vibration at a frequency between 35 and 40 Hz. These mechanical stimuli are transmitted to the body where they stimulate in turn sensory receptors, most likely muscle spindles. This leads to the activation of the alpha-motoneurons and initiates muscle contractions comparable to the earlier described "tonic vibration reflex" Whole-body vibration (WBV) has become increasingly popular with reports of improved strength, power, movement velocity as well as balance and flexibility (Pollock et al., 2010). WBV exercises are performed while standing on a motor driven oscillating platform device. The mechanical vibration stimulus applied to the muscles and tendons during WBV exercise is characterized by a cyclic transition between eccentric and concentric muscle contractions and leads to a neuromuscular response
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Double blind (investigator, outcomes assessor)
- Number of arms
- 2
- Model description
- This trail has 2 groups one control and one experimental
| Arm | Type | Receives |
|---|---|---|
| Conventional treatment | Active comparator | Other: Conventional physical treatmentwill receive conventional physical therapy prograM |
| Experimental treatment | Experimental | Other: Whole body vibration training, Other: Conventional physical treatmentwill receive conventional physical therapy program and whole body vibration training |
Who may qualify
- Ages
- 18 to 23 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult
Key inclusion criteria (3 listed)
- Adolescent physical therapy students of both gender between 18-23 years old
- BMI between 18.5-25 kg/m²
- Symptomatic forward head posture with CVA 49° or less.
Key exclusion criteria (4 listed)
- Cervical disc
- Myelopathy or cervical radiculopathy
- Cervical spine surgery in the past
- Having received physical therapy in the three months prior to the study
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Whole body vibration trainingThe participants will be instructed to stand on the vibration platform bare footed and distribute their weight evenly on both feet (fig 3). Next, they will be asked to do a head and neck retraction while looking forward with their knees at 30 degrees of flexion. In order to prevent fatigue in the subject's cervical area due to holding their head and neck in retraction, they will be asked to hold this position for 15 seconds then rest for 5 seconds. Since each set will last 60 second this allowed the subjects to do 3 retractions in each set. In total each subject will perform 15 retractions during the training. The subjects will experience a vertical vibration at a frequency and amplitude of 30 Hz and 4 mm during the sets (Salami et al., 2018). | Other | Experimental treatment |
| Conventional physical treatmentPosturalcorrectionexercisesintheformofstretchingandstrengthening exercise. Manual stretching exercises as passive stretch to (upper trapezius, levator scapulae, sub occipitalis, scalene, sternocleidomastoid, and pectoralis major muscles), 30 seconds of 3-5 repetitions for each muscle, followed by 30 seconds of rest, as well as isotonic exercises (to strength deep neck flexors and scapular retractor muscles) 3 sets of 12 repetitions each with a 6 second hold in between, with a 1-2-minute rest between sets (Kisner. and Colby 2012). | Other | Conventional treatment, Experimental treatment |
Primary outcome
The change in Neck disability
Time frame: immediately after the treatment
Neck disability will be measured by English neck disability index (NDI) questionnaire is composed of a total of 10 questions. Each question has 6 answer options which pertain to a level of severity (0-5) With total score of 50 , when NDI is high the neck function is the worst
The change in Neck proprioception
Time frame: immediately after the treatment
Neck proprioception will be measured by clinometer application
2 secondary outcomes
Neck pain
Time frame: Before and immediately after the treatment
Cervical ROM
Time frame: Before and immediately after the treatment
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 26 May 2023.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
The record lists no contact. Use the official record to reach the sponsor.
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Whole body vibration training and Conventional physical treatment in people with Forward Head Posture, run by Cairo University at 1 site in Egypt.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 3 inclusion and 4 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 26 May 2023. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Egypt. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
The change in Neck disability (time frame: immediately after the treatment). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 26 May 2023.