Forward Head PostureNCT06197919
Effect of Posture and Breathing Exercises in Forward Head Posture
A study testing postural exercises and postural exercises with breathing exercises in people with Forward Head Posture, run by Riphah International University at 2 sites in Pakistan.
Trial summary
This study aims to compare the effects of postural exercises with and without breathing exercises in the subjects having forward head posture. Read more about this study
- Who is it for?
- Ages 20 to 35 yearsHealthy volunteers can take part
- Conditions the study is for
- Forward Head Posture
- What is being tested?
- postural exercises and postural exercises with breathing exercises
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 36 participants
- Where
- 2 sitesPakistan
- Study dates
- 10 May 2023to 10 Jan 2024
- 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 20 to 35 years
- All sexes
- Healthy volunteers accepted
- Adult
Who may be able to join
- Individuals with 20 to 35 years of age, both male and female
- Individuals with CVA <49.
Who cannot join
- History of Surgery of thorax or spine or both.
- Traumatic neck injury.
- Acute or chronic neuro-muscular pain.
- Clinical deformity present in thoracic cage or spine
Trial locations and contacts
2 sites in 1 country.
Pakistan2 sites, 2 recruiting
- Recruiting
Sehat Medical Complex
Lahore, Punjab Province, 54000
waseem javed, phD, 03457881133, wasim800@hotmail.com
- Recruiting
Shalamar Hospital
Lahore, Punjab Province, 54000
usman sarwar, FCPS, 03004280554, onlyawan@yahoo.com
usman sarwar, FCPS, 03326099065, onlyawan@yahoo.com
About this study
Official title: Effects of Posture Exercises With and Without Breathing Exercises in Forward Head Posture
This study aims to compare the effects of postural exercises with and without breathing exercises in the subjects having forward head posture.
Read the detailed description
Forward head posture (FHP) is a prevalent postural deviation that can occur in individuals of various age groups, spanning from childhood to old age. It manifests as an anterior positioning of the head in relation to the neck in the sagittal plane. . FHP is commonly associated with the excessive extension of the upper cervical spine (C1-C3) and flexion of the lower cervical spine (C4-C7). A common method to diagnose forward head posture is by measuring craniovertebral angle i.e. if CVA<49 than FHP is positive. In many cases faulty postures are linked with different musculoskeletal conditions as well as breathing difficulties. Forward head posture specifically impairs the mobility and functionality of the diaphragm, resulting in inefficient contraction of abdominal muscles and reduced lung capacity. A randomized clinical trial will be conducted so that we can rule out proper treatment protocol for forward head posture.
For this randomized clinical trial, 36 participants having forward head posture will be recruited from Sehat medical complex and shalamar hospitals Lahore by nonprobability convenient sampling. Participants will divide in two groups A and B by randomization. Group A will be given both exercise regimes of postural exercises and breathing exercises while group B will be given with only postural exercise protocol. Pain, ROM and craniovertebral angle will be assessment before the treatment start, after 5 weeks and at the end of treatment after 10 weeks. After the collection of data in 8 months, Statistical analysis using SPSS version 21, will be done to summarize the results.
- Conditions
- Forward Head Posture
- Being tested
- postural exercises, postural exercises with breathing exercises
- Keywords
- breathing exercises
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
postural exercisesOther
In this study forward head posture will be defined as CVA<49°, which was diagnosed by photogrammetry method.
The postural exercise program consisted of two strengthening (deep cervical flexors and shoulder retractors) and two stretching (cervical extensors and pectoral muscles) exercises based on Kendall et al's approach. The exercises involved
- chin tucks ins
- a chin drop in sitting
- shoulder retraction
- unilateral and bilateral pectoralis stretches Participants were instructed to complete 3 sets of 12 repetitions of the strengthening exercises and 3 stretching exercises held for 30 seconds each. This program was to be repeated 4 times per week. They also returned for a consultation every 2 weeks to be checked for exercise technique and progression, if appropriate. Progress to the next exercise level was indicated if the participant could complete 12 repetitions, 3 times easily with correct form
postural exercises with breathing exercisesOther
The postural exercise program consisted the exercises i.e chin tucks in, a chin drop in sitting, shoulder retraction. Participants were instructed to complete 3sets of 12repetitions of these exercises. This program was to be repeated 4times per week. They also returned for a consultation every 2weeks to be checked for exercise technique and progression, if appropriate. Progress to the next exercise level was indicated if the participant could complete 12repetitions, 3times easily with correct form.
For the breathing exercises in experimental group, breathing program includes respiratory muscle training, relaxation techniques, breathing techniques, e.g., deep breathing, hand controlled diaphragmatic breathing, relaxation technique, deep breathing, controlled diaphragmatic breathing, slow relaxed exhalation with pursed lips technique, and segmental breathing techniques. exercise protocol will be continued for 6 weeks with and initial, after 3weeks and final assessment of pain and CVA.
| Study group | Role | What they receive |
|---|---|---|
| postural exercises with breathing exercises | Experimental | The postural exercise program consisted of two strengthening and stretching exercises. The exercises involved chin tucks in, shoulder retraction , and unilateral and bilateral pectoralis stretches alternating each 2-week period. 36 Participants were instructed to complete 3 sets of 12 repetitions of the strengthening exercises and 3 stretching exercises held for 30 seconds each.
For the breathing exercises in experimental group, breathing program includes respiratory muscle training, relaxation techniques, breathing techniques, e.g., deep breathing, hand controlled abdominal/diaphragmatic breathing, aimed stretching and strengthening exercises are combined with each other. Deep breathing, controlled diaphragmatic breathing, slow relaxed exhalation with pursed lips technique, direct apnoea exercises and segmental breathing techniques. exercise protocol will be continued for 10 weeks with and initial, after 5 weeks and final assessment of pain and CVA. Receives: Other: postural exercises with breathing exercises |
| postural exercises without breathing exercises | Experimental | In this study forward head posture will be defined as CVA<49°, which was diagnosed by photogrammetry method.
The postural exercise program consisted of two strengthening and stretching exercises. The exercises involved
(a) chin tucks in (c) shoulder retraction , and (d) unilateral and bilateral pectoralis stretches alternating each 2-week period. 36 Participants were instructed to complete 3 sets of 12 repetitions of the strengthening exercises and 3 stretching exercises held for 30 seconds each. This program was to be repeated 4 times per week. They also returned for a consultation every 2 weeks to be checked for exercise technique and progression, if appropriate. Progress to the next exercise level was indicated if the participant could complete 12 repetitions, 3 times easily with correct form. Receives: Other: postural exercises |
What is being measured
The primary outcome is the main question the study is designed to answer.
photogrammetry for CVA and cervical range of motion(ROM) (image j)
CVA, can be measured using the lateral photo exposing C7 and the ear. The participants will maintain the natural head posture through the measurement method of self balance posture.It is the angle made by the line that connects the seventh cervical spine with the tragus and the horizontal line of 7th cervical spine in the standing position. A CVA is of ,49 is characterized as Forward head posture.
image j is an image processing and analysis program that can read both image file formats and raw formats. it has been introduces as a reliable assessment tool used to measure cervical angle in several studies on forward head posture.
Measured: 6 weeks
Secondary outcomes (2)
Numeric pain rating scale (NPRS):
The NPRS is a subjective pain rating scale using an 11 point scale from 0 to 10, where 0 means "no pain" and 10 means "intolerable pain". Participants select the whole number that best represent their level of pain. The reliability is>0.95 with ICC value 0.86-0.95
Measured: 6 weeks
Goniometer
Goniometer is an objective tool to measure range of motion of different joints of body. it has good reliability (r = .70)
Measured: 6 weeks
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted9 Jan 2024
- Study start10 May 2023
- Primary completion10 Jan 2024 (estimated)
- Study completion10 Jan 2024 (estimated)
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 Riphah International 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
- Masking
- Double blind
- Who is masked
- Participant, Outcomes assessor
- Enrolment
- 36 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Riphah International University
- Sponsor type
- University, hospital or other
- Responsible party
- Sponsor
- Investigators
- Ali Raza, MS, Principal investigator, Riphah International Universityizzah ijaz, Principal investigator, Riphah International University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT06197919
- Sponsor's protocol ID
- REC/RCR &AHS/23/0169
- Status last verified
- Dec 2023
- First submitted
- 26 Dec 2023
- Last updated
- 9 Jan 2024
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Study at a glance
From the registry record, last updated by the sponsor on 9 Jan 2024. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Effects of Posture Exercises With and Without Breathing Exercises in Forward Head Posture
- ClinicalTrials.gov ID
- NCT06197919
- Acronym / sponsor ID
- REC/RCR &AHS/23/0169
- Conditions
- Forward Head Posture
- Keywords
- breathing exercises
- Study type
- Interventional
- Recruitment status
- Unknown status
- Enrolment
- 36 participants (estimated)
- Lead sponsor
- Riphah International UniversityUniversity, hospital or other
- Study start
- 10 May 2023 (actual)
- Primary completion
- 10 Jan 2024 (estimated)
- Study completion
- 10 Jan 2024 (estimated)
- First posted
- 9 Jan 2024 (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.
This study aims to compare the effects of postural exercises with and without breathing exercises in the subjects having forward head posture.
Detailed description
Forward head posture (FHP) is a prevalent postural deviation that can occur in individuals of various age groups, spanning from childhood to old age. It manifests as an anterior positioning of the head in relation to the neck in the sagittal plane. . FHP is commonly associated with the excessive extension of the upper cervical spine (C1-C3) and flexion of the lower cervical spine (C4-C7). A common method to diagnose forward head posture is by measuring craniovertebral angle i.e. if CVA<49 than FHP is positive. In many cases faulty postures are linked with different musculoskeletal conditions as well as breathing difficulties. Forward head posture specifically impairs the mobility and functionality of the diaphragm, resulting in inefficient contraction of abdominal muscles and reduced lung capacity. A randomized clinical trial will be conducted so that we can rule out proper treatment protocol for forward head posture.
For this randomized clinical trial, 36 participants having forward head posture will be recruited from Sehat medical complex and shalamar hospitals Lahore by nonprobability convenient sampling. Participants will divide in two groups A and B by randomization. Group A will be given both exercise regimes of postural exercises and breathing exercises while group B will be given with only postural exercise protocol. Pain, ROM and craniovertebral angle will be assessment before the treatment start, after 5 weeks and at the end of treatment after 10 weeks. After the collection of data in 8 months, Statistical analysis using SPSS version 21, will be done to summarize the results.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Double blind (participant, outcomes assessor)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| postural exercises with breathing exercises | Experimental | Other: postural exercises with breathing exercisesThe postural exercise program consisted of two strengthening and stretching exercises. The exercises involved chin tucks in, shoulder retraction , and unilateral and bilateral pectoralis stretches alternating each 2-week period. 36 Participants were instructed to complete 3 sets of 12 repetitions of the strengthening exercises and 3 stretching exercises held for 30 seconds each. For the breathing exercises in experimental group, breathing program includes respiratory muscle training, relaxation techniques, breathing techniques, e.g., deep breathing, hand controlled abdominal/diaphragmatic breathing, aimed stretching and strengthening exercises are combined with each other. Deep breathing, controlled diaphragmatic breathing, slow relaxed exhalation with pursed lips technique, direct apnoea exercises and segmental breathing techniques. exercise protocol will be continued for 10 weeks with and initial, after 5 weeks and final assessment of pain and CVA. |
| postural exercises without breathing exercises | Experimental | Other: postural exercisesIn this study forward head posture will be defined as CVA<49°, which was diagnosed by photogrammetry method. The postural exercise program consisted of two strengthening and stretching exercises. The exercises involved (a) chin tucks in (c) shoulder retraction , and (d) unilateral and bilateral pectoralis stretches alternating each 2-week period. 36 Participants were instructed to complete 3 sets of 12 repetitions of the strengthening exercises and 3 stretching exercises held for 30 seconds each. This program was to be repeated 4 times per week. They also returned for a consultation every 2 weeks to be checked for exercise technique and progression, if appropriate. Progress to the next exercise level was indicated if the participant could complete 12 repetitions, 3 times easily with correct form. |
Who may qualify
- Ages
- 20 to 35 years
- Sex
- All
- Healthy volunteers
- Accepted
- Age groups
- Adult
Key inclusion criteria (2 listed)
- Individuals with 20 to 35 years of age, both male and female
- Individuals with CVA <49.
Key exclusion criteria (4 listed)
- History of Surgery of thorax or spine or both.
- Traumatic neck injury.
- Acute or chronic neuro-muscular pain.
- Clinical deformity present in thoracic cage or spine
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 |
|---|---|---|
| postural exercisesIn this study forward head posture will be defined as CVA<49°, which was diagnosed by photogrammetry method. The postural exercise program consisted of two strengthening (deep cervical flexors and shoulder retractors) and two stretching (cervical extensors and pectoral muscles) exercises based on Kendall et al's approach. The exercises involved 1. chin tucks ins 2. a chin drop in sitting 3. shoulder retraction 4. unilateral and bilateral pectoralis stretches Participants were instructed to complete 3 sets of 12 repetitions of the strengthening exercises and 3 stretching exercises held for 30 seconds each. This program was to be repeated 4 times per week. They also returned for a consultation every 2 weeks to be checked for exercise technique and progression, if appropriate. Progress to the next exercise level was indicated if the participant could complete 12 repetitions, 3 times easily with correct form | Other | postural exercises without breathing exercises |
| postural exercises with breathing exercisesThe postural exercise program consisted the exercises i.e chin tucks in, a chin drop in sitting, shoulder retraction. Participants were instructed to complete 3sets of 12repetitions of these exercises. This program was to be repeated 4times per week. They also returned for a consultation every 2weeks to be checked for exercise technique and progression, if appropriate. Progress to the next exercise level was indicated if the participant could complete 12repetitions, 3times easily with correct form. For the breathing exercises in experimental group, breathing program includes respiratory muscle training, relaxation techniques, breathing techniques, e.g., deep breathing, hand controlled diaphragmatic breathing, relaxation technique, deep breathing, controlled diaphragmatic breathing, slow relaxed exhalation with pursed lips technique, and segmental breathing techniques. exercise protocol will be continued for 6 weeks with and initial, after 3weeks and final assessment of pain and CVA. | Other | postural exercises with breathing exercises |
Primary outcome
photogrammetry for CVA and cervical range of motion(ROM) (image j)
Time frame: 6 weeks
CVA, can be measured using the lateral photo exposing C7 and the ear. The participants will maintain the natural head posture through the measurement method of self balance posture.It is the angle made by the line that connects the seventh cervical spine with the tragus and the horizontal line of 7th cervical spine in the standing position. A CVA is of ,49 is characterized as Forward head posture. image j is an image processing and analysis program that can read both image file formats and raw formats. it has been introduces as a reliable assessment tool used to measure cervical angle in several studies on forward head posture.
2 secondary outcomes
Numeric pain rating scale (NPRS):
Time frame: 6 weeks
Goniometer
Time frame: 6 weeks
Results and safety
Results are not available in the source record.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 9 Jan 2024.
- Individual participant dataSharing planned: No
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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.
Ali Raza, MS principal investigator
Riphah International University
izzah ijaz principal investigator
Riphah International University
2 sites in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing postural exercises and postural exercises with breathing exercises in people with Forward Head Posture, run by Riphah International University at 2 sites in Pakistan.
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 2 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: status not confirmed, as of the sponsor's last update on 9 Jan 2024. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 2 sites in Pakistan. 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?
Results are not available in the source record.
How can a doctor refer a patient or contact the research team?
Contact imran amjad, PhD (03324390125, imran.amjad@ripha.edu.pk), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
photogrammetry for CVA and cervical range of motion(ROM) (image j) (time frame: 6 weeks). 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 9 Jan 2024.