Forward Head PostureNCT06325124
Muscle Energy Technique of Lower Limb Muscles in Forward Head Posture
A study testing Muscle energy technique and Conventional PT in people with Forward Head Posture, run by Riphah International University at 1 site in Pakistan.
Trial summary
The aim of this randomized controlled trial is to find the effect of muscle energy technique of muscles involved in lower limb superficial backline (hamstring and Gastro-soleus) on improving craniovertebral angle and cervical proprioception and minimizing pain among patients with forward head posture Read more about this study
- Who is it for?
- Ages 20 to 35 years
- Conditions the study is for
- Forward Head Posture
- What is being tested?
- Muscle energy technique and Conventional PT
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 36 participants
- Where
- 1 sitePakistan
- Study dates
- 26 Mar 2024to 20 Apr 2025
- 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
- No healthy volunteers
- Adult
Who may be able to join
- Age between 20 and 35 years
- Both Genders
- Craniovertebral angle <49.9 degrees
- History of neck pain >3 months
- Patients with hamstring tightness(Inability to achieve greater than 160° of knee extension with hip at 90° of flexion)
- Patients with calf muscle tightness(The Taloche Sign (Maestro) If a patient with a tight gastrocnemius tries to stand on an inclined plane, it is immediately evident that it is impossible for the patient to be stable in this position)
Who cannot join
- Patient with recent injuries or surgeries in and around the neck region
- Vertigo
- radiating pain in upper limb
- spinal deformities
- malignancy in and around the neck region
- cervical instabilities
- fibromyalgia
- patients with any lower limb or lower back pathology(e.g arthritis)
Trial locations and contacts
1 site in 1 country.
Pakistan1 site, 1 recruiting
- Recruiting
We Care Physical Therapy Clinic street 13 phase 4A, Ghouri town Islamabad
Islamabad, Punjab Province
KINZA ANWAR, MS-OMPT, +92-3239735427, kinza.anwar@riphah.edu.pk
MARIA NAWAZ, MS-OMPT*, +92-3435625466
About this study
Official title: Effect Of Muscle Energy Technique Of Lower Limb Superficial Backline Muscles in Patients With Forward Head Posture
The aim of this randomized controlled trial is to find the effect of muscle energy technique of muscles involved in lower limb superficial backline (hamstring and Gastro-soleus) on improving craniovertebral angle and cervical proprioception and minimizing pain among patients with forward head posture
Read the detailed description
Forward head posture (FHP) is a common postural disorder (66%), occurring when the head is anterior to a vertical line passing through the center of gravity. This malalignment causes muscle weakness in deep cervical flexors and shortened opposing cervical extensor muscles. This posture increases lordosis in the lower cervical spine, leading to increased extension over upper, and flexion over the lower cervical spine. Abnormal postures can lead to headaches, myofascial pain syndrome, abnormal scapular movement, temporomandibular disorders, and limited cervical range of motion.
Muscles of the neck, back and lower limb are interconnected through myofascial called superficial backline. Prolonged forward head posture affects muscles and involved in superficial backline. So remote muscle stretching has a same effect on local neck muscles.
Muscle energy technique is a soft tissue technique designed to improve musculoskeletal function through stretching tight muscles and fascia, to reduce pain and improve circulation. MET is characterized by a patient-induced skeletal muscle contraction against physiotherapist resistance in a controlled direction and position. Pathological barrier of a muscle is located through joint positioning which is followed by active muscle contraction by the patient moving away from the resistance followed by relaxation of the muscle. A new pathological barrier is located through passive movement and process is repeated. The rationale for the use of these techniques is to identify the effects of MET of lower limb superficial backline muscles which are interconnected with cervical muscles through myofacial chain, on cervical pain ROM, craniovertebral angle , disability and cervical proprioception.
- Conditions
- Forward Head Posture
- Being tested
- Muscle energy technique, Conventional PT
- Keywords
- Muscle energy technique, Conventional physical therapy, Superficial backline MUSCLES
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Muscle energy techniqueOther
They would be receiving treatment as follow:
Muscle energy technique of hamstring and gastro-soleus. Frequency: 10 reps 3 times/week for 4 consecutive weeks Intensity starting from 20% to 50% resistance across barrier provided by Physical therapist Conventional PT including 1-cervical isometric exercises 2-Transcutaneous Electrical Nerve Stimulation (TENS) for 1o minutes 3-hot pack for 10 minutes 4-Stretching exercise for suboccipitals, sternocleidomastoid 5-gentle stretching of calf and hamstrings.
Conventional PTOther
They would be receiving treatment as follow:
Conventional PT including 1-cervical isometric exercises 2-Transcutaneous Electrical Nerve Stimulation (TENS) for 1o minutes 3-hot pack for 10 minutes 4-Stretching exercise for suboccipitals, sternocleidomastoid 5-gentle stretching of calf and hamstrings.
| Study group | Role | What they receive |
|---|---|---|
| Muscle Energy Technique of Calf and hamstrings | Active comparator | Muscle Energy Technique of Calf and hamstrings (soft tissue technique) Receives: Other: Muscle energy technique |
| Conventional PT | Other | Cervical isometric exercises Hot pack Receives: Other: Conventional PT |
What is being measured
The primary outcome is the main question the study is designed to answer.
Neck disability index (NDI)
The NDI is a Patient-completed, condition-specific functional status questionnaire with 10 items including pain, personal care, lifting, reading, headaches, concentration, work, driving, sleeping and recreation.
The NDI is composed of 10 items. Each item consists of different statements which describe how much neck pain interferes with certain activity. Patient choses one option which describes his pain most precisely.
Measured: 4 weeks
Numeric Pain Rating Scale NPRS
The NPRS is a segmented numeric version of the visual analog scale which is used to assess pain. It scores ranges from 0-10, 0 means No pain and 10 means Severe pain. Patient will be asked to verbally report the pain score.
Measured: 4 weeks
Secondary outcomes (3)
Bubble inclinometer
It is an instrument that measures the available range of motion at a joint.
Measured: 4 weeks
FHP Mobile Application (To measure Craniovertebral angle)
FHP app is a free mobile application that enables measurement of the CV angle for the analysis of cervical posture in the sagittal plane. It was used to measure the CV angle. The protocol involved:(1) Preparation of the location of the camera and the subject; (2) palpation and marking anatomical reference points(3) realization of the photographs.
Measured: 4 weeks
Cervical Joint Position Error
The patient is sitting 90 cm from the wall, and the starting point (center of target or reference point) of the laser projection is marked. The patient (blindfolded or closed) performs active neck movement and then returns to the starting position as accurately as possible. The final laser position is measured relative to the starting position (distance or angle). The errors are measured after cervical extension and flexion.
Measured: 4 weeks
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted22 Mar 2024
- Study start26 Mar 2024
- Primary completion20 Mar 2025 (estimated)
- Study completion20 Apr 2025 (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
- Single blind
- Who is masked
- Participant
- Enrolment
- 36 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Riphah International University
- Sponsor type
- University, hospital or other
- Responsible party
- Sponsor
- Investigators
- KINZA ANWAR, MS-OMPT, Principal investigator, RIPHAH INTERNATIONAL UNIVERSITY,ISLAMABAD,PAKISTAN
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT06325124
- Sponsor's protocol ID
- REC/01805 MARIA NAWAZ
- Status last verified
- Apr 2024
- First submitted
- 17 Mar 2024
- Last updated
- 3 Apr 2024
- Results posted
- No
- Data monitoring committee
- Yes
- 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 3 Apr 2024. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Effect Of Muscle Energy Technique Of Lower Limb Superficial Backline Muscles in Patients With Forward Head Posture
- ClinicalTrials.gov ID
- NCT06325124
- Acronym / sponsor ID
- REC/01805 MARIA NAWAZ
- Conditions
- Forward Head Posture
- Keywords
- Muscle energy technique, Conventional physical therapy, Superficial backline MUSCLES
- Study type
- Interventional
- Recruitment status
- Unknown status
- Enrolment
- 36 participants (estimated)
- Lead sponsor
- Riphah International UniversityUniversity, hospital or other
- Study start
- 26 Mar 2024 (actual)
- Primary completion
- 20 Mar 2025 (estimated)
- Study completion
- 20 Apr 2025 (estimated)
- First posted
- 22 Mar 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.
The aim of this randomized controlled trial is to find the effect of muscle energy technique of muscles involved in lower limb superficial backline (hamstring and Gastro-soleus) on improving craniovertebral angle and cervical proprioception and minimizing pain among patients with forward head posture
Detailed description
Forward head posture (FHP) is a common postural disorder (66%), occurring when the head is anterior to a vertical line passing through the center of gravity. This malalignment causes muscle weakness in deep cervical flexors and shortened opposing cervical extensor muscles. This posture increases lordosis in the lower cervical spine, leading to increased extension over upper, and flexion over the lower cervical spine. Abnormal postures can lead to headaches, myofascial pain syndrome, abnormal scapular movement, temporomandibular disorders, and limited cervical range of motion.
Muscles of the neck, back and lower limb are interconnected through myofascial called superficial backline. Prolonged forward head posture affects muscles and involved in superficial backline. So remote muscle stretching has a same effect on local neck muscles.
Muscle energy technique is a soft tissue technique designed to improve musculoskeletal function through stretching tight muscles and fascia, to reduce pain and improve circulation. MET is characterized by a patient-induced skeletal muscle contraction against physiotherapist resistance in a controlled direction and position. Pathological barrier of a muscle is located through joint positioning which is followed by active muscle contraction by the patient moving away from the resistance followed by relaxation of the muscle. A new pathological barrier is located through passive movement and process is repeated. The rationale for the use of these techniques is to identify the effects of MET of lower limb superficial backline muscles which are interconnected with cervical muscles through myofacial chain, on cervical pain ROM, craniovertebral angle , disability and cervical proprioception.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind (participant)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Muscle Energy Technique of Calf and hamstrings | Active comparator | Other: Muscle energy techniqueMuscle Energy Technique of Calf and hamstrings (soft tissue technique) |
| Conventional PT | Other | Other: Conventional PTCervical isometric exercises Hot pack |
Who may qualify
- Ages
- 20 to 35 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult
Key inclusion criteria (6 listed)
- Age between 20 and 35 years
- Both Genders
- Craniovertebral angle <49.9 degrees
- History of neck pain >3 months
- Patients with hamstring tightness(Inability to achieve greater than 160° of knee extension with hip at 90° of flexion)
Key exclusion criteria (8 listed)
- Patient with recent injuries or surgeries in and around the neck region
- Vertigo
- radiating pain in upper limb
- spinal deformities
- malignancy in and around the neck region
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 |
|---|---|---|
| Muscle energy techniqueThey would be receiving treatment as follow: Muscle energy technique of hamstring and gastro-soleus. Frequency: 10 reps 3 times/week for 4 consecutive weeks Intensity starting from 20% to 50% resistance across barrier provided by Physical therapist Conventional PT including 1-cervical isometric exercises 2-Transcutaneous Electrical Nerve Stimulation (TENS) for 1o minutes 3-hot pack for 10 minutes 4-Stretching exercise for suboccipitals, sternocleidomastoid 5-gentle stretching of calf and hamstrings. | Other | Muscle Energy Technique of Calf and hamstrings |
| Conventional PTThey would be receiving treatment as follow: Conventional PT including 1-cervical isometric exercises 2-Transcutaneous Electrical Nerve Stimulation (TENS) for 1o minutes 3-hot pack for 10 minutes 4-Stretching exercise for suboccipitals, sternocleidomastoid 5-gentle stretching of calf and hamstrings. | Other | Conventional PT |
Primary outcome
Neck disability index (NDI)
Time frame: 4 weeks
The NDI is a Patient-completed, condition-specific functional status questionnaire with 10 items including pain, personal care, lifting, reading, headaches, concentration, work, driving, sleeping and recreation. The NDI is composed of 10 items. Each item consists of different statements which describe how much neck pain interferes with certain activity. Patient choses one option which describes his pain most precisely.
Numeric Pain Rating Scale NPRS
Time frame: 4 weeks
The NPRS is a segmented numeric version of the visual analog scale which is used to assess pain. It scores ranges from 0-10, 0 means No pain and 10 means Severe pain. Patient will be asked to verbally report the pain score.
3 secondary outcomes
Bubble inclinometer
Time frame: 4 weeks
FHP Mobile Application (To measure Craniovertebral angle)
Time frame: 4 weeks
Cervical Joint Position Error
Time frame: 4 weeks
Results and safety
Results are not available in the source record.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 3 Apr 2024.
- Individual participant dataSharing planned: No
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The Association Between Smartphone Overuse and Mechanical Neck Pain Among Galala University Students
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Correlation Between Forward Head Posture and Executive Functions in Cervical Radiculopathy
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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.
KINZA ANWAR, MS-OMPT principal investigator
RIPHAH INTERNATIONAL UNIVERSITY,ISLAMABAD,PAKISTAN
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Muscle energy technique and Conventional PT in people with Forward Head Posture, run by Riphah International University at 1 site 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 6 inclusion and 8 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 3 Apr 2024. 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 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 KINZA ANWAR, MS-OMPT (+92-3239735427, kinza.anwar@riphah.edu.pk), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Neck disability index (NDI) (time frame: 4 weeks). 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 3 Apr 2024.