Symptomatic Forwardhead PostureCairoUNCT06586463
Effect Of Kinetic Control Training On Pain And Craniovertebral Angle In Symptomatic Forward Head Posture
A study of Symptomatic Forwardhead Posture, run by Cairo University at 2 sites in Egypt.
Trial summary
The goal of this clinical trial is to investigate the effect of adding kinetic control training of cervical and shoulder joints on pain, neck function, neuromuscular control of the deep cervical flexors, and craniovertebral angle in symptomatic forward head posture. Read more about this study
- Who is it for?
- Ages 18 to 40 years
- Conditions the study is for
- Symptomatic Forwardhead Posture
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 50 participants
- Where
- 2 sitesEgypt
- Study dates
- Sep 2024to Oct 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 18 to 40 years
- All sexes
- No healthy volunteers
- Adult
Who may be able to join
- 1) 50 Subjects of both genders aged 18-40 years old with symptomatic forward head posture (FHP) and Body Mass Index (BMI) less than 30 kg/m2 .
- 2) Subjects have FHP if CVA ≤ 50° for assessing FHP 3) Pain between three and eight using numerical pain rating scale NPRS 4) Subjects have non-specific neck pain for at least 3 months
Who cannot join
- The patients were excluded if they had:
- Experienced a history of neck injuries, neck and shoulder surgery
- Shoulder trauma, tendinitis, thoracic surgery
- Neurological disorders such as cervical spondylosis, spondylolisthesis.
- Disc prolapse
- Rheumatic disease, fibromyalgia
Trial locations and contacts
2 sites in 1 country.
About this study
The goal of this clinical trial is to investigate the effect of adding kinetic control training of cervical and shoulder joints on pain, neck function, neuromuscular control of the deep cervical flexors, and craniovertebral angle in symptomatic forward head posture.
Read the detailed description
Forward head posture (FHP) is one of the most common postural deformity, which affects 66% of the patient population with high prevalence among university students due to prolonged usage of computer, smartphones and faulty posture during lectures with lack of awareness about proper posture among them.Participants with FHP exhibited abnormal sensorimotor control and autonomic nervous system dysfunction compared to those with normal head alignment .
Identifying and classifying movement faults is fast becoming the key of recent neuromusculoskeletal rehabilitation. Uncontrolled movement (UCM), contributing to neck pain symptoms, can cause compression or impingement on one side of joints while developing tensile strain on the other side. If UCM is not managed, and the related tissue stress and strain are sustained or repeated beyond the limits of tissue tolerance, multiple tissue pathology may develop eventually and a combination of symptoms may occur . As seen in symptomatic forward head posture.
Along with the identification of site and direction of the faults, direction-movement control intervention(kinetic control) retrains the control of the movement faults. The suggestion is that uncontrolled movement links to the pattern of movement during everyday activities and relates to neck pain. This maneuver can reduce symptoms of neck pain.
- Conditions
- Symptomatic Forwardhead Posture
- Being tested
- kinitic control training
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
kinitic control trainingOther
Also called conventional treatment
kinetic control training, Correction of Low cervical flexion UCM Initially, position the lower and upper cervical spine in neutral with the head supported. the person is trained to perform independent upper cervical flexion (nodding). The upper cervical spine can flex only so far as there is no low cervical flexion. As the ability to control upper cervical extension gets easier and the pattern of dissociation feels less unnatural the exercise can be progressed.
Correction of scapula and glenohumeral ( UCM) the arm flexion is performed unsupported through the partial range that can be controlled well. This is eventually progressed throughout the full benchmark range with the elbow straight. With visual, auditory and kinaesthetic cues the person becomes familiar with the task of flexing the glenohumeral joint to 90° without scapula movement or glenohumeral translation.
| Study group | Role | What they receive |
|---|---|---|
| conventional treatment | Active comparator | (Control group) receives conventional therapy (cervical, and scapular stabilization exercises, stretching exercises for the pectoralis minor, sternocleidomastoid, scalene muscles and hot pack ) Receives: Other: kinitic control training |
| kinetic control training | Experimental | takes the same as the control group plus kinetic control. Correction of Low cervical flexion UCM Initially, position the lower and upper cervical spine in neutral with the head supported. the person is trained to perform independent upper cervical flexion (nodding). The upper cervical spine can flex only so far as there is no low cervical flexion. As the ability to control upper cervical extension gets easier and the pattern of dissociation feels less unnatural the exercise can be progressed.
Correction of scapula and glenohumeral ( UCM) the arm flexion is performed unsupported through the partial range that can be controlled well. This is eventually progressed throughout the full benchmark range with the elbow straight. With visual, auditory and kinaesthetic cues the person becomes familiar with the task of flexing the glenohumeral joint to 90° without scapula movement or glenohumeral translation. Receives: Other: kinitic control training |
What is being measured
The primary outcome is the main question the study is designed to answer.
craniovertebral angle
- CVA is defined as the angle formed between a horizontal line through the spinous process of C7 and a line from the tragus of the ear.• To calculate the CVA, reflective markers will be put on the tragus of the ear and the spinous process of C7 before photographing.The eye level will be established by asking the subjects to look forward at a point directly in front of them (colored label will be put on the wall in front of them at their eye level) .
- A Phone camera will be fixed on an adjustable tripod 1.5 m away from the subject and its base was set at the height of the participant's shoulder. Landmark will be placed on the floor to ensure the same positon of the participants and constant distance from the camera
- The subjects will be asked to stand comfortably in a normal standing position with their hands hanging beside their bodies and a lateral view picture will be taken from the dominant side by a phone camera. The photos will be analyzed by Kinovea software
Measured: up to 4 weeks
Secondary outcomes (3)
neck pain
neck pain by Numerical pain rating scale NPRS . It is a horizontal line with graduation of numbers on it (0-10) 0 means no pain, 10 means the most severe pain that the patient can not tolerate.
Measured: up to 4weeks
neck function
Neck disability index (Arabic version):
Assessment of neck function will be performed by Arabic neck disability index. It is a valid and reliable tool in the assessment of neck function . It contains 10 categories. Each category contains six choices (0-5). Score from 0-4 no disability, from 5-15 this is mild, from 15-24 this is moderate, from 25-34 this is severe, more than 34 this is a complete disability
Measured: up to 4 weeks
neuromuscular control of the deep cervical flexors (activation and endurance)
Cranio-cervical flexion test (CCFT): to evaluate neuromuscular control of the deep cervical flexors (activation and endurance) The patient was supine, the head and neck were in a neutral position. The space between the cervical lordotic curve and the table was filled with a pneumatic PBU inflated to 20 mmHg (below the suboccipital region, not below the lower cervical area). The patient performed CCF movement in a graduated approach in 5 increments (22, 24, 26, 28, 30 mmHg), (22, 24, 26, 28, 30 mmHg) that the subject could hold steadily for 10 s using the correct CCF action. Secondly, the assessor evaluated the number of repetitions of a 10 s hold that the patient could perform at their target level. Performance on the CCFT was scored as the pressure level that the patient was able to achieve (activation score) multiplied by the number of repetitions they could perform.
Measured: up to 4 weeks
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted19 Sep 2024
- Study startSep 2024 (estimated)
- Primary completionSep 2025 (estimated)
- Study completionOct 2025 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (4)Papers the sponsor has linked to this study.
- Other trials for Symptomatic Forwardhead 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
- kinetic control training
- Masking
- Double blind
- Who is masked
- Participant, Outcomes assessor
- Enrolment
- 50 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Cairo University
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Noura metwally metwally ali khalifa, Cairo University
- Investigators
- adel rashad ahmed, PhD, Study chair, professor of physical therapy department of basic scienceeman ahmed abdelmoez, PhD, Study director, professor of physical therapy department of basic scienceasmaa hossam eldien, PhD, Study director, lecturer of physical therapy department of basic science cairo university
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT06586463
- Sponsor's protocol ID
- P.T.REC/012/005328
- Acronym
- CairoU
- Status last verified
- Sep 2024
- First submitted
- 4 Sep 2024
- Last updated
- 19 Sep 2024
- Results posted
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
Publications
Khosrokiani Z, Letafatkar A, Sokhanguei Y. Long-term effect of direction-movement control training on female patients with chronic neck pain. J Bodyw Mov Ther. 2018 Jan;22(1):217-224. doi: 10.1016/j.jbmt.2017.06.004. Epub 2017 Jun 13.
PubMed 29332749Khosrokiani Z, Letafatkar A, Gladin A. Lumbar motor control training as a complementary treatment for chronic neck pain: A randomized controlled trial. Clin Rehabil. 2022 Jan;36(1):99-112. doi: 10.1177/02692155211038099. Epub 2021 Sep 2.
PubMed 34474578Cagnie B, Struyf F, Cools A, Castelein B, Danneels L, O'leary S. The relevance of scapular dysfunction in neck pain: a brief commentary. J Orthop Sports Phys Ther. 2014 Jun;44(6):435-9. doi: 10.2519/jospt.2014.5038. Epub 2014 May 10.
PubMed 24816504Ashfaq R, Riaz H. Effect of Pressure biofeedback training on deep cervical flexors endurance in patients with mechanical neck pain: A randomized controlled trial. Pak J Med Sci. 2021 Mar-Apr;37(2):550-555. doi: 10.12669/pjms.37.2.2343.
PubMed 33679948
Study at a glance
From the registry record, last updated by the sponsor on 19 Sep 2024. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Effect Of Kinetic Control Training On Pain And Craniovertebral Angle In Symptomatic Forward Head Posture
- ClinicalTrials.gov ID
- NCT06586463
- Acronym / sponsor ID
- CairoU / P.T.REC/012/005328
- Conditions
- Symptomatic Forwardhead Posture
- Study type
- Interventional
- Recruitment status
- Unknown status
- Enrolment
- 50 participants (estimated)
- Lead sponsor
- Cairo UniversityUniversity, hospital or other
- Study start
- Sep 2024 (estimated)
- Primary completion
- Sep 2025 (estimated)
- Study completion
- Oct 2025 (estimated)
- First posted
- 19 Sep 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 goal of this clinical trial is to investigate the effect of adding kinetic control training of cervical and shoulder joints on pain, neck function, neuromuscular control of the deep cervical flexors, and craniovertebral angle in symptomatic forward head posture.
Detailed description
Forward head posture (FHP) is one of the most common postural deformity, which affects 66% of the patient population with high prevalence among university students due to prolonged usage of computer, smartphones and faulty posture during lectures with lack of awareness about proper posture among them.Participants with FHP exhibited abnormal sensorimotor control and autonomic nervous system dysfunction compared to those with normal head alignment .
Identifying and classifying movement faults is fast becoming the key of recent neuromusculoskeletal rehabilitation. Uncontrolled movement (UCM), contributing to neck pain symptoms, can cause compression or impingement on one side of joints while developing tensile strain on the other side. If UCM is not managed, and the related tissue stress and strain are sustained or repeated beyond the limits of tissue tolerance, multiple tissue pathology may develop eventually and a combination of symptoms may occur . As seen in symptomatic forward head posture.
Along with the identification of site and direction of the faults, direction-movement control intervention(kinetic control) retrains the control of the movement faults. The suggestion is that uncontrolled movement links to the pattern of movement during everyday activities and relates to neck pain. This maneuver can reduce symptoms of neck pain.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Double blind (participant, outcomes assessor)
- Number of arms
- 2
- Model description
- kinetic control training
| Arm | Type | Receives |
|---|---|---|
| conventional treatment | Active comparator | Other: kinitic control training(Control group) receives conventional therapy (cervical, and scapular stabilization exercises, stretching exercises for the pectoralis minor, sternocleidomastoid, scalene muscles and hot pack ) |
| kinetic control training | Experimental | Other: kinitic control trainingtakes the same as the control group plus kinetic control. Correction of Low cervical flexion UCM Initially, position the lower and upper cervical spine in neutral with the head supported. the person is trained to perform independent upper cervical flexion (nodding). The upper cervical spine can flex only so far as there is no low cervical flexion. As the ability to control upper cervical extension gets easier and the pattern of dissociation feels less unnatural the exercise can be progressed. Correction of scapula and glenohumeral ( UCM) the arm flexion is performed unsupported through the partial range that can be controlled well. This is eventually progressed throughout the full benchmark range with the elbow straight. With visual, auditory and kinaesthetic cues the person becomes familiar with the task of flexing the glenohumeral joint to 90° without scapula movement or glenohumeral translation. |
Who may qualify
- Ages
- 18 to 40 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult
Key inclusion criteria (2 listed)
- 1) 50 Subjects of both genders aged 18-40 years old with symptomatic forward head posture (FHP) and Body Mass Index (BMI) less than 30 kg/m2 .
- 2) Subjects have FHP if CVA ≤ 50° for assessing FHP 3) Pain between three and eight using numerical pain rating scale NPRS 4) Subjects have non-specific neck pain for at least 3 months
Key exclusion criteria (6 listed)
- The patients were excluded if they had:
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 |
|---|---|---|
| kinitic control trainingAlso: conventional treatmentkinetic control training, Correction of Low cervical flexion UCM Initially, position the lower and upper cervical spine in neutral with the head supported. the person is trained to perform independent upper cervical flexion (nodding). The upper cervical spine can flex only so far as there is no low cervical flexion. As the ability to control upper cervical extension gets easier and the pattern of dissociation feels less unnatural the exercise can be progressed. Correction of scapula and glenohumeral ( UCM) the arm flexion is performed unsupported through the partial range that can be controlled well. This is eventually progressed throughout the full benchmark range with the elbow straight. With visual, auditory and kinaesthetic cues the person becomes familiar with the task of flexing the glenohumeral joint to 90° without scapula movement or glenohumeral translation. | Other | conventional treatment, kinetic control training |
Primary outcome
craniovertebral angle
Time frame: up to 4 weeks
* CVA is defined as the angle formed between a horizontal line through the spinous process of C7 and a line from the tragus of the ear.• To calculate the CVA, reflective markers will be put on the tragus of the ear and the spinous process of C7 before photographing.The eye level will be established by asking the subjects to look forward at a point directly in front of them (colored label will be put on the wall in front of them at their eye level) . * A Phone camera will be fixed on an adjustable tripod 1.5 m away from the subject and its base was set at the height of the participant's shoulder. Landmark will be placed on the floor to ensure the same positon of the participants and constant distance from the camera * The subjects will be asked to stand comfortably in a normal standing position with their hands hanging beside their bodies and a lateral view picture will be taken from the dominant side by a phone camera. The photos will be analyzed by Kinovea software
3 secondary outcomes
neck pain
Time frame: up to 4weeks
neck function
Time frame: up to 4 weeks
neuromuscular control of the deep cervical flexors (activation and endurance)
Time frame: up to 4 weeks
Results and safety
Results are not available in the source record.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 19 Sep 2024.
- Results publication: PubMed 29332749Khosrokiani Z, Letafatkar A, Sokhanguei Y. Long-term effect of direction-movement control training on female patients with chronic neck pain. J Bodyw Mov Ther. 2018 Jan;22(1):217-224. doi: 10.1016/j.jbmt.2017.06.004. Epub 2017 Jun 13.
- Results publication: PubMed 34474578Khosrokiani Z, Letafatkar A, Gladin A. Lumbar motor control training as a complementary treatment for chronic neck pain: A randomized controlled trial. Clin Rehabil. 2022 Jan;36(1):99-112. doi: 10.1177/02692155211038099. Epub 2021 Sep 2.
- Results publication: PubMed 24816504Cagnie B, Struyf F, Cools A, Castelein B, Danneels L, O'leary S. The relevance of scapular dysfunction in neck pain: a brief commentary. J Orthop Sports Phys Ther. 2014 Jun;44(6):435-9. doi: 10.2519/jospt.2014.5038. Epub 2014 May 10.
- Results publication: PubMed 33679948Ashfaq R, Riaz H. Effect of Pressure biofeedback training on deep cervical flexors endurance in patients with mechanical neck pain: A randomized controlled trial. Pak J Med Sci. 2021 Mar-Apr;37(2):550-555. doi: 10.12669/pjms.37.2.2343.
- Related InfoLink provided by the sponsor.
- Related InfoLink provided by the sponsor.
- Related InfoLink provided by the sponsor.
- Related InfoLink provided by the sponsor.
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.
adel rashad ahmed, PhD study chair
professor of physical therapy department of basic science
eman ahmed abdelmoez, PhD study director
professor of physical therapy department of basic science
asmaa hossam eldien, PhD study director
lecturer of physical therapy department of basic science cairo university
2 sites in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study of Symptomatic Forwardhead Posture, run by Cairo University at 2 sites 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 2 inclusion and 6 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 19 Sep 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 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?
Results are not available in the source record.
How can a doctor refer a patient or contact the research team?
Contact Noura metwally khalifa, master (002 01016209561 ext. egypt, nourametwally8@gmail.com), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
craniovertebral angle (time frame: up to 4 weeks). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT06586463, which also lists 4 linked publications.
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 19 Sep 2024.