Forward Head PostureIASTMNCT07605650
Effect of Adding Thoracolumbar Fascia Release by IASTM to Conventional Treatment on Craniovertebral Angle in Forward Head Subjects
A study testing Instrument assisted soft tissue moblization in people with Forward Head Posture, run by Cairo University at 1 site in Egypt.
Trial summary
The Posture Committee of the American Academy of Orthopedic Surgery defines good posture as "that state of muscular and skeletal balance that protects the supporting structures of the body against injury or progressive deformity irrespective of the attitude (erect, lying, squatting, and stooping) in which these… Read more about this study
- Who is it for?
- Ages 18 to 30 years
- Conditions the study is for
- Forward Head Posture
- What is being tested?
- Instrument assisted soft tissue moblization
- Type of treatment
- Medical device
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 30 participants
- Where
- 1 siteEgypt
- Study dates
- 4 Mar 2026to 18 Jan 2027
- Phase
- Interventional
- Are there results?
- Not yet: the study is under way
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 30 years
- All sexes
- No healthy volunteers
- Adult
Who may be able to join
- Forward head posture subjects with CVA of < 52
- Subject's age ranged from 18-30 years old, with Body Mass Index (BMI) less than 30Kg/m2.
- Pain-free subjects for over 3 months, No PT intervention. Exclusion Criteria;
- Osteoporotic disorder.
- Any history of congenital deformities of the Cervical and Thoracic region.
- Recent injuries or fractures.
Show all 11Show fewer
- Any inflammatory joint disorder.
- Malignancy.
- Vascular disorders.
- Neurological or psychiatric disorders.
- Any respiratory disease, presence of open wound/s, or history of surgery in the past 6 months.
Who cannot join
None listed.
Trial locations and contacts
1 site in 1 country. Contact the study team or a site near you to ask about taking part.
Egypt1 site, 1 recruiting
- Recruiting
Faculty of physical therapy
Giza, Giza Governorate, 12611
Ragia M kamel, professor
Mary K Nassif, Assistant professor
About this study
Official title: Influence of Thoracolumbar Fascial Release by Instrument Assisted Soft Tissue Moblization on Craniovertebral Angle in Forward Head Posture
The Posture Committee of the American Academy of Orthopedic Surgery defines good posture as "that state of muscular and skeletal balance that protects the supporting structures of the body against injury or progressive deformity irrespective of the attitude (erect, lying, squatting, and stooping) in which these structures are working or resting." Under those conditions, the muscles will function most efficiently, and the Thoracic and abdominal organs will be in their optimal places.
Read the detailed description
The FHP is expected to have a major impact on respiratory function by weakening the accessory respiratory muscles. Persistent FHP weakens the muscles involved in breathing, leading to a decline in respiratory function. Also, it was suggested that FHP is quite common in undergraduate students and has significant effect on level of stress.
A vital component of the myofascial girdle envelops the lower torso, thoracolumbar fascia, participates in posture, load transfer, and breathing. The deep muscles at the back of the spine and the muscles in the abdomen are covered by the TLF. The latissimus dorsi, gluteus maximus, and other muscles in the area are related to a few muscles that engage in the movement of the proximal limbs, and the TLF functions as a force-transmitting structure.
When the upper extremities are impacted, the thoracolumbar fascia release (TLFR) technique should be considered, however, there has not been much research that uses TLFR for the upper extremities. The TLF works together by connecting with the deep core muscles. The medium and posterior parts of the TLF form the transversus abdominis, and the deep lamina is associated with the lumbar spinous processes .
The deep posterior layer continues cranially by merging with the splenius cervicis fascia. Therefore, TLF plays a role in Cervical region mobility. The TLFR increased bilateral sternocleidomastoid muscle resistance and decreased head-forward posture angle in the short term in young women with head-forward posture .
Another novel technique that is quickly gaining traction is IASTM, which allows physicians to treat patients with soft tissue dysfunction in a non-invasive manner. By remodeling connective tissue, resorbing excess fibrosis, recruiting fibroblasts, and inducing collagen repair and regeneration, IASTM mobilizes connective tissue and myofascial adhesions using specially designed instruments. The use of IASTM is recommended to improve the range of motions in healthy individuals, reduce pain in patients with musculoskeletal injuries.
However, there is a gap of empirical data establishing the effect of adding TLF release by IASTM to conventional treatment protocol of FHP on CVA, Cervical ROM, Cervical proprioception and stress level.
Therefore, this study sought to determine the effect of adding TLFR to conventional treatment protocol of FHP to improve CVA, Cervical ROM, Cervical proprioception and stress level.
- Conditions
- Forward Head Posture
- Being tested
- Instrument assisted soft tissue moblization
- Keywords
- FHP
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Instrument assisted soft tissue moblizationDevice
Also called IASTM
Instrument-assisted soft tissue mobilization (IASTM) is a special instrument with beveled edges to assist the clinician in the evaluation and mobilization of soft tissue. Instruments are used in a multi directional stroking fashion applied to the skin at 30°-60° angles to detect soft tissue irregularities via the undulation of the tools. It has been purported to enhance proliferation of extracellular matrix fibro blasts, improve ion transport, and decrease cell matrix adhesions
| Study group | Role | What they receive |
|---|---|---|
| control group | Other | Control group (conventional treatment protocol):
The control group will receive firstly, Kendall exercises; every strengthening exercise will be repeated for 12 repetitions and done for 3 sets and each stretching exercise will be held for 30 seconds and repeated 3 times.
Then, participants will receive IASTM application on cervical muscles as follows: IASTM for upper fibers of trapezius, levator scapulae muscles and scalnae. Receives: Device: Instrument assisted soft tissue moblization |
| experimental group | Experimental | participants will receive same protocol as control group (IASTM on cervical muscles and Kendel exercises) in addition to Thoraco lumber fascia release using IASTM tool Receives: Device: Instrument assisted soft tissue moblization |
What is being measured
The primary outcome is the main question the study is designed to answer.
Craniovertebral angle(CVA)
Craniovertebral angle (CVA) is a line drawn from the tragus of the ear to the C7 vertebra intersects a horizontal line. It is used to measure the value of FHP, and the greater the value of this angle, the more forward the head is positioned on the neck. A vast variety of names exist for this angle, such as sagittal C7-tragus angle, sagittal plane head alignment, neck inclination angle, Cervical angle, head protrusion angle, head position, FHP, forward head position, and head anteriorization in relation to Cervical vertebra
Measured: measurement at Day 1 then after 1 month
Secondary outcomes (3)
cervical range of motion
flexion ,extension,sidebending ,rotation
Measured: measurement at Day 1 then after 1 month
cervical proprioception
flexion, extension,sidebending,rotation
Measured: measurement at Day 1 then after 1 month
Cohen perceived stress scale
Arabic version for stress scale
Measured: measurement at Day 1 then after 1 month
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted26 May 2026
- Study start4 Mar 2026
- Primary completion18 Dec 2026 (estimated)
- Study completion18 Jan 2027 (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 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
- Randomized clinical trial
- Masking
- Single blind
- Who is masked
- Participant
- Enrolment
- 30 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Cairo University
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Mariam Mohamed, Cairo University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07605650
- Sponsor's protocol ID
- Faculty of Physical Therapy CU
- Acronym
- IASTM
- Status last verified
- Feb 2026
- First submitted
- 1 May 2026
- Last updated
- 26 May 2026
- Results posted
- No
- Data monitoring committee
- Yes
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- Undecided
Study at a glance
From the registry record, last updated by the sponsor on 26 May 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Influence of Thoracolumbar Fascial Release by Instrument Assisted Soft Tissue Moblization on Craniovertebral Angle in Forward Head Posture
- ClinicalTrials.gov ID
- NCT07605650
- Acronym / sponsor ID
- IASTM / Faculty of Physical Therapy CU
- Conditions
- Forward Head Posture
- Keywords
- FHP
- Study type
- Interventional
- Recruitment status
- Recruiting
- Enrolment
- 30 participants (estimated)
- Lead sponsor
- Cairo UniversityUniversity, hospital or other
- Study start
- 4 Mar 2026 (actual)
- Primary completion
- 18 Dec 2026 (estimated)
- Study completion
- 18 Jan 2027 (estimated)
- First posted
- 26 May 2026 (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 Posture Committee of the American Academy of Orthopedic Surgery defines good posture as "that state of muscular and skeletal balance that protects the supporting structures of the body against injury or progressive deformity irrespective of the attitude (erect, lying, squatting, and stooping) in which these structures are working or resting." Under those conditions, the muscles will function most efficiently, and the Thoracic and abdominal organs will be in their optimal places.
Detailed description
The FHP is expected to have a major impact on respiratory function by weakening the accessory respiratory muscles. Persistent FHP weakens the muscles involved in breathing, leading to a decline in respiratory function. Also, it was suggested that FHP is quite common in undergraduate students and has significant effect on level of stress.
A vital component of the myofascial girdle envelops the lower torso, thoracolumbar fascia, participates in posture, load transfer, and breathing. The deep muscles at the back of the spine and the muscles in the abdomen are covered by the TLF. The latissimus dorsi, gluteus maximus, and other muscles in the area are related to a few muscles that engage in the movement of the proximal limbs, and the TLF functions as a force-transmitting structure.
When the upper extremities are impacted, the thoracolumbar fascia release (TLFR) technique should be considered, however, there has not been much research that uses TLFR for the upper extremities. The TLF works together by connecting with the deep core muscles. The medium and posterior parts of the TLF form the transversus abdominis, and the deep lamina is associated with the lumbar spinous processes .
The deep posterior layer continues cranially by merging with the splenius cervicis fascia. Therefore, TLF plays a role in Cervical region mobility. The TLFR increased bilateral sternocleidomastoid muscle resistance and decreased head-forward posture angle in the short term in young women with head-forward posture .
Another novel technique that is quickly gaining traction is IASTM, which allows physicians to treat patients with soft tissue dysfunction in a non-invasive manner. By remodeling connective tissue, resorbing excess fibrosis, recruiting fibroblasts, and inducing collagen repair and regeneration, IASTM mobilizes connective tissue and myofascial adhesions using specially designed instruments. The use of IASTM is recommended to improve the range of motions in healthy individuals, reduce pain in patients with musculoskeletal injuries.
However, there is a gap of empirical data establishing the effect of adding TLF release by IASTM to conventional treatment protocol of FHP on CVA, Cervical ROM, Cervical proprioception and stress level.
Therefore, this study sought to determine the effect of adding TLFR to conventional treatment protocol of FHP to improve CVA, Cervical ROM, Cervical proprioception and stress level.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind (participant)
- Number of arms
- 2
- Model description
- Randomized clinical trial
| Arm | Type | Receives |
|---|---|---|
| control group | Other | Device: Instrument assisted soft tissue moblizationControl group (conventional treatment protocol): The control group will receive firstly, Kendall exercises; every strengthening exercise will be repeated for 12 repetitions and done for 3 sets and each stretching exercise will be held for 30 seconds and repeated 3 times. Then, participants will receive IASTM application on cervical muscles as follows: IASTM for upper fibers of trapezius, levator scapulae muscles and scalnae. |
| experimental group | Experimental | Device: Instrument assisted soft tissue moblizationparticipants will receive same protocol as control group (IASTM on cervical muscles and Kendel exercises) in addition to Thoraco lumber fascia release using IASTM tool |
Who may qualify
- Ages
- 18 to 30 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult
Key inclusion criteria (11 listed)
- Forward head posture subjects with CVA of < 52
- Subject's age ranged from 18-30 years old, with Body Mass Index (BMI) less than 30Kg/m2.
- Pain-free subjects for over 3 months, No PT intervention. Exclusion Criteria;
Key exclusion criteria (0 listed)
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 |
|---|---|---|
| Instrument assisted soft tissue moblizationAlso: IASTMInstrument-assisted soft tissue mobilization (IASTM) is a special instrument with beveled edges to assist the clinician in the evaluation and mobilization of soft tissue. Instruments are used in a multi directional stroking fashion applied to the skin at 30°-60° angles to detect soft tissue irregularities via the undulation of the tools. It has been purported to enhance proliferation of extracellular matrix fibro blasts, improve ion transport, and decrease cell matrix adhesions | Device | control group, experimental group |
Primary outcome
Craniovertebral angle(CVA)
Time frame: measurement at Day 1 then after 1 month
Craniovertebral angle (CVA) is a line drawn from the tragus of the ear to the C7 vertebra intersects a horizontal line. It is used to measure the value of FHP, and the greater the value of this angle, the more forward the head is positioned on the neck. A vast variety of names exist for this angle, such as sagittal C7-tragus angle, sagittal plane head alignment, neck inclination angle, Cervical angle, head protrusion angle, head position, FHP, forward head position, and head anteriorization in relation to Cervical vertebra
3 secondary outcomes
cervical range of motion
Time frame: measurement at Day 1 then after 1 month
cervical proprioception
Time frame: measurement at Day 1 then after 1 month
Cohen perceived stress scale
Time frame: measurement at Day 1 then after 1 month
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 26 May 2026.
- Individual participant dataSharing planned: Undecided
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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.
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Instrument assisted soft tissue moblization 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 11 inclusion and 0 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: looking for participants now, as of the sponsor's last update on 26 May 2026. 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?
This study is still under way. Results are not available in the source record yet.
How can a doctor refer a patient or contact the research team?
Contact Mariam M Abdallah, Assistant lecturer (+201221337723, mariam.youssef@cu.edu.eg), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Craniovertebral angle(CVA) (time frame: measurement at Day 1 then after 1 month). 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 2026.