Forward Head PostureNCT07758530
Effects of Electrotherapy on Muscle Properties in Forward Head Posture
A study testing Therapeutic Ultrasound (Chattanooga Intelect® Vet), Interferential Current (Chattanooga Intelect® Vet) and Conventional TENS in people with Forward Head Posture, run by Medipol University.
Trial summary
This randomized controlled trial investigates the acute effects of three electrotherapy modalities (therapeutic ultrasound, interferential current, and TENS) on the mechanical and viscoelastic properties of neck muscles in young adults with forward head posture. Read more about this study
- Who is it for?
- Ages 18 to 30 yearsHealthy volunteers can take part
- Conditions the study is for
- Forward Head Posture
- What is being tested?
- Therapeutic Ultrasound (Chattanooga Intelect® Vet), Interferential Current (Chattanooga Intelect® Vet) and Conventional TENS
- Type of treatment
- Medical device
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 75 participants
- Where
- No sites listed yet
- Study dates
- 1 Oct 2026to 1 Nov 2027
- Phase
- Interventional
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
- Healthy volunteers accepted
- Adult
Who may be able to join
- Aged 18-30 years
- Craniovertebral angle (CVA) < 55°
- Male and female
- Voluntary participation
Who cannot join
- Cervical instability
- Diagnosed inflammatory joint disease
- History of accident, trauma, or surgery
- Cervical pain treatment within the last 6 months
- Presence of cervical implant
- Skin irritation at measurement/electrode sites
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- Diagnosed epilepsy
- Presence of cardiac/brain pacemaker
- Unwillingness to participate
Trial locations and contacts
No sites are listed yet. Contact the study team or a site near you to ask about taking part.
About this study
Official title: Acute Effects of Electrotherapy Modalities on Muscle Mechanical Properties in Individuals With Altered Head-Neck Posture
This randomized controlled trial investigates the acute effects of three electrotherapy modalities (therapeutic ultrasound, interferential current, and TENS) on the mechanical and viscoelastic properties of neck muscles in young adults with forward head posture. Seventy-five participants will be randomly allocated to one of three groups. Muscle stiffness, oscillation frequency, and craniovertebral angle will be assessed before and immediately after a single treatment session.
Read the detailed description
Forward head posture (FHP) is a common postural deviation associated with increased mechanical loading of the cervical spine and altered muscle length-tension relationships. While electrotherapy modalities are widely used clinically to manage neck pain, their acute effects on the biomechanical and viscoelastic properties of cervical muscles remain insufficiently characterized. This study will evaluate the acute effects of therapeutic ultrasound, interferential current, and TENS on the dynamic stiffness, oscillation frequency, elasticity, and pain of the upper trapezius, splenius capitis, sternocleidomastoid, and cervical erector spinae muscles, measured using myotonometry (MyotonPRO) immediately before (T0) and after (T1) a single treatment session.
- Conditions
- Forward Head Posture
- Being tested
- Therapeutic Ultrasound (Chattanooga Intelect® Vet), Interferential Current (Chattanooga Intelect® Vet), Conventional TENS
- Keywords
- Forward head posture, Craniovertebral angle, Electrotherapy, Therapeutic ultrasound, Interferential current, TENS, myotonometry, muscle stiffness, cervical muscles
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Therapeutic Ultrasound (Chattanooga Intelect® Vet)Device
Pulsed therapeutic ultrasound applied to the cervical region at 1-3 MHz frequency and 0.1-3 W/cm² intensity for 8-10 minutes in prone position, using circular head movements.
Interferential Current (Chattanooga Intelect® Vet)Device
Bipolar interferential current applied via two electrodes covering the target muscles, ~2500 Hz carrier frequency, 100 Hz amplitude modulation frequency, for 15 minutes, at an intensity producing a clear but painless paresthesia sensation, in prone position.
Conventional TENSDevice
Conventional TENS applied via surface electrodes covering the target muscles, 60-120 Hz frequency, 50-100 µsec pulse duration, for 15 minutes, at an intensity producing a clear but painless paresthesia sensation, in prone position.
| Study group | Role | What they receive |
|---|---|---|
| Ultrasound Group | Active comparator | Pulsed therapeutic ultrasound applied to the cervical region at 1-3 MHz frequency and 0.1-3 W/cm² intensity for 8-10 minutes in prone position, using circular head movements. Receives: Device: Therapeutic Ultrasound (Chattanooga Intelect® Vet) |
| Interferential Current Group | Active comparator | Bipolar interferential current applied via two electrodes covering the target muscles, ~2500 Hz carrier frequency, 100 Hz amplitude modulation frequency, for 15 minutes, at an intensity producing a clear but painless paresthesia sensation, in prone position. Receives: Device: Interferential Current (Chattanooga Intelect® Vet) |
| TENS Group | Active comparator | Conventional TENS applied via surface electrodes covering the target muscles, 60-120 Hz frequency, 50-100 µsec pulse duration, for 15 minutes, at an intensity producing a clear but painless paresthesia sensation, in prone position. Receives: Device: Conventional TENS |
What is being measured
The primary outcome is the main question the study is designed to answer.
Change in Dynamic Stiffness (N/m)
Dynamic stiffness reflects the resistance of the muscle to an external deforming force. It will be measured using MyotonPRO on the upper trapezius, splenius capitis, sternocleidomastoid, and cervical erector spinae muscles. The normative reference range for stiffness (S) is 220-380 N/m.
Measured: Baseline (T0) and immediately after single intervention session (T1)
Change in Oscillation Frequency (Hz)
Oscillation frequency reflects the resting muscle tone. It will be measured using MyotonPRO on the same muscle groups. The normative reference range for oscillation frequency (F) is 12.0-18.0 Hz.
Measured: Baseline (T0) and immediately after single intervention session (T1)
Change in Craniovertebral Angle (degrees)
The craniovertebral angle (CVA) is the angle between a horizontal line passing through the tragus of the ear and a line connecting the tragus to the spinous process of C7, and it is used to assess forward head posture. It will be measured from photographs using the Kinovea 2D motion analysis software. According to Salahzadeh et al. (2014), the mean CVA value in individuals without forward head posture is 55 degrees.
Measured: Baseline (T0) and immediately after single intervention session (T1)
Secondary outcomes (4)
Change in Muscle Elasticity (Logarithmic Decrement)
The logarithmic decrement reflects muscle elasticity, describing how quickly the natural oscillation of the muscle decays after mechanical perturbation. It will be measured using MyotonPRO on the same muscle groups. The normative reference range for logarithmic decrement (D) is 1.00-1.60.
Measured: Baseline (T0) and immediately after single intervention session (T1)
Change in Mechanical Stress Relaxation Time
Mechanical stress relaxation time reflects the viscoelastic properties of the muscle, specifically the time required for the muscle to relax after removal of an applied mechanical load. It will be measured using MyotonPRO on the same muscle groups. The normative reference range for relaxation time (R) is 14.0-30.0 ms.
Measured: Baseline (T0) and immediately after single intervention session (T1)
Change in Creep (Deformation/Relaxation Ratio)
Creep reflects the ratio between the deformation time and the relaxation time of the muscle and is used as an indicator of its viscoelastic behavior. It will be measured using MyotonPRO on the same muscle groups. The normative reference range for creep (C) is 1.00-2.00.
Measured: Baseline (T0) and immediately after single intervention session (T1)
Change in Pain (Numeric Pain Rating Scale, 0-10)
Pain will be assessed using the Numeric Pain Rating Scale, an 11-point scale ranging from 0 to 10, where 0 indicates no pain and 10 indicates the worst pain imaginable. Participants who report pain will rate its severity using this scale.
Measured: Baseline (T0) and immediately after single intervention session (T1)
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted11 Aug 2026
- Study start1 Oct 2026 (estimated)
- Primary completion1 Nov 2026 (estimated)
- Study completion1 Nov 2027 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (22)Papers the sponsor has linked to this study.
- Other trials for Forward Head PostureStudies of the same condition, open and under way.
- 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
- Outcomes assessor
- Enrolment
- 75 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Medipol University
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Fatma Dilge ASIK BOZDEMIR, Medipol University
- Investigators
- Fatma Dilge AŞIK BOZDEMİR, Principal investigator, Medipol UniversityHande TUNÇ, Study director, Medipol UniversityAyşe Nur TUNALI, Study chair, Medipol University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07758530
- Sponsor's protocol ID
- E-10840098-50.04-3320
- Status last verified
- Aug 2026
- First submitted
- 4 Aug 2026
- Last updated
- 11 Aug 2026
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- Undecided: No decision has been made yet regarding the sharing of IPD. This decision will be finalized prior to or at the time of publication, taking into account journal requirements and participant consent.
Publications
Kendall, F. P., McCreary, E. K., Provance, P. G., Rodgers, M. M., & Romani, W. A. (2005). Muscles: Testing and Function with Posture and Pain (5th ed.). Lippincott Williams & Wilkins.
Hislop, H. J., Avers, D., & Brown, M. (2014). Daniels and Worthingham's Muscle Testing: Techniques of Manual Examination and Performance Testing (9th ed.). Elsevier Saunders.
Norkin, C. C., & White, D. J. (2016). Measurement of Joint Motion: A Guide to Goniometry (5th ed.). F.A. Davis Company.
Neumann, D. A. (2017). Kinesiology of the Musculoskeletal System: Foundations for Rehabilitation (3rd ed.). Elsevier.
Magee, D. J. (2014). Orthopedic Physical Assessment (6th ed.). Elsevier Saunders.
The New York Physical Fitness Test: A Manual for Teachers of PE. (1958). New York, USA: New York State Education Department (Division of Health, Physical Education and Recreation); 1958.
Sandeep K, Bhardwaj B, Jadon JS, Kumar M. Effect of Visualistic Imagery Training on Body Posture. VSRD-TNTJ. 2011; 2(6); 301-305.
McRoberts LB, Cloud RM, Black CM. Evaluation of the New York Posture Rating Chart for Assessing Changes in Postural Alignment in a Garment Study. Clothing and Textiles Research Journal 2013; 00(0); 1-16.
Salahzadeh Z, Maroufi N, Ahmadi A, Behtash H, Razmjoo A, Gohari M, Parnianpour M. Assessment of forward head posture in females: observational and photogrammetry methods. J Back Musculoskelet Rehabil. 2014;27(2):131-9. doi: 10.3233/BMR-130426.
PubMed 23963268Lee CH, Lee S, Shin G. Reliability of forward head posture evaluation while sitting, standing, walking and running. Hum Mov Sci. 2017 Oct;55:81-86. doi: 10.1016/j.humov.2017.07.008. Epub 2017 Aug 4.
PubMed 28780477Michener LA, Snyder AR, Leggin BG. Responsiveness of the numeric pain rating scale in patients with shoulder pain and the effect of surgical status. J Sport Rehabil. 2011 Feb;20(1):115-28. doi: 10.1123/jsr.20.1.115.
PubMed 21411827Alghadir AH, Anwer S, Iqbal A, Iqbal ZA. Test-retest reliability, validity, and minimum detectable change of visual analog, numerical rating, and verbal rating scales for measurement of osteoarthritic knee pain. J Pain Res. 2018 Apr 26;11:851-856. doi: 10.2147/JPR.S158847. eCollection 2018.
PubMed 29731662Hjermstad MJ, Fayers PM, Haugen DF, Caraceni A, Hanks GW, Loge JH, Fainsinger R, Aass N, Kaasa S; European Palliative Care Research Collaborative (EPCRC). Studies comparing Numerical Rating Scales, Verbal Rating Scales, and Visual Analogue Scales for assessment of pain intensity in adults: a systematic literature review. J Pain Symptom Manage. 2011 Jun;41(6):1073-93. doi: 10.1016/j.jpainsymman.2010.08.016.
PubMed 21621130Bailey, L., Samuel, D., Warner, M. B., & Stokes, M. (2013). Parameters representing muscle tone, elasticity and stiffness of biceps brachii in healthy older males: symmetry and within-session reliability using the MyotonPRO. Journal of Neurological Disorders, 1(1), 1-7.
Schneider S, Peipsi A, Stokes M, Knicker A, Abeln V. Feasibility of monitoring muscle health in microgravity environments using Myoton technology. Med Biol Eng Comput. 2015 Jan;53(1):57-66. doi: 10.1007/s11517-014-1211-5. Epub 2014 Oct 21.
PubMed 25331739