Forward Head PostureNCT07780396
Electromyographic Effects of Postural Correction Exercises in Individuals With Forward Head Posture
A study testing Specific strengthening and stretching exercise and General Exercise in people with Forward Head Posture, run by Cairo University at 1 site in Lebanon.
Trial summary
This study investigates the effects of specific corrective exercises on EMG of masticatory and cervical muscles in individuals with forward head posture. The study's design will be a retrospective, double- blinded, randomized controlled trial. 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?
- Specific strengthening and stretching exercise and General Exercise
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 60 participants
- Where
- 1 siteLebanon
- Study dates
- 15 May 2026to 30 Oct 2026
- 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
- 1. Participants aged 18- 30 years. 2. Presence of forward head posture, defined as CVA of less than 50° with no symptoms of neck pain [18, 19]. 3. No treatment for TMD or cervical symptoms (e.g., medication, physical therapy, or intra-articular injection) within the previous 2 weeks.
Who cannot join
- 1. Current or previous diagnosis of temporomandibular disorder (TMD), or the presence of TMD-related signs or symptoms (e.g., joint sounds, restricted mouth opening, or orofacial pain) during screening.
- 2. History of TMJ subluxation or dislocation that could interfere with mouth opening.
- 3. History of recent head or neck trauma. 4. Angle Class II or Class III malocclusion. 5. Postural abnormalities secondary to structural spinal deformities (e.g., scoliosis or kyphosis), rheumatic diseases, or other medical conditions affecting posture.
- 6. Missing posterior teeth, recent orthodontic treatment (within the previous 12 months), or dental restorations that altered occlusion.
Trial locations and contacts
1 site in 1 country. Contact the study team or a site near you to ask about taking part.
Lebanon1 site, 1 recruiting
- Recruiting
Physical therapy outpatient clinic
Beirut
Ahmed ElMelhat, PhD, 00201027943622, ahmed.elmelhat@cu.edu.eg
About this study
Official title: Electromyographic Changes in Masticatory and Cervical Muscles Following a Structured 10-week Postural Correction Exercise Program in Individuals With Asymptomatic Forward Head Posture: A Randomized Controlled Trial
This study investigates the effects of specific corrective exercises on EMG of masticatory and cervical muscles in individuals with forward head posture. The study's design will be a retrospective, double- blinded, randomized controlled trial. The participants will be randomly allocated to one of two groups: the exercise group and the control group. The training groups will perform a program consisting of two strengthening (deep cervical flexors and shoulder retractors) and two stretchings (cervical extensors and pectoral muscles) exercises. This exercise program will be repeated 4 times per week for 10 weeks, and each session lasted 30 minutes.
The pre/post assessment of forward head posture will measure by using craniovertebral angle CVA. While the muscle activity EMG of the masseter, temporalis, splenius, upper trapezius, and SCM will measure pre and post-assessment using a biopic data acquisition system.
Read the detailed description
Forward head posture (FHD) is a common habitual faulty posture exists in the surrounding that can alter the resting position of the mandible and may affect the masticatory muscle activity.
The aim of this study is to investigate the effect of postural correction on masticatory and cervical muscle activity and mandibular opening in forward-head posture patients.
Materials and Methods:
Cranio-vertebral angle measurement CVA EMG activity of masseter, temporalis, splenius, upper trapezius and SCM BAU - Institutional Review Board (Form H-II) | BEIRUT ARAB UNIVERSITY
-Electrodes will be placed on the muscle belly parallel to the direction of muscle fibers. The distance between the two electrodes was 2 cm. The subjects will be instructed to complete maximum voluntary contraction (MVC) of clenching the teeth for 3 s and repeating twice. The average of the two trials of MVC will be used for further analysis. The subjects will be seated comfortably in a chair.
- Conditions
- Forward Head Posture
- Being tested
- Specific strengthening and stretching exercise, General Exercise
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Specific strengthening and stretching exerciseOther
The program consisted of two strengthening (deep cervical flexors and shoulder retractors) and two stretching (cervical extensors and pectoral muscles) exercises based on Harman and Mostafa et al's approach. This exercise program will be repeated 4 times per week for 10 weeks, and each session lasted for 30 minutes.
General ExerciseOther
The program will consist of regular general postural exercises such as postural awareness exercises as well as general strengthening exercises such as range of motion exercises for the upper quadrant. The program will also be repeated 4 times per week for 10 weeks, with each session lasting 30 minutes
| Study group | Role | What they receive |
|---|---|---|
| Specific strengthening and stretching exercise | Experimental | Not described Receives: Other: Specific strengthening and stretching exercise |
| General exercises | Active comparator | Not described Receives: Other: General Exercise |
What is being measured
The primary outcome is the main question the study is designed to answer.
EMG activity
Electrodes will be placed on the muscle belly parallel to the direction of muscle fibers. The distance between the two electrodes was 2 cm.
The subjects will be instructed to complete maximum voluntary contraction (MVC) of clenching the teeth for a period of 3 s and repeated twice. The average of the two trials of MVC will be used for further analysis. The subjects will be seated comfortably in a chair (---cm height).
Measured: 10 weeks
Secondary outcomes (1)
craniovertebral angle
Forward head posture will be assess by the craniovertebral angle, one of the most reliable tool for evaluating the FHP.
The examiner takes 2 lateral photographs of the subject in standing position, according to Shaghayegh fard et al.
A digital camera will be positioned on a tripod at a distance of 0.8m from the subject at shoulder height. Two land mark will be taken, the spinous process of C7 and the tragus of ear. A horizontal line will be drawn passing through C7 making a right angle with the vertical. Then, the angle between the line connecting C7 spinous process with the tragus of the ear and the horizontal line.
Measured: 10 weeks
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted21 Aug 2026
- Study start15 May 2026
- Primary completion15 Oct 2026 (estimated)
- Study completion30 Oct 2026 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (6)Papers the sponsor has linked to this study.
- 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
- Masking
- Double blind
- Who is masked
- Participant, Outcomes assessor
- Enrolment
- 60 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Cairo University
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Ahmed ElMelhat, Cairo University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07780396
- Sponsor's protocol ID
- 2023-H-0145-HS-R-0505
- Status last verified
- Aug 2026
- First submitted
- 19 Aug 2026
- Last updated
- 21 Aug 2026
- Results posted
- No
- Data monitoring committee
- Yes
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No: Any study records that identify patient will be kept confidential. The records from the participation may be reviewed by people responsible for making sure that research is done properly, including members of the BAU Institutional Review Board. All of these people are required to keep their identities confidential. Otherwise, records that identify patients will be available only to people working on the study. • The investigators will use a code of numbers and alphabets rather than participants' names on data sheets, keeping records in a safe place.
Publications
Kim SD. Effects of yoga exercises for headaches: a systematic review of randomized controlled trials. J Phys Ther Sci. 2015 Jul;27(7):2377-80. doi: 10.1589/jpts.27.2377. Epub 2015 Jul 22.
PubMed 26311986Lee SM, Lee CH, O'Sullivan D, Jung JH, Park JJ. Clinical effectiveness of a Pilates treatment for forward head posture. J Phys Ther Sci. 2016 Jul;28(7):2009-13. doi: 10.1589/jpts.28.2009. Epub 2016 Jul 29.
PubMed 27512253Quek J, Pua YH, Clark RA, Bryant AL. Effects of thoracic kyphosis and forward head posture on cervical range of motion in older adults. Man Ther. 2013 Feb;18(1):65-71. doi: 10.1016/j.math.2012.07.005. Epub 2012 Sep 5.
PubMed 22959228Lee KJ, Han HY, Cheon SH, Park SH, Yong MS. The effect of forward head posture on muscle activity during neck protraction and retraction. J Phys Ther Sci. 2015 Mar;27(3):977-9. doi: 10.1589/jpts.27.977. Epub 2015 Mar 31.
PubMed 25931773Zabihhosseinian M, Holmes MW, Ferguson B, Murphy B. Neck muscle fatigue alters the cervical flexion relaxation ratio in sub-clinical neck pain patients. Clin Biomech (Bristol). 2015 Jun;30(5):397-404. doi: 10.1016/j.clinbiomech.2015.03.020. Epub 2015 Mar 27.
PubMed 25843481Shaghayegh Fard B, Ahmadi A, Maroufi N, Sarrafzadeh J. Evaluation of forward head posture in sitting and standing positions. Eur Spine J. 2016 Nov;25(11):3577-3582. doi: 10.1007/s00586-015-4254-x. Epub 2015 Oct 17.
PubMed 26476717
Study at a glance
From the registry record, last updated by the sponsor on 21 Aug 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Electromyographic Changes in Masticatory and Cervical Muscles Following a Structured 10-week Postural Correction Exercise Program in Individuals With Asymptomatic Forward Head Posture: A Randomized Controlled Trial
- ClinicalTrials.gov ID
- NCT07780396
- Acronym / sponsor ID
- 2023-H-0145-HS-R-0505
- Conditions
- Forward Head Posture
- Study type
- Interventional
- Recruitment status
- Recruiting
- Enrolment
- 60 participants (estimated)
- Lead sponsor
- Cairo UniversityUniversity, hospital or other
- Study start
- 15 May 2026 (actual)
- Primary completion
- 15 Oct 2026 (estimated)
- Study completion
- 30 Oct 2026 (estimated)
- First posted
- 21 Aug 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.
This study investigates the effects of specific corrective exercises on EMG of masticatory and cervical muscles in individuals with forward head posture. The study's design will be a retrospective, double- blinded, randomized controlled trial. The participants will be randomly allocated to one of two groups: the exercise group and the control group. The training groups will perform a program consisting of two strengthening (deep cervical flexors and shoulder retractors) and two stretchings (cervical extensors and pectoral muscles) exercises. This exercise program will be repeated 4 times per week for 10 weeks, and each session lasted 30 minutes.
The pre/post assessment of forward head posture will measure by using craniovertebral angle CVA. While the muscle activity EMG of the masseter, temporalis, splenius, upper trapezius, and SCM will measure pre and post-assessment using a biopic data acquisition system.
Detailed description
Forward head posture (FHD) is a common habitual faulty posture exists in the surrounding that can alter the resting position of the mandible and may affect the masticatory muscle activity.
The aim of this study is to investigate the effect of postural correction on masticatory and cervical muscle activity and mandibular opening in forward-head posture patients.
Materials and Methods:
Cranio-vertebral angle measurement CVA EMG activity of masseter, temporalis, splenius, upper trapezius and SCM BAU - Institutional Review Board (Form H-II) | BEIRUT ARAB UNIVERSITY
-Electrodes will be placed on the muscle belly parallel to the direction of muscle fibers. The distance between the two electrodes was 2 cm. The subjects will be instructed to complete maximum voluntary contraction (MVC) of clenching the teeth for 3 s and repeating twice. The average of the two trials of MVC will be used for further analysis. The subjects will be seated comfortably in a chair.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Double blind (participant, outcomes assessor)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Specific strengthening and stretching exercise | Experimental | Other: Specific strengthening and stretching exercise |
| General exercises | Active comparator | Other: General Exercise |
Who may qualify
- Ages
- 18 to 30 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult
Key inclusion criteria (1 listed)
- 1. Participants aged 18- 30 years. 2. Presence of forward head posture, defined as CVA of less than 50° with no symptoms of neck pain [18, 19]. 3. No treatment for TMD or cervical symptoms (e.g., medication, physical therapy, or intra-articular injection) within the previous 2 weeks.
Key exclusion criteria (4 listed)
- 1. Current or previous diagnosis of temporomandibular disorder (TMD), or the presence of TMD-related signs or symptoms (e.g., joint sounds, restricted mouth opening, or orofacial pain) during screening.
- 2. History of TMJ subluxation or dislocation that could interfere with mouth opening.
- 3. History of recent head or neck trauma. 4. Angle Class II or Class III malocclusion. 5. Postural abnormalities secondary to structural spinal deformities (e.g., scoliosis or kyphosis), rheumatic diseases, or other medical conditions affecting posture.
- 6. Missing posterior teeth, recent orthodontic treatment (within the previous 12 months), or dental restorations that altered occlusion.
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 |
|---|---|---|
| Specific strengthening and stretching exerciseThe program consisted of two strengthening (deep cervical flexors and shoulder retractors) and two stretching (cervical extensors and pectoral muscles) exercises based on Harman and Mostafa et al's approach. This exercise program will be repeated 4 times per week for 10 weeks, and each session lasted for 30 minutes. | Other | Specific strengthening and stretching exercise |
| General ExerciseThe program will consist of regular general postural exercises such as postural awareness exercises as well as general strengthening exercises such as range of motion exercises for the upper quadrant. The program will also be repeated 4 times per week for 10 weeks, with each session lasting 30 minutes | Other | General exercises |
Primary outcome
EMG activity
Time frame: 10 weeks
Electrodes will be placed on the muscle belly parallel to the direction of muscle fibers. The distance between the two electrodes was 2 cm. The subjects will be instructed to complete maximum voluntary contraction (MVC) of clenching the teeth for a period of 3 s and repeated twice. The average of the two trials of MVC will be used for further analysis. The subjects will be seated comfortably in a chair (---cm height).
1 secondary outcome
craniovertebral angle
Time frame: 10 weeks
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 21 Aug 2026.
- Results publication: PubMed 26311986Kim SD. Effects of yoga exercises for headaches: a systematic review of randomized controlled trials. J Phys Ther Sci. 2015 Jul;27(7):2377-80. doi: 10.1589/jpts.27.2377. Epub 2015 Jul 22.
- Results publication: PubMed 27512253Lee SM, Lee CH, O'Sullivan D, Jung JH, Park JJ. Clinical effectiveness of a Pilates treatment for forward head posture. J Phys Ther Sci. 2016 Jul;28(7):2009-13. doi: 10.1589/jpts.28.2009. Epub 2016 Jul 29.
- Results publication: PubMed 22959228Quek J, Pua YH, Clark RA, Bryant AL. Effects of thoracic kyphosis and forward head posture on cervical range of motion in older adults. Man Ther. 2013 Feb;18(1):65-71. doi: 10.1016/j.math.2012.07.005. Epub 2012 Sep 5.
- Results publication: PubMed 25931773Lee KJ, Han HY, Cheon SH, Park SH, Yong MS. The effect of forward head posture on muscle activity during neck protraction and retraction. J Phys Ther Sci. 2015 Mar;27(3):977-9. doi: 10.1589/jpts.27.977. Epub 2015 Mar 31.
- Results publication: PubMed 25843481Zabihhosseinian M, Holmes MW, Ferguson B, Murphy B. Neck muscle fatigue alters the cervical flexion relaxation ratio in sub-clinical neck pain patients. Clin Biomech (Bristol). 2015 Jun;30(5):397-404. doi: 10.1016/j.clinbiomech.2015.03.020. Epub 2015 Mar 27.
- Results publication: PubMed 26476717Shaghayegh Fard B, Ahmadi A, Maroufi N, Sarrafzadeh J. Evaluation of forward head posture in sitting and standing positions. Eur Spine J. 2016 Nov;25(11):3577-3582. doi: 10.1007/s00586-015-4254-x. Epub 2015 Oct 17.
- Individual participant dataSharing planned: No. Any study records that identify patient will be kept confidential. The records from the participation may be reviewed by people responsible for making sure that research is done properly, including members of the BAU Institutional Review Board. All of these people are required to keep their identities confidential. Otherwise, records that identify patients will be available only to people working on the study. • The investigators will use a code of numbers and alphabets rather than participants' names on data sheets, keeping records in a safe place.
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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 Specific strengthening and stretching exercise and General Exercise in people with Forward Head Posture, run by Cairo University at 1 site in Lebanon.
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 1 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: looking for participants now, as of the sponsor's last update on 21 Aug 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 Lebanon. 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 Ahmed M Elsayed, PhD (00201027943622, ahmed.elmelhat@cu.edu.eg), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
EMG activity (time frame: 10 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 NCT07780396, which also lists 6 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 21 Aug 2026.