Effects of Postural Education or Corrective Exercise on Forward Head Posture

NCT05321654 | Completed

• 2 other identifiers: IRB-FY20-21-1073UR2201
• Study Type: interventional
• Target: 79
• Locations: 1 country
• Sites: 1

Brief Summary

This randomized control trial examined the effects of postural education or corrective exercise intervention on the craniovertebral angle (CVA) in young adults with forward head posture (FHP). The objectives were 1: to investigate whether or not a corrective exercise program (CEP) consisting of self-myofascial release (SMR) + stretching; a CEP consisting of SMR + stretching + strengthening; or postural education (PE) had an effect on the CVA; 2. to determine which intervention yielded the greatest postural enhancement if a positive effect was observed in more than one intervention. \*\[note: SMR is a technique involving the self-application of pressure to fascia and muscle tissue for the purpose of enhancing flexibility, reducing muscle soreness, and influencing muscle relaxation\]. It was hypothesized that 4 weeks after receiving either CEP intervention or PE there would be a significant change in the CVA compared to a control group; and that there would be an intervention more effective than the others for improving the CVA. The null hypotheses were: there would be no CVA change after intervention in any of the groups; and there will be no intervention more effective than another for improving the CVA.

Conditions

Postural; Defect

Keywords

Forward Head Posture; Craniovertebral Angle; Corrective Exercise Program; Postural Education

Outcome Measures

Primary Outcomes (1)

• Change in Craniovertebral Angle after 4 weeks

  The angle between the intersection of two lines drawn on the photograph: the first line drawn from the tragus of the ear to the spinous process of C7 vertebrae and the second line drawn horizontally through C7 spinous process. In this study, a second researcher directly observed the primary investigator performing each CVA assessment, as well as provided verbal agreement with the accuracy of angle measurement. For each participant, the CVA was derived by taking the mean of two CVA measurements that were assessed on the captured photographs.

  Baseline: On day 1 of study enrollment; Post-Intervention: Within 5 days after the end of the 4 week intervention period

Secondary Outcomes (2)

• Midpoint Intervention Compliance

  Assessed at the start of week 3

• Endpoint Intervention Compliance

  Within 5 days after the end of the 4 week intervention period.

Study Arms (4)

Posture Education (PE) Group

EXPERIMENTAL

PE group members received a 20-minute in-person one-on-one standardized educational session by a research team member in the laboratory on the following topics: health risks associated with forward head posture; postural guidelines for using mobile electronic devices, desktop computers, and laptop computers; as well as rest break guidelines. Participants were asked to adhere to the postural guidelines provided in the educational session for the next 4 weeks.

Behavioral: Education for Behavior Modification

Self-Myofascial Release + Stretching (SMRS) Group

EXPERIMENTAL

This group applied self-myofascial release (SMR) to their thoracic spine with a myofascial roller for 30 sec., then 6 repetitions of myofascial rolling for 90 sec. They applied SMR for 30 sec. to their neck flexors and extensors using their fingertips. They applied SMR to the upper trapezius and pectoralis for 30 sec using a soft tissue mobilization tool. For the first 2 weeks, they performed SMR 3x/wk. During wks. 3 and 4, they progressed SMR to 5 days/wk. Group members also performed stretching to these same muscles after SMR 3 days/wk for the first 2 weeks of the study, progressing to 5 days/wk during weeks 3 and 4.

Behavioral: Corrective Exercise Program

Self-Myofascial Release + Stretching + Strengthening (SMRSS) Group

EXPERIMENTAL

This group performed the same protocol as SMRS group, as well as include the following strengthening exercises: the supine chin tuck (SCT), upper thoracic-lower cervical extension (UTLCE) using an exercise band that provided 5.5 pounds of resistance, and a single-arm row with trunk rotation (SARTR) using exercise tubing that provided 20 pounds of resistance. The SCT was progressed in 3 phases: Week 1: chin tuck held 2 sec., 5 reps. Week 2: same as week 1, but included us of a towel roll placed under the head. Wks. 3 and 4: chin tuck with head lift 1 in., 2 sec. hold. UTLCE: neck extension with exercise band, held 2 sec. SARTR: single arm row with trunk rotation was performed in a controlled and fluid manner using a self-selected speed. The UTLCE and SARTR were performed with 1 X 10 reps for wks 1-2 and progressed to 2 X10 reps in wks 3-4. Strengthening exercises were performed 3x/wk. for 4 wks.

Behavioral: Corrective Exercise Program

Control Group (CG)

NO INTERVENTION

Participants in the CG did not receive an intervention.

Interventions

Education for Behavior Modification BEHAVIORAL

Please see arm description for a detailed description of the intervention

Posture Education (PE) Group

Corrective Exercise Program BEHAVIORAL

Please see arm description for a detailed description of the intervention

Self-Myofascial Release + Stretching (SMRS) Group; Self-Myofascial Release + Stretching + Strengthening (SMRSS) Group

Eligibility Criteria

• Age: 18 Years - 29 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64)

You may qualify if:

• Completion of informed consent
• Craniovertebral angle ≤ 53 degrees
• Self-rating of Transtheoretical Model stage of change stage ≥ 3/5

You may not qualify if:

• Any musculoskeletal injury to the head, shoulders, or spine within the last six months
• Diagnosis of pathology related to the cervical spine, thoracic spine, or upper extremities
• Non-clearance for physical activity based on results of the 2020 PAR-Q+ questionnaire

Sponsors & Collaborators

• Liberty University: lead
• National Academy of Sports Medicine: collaborator

Study Sites (1)

Liberty University

Lynchburg, Virginia, 24515, United States

Location

Related Publications (22)

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  BACKGROUND

MeSH Terms

Interventions

Educational Status; Behavior Therapy

Intervention Hierarchy (Ancestors)

Socioeconomic Factors; Population Characteristics; Psychotherapy; Behavioral Disciplines and Activities

Study Officials

• David A Titcomb, DPT

  Liberty University

  PRINCIPAL INVESTIGATOR

• Bridget F Melton, EdD

  Concordia University Chicago

  STUDY CHAIR

• Theresa Miyashita, PhD

  Concordia University Chicago

  STUDY DIRECTOR

• Helen W Bland, PhD

  Concordia University Chicago

  STUDY DIRECTOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: PREVENTION
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Professor of Health Sciences

Model Details: A prospective parallel randomized controlled trial with repeated measures

Study Record Dates

• First Submitted: March 18, 2022
• First Posted: April 11, 2022
• Study Start: August 26, 2021
• Primary Completion: November 4, 2021
• Study Completion: November 4, 2021
• Last Updated: April 11, 2022

Record last verified: 2022-04

Data Sharing

• IPD Sharing: Will share
• Shared Documents: STUDY PROTOCOL, SAP, ICF, CSR, ANALYTIC CODE
• Time Frame: Starting immediately after publication. No end date.
• Access Criteria: The primary investigator will review requests received by email. Requests granted to researchers and/or research institutions for the purpose of future research studies. The Liberty University Institutional Review Board will also be notified prior to releasing IPD and/or supporting information. Rather than a URL, individuals interested in IPD and/or supporting information will contact the primary investigator by email, which will be provided in the publication along with a statement about the plan to share IPD.

Locations

US (1)