Effect of Cervicothoracic Junction Manipulation on Craniovertebral Angle and Proprioception in Forward Head Posture

NCT06699888 | Completed

• 1 other identifier: Riphah IU Samiyah Asghar
• Study Type: interventional
• Target: 36
• Locations: 1 country
• Sites: 1

Brief Summary

The aim of this research is to find out the effect of Cervicothoracic Junction Manipulation on neck Proprioception in individuals with Forward Head Posture. A Randomized controlled trials done at Barki Advance Physiotherapy Center. The sample size was 36. The subjects were divided in two groups, 18 subjects in control group and 16 in experimental (Cervicothoracic Manipulation) group. Study duration is of 6 months after the ethical approval. Sampling technique applied was non probability connivance sampling technique. Only 18-45 years individuals with forward head posture, craniovertebral angle less than 53° degrees and Joint position error, an average of \>4.5◦ error in rotation or extension direction were included. Tools used in the study are Craniovertebral Angle (CVA) and Joint Position Error Test (JPE).

Conditions

Forward Head Posture

Keywords

Cervicothoracic Manipulation; Craniovertebral Angle; Joint position Error; Proprioception

Outcome Measures

Primary Outcomes (2)

• Craniovertebral Angle

  The CV angle was measured for assessment of head posture. All subjects were instructed to stand in a self-selected comfortable upright posture. Then, the skin overlying the spinous process of the seventh cervical vertebra (C7) and tragus of the ear was marked. A lateral view digital photograph of each subject was taken. The CV angle was calculated based on the angle between a horizontal line passing through C7 and a line extending from the tragus of the ear to C7. The x-axis values for the craniovertebral angle were measured prior to movement.

  baseline to 2 weeks

• Joint Position Error Test

  Proprioceptive accuracy, pertaining to the sense of joint and body movement and position, was evaluated using the Joint Position Error (JPE) Test. The Cervical JPE Test measures the ability of a blindfolded patient to accurately relocate their head position back to a predetermined neutral point after cervical joint movement

  baseline to 2 weeks

Study Arms (2)

Cervicothoracic Manipulation group

EXPERIMENTAL

the subject will receive cervicothoracic manipulation and Chin tuck, Strengthening Shoulder Retractors, Stretching SCM, Pectoralis Stretch

Other: cervicothoracic manipulation group

forward head correction exercises group

ACTIVE COMPARATOR

this group receive Chin tuck, Strengthening Shoulder Retractors, Stretching SCM, Pectoralis Stretch

Other: forward head correction exercises traditional group

Interventions

cervicothoracic manipulation group OTHER

The participant lay prone with the head firmly into the head piece Palpation of the upper cervico-thoracic segment observed the side of the restriction. The participants head was rotated to the contralateral side of the restriction. The practitioner's hand contacted the forehead and the other hand's thumb contacted the spinous process of the restricted side. A low amplitude, high velocity thrust towards the axilla was applied, on the spinous process in PA direction. Experimental group also received following exercises Chin tuck Strengthening Shoulder Retractors. Stretching SCM Pectoralis Stretch 3 × 10 repetitions, 3 times a week for 2 weeks

Cervicothoracic Manipulation group

forward head correction exercises traditional group OTHER

Chin tuck Strengthening Shoulder Retractors. Stretching SCM Pectoralis Stretch 3 × 10 repetitions, 3 times a week for 2 weeks.

forward head correction exercises group

Eligibility Criteria

• Age: 18 Years - 45 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64)

You may qualify if:

• Both male and female patients with age between 18-45 years
• Participants with asymptomatic Forward head posture
• Participants having no active complain of neck pain and muscle stiffness
• Joint position error, an average of \>4.5◦ error in rotation or extension directions
• For FHP patient, the Craniovertebral angle should be ≤ 53º

You may not qualify if:

• Previous history of neck and head trauma
• Vestibular pathologies i.e. vertigo, dizziness
• Musculoskeletal or neurological conditions that could affect Proprioception, cognitive impairment
• History of spinal and thoracic surgeries

Sponsors & Collaborators

• Riphah International University: lead

Study Sites (1)

Barki Rehabilitation Center

Multan, Punjab Province, 46000, Pakistan

Location

Study Officials

• Aisha Razzaq, PHD*

  Riphah International University

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: DOUBLE
• Who Masked: PARTICIPANT, OUTCOMES ASSESSOR
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: November 19, 2024
• First Posted: November 21, 2024
• Study Start: June 1, 2024
• Primary Completion: February 25, 2025
• Study Completion: April 16, 2025
• Last Updated: April 18, 2025

Record last verified: 2025-04

Data Sharing

• IPD Sharing: Will not share

Locations

PA (1)