Cervical Exercises and Balance in Forward Head Posture

NCT06932965 | Completed DMC

• 1 other identifier: NevsehirHBVUKozakli
• Study Type: interventional
• Target: 99
• Locations: 1 country
• Sites: 1

Brief Summary

This study aims to evaluate the effects of neck stabilization exercises and proprioception training on balance and posture in university students aged 18-25 who are detected to have forward head posture. Individuals will be evaluated before the study, and following the evaluation, stabilization exercises will be applied to the first group under the control of a physiotherapist 3 days a week for 6 weeks. In addition to the stabilization exercises, proprioception training will be given to the second group. Individuals are trained with cervical proprioceptive training, exercises performed by returning the neck to its natural neutral posture and to positions within a predetermined range. Patients are first trained with their eyes open, then with their eyes closed. Feedback for proprioceptive performance is necessary to reduce the margin of error in repositioning. Laser pointer headbands were used for feedback. With the help of this laser pointer, exercises will be applied to the patients by increasing the level of difficulty. In order to make the exercises more difficult, they will first be applied sitting, then standing, then in semi-tandem and tandem positions. No program will be applied to the 3rd group, the control group.

Conditions

Forward Head Posture

Keywords

cervical stabilization; proprioception; forward head posture

Outcome Measures

Primary Outcomes (2)

• CVA

  Participants were included when they have a CVA \< 54°, had no cervical trauma or surgical history, systemic disease, and dizziness problem. We fixed the camera (Nikon D5100) 1.5 meters away from the individual and at the shoulder level. According to radiography, which is considered the gold standard in determining the head forward posture, measurements made by photography were found to be valid and reliable (Van Niekerk et al., 2008). A self-balanced position was chosen and side-shots were taken. The examiner marked the C7 spinous process as well as the tragus of the ear. The CVA is calculated at the intersection angle of a line extending to the ear's tragus and a horizontal line passing the spinous of C7. We used Adobe Acrobat software to measure the angle. CVA less than 54 is defined as FHP. We did not include the individual in the study if the CVA was 54 degrees or greater

  baseline

• Y-Balance Test (YBT)

  This test, an adaptation of the Star Excursion Balance Test (SEBT), was employed to assess the dynamic balance of participants. This evaluation was conducted for both feet, starting with the dominant leg positioned at the center of the test. Three reaching directions-anterior, posteromedial, and posterolateral-were incorporated into the test, with the apparatus pulled using three tape measures between 90° and 135° in these directions. Participants were instructed to reach as far as possible along the specified line, touching the ground with the most distal part of the reaching foot. Subsequently, they were required to return the reaching leg to a double-leg stance while maintaining a single-leg stance. The test was performed clockwise or counterclockwise, corresponding to the dominance of the right or left leg, respectively. Participants were instructed to keep their hands on the iliac crest and ensure that the heels of the standing legs remained in contact with the ground throughout.

  baseline and after 8 weeks

Secondary Outcomes (4)

• Joint Position Sense

  Baseline and after 8 weeks

• Stork Balance Test

  Baseline and after 8 weeks

• Postural Assessment

  Baseline and after 8 weeks

• Balance Performance

  Baseline and after 8 weeks

Study Arms (3)

control

NO INTERVENTION

no intervention only measurement

Cervical Stabilization Group

EXPERIMENTAL

Participants performed supervised cervical stabilization exercises for 8 weeks, 3 sessions per week.

Behavioral: Cervical Stabilization Group

Combined Group

EXPERIMENTAL

Participants performed both exercise protocols as described above over the same period.

Behavioral: combined group

Interventions

Cervical Stabilization Group BEHAVIORAL

Participants performed supervised cervical stabilization exercises for 8 weeks, 3 sessions per week.

Cervical Stabilization Group

combined group BEHAVIORAL

Participants performed both exercise protocols as described above over the same period

Combined Group

Eligibility Criteria

• Age: 18 Years - 25 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64)

You may qualify if:

• Individuals aged between 18-35
• Diagnosed with forward head posture based on craniovertebral angle
• No prior neck surgery or trauma
• Able to participate in exercise sessions

You may not qualify if:

• Neurological or musculoskeletal disorders affecting balance
• Recent injury or surgery in cervical spine
• Use of medications affecting postural control

Sponsors & Collaborators

• Nevsehir Haci Bektas Veli University: lead

Study Sites (1)

Kozakli Vocational School

Nevşehir, 50100, Turkey (Türkiye)

Location

Related Publications (1)

• Ozalp M, Talu B, Kayabinar E. Assessment of the effects of cervical stabilization exercises and proprioception training on balance and posture in individuals with forward head posture. BMC Musculoskelet Disord. 2025 Nov 21;26(1):1077. doi: 10.1186/s12891-025-09259-7.

  PMID: 41272563 DERIVED

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Assistant Professor, PhD, Physiotherapist

Study Record Dates

• First Submitted: April 10, 2025
• First Posted: April 17, 2025
• Study Start: April 1, 2017
• Primary Completion: May 1, 2017
• Study Completion: June 30, 2017
• Last Updated: April 23, 2025

Record last verified: 2025-04

Data Sharing

• IPD Sharing: Will not share

Locations

TU (1)