The Effect of Different Exercises on Craniovertebral Angle in Individuals With Forward Head Posture

NCT06947421 | Active Not Recruiting

• 1 other identifier: E-10840098-202.3.02-2206
• Study Type: interventional
• Target: 44
• Locations: 1 country
• Sites: 1

Brief Summary

Forward head posture (FHP) is a prevalent postural misalignment commonly attributed to prolonged exposure to poor ergonomic conditions and insufficient physical activity. This condition adversely affects craniovertebral angle (CVA), cervical muscle activity, and upper extremity function, ultimately compromising overall physical health and quality of life. Current literature highlights the corrective effects of McKenzie exercises on postural awareness and cervical alignment, while standard neck exercises are frequently employed to address muscular imbalances and alleviate posture-related pain and functional limitations. However, studies that directly compare these two exercise approaches in individuals with FHP particularly in terms of their short-term effects on craniovertebral angle, hand grip strength, and psychosocial outcomes remain scarce. Accordingly, the present study aims to fill this critical gap by conducting a multidimensional analysis of the immediate effects of McKenzie versus standard neck exercise programs in individuals with FHP, thereby contributing meaningful insights to clinical rehabilitation practices.

Conditions

Forward Head Posture

Keywords

forward head posture; craniovertebral angle; McKenzie; Standard Neck Exercises

Outcome Measures

Primary Outcomes (1)

• 1.Craniovertebral Angle (CVA)

  CVA is used to assess forward head posture. Participants will be asked to stand in a natural and relaxed posture while focusing on a marked point at eye level on the wall. A lateral photograph will be taken using a Iphone 13 camera mounted on a tripod at shoulder height and placed 1.5 meters from the participant. The spinous process of the C7 vertebra and the tragus of the ear will be marked. The angle between the line connecting the tragus to C7 and a horizontal reference line will be calculated using the ImageJ software. The measurement results will be recorded on the evaluation form. Analysis Metric: Change in CVA (degrees)

  through study completion, an average of 6 months

Secondary Outcomes (4)

• 2.Cognitive Exercise Therapy Approach Scale (BETY)

  through study completion, an average of 6 months

• 3.Hand Grip Strength (HGS)

  through study completion, an average of 6 months

• 4.Neck Disability Index (NDI)

  through study completion, an average of 6 months

• 5. Visual Analog Scale (VAS) for Neck Pain

  through study completion, an average of 6 months

Study Arms (2)

McKenzie Exercise Group (MG)

EXPERIMENTAL

Participants in this group will follow a McKenzie-based cervical exercise program consisting of four specific movements: retraction, rotation, lateral flexion, and combined rotation.

Behavioral: McKenzie Exercise

Standard Neck Exercise Group (SG)

EXPERIMENTAL

Participants in this group will follow a standard cervical postural correction program focused on strengthening deep cervical flexors and scapular retractors, and stretching cervical extensors and pectoralis muscles.

Behavioral: Standard Neck Exercise

Interventions

McKenzie Exercise BEHAVIORAL

Exercises will be performed in seated or supine positions, 15 repetitions per session, twice daily, for a total duration of 6 weeks. The program will begin with physiotherapist-supervised sessions and continue at home with guidance via a digital training manual. Weekly follow-up and progress will be ensured through individual exercise diaries. Participants missing two consecutive days of exercise will be excluded from the study. Includes: * Cervical retraction in sitting and supine positions * Cervical rotation to both sides * Lateral flexion of the neck * Combined chin rotation toward the shoulder

McKenzie Exercise Group (MG)

Standard Neck Exercise BEHAVIORAL

The protocol includes chin tucks, chin drop stretches, scapular retraction with resistance, and both unilateral and bilateral pectoral stretching. Exercises will be performed twice daily, 15 repetitions per session, over a period of 6 weeks. Exercise progression will be adapted biweekly based on participant tolerance. Includes: * Chin tucks in supine with progressive hold durations * Chin drop stretch in sitting with optional manual assistance * Scapular retraction using theraband or weights * Pectoral muscle stretching using doorway and seated techniques

Standard Neck Exercise Group (SG)

Eligibility Criteria

• Age: 18 Years - 30 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64)

You may qualify if:

• Individuals diagnosed with forward head posture, defined by a craniovertebral angle (CVA) of less than 50°, based on established diagnostic criteria
• Age between 18 and 30 years
• Pain intensity greater than 3 on the Visual Analog Scale (VAS)
• Mild to moderate neck disability, indicated by a Neck Disability Index (NDI) score below 15 out of 50
• Voluntary participation with signed informed consent

You may not qualify if:

• Presence of medical contraindications to exercise
• Regular engagement in structured spinal exercise programs
• History of spinal surgery
• Diagnosis of cancer or other malignant conditions
• Presence of an implanted cardiac pacemaker
• Visual, auditory, or cognitive impairments that would prevent adherence to the exercise protocol

Sponsors & Collaborators

• Bahçeşehir University: lead

Study Sites (1)

Mudanya University

Bursa, 16940, Turkey (Türkiye)

Location

Study Officials

• Pelin Pişirici, PhD

  Bahcesehir University, Faculty of Health Sciences, Department of Physiotherapy

  STUDY DIRECTOR

• Esra Beceni, PhD Student

  Bahcesehir University, Graduate Education Institute

  PRINCIPAL INVESTIGATOR

• Büşra Tamgüç, PhD Student

  Bahcesehir University, Graduate Education Institute

  STUDY CHAIR

• Gülay Yalcin, PhD

  Mudanya University, Faculty of Health Sciences, Department of Physiotherapy

  STUDY CHAIR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Masking Details: Randomization will be done by the sealed envelope method.
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: lecturer

Model Details: a randomized, controlled, assessor-blind, prospective study

Study Record Dates

• First Submitted: April 21, 2025
• First Posted: April 27, 2025
• Study Start: April 16, 2025
• Primary Completion: October 16, 2025
• Study Completion: December 16, 2025
• Last Updated: April 27, 2025

Record last verified: 2025-04

Locations

TU (1)