Efficacy of Combined Manual Diaphragm Release Technique and Neck Exercises in Adolescents With Forward Head Posture

NCT07039565 | Active Not Recruiting DMC

• 1 other identifier: Treatment of forward head
• Study Type: interventional
• Target: 100
• Locations: 1 country
• Sites: 1

Brief Summary

• Due to the heavy use of smartphones among adolescents the cervical spine destabilizes and moves forward, so do the vital structures (nerves, arteries, veins) within the neck undergo torsion, stretch and compression including the autonomic nervous system nerves (which can cause dysfunction in heart rate, digestion, breathing among other symptoms).
• Forward head posture (FHP) puts more compressive strain on the cervical spine's tissues, especially the ligaments and facet joints. Because FHP weakens the respiratory muscles, it has a significant impact on respiratory function. Static balance may be negatively impacted by FHP.
• FHP is effectively treated by a proper and suitable physical therapy program.

Conditions

Forward Head Posture

Keywords

Manual diaphragm release technique; Postural assessment software (SAPO/PAS); adolescents; Forward head posture; Craniovertebral angle (CVA); Postural deviations

Outcome Measures

Primary Outcomes (2)

• craniovertebral angle (CVA) Forward head posture

  The angle formed by a horizontal line crossing c7 and a line crossing c7 to the tragus of the ear is known as the CVA

  12 weeks

• Vertical head alignment (VHA)

  Angle between right tragus, right acromion and vertical.

  12 weeks

Study Arms (2)

Experimental group

EXPERIMENTAL

Manual diaphragm release technique and traditional neck exercises

Other: Stretching and strengthening exercises; Other: Diaphragm release technique

Control group

ACTIVE COMPARATOR

Traditional neck exercises

Other: Stretching and strengthening exercises

Interventions

Stretching and strengthening exercises OTHER

Strengthening exercises were progressively performed for three sets, with 10 to 15 repetitions. The stretching part of the exercises was done with the purpose of increasing the flexibility of the pectoralis and the cervical neck extensors muscles (pectoralis stretch, chin tuck). Exercises have been approved to be effective on the lengthening of the pectoralis minor, activation of the lower trapezius/middle trapezius, serratus anterior, and improvement of the posture

Control group; Experimental group

Diaphragm release technique OTHER

the patient will positioned in the supine position. The therapist stand at the head of the patient. The therapist make manual contact bilaterally under the costal cartilages of the lower ribs (7th to 10th ) with hypothenar regions of the hands and last three fingers. During the patient's inspiration, the therapist is gently pulling the points of hands contacts toward the head and slightly laterally, while elevating the ribs simultaneously

Experimental group

Eligibility Criteria

• Age: 17 Years - 18 Years
• Sex: male
• Healthy Volunteers: No
• Age Groups: Child (0-17), Adult (18-64)

You may qualify if:

• Male students their age ranged from 17 to 18 years.
• Has Body Mass Index (BMI) = 5th percentile to less than the 85th percentile.
• \_ has forward head posture
• Studying at any faculty at Pharos University in Alexandria.
• Cooperative and followed the instructions.

You may not qualify if:

• \- Subjects were excluded from the study if the student had visual or hearing defects.
• Overweight, obese or cachexic students.
• Had any neurological disorders.
• Had musculoskeletal problems.
• Had any congenital abnormalities that might affect the study.

Sponsors & Collaborators

• Pharos University in Alexandria: lead

Study Sites (1)

Pharos University in Alexandria

Alexandria, Egypt, Egypt

Location

Related Publications (2)

• Lee 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.

  PMID: 25931773 BACKGROUND

• https://www.researchgate.net/publication/379140193_Forward_Head_Posture_and_Its_Effect_on_Muscle_Activation

  BACKGROUND

Related Links

• Forward head posture (FHP), which is defined as a forward displacement of the head on the cervical spine, is a common postural disorder. It is suggested that this malalignment alters the loads on the spine, affects the length-tension relationship in musc

Study Officials

• Lamiaa said Tolba, LecturerP

  Pharos University in Alexandria

  STUDY CHAIR

• Amal Youssef Wahba, Lecturer

  Pharos University in Alexandria

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: QUADRUPLE
• Who Masked: PARTICIPANT, CARE PROVIDER, INVESTIGATOR, OUTCOMES ASSESSOR
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Lecturer

Study Record Dates

• First Submitted: June 9, 2025
• First Posted: June 26, 2025
• Study Start: June 28, 2025
• Primary Completion: June 30, 2025
• Study Completion: September 30, 2025
• Last Updated: July 9, 2025

Record last verified: 2025-07

Data Sharing

• IPD Sharing: Will share
• Shared Documents: STUDY PROTOCOL, SAP, ICF
• Time Frame: 11/2025 - 5/2026
• Access Criteria: Access through contacting E-mail: amal.youssef@pua.edu.eg

Locations

EG (1)