Comparative Analysis of Artificial Intelligence-Generated and Studio-Based Reformer Pilates Interventions for Forward Head Posture

NCT07205835 | Completed

• 1 other identifier: FZT2024/37
• Study Type: interventional
• Target: 40
• Locations: 1 country
• Sites: 1

Brief Summary

Posture is the alignment of body segments. While ideal posture places minimal stress on the joints, poor posture increases joint stress. Forward head posture (FHP) is a common postural abnormality characterized by the anterior displacement of the head in the sagittal plane. This condition may lead to muscle imbalances, pain, reduced cervical range of motion (ROM), decreased quality of life, and spinal degeneration. The most common method for evaluating FHP is the craniovertebral angle (CVA). Causes of FHP include excessive smartphone and computer use, mouth breathing, carrying heavy bags, and rounded shoulders. Cervical stabilization exercises and holistic approaches are recommended for prevention and treatment. Pilates, developed by Joseph Pilates, especially in its clinical form, has been shown to improve posture, strengthen core muscles, and enhance quality of life. Literature indicates that stretching- and strengthening-based exercise programs targeting FHP positively affect CVA, neck pain, and ROM. In recent years, artificial intelligence (AI) has gained importance in physiotherapy as a diagnostic and therapeutic support tool. Its potential in generating exercise prescriptions is being explored, though whether AI can replace physiotherapists remains debated. The aim of this study is to compare the effectiveness of an AI-generated reformer Pilates protocol and a studio-based reformer Pilates protocol in individuals with FHP. Hypotheses: H0: The studio-based reformer Pilates protocol has no effect on CVA, ROM, pain, muscle endurance, or quality of life in individuals with FHP. H1: The studio-based reformer Pilates protocol has a positive effect on these parameters.

Conditions

Posture; Neck Disorder

Keywords

posture; Pain; Artificial intelligence (AI); Pilates exercises; Physiotherapy and rehabilitation

Outcome Measures

Primary Outcomes (1)

• Change in Craniovertebral Angle

  Craniovertebral angle will be measured using digital photography and goniometric analysis to evaluate postural improvement.

  Baseline and after 6 weeks

Study Arms (2)

Clinical Pilates Group

EXPERIMENTAL

Participants in this group will perform clinical Pilates exercises under the supervision of a physiotherapist, twice a week for 6 weeks. Each session will last 50 minutes and will include core stabilization, postural correction, and flexibility exercises.

Behavioral: Clinical Pilates Group

ChatGPT Exercise Group

ACTIVE COMPARATOR

Participants in this group will perform an exercise program generated by ChatGPT and supervised by a physiotherapist, twice a week for 6 weeks. Each session will last 50 minutes and will include exercises designed to improve posture, flexibility, and musculoskeletal function.

Behavioral: ChatGPT Exercise Group

Interventions

ChatGPT Exercise Group BEHAVIORAL

Participants in the ChatGPT group will follow an exercise program generated by ChatGPT and supervised by a physiotherapist. The program will be delivered twice weekly for 6 weeks, with each 50-minute session including exercises designed to improve posture, flexibility, and musculoskeletal function.

ChatGPT Exercise Group

Clinical Pilates Group BEHAVIORAL

Participants in this arm will perform supervised clinical Pilates exercises twice weekly for 6 weeks. Each session will last 50 minutes and include core stabilization, postural correction, and flexibility exercises.

Clinical Pilates Group

Eligibility Criteria

• Age: 18 Years - 50 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64)

You may qualify if:

• Volunteers aged between 18-50 years
• Craniovertebral angle less than 54°
• Ability to participate in exercise sessions twice a week for 6 weeks
• Willingness to provide informed consent

You may not qualify if:

• History of musculoskeletal, neurological, or cardiovascular disorders
• Previous surgery affecting posture or spine
• Current participation in another structured exercise program
• Pregnancy

Sponsors & Collaborators

• Uskudar University: lead

Study Sites (1)

Üsküdar Üniversitesi NP Sağlık Yerleşkesi

Istanbul, Ümraniye, 34764, Turkey (Türkiye)

Location

MeSH Terms

Conditions

Pain

Condition Hierarchy (Ancestors)

Neurologic Manifestations; Signs and Symptoms; Pathological Conditions, Signs and Symptoms

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Asst. Prof.

Model Details: The study population consisted of a total of 40 male and female volunteers aged between 18 and 50 years with a craniovertebral angle of less than 54 degrees. Participants were randomized into two groups: the Clinical Pilates group and the ChatGPT group. The Clinical Pilates group (n=20) performed clinical Pilates exercises under the supervision of a physiotherapist for 6 weeks, twice a week, 50 minutes per session. The ChatGPT group (n=20) followed an exercise program generated by ChatGPT under the supervision of a physiotherapist for 6 weeks, twice a week, 50 minutes per session.

Study Record Dates

• First Submitted: September 26, 2025
• First Posted: October 3, 2025
• Study Start: November 1, 2024
• Primary Completion: November 5, 2024
• Study Completion: January 10, 2025
• Last Updated: October 3, 2025

Record last verified: 2025-09

Data Sharing

• IPD Sharing: Will not share

Locations

TU (1)