The Effect of Exercise Intervention on Forward Head Posture and Round Shoulder Posture in Symptomatic Competitive Swimmer

NCT07403123 | Completed DMC

• 1 other identifier: NCKU HREC-E-112-082-2
• Study Type: interventional
• Target: 42
• Locations: 1 country
• Sites: 1

Brief Summary

This study is an exercise intervention study, and its findings will help to clarify the effects of exercise on forward head posture and rounded shoulder posture in competitive swimmers. It is expected that the results of this study will assist in ensuring that forward head posture and rounded shoulder posture are taken into consideration when competitive swimmers undergo related exercise training in the future. The purpose of this experiment is purely for academic research and does not constitute a physical examination or a medical diagnosis.

Conditions

Swimmer Shoulder; Forward Head Posture; Posture and Mobility of the Upper Quadrant

Keywords

swimmer shoulder; forward head posture; round shoulder posture

Outcome Measures

Primary Outcomes (2)

• forward head angle (FHA)

  The forward head angle (FHA) (Degree): The FHA is defined as the angle formed by the intersection of two lines: one vertical line passing through the spinous process of the seventh cervical vertebra (C7), and a second line connecting the C7 spinous process to the tragus of the ear. A larger FHA value indicates a more severe FHP. The examiner photographed the standing posture. The photograph was then analyzed using AutoCAD software (AutoDesk Inc., Sausalito, CA) to calculate the FHA (forward head angle) value.

  Both groups underwent baseline posture assessments prior to the intervention and post-intervention posture assessments at the end of the 8-week training period.

• forward shoulder angle (FSA)

  The FSA (forward shoulder angle) (Degree): The FSA is defined as the angle formed by the intersection of two lines: one vertical line passing through the spinous process of the seventh cervical vertebra (C7), and a second line connecting the C7 spinous process to the center of the humerus. A larger FSA value indicates a more severe RSP. The examiner photographed the standing posture. The photograph was then analyzed using AutoCAD software (AutoDesk Inc., Sausalito, CA) to calculate the FSA (forward shoulder angle) value.

  Both groups underwent baseline posture assessments prior to the intervention and post-intervention posture assessments at the end of the 8-week training period.

Secondary Outcomes (4)

• Pectoralis minor index (PMI)

  Both groups underwent baseline assessments prior to the intervention and post-intervention assessments at the end of the 8-week training period.

• Shoulder pain and disability index (SPADI)

  Both groups underwent baseline assessments prior to the intervention and post-intervention assessments at the end of the 8-week training period.

• Scapular upward rotation (SUR) angle

  Both groups underwent baseline assessments prior to the intervention and post-intervention assessments at the end of the 8-week training period.

• Scapular anterior tilt index (SATI)

  Both groups underwent baseline assessments prior to the intervention and post-intervention assessments at the end of the 8-week training period.

Study Arms (2)

intervention group

EXPERIMENTAL

The intervention group performed an exercise program targeting RSP and FHP, which included three strengthening exercises and two stretching exercises. Each session lasted approximately 50 minutes and was conducted three times per week for a total of eight weeks.

Other: exercise intervention: included three strengthening exercises and two stretching exercises.

non-intervention group

NO INTERVENTION

The non-intervention group did not receive the above exercise training during the eight-week intervention period; however, the relevant exercise training was provided after the completion of the eight-week experiment.

Interventions

exercise intervention: included three strengthening exercises and two stretching exercises. OTHER

Strengthening exercises: Based on the relevant literature review, the primary aim of the strengthening exercises was to enhance the strength of the middle trapezius, lower trapezius, and serratus anterior muscles, including: Y to W exercise, L to Y exercise and Scapular protraction exercise. Stretching exercises: Based on a review of the relevant literature, stretching exercises primarily target the pectoralis minor and the cervical extensor muscles, including: Pectoralis flexibility and Chin tucks exercise.

intervention group

Eligibility Criteria

• Age: 16 Years - 18 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Child (0-17), Adult (18-64)

You may qualify if:

• High school competitive swimmers
• With shoulder pain: unilateral or bilateral shoulder pain who had a self-reported shoulder pain score of ≥ 40 points for at least one month, measured using a visual analogue scale (VAS). VAS scores range from 0 to 100, with higher scores indicating greater pain.
• With round shoulder posture (RSP): Forward shoulder angle (FSA) ≥ 52°.
• With forward head posture (FHP): forward head angle (FHA) ≥ 46°.

You may not qualify if:

• A history of fractures
• Previous surgery to the upper extremity or shoulder joint
• Full-thickness rotator cuff tears
• Cervical radiculopathy
• Shoulder dislocation
• Structural deformities of the cervical or thoracic spine
• Any neurological disorder

Sponsors & Collaborators

• Fooyin University: lead
• National Science and Technology Council, Taiwan: collaborator

Study Sites (1)

Department of physical therapy, Fooyin university

Kaohsiung, Taiwan, 831301, Taiwan

Location

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: Assistant professor

Study Record Dates

• First Submitted: January 20, 2026
• First Posted: February 11, 2026
• Study Start: September 27, 2023
• Primary Completion: March 23, 2024
• Study Completion: October 31, 2024
• Last Updated: February 11, 2026

Record last verified: 2026-02

Data Sharing

• IPD Sharing: Will share
• Shared Documents: STUDY PROTOCOL

Locations

TW (1)