Effect of Bruegger's Exercise in Chronic Mechanical Neck Pain With Forward Head Posture

NCT07669844 | Not Yet Recruiting

• 1 other identifier: P.T.REC/012/004505
• Study Type: interventional
• Target: 24
• Locations: 1 country
• Sites: 1

Brief Summary

The purpose of the study is to investigate the effect of adding Bruegger's exercises on conventional exercise program in treatment of forward head posture.

Conditions

Neck Pain

Outcome Measures

Primary Outcomes (3)

• Assessment of pain intensity

  The numerical pain rating scale will be used to assess pain intensity. It is 11-point numeric scale ranges from '0' representing one pain extreme (e.g. "no pain") to '10' representing the other pain extreme (e.g. "pain as bad as you can imagine" or "worst pain imaginable.

  4 weeks

• Assessment of craniocervical angle (CVA)

  The CVA will be evaluated with forward head posture (FHP) application on a Xiaomi® MiA2. Two markers are placed on the ground separated by 1.5 m, where the camera or smart phone and the subject are located. Reference markers are placed on the spinous process of C7 and in the swallow of the subjects' ears, which were identified through palpation. The subject is placed on the floor mark, barefoot and standing, lateral to the evaluator. The application provides the complement to the CVA, thus making further calculation necessary. To determine the CVA, it is necessary to subtract the angle provided by the application from 360°. The presence of FHP will be determined by an angle value lower than 50°, and the absence of FHP if the angle value is greater than or equal to 50°

  4 weeks

• Assessment of craniocervical flexion endurance

  Craniocervical flexion endurance test (CCFE test) will be used. The position of the participant is supine with cervical spine in the neutral position. The PBU is placed between the plinth and the posterior neck just below the occiput. The cuff is then inflated to a baseline of 20 mmHg. The participant was then asked to avoid head lift during CCFE test, thereby reducing the recruitment of superficial flexors. Each participant will be asked to perform the neck flexion movement at five different pressure levels (22, 24, 26, 28, and 30 mmHg) with 10 s hold at each level and 30 s rest between each level. The test is terminated if the subject is not able to hold the position of the neck for 10 s at a specific pressure level or if the maximum level of 30 mmHg is achieved.

  4 weeks

Secondary Outcomes (1)

• Assessment of function disability

  4 weeks

Study Arms (2)

Core stability exercises

ACTIVE COMPARATOR

The participants will receive conventional core stability exercise for 12 sessions (3 sessions per week for four weeks).

Other: Core stability exercise

Bruegger's training and core stability exercises

EXPERIMENTAL

will receive a program of Bruegger's training plus conventional core stability exercise for 4 weeks, 3 sessions per week, total 12 sessions, with about 30:45 minutes per session.

Other: Core stability exercise; Other: Bruegger's training

Interventions

Core stability exercise OTHER

The participants will be treated with conventional core stability exercise; Neck Stability Exercises-Free exercise for cervical spine, Neck isometric exercises (flexion, extension, lateral flexion, rotation), Wall angle exercises for lower trapezius, Chin tuck, Chin tuck into the towel

Bruegger's training and core stability exercises; Core stability exercises

Bruegger's training OTHER

Bruegger's Position of external arm rotation, shoulder abduction and retraction of the scapulae . This position with simultaneous head and neck retraction is a strengthening exercise for deep neck flexors and lower scapular stabilizers. The subjects are instructed to place their feet on the floor completely and keep their knee joints 10 ㎝ below the hip joints in 45° of abduction. The subjects sit hitting their ischial tuberosity on the chair and maintained their physiological curvature for the TL spine. Following external rotation of the glenohumeral joints, tension is relaxed with each inhalation, and depression and retraction of the shoulder girdle are performed with each exhalation.

Bruegger's training and core stability exercises

Eligibility Criteria

• Age: 18 Years - 35 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64)

You may qualify if:

• Participant with neck pain and craniovertebral angle value lower than 50°.
• Numeric pain rating score above 3.
• More than 10 on neck disability index.

You may not qualify if:

• Arthritis (or other inflammatory diseases).
• Locoregional tumor or metastasis .
• Myopathy .
• Severe psychiatric disorders.
• Previous neck surgery.
• Fibromyalgia.

Sponsors & Collaborators

• Cairo University: lead

Study Sites (1)

Hadeer SalahEldin Mahmoud

Cairo, Egypt

Location

MeSH Terms

Conditions

Neck Pain

Condition Hierarchy (Ancestors)

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

Study Officials

• Salwa Abd E-Majeed, Professor

  Cairo University

  STUDY CHAIR

Central Study Contacts

Hadeer Morsi, Master

CONTACT

01157677014; happypt91@gmail.com

Dina AbdAllah, PHD

CONTACT

01282742057; drdinasayed_ptW@yahoo.com

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: Principal investigator

Study Record Dates

• First Submitted: June 21, 2026
• First Posted: June 25, 2026
• Study Start: July 1, 2026
• Primary Completion (Estimated): September 1, 2026
• Study Completion (Estimated): September 16, 2026
• Last Updated: June 25, 2026

Record last verified: 2026-06

Locations

EG (1)