Comparative Effects of Pressure and Visual Biofeedback Training on Pain, Disability, Range of Motion Among Patients With Forward Head Posture Correction: A Randomized Controlled Trial

NCT07856433 | Recruiting

• 1 other identifier: IIUI//RERC/ADT/2026/02/233
• Study Type: interventional
• Target: 44
• Locations: 1 country
• Sites: 1

Brief Summary

The study will take place at Akbar Niazi Teaching Hospital and AL kauther International hospital, Bhara Kahu, Islamabad with formal permission obtained from the institution. Patients with forward head posture, who meet the inclusion criteria, will be selected and asked for consent. Participants will be randomly assigned to either a pressure bio feedback training group or a visual biofeedback training group using a computer randomizer. Before starting the training, baseline measurements of neck muscle activation and posture will be recorded. Group1will receive pressure bio feedback training using a cuff, while Group 2 will use visual feedback through a mirror or screen to correct posture. An 6 weeks intervention will be implemented, with treatments administered three times per week. Outcome measures will be assessed at baseline and again at the conclusion of the 6 weeks intervention period. The results will be analyzed using the latest version of SPSS (Statistical Package for the Social Sciences).

Conditions

Forward Head Posture

Keywords

FHP

Outcome Measures

Primary Outcomes (3)

• Numeric Pain Rating Scale

  Pain intensity will be assessed as an outcome measure to determine the effect of the intervention on participants' perceived pain. Pain will be measured using a validated pain-rating scale, such as the Visual Analogue Scale (VAS) or Numeric Pain Rating Scale (NPRS). Participants will rate the intensity of their pain at the specified assessment time points, with higher scores indicating greater pain intensity. Changes in pain scores from baseline to post-intervention will be evaluated to determine the effect of the intervention.

  participants wiill be assesed at baseline, then at week 3 and then at week 6

• Neck Disability Index

  Neck Disability Index (NDI) The Neck Disability Index (NDI) will be used to assess neck-related pain and disability and its impact on participants' daily activities. The NDI is a 10-item patient-reported questionnaire covering areas such as pain intensity, personal care, lifting, reading, headaches, concentration, work, driving, sleeping, and recreation. Each item is scored from 0 to 5, with a total score ranging from 0 to 50. Higher scores indicate greater neck-related disability. The NDI score will be assessed at the predefined time points to evaluate changes in neck disability following the intervention.

  Participants will be assesd as baseline then at week 3, and then at week 6

• Range of Motion

  Cervical Range of Motion (ROM) Cervical range of motion will be assessed to determine changes in neck mobility following the intervention. Cervical movements including flexion, extension, lateral flexion, and rotation will be measured using a standardized method, such as a cervical goniometer or digital inclinometer. The range of movement will be recorded in degrees at the specified assessment time points. Changes in cervical ROM from baseline to post-intervention will be evaluated to determine ch

  Participants will be assed at baseline, then week 3 and then week 6

Study Arms (2)

Pressure Biofeedback

ACTIVE COMPARATOR

Active Comparator Arm: Pressure Biofeedback Training Participants assigned to the active comparator group (Pressure Biofeedback Training) will receive a structured cervical postural correction and deep cervical muscle activation training program using a pressure biofeedback cuff. The intervention is designed to provide objective pressure-based feedback during exercise, allowing participants to monitor and control their cervical position and muscle activation while performing the prescribed exercises. The pressure biofeedback cuff will be appropriately positioned in the cervical region according to the standardized study protocol. Participants will be instructed to maintain a neutral cervical position and perform the prescribed cervical stabilization and postural control exercises while monitoring the pressure changes displayed on the pressure biofeedback device.

Behavioral: Pressure Biofeedback

Visual Biofeedback

EXPERIMENTAL

Participants will receive visual biofeedback during the intervention sessions. Information related to the targeted physiological or biomechanical parameter will be measured using the study's assessment/biofeedback system and presented visually on a screen in real time. Participants will be instructed to observe the visual feedback and modify their performance or movement according to the predefined target. The visual feedback will be provided consistently across intervention sessions according to the study protocol.

Behavioral: VISUAL FEEDBACK

Interventions

VISUAL FEEDBACK BEHAVIORAL

Intervention: Visual Biofeedback Participants will receive visual biofeedback during the intervention sessions. Information related to the targeted physiological or biomechanical parameter will be measured using the study's assessment/biofeedback system and presented visually on a screen in real time. Participants will be instructed to observe the visual feedback and modify their performance or movement according to the predefined target. The visual feedback will be provided consistently across intervention sessions according to the study protocol.

Visual Biofeedback

Pressure Biofeedback BEHAVIORAL

Pressure Biofeedback Participants will receive pressure biofeedback during the intervention sessions using a pressure-sensing device. The device will detect changes in pressure associated with the targeted movement or muscle activity and provide immediate visual feedback of the measured pressure. Participants will be instructed to observe the feedback and adjust their muscle activation or movement to achieve and maintain the predefined target pressure. The intervention will be delivered according to a standardized protocol throughout the treatment sessions.

Pressure Biofeedback

Eligibility Criteria

• Age: 19 Years - 44 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64)

You may qualify if:

• Patients between 19 and 44 years with primary complain of neck pain Those with craniovertebral angle more than 48-50 degreeswould be incorporated Eagerness to take part and give informed consent Get a score of greater than 3 and having less than 8 on NPRS

You may not qualify if:

• Those with craniovertebral angle less than48-50 degree would be incorporated Eagerness to take part and give informed consent Get a score of greater than 3 and having less than 8 on NPRS

Sponsors & Collaborators

• Ibadat International University, Islamabad: lead

Study Sites (1)

Ibadat International University

Islamabad, Federal, 44000, Pakistan

RECRUITING

MeSH Terms

Interventions

Feedback, Sensory

Intervention Hierarchy (Ancestors)

Biofeedback, Psychology; Behavior Therapy; Psychotherapy; Behavioral Disciplines and Activities; Feedback, Psychological; Feedback, Physiological; Homeostasis; Physiological Phenomena

Study Officials

• Marium Khalid, MSOPMT

  Ibadat International University, Islamabad

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Marium Khalid ASSISTANT PROFESSOR, MSOMPT

CONTACT

+923341510369; marium.khalid@uipt.iiui.edu.pk

Zunaira Anwar, DPT

CONTACT

+923436227872; zunairaanwar253@gmail.com

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: PARTICIPANT
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Assistant Professor

Study Record Dates

• First Submitted: September 28, 2026
• First Posted: October 2, 2026
• Study Start: March 5, 2026
• Primary Completion: September 29, 2026
• Study Completion: September 30, 2026
• Last Updated: October 2, 2026

Record last verified: 2026-09

Data Sharing

• IPD Sharing: Will not share

Locations

PA (1)