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To compare the effects of targeted cervical spine strengthening exercises and Kendall exercise in patients with forward head posture
Studies have evaluated the effect of Kendall's exercises and found it effective for recovery. Studies have also concluded that targeted strengthening of flexors reverse the symptoms. The purpose of this study will elaborate either there is a difference in time taken to achieve normal head alignment between a targeted muscle that is prone to weakness or a technique that involves strengthening of weakened muscle plus stretching of shortened muscles. As there is a vast variety of correcting exercise program in the literature, the decision to choose the best option may be challenging. This study may help physiotherapists to apply treatment that is directly directing the main culprit.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| cervical spine strengthening group | Experimental | The participant will nod and chin tuck the head against the block with bands supporting the movement. An air-filled pressure cushion is placed under the occiput behind the cervical spine and conforms to the subject's shape. With a head nod, the pressure on the cuff increases and is shown by the dial. 10 repetitions of 5 seconds hold will be performed for 8 weeks and strength is measured by sphygmomanometer |
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| Kendall exercise group | Active Comparator | patient is seated and the exercises are performed which include stretching pectoralis muscle, placing both hands on the occipital area and pulling the elbows back up and performing arm abduction and external rotation; and (2) strengthening shoulder retraction, Strengthening the deep cervical flexors and Stretching the cervical extensors |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| kendall's exercise | Other | comparative effect of targeted cervical spine strengthening versus kendalls exercise will be analyzed |
|
| Measure | Description | Time Frame |
|---|---|---|
| Change in NPRS | Pain intensity will be assessed by numeric pain rating scale NPRS. The 11-point NPRS (intervals from 0-10) is used to quantify pain intensity; 0 represents no pain, and 10 represent the worst possible agony. The NPRS is a valid and reliable instrument for older persons. Participants will be asked to select the number that most accurately describes their level of pain. At the baseline assessment, following each exercise session during the 8-week intervention, and finally at the end of the intervention Programmed, the NPRS scores will be recorded Changes from Basline to 8th week | 8th week |
| Measure | Description | Time Frame |
|---|---|---|
| Range of motion | A goniometer is a device that measures an angle or permits the rotation of an object to a definite position. The long arm goniometers are more accurate for joints with long levers like the knee and hip joints. A universal goniometer has three parts. A body: It is designed like a protractor and may form a full or a half-circle. It has a scale for the measurement of the angle. The scale can extend either from 0 to 180 degrees or 180 to 0 degrees. A fulcrum: The screw-like device can be tightened to fix the moving arm in a particular position or loosened to permit free movement. The moving arm is the arm of the goniometer, which aligns with the mobile part of the joint measured. Changes from Basline to 8th week |
| Measure | Description | Time Frame |
|---|---|---|
| neck disability index | The neck disability index NDI has become a standard instrument for measuring self-rated disability due to neck pain. Each of the 10 items scores from 0 to 5. The maximum score is 50 Changes from Basline to 8th week | 8th week |
| Photogrammetry |
Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Rabiya Noor, PHD | Riphah International University | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| The Bank of Punjab, Lahore | Lahore | Punjab Province | 54000 | Pakistan |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 33612123 | Background | Mylonas K, Angelopoulos P, Billis E, Tsepis E, Fousekis K. Combining targeted instrument-assisted soft tissue mobilization applications and neuromuscular exercises can correct forward head posture and improve the functionality of patients with mechanical neck pain: a randomized control study. BMC Musculoskelet Disord. 2021 Feb 21;22(1):212. doi: 10.1186/s12891-021-04080-4. | |
| 34068139 |
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| cervical spine strengthening | Other | sole effect of cervical spine strengthening will be analyzed |
|
| 8th week |
It is used for postural evaluation. Most common way to find forward head posture is y measuring craniovertebral angle. Photos were taken from patients' right side and analysis is done by using ImageJ software Changes from Basline to 8th week |
| 8th week |
| Background |
| Handa Y, Okada K, Takasaki H. Lumbar Roll Usage While Sitting Reduces the Forward Head Posture in Healthy Individuals: A Systematic Review with Meta-Analysis. Int J Environ Res Public Health. 2021 May 13;18(10):5171. doi: 10.3390/ijerph18105171. |
| 21849731 | Background | Baskurt Z, Baskurt F, Gelecek N, Ozkan MH. The effectiveness of scapular stabilization exercise in the patients with subacromial impingement syndrome. J Back Musculoskelet Rehabil. 2011;24(3):173-9. doi: 10.3233/BMR-2011-0291. |
| 31013190 | Background | Shiravi S, Letafatkar A, Bertozzi L, Pillastrini P, Khaleghi Tazji M. Efficacy of Abdominal Control Feedback and Scapula Stabilization Exercises in Participants With Forward Head, Round Shoulder Postures and Neck Movement Impairment. Sports Health. 2019 May/Jun;11(3):272-279. doi: 10.1177/1941738119835223. Epub 2019 Apr 23. |
| 32724778 | Background | Ravichandran H, Janakiraman B, Gelaw AY, Fisseha B, Sundaram S, Sharma HR. Effect of scapular stabilization exercise program in patients with subacromial impingement syndrome: a systematic review. J Exerc Rehabil. 2020 Jun 30;16(3):216-226. doi: 10.12965/jer.2040256.128. eCollection 2020 Jun. |
| 24298922 | Background | Mahashabde R, Fernandez R, Sabnis S. Validity and reliability of the aneroid sphygmomanometer using a paediatric size cuff for craniocervical flexion test. Int J Evid Based Healthc. 2013 Dec;11(4):285-90. doi: 10.1111/1744-1609.12048. |
| 31773477 | Background | Mahmoud NF, Hassan KA, Abdelmajeed SF, Moustafa IM, Silva AG. The Relationship Between Forward Head Posture and Neck Pain: a Systematic Review and Meta-Analysis. Curr Rev Musculoskelet Med. 2019 Dec;12(4):562-577. doi: 10.1007/s12178-019-09594-y. |
| 29184298 | Background | Lee DY, Nam CW, Sung YB, Kim K, Lee HY. Changes in rounded shoulder posture and forward head posture according to exercise methods. J Phys Ther Sci. 2017 Oct;29(10):1824-1827. doi: 10.1589/jpts.29.1824. Epub 2017 Oct 21. |
| 30777064 | Background | Fathollahnejad K, Letafatkar A, Hadadnezhad M. The effect of manual therapy and stabilizing exercises on forward head and rounded shoulder postures: a six-week intervention with a one-month follow-up study. BMC Musculoskelet Disord. 2019 Feb 18;20(1):86. doi: 10.1186/s12891-019-2438-y. |