This study investigates the effects of specific corrective exercises on EMG of masticatory and cervical muscles in patients with forward head posture. The study's design will be a prospective, double- blinded, randomized controlled trial. The participants will be randomly allocated to one of two groups: the exercise group and the control group. The training groups will perform a program consisting of two strengthening (deep cervical flexors and shoulder retractors) and two stretchings (cervical extensors and pectoral muscles) exercises. This exercise program will be repeated 4 times per week for 10 weeks, and each session lasted 30 minutes.

The pre/post assessment of forward head posture will measure by using craniovertebral angle CVA. While the muscle activity EMG of the masseter, temporalis, splenius, upper trapezius, and SCM will measure pre and post-assessment using a biopic data acquisition system. There will be a high significance increase (p-value 0.000) between the pre-and-post CVA between the training groups and the control. And there will be a significant decrease in EMG of the masseter, temporalis, splenius, upper trapezius, and SCM across exercise groups compared to the control. As per the results and analysis, specific postural corrective exercises effectively decrease the EMG of masticatory and cervical muscles in patients with forward head postures.

Forward head posture (FHD) is a common habitual faulty posture exists in the surrounding that can alter the resting position of the mandible and may affect the masticatory muscle activity.

The aim of this study is to investigate the effect of postural correction on masticatory and cervical muscle activity and mandibular opening in forward-head posture patients.

Materials and Methods:

• Cranio-vertebral angle measurement CVA
• EMG activity of masseter, temporalis, splenius, upper trapezius and SCM

BAU - Institutional Review Board (Form H-II) | BEIRUT ARAB UNIVERSITY

-Electrodes will be placed on the muscle belly parallel to the direction of muscle fibers. The distance between the two electrodes was 2 cm. The subjects will be instructed to complete maximum voluntary contraction (MVC) of clenching the teeth for 3 s and repeating twice. The average of the two trials of MVC will be used for further analysis. The subjects will be seated comfortably in a chair (---cm height).

Inclusion Criteria:

• Men and women
• Age between 18-40
• Patient with forward head posture, CVA less than 48-50.
• Patient suffer from temporomandibular joint disorder
• No other treatment, such as medication, physical therapy, and joint injection, in the past 2 weeks

Exclusion Criteria:

• Previous history of TMG subluxation or dislocation that may interfere with the opening of the mouth
• Neck pain which may affect the head and neck posture;
• Head or neck trauma
• Class II or III malocclusion
• Posture disorder caused by abnormal curvature of spine; rheumatic disease; haemorrhagic disease, etc.; and
• Lateral deviation of mandible

Any study records that identify patient will be kept confidential. The records from the participation may be reviewed by people responsible for making sure that research is done properly, including members of the BAU Institutional Review Board. All of these people are required to keep their identities confidential. Otherwise, records that identify patients will be available only to people working on the study.

• The investigators will use a code of numbers and alphabets rather than participants' names on data sheets, keeping records in a safe place.