Global Postural Reeducation Exercises Versus Deep Neck Flexor Activation on Non Specific Neck Pain With Forward Head Posture

Global Postural Reeducation Exercises Versus Deep Neck Flexor Activation on Non Specific Neck Pain With Forward Head Posture

this study will be conducted to compare between global postural reeducation (GPR) and deep neck flexors (DNF) activation in patients with chronic nonspecific neck pain (NSNP) on pain, disability, forward head posture and deep neck flexors endurance

Neck pain (NP) is highly prevalent and is the sixth largest cause of disability in the world, causing considerable economic impact. Between 50% and 75% of people will not recover from an acute episode and will experience recurrent neck pain within the next 1 to 5 years, approximately 68% of people will develop persistent and chronic neck pain.Forward head posture (FHP) is a common posture malalignment which characterized by increased craniocervical angle more than 50 degrees. There is a significant association between neck pain and forward head posture. According to previous studies, it has been proven that an average of 60% of patients with neck pain have a forward head posture.Cranio-cervical flexor muscles training focuses on the deep flexor muscles such as longus capitis and longus colli muscles, which flex the neck, not the head. Also, these low-load exercises train the deep cervical flexors more specifically, rather than all the neck flexors involved in the head-lifting exercise.Global postural reeducation (GPR) is a method of physiotherapy, developed by Phillipe Souchard in the 1950s.Its therapeutic approach depends on causality, and globality and is based on the hypothesis that the muscular system is organized into muscle chains, which can be shortened because of musculoskeletal disorders and constitutional, behavioral and psychological factors. forty four patients will be assigned randomly into two equal groups; fist one will receive global postural reeducation plus active neck exercise and the other will receive deep neck flexor exercises plus active neck exercise

Inclusion Criteria:

• Adult physiotherapists with mechanical neck pain and base line score of at least 3 out of 10 pain intensity on VAS .
• Adult physiotherapists with FHP and CVA less than 50 as a reference angle
• Adult physiotherapists aged from 18 to 24.

Exclusion Criteria:

• Specific cause of neck pain as (rheumatic ,sytemic ,neuromuscular diseases ).
• Cognitive impairment .
• Cervical radiculopathy .
• Cervical spondylolisthesis