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In the past few years, the number of smart phone users has progressively increased worldwide. With the growing use of smart phones, concerns have also increased about musculoskeletal problems associated with the prolonged use of smart phones.
Concerns have also increased about musculoskeletal problems associated with the prolonged use of smartphones. Recent investigations have shown that smartphone users tend to report pain in the neck, shoulder, and thumb, and the severity of the symptoms as the total time spent using the smartphone increases.
One of the most overspread postural abnormalities is forward head posture (FHP) and it is described as head projection anteriorly in relation to the trunk which appears mainly in sagittal plane. When using a smartphone, people usually flex their neck downwards to stare at the lowered object and maintain the head in a forward position for long periods of time, the maintenance of a head-forward posture decreases cervical lordosis of the lower cervical vertebrae and creates a posterior curve in the upper thoracic vertebrae to maintain balance; this is known as the forward head posture (FHP) that causes shortening of the extensors of the neck and producing chronic neck pain.
The weight supported by the spine dramatically increases when flexing the head forward at varying degrees. An adult head weighs 10-12 pounds in the neutral position. As the head tilts forward, the forces felt by the neck surge to 27 pounds at 15 degrees, 40 pounds at 30 degrees, 49 pounds at 45 degrees, and 60 pounds at 60 degrees. At 90 degrees, the model prediction was not reliable.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Experimental group | Experimental | Manual diaphragm release technique and traditional neck exercises |
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| Control group | Active Comparator | Traditional neck exercises |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Stretching and strengthening exercises | Other | Strengthening exercises were progressively performed for three sets, with 10 to 15 repetitions. The stretching part of the exercises was done with the purpose of increasing the flexibility of the pectoralis and the cervical neck extensors muscles (pectoralis stretch, chin tuck). Exercises have been approved to be effective on the lengthening of the pectoralis minor, activation of the lower trapezius/middle trapezius, serratus anterior, and improvement of the posture |
| Measure | Description | Time Frame |
|---|---|---|
| craniovertebral angle (CVA) Forward head posture | The angle formed by a horizontal line crossing c7 and a line crossing c7 to the tragus of the ear is known as the CVA | 12 weeks |
| Vertical head alignment (VHA) | Angle between right tragus, right acromion and vertical. | 12 weeks |
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Inclusion Criteria:
Male students their age ranged from 17 to 18 years.
Has Body Mass Index (BMI) = 5th percentile to less than the 85th percentile.
_ has forward head posture
Studying at any faculty at Pharos University in Alexandria.
Cooperative and followed the instructions.
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Lamiaa said Tolba, LecturerP | Pharos University in Alexandria | Study Chair |
| Amal Youssef Wahba, Lecturer | Pharos University in Alexandria | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Pharos University in Alexandria | Alexandria | Egypt | Egypt |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 25931773 | Background | Lee KJ, Han HY, Cheon SH, Park SH, Yong MS. The effect of forward head posture on muscle activity during neck protraction and retraction. J Phys Ther Sci. 2015 Mar;27(3):977-9. doi: 10.1589/jpts.27.977. Epub 2015 Mar 31. | |
| Background | https://www.researchgate.net/publication/379140193_Forward_Head_Posture_and_Its_Effect_on_Muscle_Activation |
| Label | URL |
|---|---|
| Forward head posture (FHP), which is defined as a forward displacement of the head on the cervical spine, is a common postural disorder. It is suggested that this malalignment alters the loads on the spine, affects the length-tension relationship in musc | View source |
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Age, Degree of CVA, smart phone usage (hours/day)
11/2025 - 5/2026
Access through contacting E-mail: amal.youssef@pua.edu.eg
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| Diaphragm release technique | Other | the patient will positioned in the supine position. The therapist stand at the head of the patient. The therapist make manual contact bilaterally under the costal cartilages of the lower ribs (7th to 10th ) with hypothenar regions of the hands and last three fingers. During the patient's inspiration, the therapist is gently pulling the points of hands contacts toward the head and slightly laterally, while elevating the ribs simultaneously |
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