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This study will be conducted to Compare between virtual reality exercises versus motor control training on cervical proprioception in symptomatic forward head posture
Various occupations require people to maintain a static position for long periods that causes continuous contractions of the head and neck muscle.The poor posture leads to pain and deformity such as forward head posture.Virtual reality exercises(VRE) have been more commonly considered for the improvement of pain , functional ability, and muscular strength.Motor control training (MCT) re-establish the activation pattern of neck muscles and have proven to be effective in improving motor function of deep cervical muscles, reducing discomfort and impairment in patient with FHP and neck pain. 93 subjects from both sexes will participate in the study with CVA less than 50º.Group A:31 subjects will receive virtual reality exercises by VR Training using Xbox Kinect
.Group B: 31 subjects will receive motor control training Group C: 31 subjects will receive conventional treatment in form of (Posture correction (chin tuck exercise)and Stretching exercises .
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Virtual reality exercises | Experimental | Thirty one subjects will receive virtual reality exercises by VR Training using Xbox Kinect for four weeks . |
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| Motor control training | Experimental | Motor control training for four weeks |
|
| conventional treatment | Active Comparator | conventional treatment for four weeks in form of posture correction and stretching exercises |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Virtual reality exercises | Other | Thirty one subjects will receive virtual reality exercises by VR Training using Xbox Kinect. The Kinect sensor is an infrared camera that can recognize the positions and motions of the player without the need for special controller. The console controls the various games .For the VR training, the Xbox Kinect, console, and monitor will set up in a dedicated space. The patient will placed 1.5-2 m away from the Kinect sensor. Before the start of the training session, the research assistant adjusted the position of the sensor while the patient is sitting to ensure optimal position and motion capture, and loaded games into the system. After the setup is completed, the research assistant demonstrated games included in the Kinect adventure |
| Measure | Description | Time Frame |
|---|---|---|
| cervical propioception | Cervical proprioception will be assessed using CROM . | up to four weeks |
| Craniovertebral angle (CVA) | Photogrammetric method will be used to assess CVA | up to four weeks |
| Measure | Description | Time Frame |
|---|---|---|
| pain intensity | Visual Analogue Scale (VAS) to assess pain intensity | up to four weeks |
| Neck function | Arabic version of neck disability index will be used to assess neck function |
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Inclusion Criteria:
Exclusion Criteria:
1-Individuals with a recent history of neck or back surgery. 2- Individuals with recent history of trauma or fracture. 3- Individuals with congenital disorders 4- Individuals with any psychiatric diseases
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Shaimaa N Shaimaa N Abdelmageed, master | Contact | 01221792786 | shaimaafayedg33@gmail.com |
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| ID | Term |
|---|---|
| D010146 | Pain |
| ID | Term |
|---|---|
| D009461 | Neurologic Manifestations |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |
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| ID | Term |
|---|---|
| D000088544 | Exergaming |
| ID | Term |
|---|---|
| D015444 | Exercise |
| D009043 | Motor Activity |
| D009068 | Movement |
| D009142 | Musculoskeletal Physiological Phenomena |
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Virtual reality systems have been used in assessments and treatments in the field of rehabilitation .
Motor control training motor control training of deep neck flexors with pressure biofeedback is an effective intervention for improving pain intensity and disability in patients with neck pain and preferable to strength-endurance training of cervical muscles . Scapular stabilization exercise can help improve the head posture and pain in the patients with neck pain and forward head posture.
conventional treatment in form of Posture correction (chin tuck exercise) and Stretching exercises
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| Motor control training | Other | Thirty one subjects will receive motor control training two times a week for eight weeks in form of deep cervical flexors strengthening using pressure biofeedback unit (craniocervical flexor exercise) :Pressure biofeedback unit will be used to perform Cranio-cervical flexor muscle training. Through which an endurance and isometric exercise for DNFs in progressive range positions will be performed each session, the PBU's air bag will be positioned below the occiput, and the inflatable cuff pressure sensor will be inflated to a baseline of 20 mmHg. Participants will instruct to target five pressure levels between 22 and 30 mmHg by nodding. scapular exercises .With patient in prone position, pillow under the chest and upper limb in varying degree of shoulder abduction, the participant lifts the hand toward the ceiling while retracting the scapula |
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| conventional treatment | Other | Thirty one subjects will receive conventional treatment for 3 times per week for 4 weeks. Conventional treatment will include the following: 1-Posture correction (chin tuck exercise) Stand with the upper back against the wall, with the feet shoulder-width apart. Tuck the chin in and hold for 5 seconds 10 repetitions .Return to the starting position and repeat a number of times. This can help stretch the muscles in the upper neck 2. Stretching exercise: Self-stretching exercise for most common tight muscles. These muscles include upper trapezius (by contralateral side bending), levator scapulae (flexion, contralateral side bending and rotation) and sternocleidomastoid muscle (slight flexion with ipsilateral side bending and rotation). Each position should be maintained for 30 seconds and repeated for 3 times. |
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| up to four weeks |
| Deep neck flexors endurance | Pressure Biofeedback Unit (PBU, Chattanooga, TN, USA) will be used to assess endurance | up to four weeks |
| D055687 |
| Musculoskeletal and Neural Physiological Phenomena |