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This assessor-blinded randomized controlled trial aims to compare the effects of motor control training, sensor-based biofeedback training using a wearable inertial measurement unit (IMU), and standardized postural correction exercises on mild visual dysfunction in university students with forward head posture (FHP). The trial seeks to establish whether targeted postural rehabilitation can produce measurable improvements in validated visual and sensorimotor outcomes.
Forward head posture is highly prevalent among young adults due to prolonged screen exposure and sustained cervical flexion. Emerging neurophysiological evidence suggests that cervical alignment influences visual stability through altered proprioceptive input, cervico-ocular reflex mechanisms, and sensorimotor integration. However, no randomized controlled trials have investigated whether correcting FHP leads to measurable improvements in validated visual parameters.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| motor control training group | Experimental | the motor control training is done in the stationary and in motion conditions with and without inertia and with and without object manipulations for the forward head posture participants. |
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| Sensor biofeedback training group | Experimental | Real time biofeedback training is being done through the sensor being applied to cervical spine during normal day activities. |
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| conventional postural training | Experimental | this program consists on strengthening of deep cervical flexors and scapular retractors and stretching of cervical extensors and pectoralis major muscles |
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| control group | No Intervention | postural education about proper ergonomics is being shared to the participants |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| motor control training | Other | the intervention will be a progressive training starting from the stationary, no inertia and no object manipulation to in motion with inertia and with object manipulation taking help of sitting standing and stepping stairs like activities keep the head in normal position with the help of a laser gun. the intervention duration is 45 minutes/day, with three sessions per week for 4 weeks. |
| Measure | Description | Time Frame |
|---|---|---|
| visual impairment | The mild visual impairment will be measured by LogMar chart. the smallest line that person can read will be recorded as reading of visual impairment. the score is generally in form of fractions. | baseline to 8th week |
| oculomotor function | this will be measured by the near point convergence test. the point at which blurring stated by participant will be measured in cms. | baseline to 8th week |
| visual reaction time | this will be measured on visual reaction time app on phone. the person has to click the screen when the stimulus arrives on screen. The average of 3 readings will be recorded as the visual reaction time | baseline to 8th week |
| visual fatigue | The visual fatigue will be measured by 17 item asthenopia questionnaire (ASQ-17). the score will be marked on 5 point likert scale with greater score shows more severity | baseline to 8th week |
| craniovertebral angle | this will be measured by mobile app specified for said purpose. sideways picture will be taken and CVA will be noted from the app. | baseline to 8th week |
| Measure | Description | Time Frame |
|---|---|---|
| flexor muscle endurance | this will be measure by flexor endurance test as the end of couch in supine lying with head lift in chin tuck in position. the time of hold in seconds will be noted. | baseline to 8th week |
| extensor muscle endurance |
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Inclusion Criteria:
Exclusion Criteria:
• Head and neck trauma or surgical history, Neurological disorders
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Qamar Mehmood, PHD | Contact | 03335151063 | qamar.mehmood@riphah.edu.pk |
| Name | Affiliation | Role |
|---|---|---|
| Qamar Mehmood, PHD | Riphah internatioal university | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Post-graduate research Lab, Riphah international university, gulberg greens campus, islamabad | Islamabad | Capital | 46000 | Pakistan |
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| ID | Term |
|---|---|
| D014786 | Vision Disorders |
| ID | Term |
|---|---|
| D012678 | Sensation Disorders |
| D009461 | Neurologic Manifestations |
| D009422 | Nervous System Diseases |
| D005128 | Eye Diseases |
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| Sensor development training group | Device | the sensor will be being placed at C7 measuring current craniovertebral angle with the threshold being set at 50 degrees. the real time feedback will be shown on the mobile app. and the data will be recorded for whole intervention time. the intervention duration is 45 minutes/day, with three sessions per week for 4 weeks. |
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| conventional posture training | Other | the strengthening of deep neck flexors and retractors and stretching of pectoralis major and cervical extensors will be done using intervention duration is 45 minutes/day, with three sessions per week for 4 weeks. |
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the test will be done in prone lying holding the head in static position at the end of couch. the time of hold will be measured in seconds.
| baseline to 8th weeks |
| pelvic tilt | the pelvic tilt will be measured by the pelvic inclinometer in degrees by place its both ends at anterior superior iliac spine. | baseline to 8th week |
| static balance | the static balance will be measured by Balance Error Scoring System test. the readings in double foot stance, single leg stance and tandem stance will be done on firm and foam surface and the composite score will be used. the no. of wrrors in adopting position will be marked as points. total score is 60. lower score indicate good balance. | baseline to 8th week |
| dynamic balance | The dynamic balance will be measured by the Y-balance test in anterior, postero-medial and postero-latertal positions. the composite score according to formula will be taken as final score. the higher score indicates good balance. | baseline to 8th week |
| D012816 |
| Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |