Comparison Between Effect of Posterior Cervical Weighting and Deep Cervical Flexion Exercise on Forward Head Posture
Condition: Postural Kyphosis; Neck Pain; Deformity of Spine; Deformity; Muscle Weakness; Neck Syndrome; Forward Head Posture; Brace
MeSH terms: Muscle Weakness; Kyphosis; Congenital Abnormalities; Neck Pain
Study type: Interventional

Summary: 
      It has been reported that the head protrudes forward relative to the body from the sagittal
      plane associated with the anterior shifting of the line of gravity (LOG) relative to the base
      of support (BOS). On the other hand, the center of gravity (COG) has changed with the forward
      head posture (FHP) and is related to mechanical and musculoskeletal modifications due to
      postural control, which affects the whole body balance. Griegel-Morris et al. Reported that,
      after evaluating eighty-eight healthy participants, 66% had a forward head posture (FHP). In
      addition, he stated that the inverted head posture in the forward head posture will not only
      cause neck problems, but also can extend to the shoulder joint and thoracic spine. As a
      result, it causes a general imbalance in the musculoskeletal system. Jung-Ho Kang and his
      colleagues examined the effect of daily sitting times of computer users on dynamic and static
      balance and stated that balance ability decreased in heavy computer users. Another study on
      forward head posture (IBP) revealed that it limits ankle joint movement, especially in ankle
      plantarflexion.
    

Detailed description: 
      One of the most common postural deformities in the neck region is forward head posture seen
      in 66% of the population according to the American Physical Therapy Association. The use of
      computers and smartphones and long readings, which are the result of today's technological
      lifestyle, is one of the most common causes of FHP, causing the body to lean forward for
      hours. Maintaining the reverse neck posture also forces the body into many bad postures that
      damage the spine. Although forward head posture is experienced unconsciously at first, this
      unbalanced posture will accompany various degrees of advanced head posture, which turns into
      deformity, symptoms and complications.

      FHP is an anterior translation of the head characterized by the extension of the upper
      cervical vertebra C1 and 2 and the bending of the lower cervical vertebra. According to
      Kapandji, each inch (2.54 cm) of the head forward equals the extra 4.5 kg on the neck
      extensor muscle, which leads to muscle fatigue and weakness, resulting in an unbalanced head
      posture with an abnormal bow in the neck. Immunohistochemical studies conducted by Satoshi
      Inami and colleagues showed that there is damage to the synovial folds containing nociceptive
      nerve endings as a result of compression of the facet joints in the forward head posture.

      Aim of the work The aim of this study is to present a neck orthosis to correct neck posture
      and to see how posture correction will reflect on balance and plantar pressure distribution
      in individuals with forward head posture. This study can help answer questions about changes
      in gait level and mechanics between the spine and peripheral levels.
    

Intervention name(s): Neck orthosis - with posterior cervical weight; Deep cervical flexors exercise
Intervention type(s): Device; Other
Intervention description(s): The posterior cervical weight orthosis is made of a well-padded adjustable Velcro attached to the end with a two-kilogram weight attached with two durable straps. The device is firmly anchored around the curvature of the jaw and attached with Velcro to the apex of the skull.; The participant will lay down in crook lying position, participant's head relaxed on the flat surface. Each participant will passively tuck in his/her chin without activation of superficial cervical muscles. Participants of this group will do 15 repetitions x 3 sets of deep neck flexor exercises every day of the week.
Other intervention name(s): Posterior cervical neck weight - Azzkol Orthosis; Deep cervical flexors activation
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: 61 healthy individuals aged 18-65 are planned to participate in our study. Each case will fill out a questionnaire and will be subjected to a detailed examination by checking whether there have any factors that would cause the participant to be excluded from the study. Participants meeting the criteria will be divided into two groups according to their degrees of craniovertebral angle (CVA) after their participation in the study is approved. Neck Injury Index: The scale consists of 20 questions, the intensity of the pain; researches in terms of recreational, professional, social and daily life functions and emotional factors. Each question consists of a 10 cm long visual analog scale. CVA above 52 degrees will be considered as normal head posture, while less than 48 degrees will be considered as forward head posture.
Masking: Single (Outcomes Assessor)
Primary purpose: Treatment