Motion Analysis in Young Adults with Neck Pain: Impact of Cranio-Cervical Flexion Training

The goal of this observational study is to evaluate the immediate effects of cranio-cervical flexion exercises and correct posture training on upper extremity and trunk kinematics during functional activities in young adults with neck pain.

The main questions it aims to answer are:

* Does the immediate cranio-cervical flexion and posture training improve postural control and induce immediate changes in individuals with neck pain?
* Does this training intervention enhance functional movement and daily activity performance from a kinematic analysis perspective?

Participants will:

Undergo a baseline assessment, where sociodemographic and physical data will be recorded using the Numeric Pain Rating Scale (NPRS) and the Neck Disability Index (NDI).

Receive cranio-cervical flexion and correct posture training as an intervention, after which the evaluation will proceed immediately.

Perform functional activities (typing, talking on the phone, eating, lifting a load), with each activity being repeated three times, and these will be evaluated using 3D kinematic analysis with the Movella XSens (MVN Awinda) system.

The motivation for this study stems from the observation that previous research has primarily focused on the long-term effects of craniocervical flexion exercises, while the immediate effects of such exercises have not been explored. Craniocervical flexion exercises and correct posture training have been shown to be effective in reducing neck pain and improving functionality. Therefore, this study aims to examine the immediate impact of craniocervical flexion exercises and correct posture training on upper extremity and trunk kinematics during functional activities.This study aimed to examine the immediate effects of cranio-cervical flexion exercises and correct posture training on upper extremity and trunk kinematics during functional activities in individuals with neck pain. The study was a cross-sectional design conducted at XXX University, Faculty of Physical Therapy and Rehabilitation, and was approved by the university's ethics committee (FTREK 24/117).

A total of 28 young adults (aged 18-35) with chronic neck pain participated in the study. Participants were selected based on specific inclusion criteria, including a minimum Neck Disability Index (NDI) score of 20%. Individuals with congenital or acquired spinal deformities, herniated discs, neurological or vestibular disorders, and pregnant individuals were excluded. Participants were randomly divided into two groups: one group received immediate cranio-cervical flexion and correct posture training, while the other group followed their routine daily activities. At the end of the study, the second group also received the same training program.

The study consisted of three phases: baseline assessment, immediate training intervention, and post-training assessment. During the baseline phase, sociodemographic, physical, and pain-related data were collected. In the immediate training intervention phase, participants in the intervention group were instructed in cranio-cervical flexion exercises and correct posture training. In the post-training phase, functional tasks such as typing, phone conversation, heavy load lifting, and eating were performed. Kinematic changes during these tasks were assessed using a 3D inertial measurement system (Movella XSens), which is well-regarded for its reliability in biomechanical research.

Sample size calculation using G\*Power software indicated that a total of 28 participants (14 per group) was sufficient to achieve 80% statistical power with an alpha level of 0.05. Data were analyzed using SPSS Version 26.0 to assess the immediate effects of the cranio-cervical flexion and posture training on kinematic parameters during the functional tasks.

Eligibility Criteria:
Inclusion Criteria:

* Willingness to voluntarily participate in the study,
* Being between 18 and 35 years old,
* Having an initial Neck Disability Index (NDI) score of at least 20%,
* Experiencing neck pain for at least 6 months.

Exclusion Criteria:

* Unwillingness to participate in the study voluntarily,• Unwillingness to participate in the study voluntarily,
* Having neurological, orthopedic, musculoskeletal and/or vestibular disorders,
* A history of cervical spine surgery,
* Receiving exercise or physical therapy interventions within the last 6 months,
* Having congenital and/or acquired spinal deformities,
* Being pregnant.