Pilates Mat Versus Cervical Stabilization Exercises on Myoelectric Activity of Cervical Muscles in Forward Head Posture

Study Overview
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Brief Summary
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see if there is no statistical significant difference between the effects of Pilates mat versus cervical stabilization exercises on myoelectric activity of cervical muscles in young adults with forward head posture.

Detailed Description
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Forward head posture (FHP) increases extension of the atlanto-occipital joint and the upper cervical vertebrae as well as flexion of the lower cervical and upper thoracic vertebrae. Furthermore, this posture causes persistent and abnormal contraction of the suboccipital, neck, and shoulder muscles. Additionally, the muscles around the head and shoulders, including the trapezius, sternocleidomastoid, suboccipital, and temporal, are affected by FHP, which further worsens postural deformity. FHP is the most common deviation from ideal head posture and is characterized by the head projecting forward into the sagittal plane such that it is anterior to the trunk. Head in forward posture can add up to thirty pounds of abnormal leverage on the cervical spine, which pull the entire spine out of alignment, in addition, loss of the physiological lordosis could be a possible cause of pain due to muscular imbalance.

Official Title
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Pilates Mat Versus Cervical Stabilization Exercises on Myoelectric Activity of Cervical Muscles, Craniovertebral Angle, Pain and Function in Young Adults With Forward Head Posture: Randomized Controlled Trial

Conditions
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Musculoskeletal Diseases

Intervention / Treatment
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* Other: Pilates mat exercises
* Other: cervical stabilization exercises
* Other: conventional physiotherapy


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Subjects of both genders aged 18-25 years old with forward head posture will be included in this study Subjects have forward head posture if craniovertebral angle ≤ 50. Subjects complain non- specific neck pain for at least 3 months or at least two episodes of non-specific neck pain during the last three months. Normal body mass index Exclusion Criteria: Subjects with any spinal problems Subjects with experience in Pilates exercises through the last 3 months of the start of intervention will be excluded from the study Previous surgery in the neck and shoulder regions Current participation in a structured exercises program Neurological symptoms of the upper extremities during screening tests (e.g., Spurling test and upper limb tension tests) Red flags suggesting of cancer, infection, vascular insufficiency Cervical radiculopathy or myelopathy

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 25 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Other
Allocation: Randomized
Intervention Model: Factorial Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Pilates mat exercises<br>one hour Pilates exercises with 10 min warm up and 5-10 min cooling down | Other: Pilates mat exercises<br>* Pilates mat exercises: Each Pilates session will last for one hour and commence with a 10 minute warm up and finish with a 10 min cool down. The subjects will be taught the 5 key elements of Pilates (lateral costal breathing, centring which is a neutral position of the lumbar spine with activation of the core muscles, ribcage placement, shoulder blade placement and neutral position of the cervical spine with slight upper cervical flexion at the cranio-cervical junction). Pilates exercise program will consist of warm up exercises, main treatment program (10 level) and cooling down exercises.<br>Other: conventional physiotherapy<br>* 10 min hot pack on cervical area range of motion exercises and isometric neck exercises as a home program 3 days/week for 12 weeks<br>|
| Experimental: cervical stabilization exercises<br>training of deep cervical flexor muscles with pressure biofeedback unit | Other: cervical stabilization exercises<br>* training of deep cervical flexor muscles with pressure biofeedback unit, 20 min/day, 3 days/week for 12 weeks.<br>Other: conventional physiotherapy<br>* 10 min hot pack on cervical area range of motion exercises and isometric neck exercises as a home program 3 days/week for 12 weeks<br>|
| Active Comparator: conventional physiotherapy<br>10 min hot pack on cervical area range of motion exercises and isometric neck exercises as a home program | Other: conventional physiotherapy<br>* 10 min hot pack on cervical area range of motion exercises and isometric neck exercises as a home program 3 days/week for 12 weeks<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Myoelectric activity of cervical muscles | by surface electromyography (EMG) | up to twelve weeks | 
| Craniocervical angle | by photogrammetric method. | up to twelve weeks | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Pain intensity of neck area | by visual analogue scale 10 cm line with 2 ends, 0 and 10 ends 0 end means no pain 10 end means the worst pain | up to twelve weeks | 
| function of daily life | by neck disability index | up to twelve weeks | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Forward head posture, Craniovertebral angle, Pilates mat exercises