Effects of Deep Cervical Flexors Training On Forward Head Posture, Neck Pain and Functional Status

Study Overview
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Brief Summary
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Using computer for long hours is related to higher risk of computer related muscular disorders like forward head posture and neck pain. Deep cervical flexor muscles are important head-on-neck posture stabilizers thus their training may lead to improvement in forward head posture (FHP) and neck pain (NP).

Detailed Description
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In contemporary societies, computer use by children is a necessity and thus highly prevalent. Using computer for long hours is related to higher risk of computer-related muscular disorders like forward head posture and neck pain. Deep cervical flexor muscles are important head-on-neck posture stabilizers thus their training may lead to improvement in forward head posture (FHP) and neck pain (NP). Aim of study was to determine if 4 weeks of deep cervical flexors training is effective in alleviating neck pain and improving forward head posture in adolescent children using computer regularly. A pretest-posttest experimental group design was used. Subjects were randomly assigned into control group (receiving postural advice only) and experimental group (receiving deep cervical flexor training and postural advice). Dependent variables were measured on day 0 (at baseline) and after 4weeks of training. The photographic analysis was used for measuring forward head posture, visual analog scale (VAS) for neck pain intensity and Neck Disability Index (NDI) for functional disability. Experimental group received craniocervical flexion training for 4 weeks and postural advice. Control group received only postural advice.

Official Title
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Effects of Deep Cervical Flexors Training On Forward Head Posture, Neck Pain and Functional Status in Adolescent Children Using Computer Regularly

Conditions
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Forward Head Posture, Neck Pain

Intervention / Treatment
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* Other: Craniocervical flexion training


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Neck pain with or without headache, of duration more than 3 months and less than 1 year and 6 months, as identified by body discomfort chart and Neck disability index value less than 24 (mild to moderate disability scores on NDI) Forward head posture as identified by straight line down from external meatus falling anterior to shoulder and mid thorax. Using computer for at least 3 hours a day for at least 4 days a week or more. Exclusion Criteria: Ongoing or previous history of spinal fracture Ongoing or previous history of neurological signs Ongoing or previous history of inflammatory disease Ongoing or previous history of spinal tumor Ongoing or previous history of spinal infection Ongoing or previous history of spinal cord compression Ongoing or previous history of congenital, or acquired postural deformity Ongoing or previous history of cervical spinal surgery Ongoing or previous history of spinal instability

Ages Eligible for Study
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Minimum Age: 13 Years
Maximum Age: 18 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: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Experimental<br>Experimental group received craniocervical flexion training for 4 weeks and postural advice | Other: Craniocervical flexion training<br>* PBU airbag was clipped together and folded in, fastened, and placed suboccipital. Uninflated pressure sensor was kept below the neck, so that it touched the occiput then inflated to a stable baseline pressure of 20 mmHg to just fill the space below the neck but not to push it into lordosis. Subjects were demonstrated the correct action of the deep cervical flexors that is gentle nodding of head as if saying yes.<br>|
| No Intervention: Control Group<br>Control group received only postural advice | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in craniovertebral angle | Change in the craniovertebral angle is assessed from baseline at 4 weeks interval. | 4 weeks | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in Neck Disability Index | Change in Functional status is assessed from baseline at 4 weeks interval. | 4 weeks | 
| Change in Visual Analog Scale | Change in Neck pain intensity assessed from baseline at 4 weeks interval. It is a scale on a piece of paper equal to the length of 10 cm. Each centimeter has 1 point, with 0 means no pain and 10 means worst pain felt ever. Lower the score, better the outcome measure. | 4 weeks | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Neck pain, Forward head posture, Deep cervical flexors