Pilates Mat Versus Cervical Stabilization Exercises on Balance in Young Adults With Forward Head Posture

Study Overview
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Brief Summary
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see if there will be no statistical significant difference between the effects of Pilates mat versus cervical stabilization exercises on dynamic balance in young adults with forward head posture.

Detailed Description
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In modernized time, extended use of mobile phone and computers has increased anterior weight bearing of cervical spine leading to a variety of musculoskeletal disorders related to the neck by changing the biomechanical stress of cervical spine. Additionally, forward head posture (FHP) alters the center of gravity (COG) of the body that lead to mechanical modifications related to postural control in the torso and every joint. The body attempts to adapt to these changes by altering its balance control mechanisms; these adaptations decrease balance ability while performing different activities and increase the risk of falling and musculoskeletal injury.

Official Title
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Pilates Mat Versus Cervical Stabilization Exercises on Craniovertebral Angle, Pain, Function of Daily Life, Cervical Range of Motion, Dynamic Balance 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 the 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 (18- 24.9). Exclusion Criteria: Subjects with any spinal problems. Temporo-mandibular disease. Subjects with experience in Pilates and who will not sedentary were 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 |
| --- | --- | --- |
| Dynamic balance | will be measured by Biodex balance system | up to twelve weeks | 
| Craniovertebral angle | will be measured by photogrammetric method | up to twelve weeks | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| pain intensity | by visual analogue scale (VAS) 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 | 
| cervical range of motion | by cervical range of motion device (CROM) | up to twelve weeks | 
| Function of daily life | by Arabic version of 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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Balance, Craniovertebral angle