CORE STABILIZATION EXERCISES IN FORWARD HEAD POSTURE

Study Overview
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Brief Summary
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Based on the reviewed literature, Core Stabilization Exercises (CSEs) have been shown to have positive effects on patients with low back pain. To our knowledge, very few studies have examined the impact of CSEs on neck pain, particularly in patients with forward head posture (FHP), despite that several authors suggested that FHP may be caused by lumbopelvic malalignment. Therefore, the purpose of the study is to assess how CSEs may affect the cervical sagittal balance parameters (CSB) in patient with FHP.

Detailed Description
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After the patient fills the consent form, the Craniovertebral angle will be measured by taking a photograph, then this photograph will be analysed by the KINOVEA software. If the CVA is less than 50 degrees, he/she will have a lateral x-ray on the cervical spine to measure the radiographic variables of the CSB parameters. These variables will be assessed and quantified by Image J software. The patients will be classified randomly into 2 groups, the intervention and control groups. The intervention will receive CSEs program and Postural Correction Exercises (PCEs) program, but control group will receive only PCEs program. Both programs will be implemented for 6 weeks 3 times/ week and after 6 weeks, patients will be reassessed again to determine the difference.

Official Title
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EFFECT OF CORE STABILIZATION EXERCISES ON CERVICAL SAGITTAL BALANCE PARAMETERS IN FORWARD HEAD POSTURE

Conditions
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Forward Head Posture

Intervention / Treatment
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* Other: exercise therapy


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: CVA less than 50 degrees/ neck pain for about 4 weeks Exclusion Criteria: Vertebrobasilar insufficiency/ cervical surgery/ cervical or TMJ fracture

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 30 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: Triple


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: core stability exercise<br> | Other: exercise therapy<br>* core stabilization exercises<br>|
| Active Comparator: traditional exercise<br> | Other: exercise therapy<br>* core stabilization exercises<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| cervical sagittal vertical alignment | calculated by measuring the horizontal distance between the posterosuperior corner of the C7 vertebral body and a plumb line drawn from the centroid of C2 | baseline, week 6 | 
| T1 slope angle | he angle formed by drawing a line along the superior endplate of T1 and horizontal reference line at the median sagittal cervical vertebra from the CT radiographs | baseline, week 6 | 
| craniovertebral angle | the intersection of a horizontal line passing through the C7 spinous process and a line joining the midpoint of the tragus of the ear to the skin overlying the C7 spinous process. | baseline, week 6 | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| numerical pain rating scale | patients are asked to circle the number between 0 and 10, 0 and 20 or 0 and 100 that fits best to their pain intensity [1]. Zero usually represents 'no pain at all' whereas the upper limit represents 'the worst pain ever possible | baseline, week 6 | 
| neck disability index | a standard instrument for measuring self-rated disability due to neck pain | baseline, week 6 |