Effect of Specific Postural Corrective Exercises on EMG Activity in Patients With Forward Head Posture

Study Overview
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Brief Summary
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This study investigates the effects of specific corrective exercises on EMG of masticatory and cervical muscles in patients with forward head posture. The study's design will be a prospective, double- blinded, randomized controlled trial. The participants will be randomly allocated to one of two groups: the exercise group and the control group. The training groups will perform a program consisting of two strengthening (deep cervical flexors and shoulder retractors) and two stretchings (cervical extensors and pectoral muscles) exercises. This exercise program will be repeated 4 times per week for 10 weeks, and each session lasted 30 minutes. The pre/post assessment of forward head posture will measure by using craniovertebral angle CVA. While the muscle activity EMG of the masseter, temporalis, splenius, upper trapezius, and SCM will measure pre and post-assessment using a biopic data acquisition system. There will be a high significance increase (p-value 0.000) between the pre-and-post CVA between the training groups and the control. And there will be a significant decrease in EMG of the masseter, temporalis, splenius, upper trapezius, and SCM across exercise groups compared to the control. As per the results and analysis, specific postural corrective exercises effectively decrease the EMG of masticatory and cervical muscles in patients with forward head postures.

Detailed Description
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Forward head posture (FHD) is a common habitual faulty posture exists in the surrounding that can alter the resting position of the mandible and may affect the masticatory muscle activity. The aim of this study is to investigate the effect of postural correction on masticatory and cervical muscle activity and mandibular opening in forward-head posture patients. Materials and Methods: Cranio-vertebral angle measurement CVA EMG activity of masseter, temporalis, splenius, upper trapezius and SCM BAU - Institutional Review Board (Form H-II) | BEIRUT ARAB UNIVERSITY -Electrodes will be placed on the muscle belly parallel to the direction of muscle fibers. The distance between the two electrodes was 2 cm. The subjects will be instructed to complete maximum voluntary contraction (MVC) of clenching the teeth for 3 s and repeating twice. The average of the two trials of MVC will be used for further analysis. The subjects will be seated comfortably in a chair (---cm height).

Official Title
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Effect of Specific Postural Corrective Exercises on EMG Activity of Masticatory and Cervical Muscles in Patients With Forward Head Posture

Conditions
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Forward Head Posture

Intervention / Treatment
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* Other: Specific strengthening and stretching exercise
* Other: General Exercise


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Men and women Age between 18-40 Patient with forward head posture, CVA less than 48-50. Patient suffer from temporomandibular joint disorder No other treatment, such as medication, physical therapy, and joint injection, in the past 2 weeks Exclusion Criteria: Previous history of TMG subluxation or dislocation that may interfere with the opening of the mouth Neck pain which may affect the head and neck posture; Head or neck trauma Class II or III malocclusion Posture disorder caused by abnormal curvature of spine; rheumatic disease; haemorrhagic disease, etc.; and Lateral deviation of mandible

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 40 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

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: Specified strengthening and stretching<br>The program consisted of two strengthening (deep cervical flexors and shoulder retractors) and two stretching (cervical extensors and pectoral muscles) exercises based on Harman and Mostafa et al's approach. This exercise program will be repeated 4 times per week for 10 weeks, and each session lasted for 30 minutes. | Other: Specific strengthening and stretching exercise<br>* The program consisted of two strengthening (deep cervical flexors and shoulder retractors) and two stretching (cervical extensors and pectoral muscles) exercises based on Harman and Mostafa et al's approach. This exercise program will be repeated 4 times per week for 10 weeks, and each session lasted for 30 minutes.<br>* Other names: Forward head correction;|
| Sham Comparator: General Exercise group<br>The program will consist of regular general postural exercises such as postural awareness exercises as well as general strengthening exercises such as range of motion exercises for the upper quadrant. The program will also be repeated 4 times per week for 10 weeks, with each session lasting 30 minutes | Other: General Exercise<br>* The program will consist of regular general postural exercises such as postural awareness exercises as well as general strengthening exercises such as range of motion exercises for the upper quadrant. The program will also be repeated 4 times per week for 10 weeks, with each session lasting 30 minutes<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| EMG activity | Electrodes will be placed on the muscle belly parallel to the direction of muscle fibers. The distance between the two electrodes was 2 cm. The subjects will be instructed to complete maximum voluntary contraction (MVC) of clenching the teeth for a period of 3 s and repeated twice. The average of the two trials of MVC will be used for further analysis. The subjects will be seated comfortably in a chair (---cm height). | 12 weeks |