Clinical trial NCT05895708: Effect of Specific Postural Corrective Exercises on EMG Activity in Patients With Forward Head Posture
Official title: Effect of Specific Postural Corrective Exercises on EMG Activity of Masticatory and Cervical Muscles in Patients With Forward Head Posture
Study type: INTERVENTIONAL
Overall status: UNKNOWN
Phase: NA
Conditions: Forward Head Posture
Lead sponsor: Beirut Arab University
Sponsor class: OTHER
First posted: 2023-06-09
Enrollment: 50
Sex: ALL
Minimum age (years): 18
Maximum age (years): 40
Standard ages: ADULT
Accepts healthy volunteers: yes
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: TREATMENT

Brief summary: 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: 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).

Eligibility criteria: 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

Primary outcomes:
measure: EMG activity
timeFrame: 12 weeks
Secondary outcomes:
Other outcomes:
measure: craniovertebral angle
timeFrame: 12 weeks
Locations:
city: Beirut
country: Lebanon
facility: Physical therapy outpatient clinic
Study officials:
affiliation: Beirut Arab University
name: ahmed el melhat, professor
role: STUDY_DIRECTOR
References:
citation: Shaghayegh Fard B, Ahmadi A, Maroufi N, Sarrafzadeh J. Evaluation of forward head posture in sitting and standing positions. Eur Spine J. 2016 Nov;25(11):3577-3582. doi: 10.1007/s00586-015-4254-x. Epub 2015 Oct 17.
citation: Zabihhosseinian M, Holmes MW, Ferguson B, Murphy B. Neck muscle fatigue alters the cervical flexion relaxation ratio in sub-clinical neck pain patients. Clin Biomech (Bristol). 2015 Jun;30(5):397-404. doi: 10.1016/j.clinbiomech.2015.03.020. Epub 2015 Mar 27.
citation: Lee KJ, Han HY, Cheon SH, Park SH, Yong MS. The effect of forward head posture on muscle activity during neck protraction and retraction. J Phys Ther Sci. 2015 Mar;27(3):977-9. doi: 10.1589/jpts.27.977. Epub 2015 Mar 31.
citation: Quek J, Pua YH, Clark RA, Bryant AL. Effects of thoracic kyphosis and forward head posture on cervical range of motion in older adults. Man Ther. 2013 Feb;18(1):65-71. doi: 10.1016/j.math.2012.07.005. Epub 2012 Sep 5.
citation: Lee SM, Lee CH, O'Sullivan D, Jung JH, Park JJ. Clinical effectiveness of a Pilates treatment for forward head posture. J Phys Ther Sci. 2016 Jul;28(7):2009-13. doi: 10.1589/jpts.28.2009. Epub 2016 Jul 29.
citation: Kim SD. Effects of yoga exercises for headaches: a systematic review of randomized controlled trials. J Phys Ther Sci. 2015 Jul;27(7):2377-80. doi: 10.1589/jpts.27.2377. Epub 2015 Jul 22.