Upper cervical and upper thoracic spine mobilization versus deep cervical flexors exercise in individuals with forward head posture: A randomized clinical trial investigating their effectiveness

J Back Musculoskelet Rehabil. 2019;32(4):595-602. doi: 10.3233/BMR-181228.

Abstract

Background: Although commonly utilized treatments, no study has directly compared the effectiveness of joint mobilization and stabilization exercise in individuals with forward head posture (FHP).

Objective: This study aimed to investigate the effects of upper cervical and upper thoracic spine mobilization versus deep cervical flexors exercise (DCFE) in individuals with FHP.

Methods: Thirty-one participants with FHP were randomized into the mobilization (n= 15) or exercise (n= 16) group. The treatment period was 4 weeks with follow-up assessment at 4 weeks and 6 weeks after the initial examination. Outcomes assessed included the craniovertebral angle (CVA), numeric pain rating scale (NPRS), respiratory function, and the global rating of change (GRC).

Results: Participants in the mobilization group demonstrated significant improvements (p< 0.05) in CVA, NPRS, and respiratory function, as compared to those in the exercise group. In addition, 9 of 15 (60%) participants in the mobilization group, as compared to 4 of 16 participants (25%) in the exercise group, had a GRC score of +4 or higher.

Conclusions: The combination of upper cervical and upper thoracic spine mobilization indicated better overall short-term outcomes in CVA, NPRS, respiratory function, and GRC compared with DCFE in individuals with FHP.

Keywords: Forward head posture; exercise; mobilization; neck pain; respiration.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Cervical Vertebrae / physiopathology
  • Exercise
  • Exercise Therapy / statistics & numerical data*
  • Female
  • Head
  • Humans
  • Male
  • Musculoskeletal Manipulations / statistics & numerical data*
  • Neck
  • Neck Muscles / physiopathology
  • Neck Pain / etiology
  • Neck Pain / physiopathology
  • Neck Pain / therapy*
  • Physical Therapy Modalities
  • Posture*
  • Respiratory Mechanics / physiology
  • Smartphone*
  • Thoracic Vertebrae / physiopathology
  • Young Adult