Forward Head PostureNCT06131164
Breathing Exercises Effects on Forward Head Posture
A study testing Diaphragmatic Breathing Exercise Group and Thoracic Extension Exercise Group in people with Forward Head Posture, run by Riphah International University at 1 site in Pakistan.
Trial summary
The main objective of this study is to find the effects of breathing exercises on cardiorespiratory parameters in subjects with forward head posture. This will be a Randomized Clinical Trial study with two different breathing exercises which include Diaphragmatic Breathing Exercise (DBE) for Treatment group A… Read more about this study
- Who is it for?
- Ages 30 to 45 years
- Conditions the study is for
- Forward Head Posture
- What is being tested?
- Diaphragmatic Breathing Exercise Group and Thoracic Extension Exercise Group
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 40 participants
- Where
- 1 sitePakistan
- Study dates
- 30 Oct 2023to 28 Feb 2024
- Phase
- Interventional
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 30 to 45 years
- All sexes
- No healthy volunteers
- Adult
Who may be able to join
- Both Males and Females are included
- Age group: Middle age adult from 30 to 45 years are included
- Individuals with forward head posture and Craniovertebral Angle <50o
Who cannot join
- Previous history of neck or back surgery or neurological signs
- Psoriatic arthritis or rheumatoid arthritis
- Currently using muscle relaxation medication
- Cervical fracture, trauma or tumor
- Unstable cardiac condition
- Undergone any thoracic or abdominal surgery
Trial locations and contacts
1 site in 1 country.
About this study
Official title: Effects Of Breathing Exercises On Cardiorespiratory Parameters In Subjects With Forward Head Posture
The main objective of this study is to find the effects of breathing exercises on cardiorespiratory parameters in subjects with forward head posture. This will be a Randomized Clinical Trial study with two different breathing exercises which include Diaphragmatic Breathing Exercise (DBE) for Treatment group A individuals and Thoracic Extension Exercise (TEE) for Treatment Group B individuals will be performed along with ergometric advices. Each exercise session will be done three times per week for total over a period of 12 weeks. Outcomes will be measured at baseline, 6th and 12th week with photogrammetry method for craniovertebral angle (CVA) and spirometer for pulmonary function test values (PFTs).
Read the detailed description
The Forward Head Posture (FHP)is the poor posture alignment of the body in which the craniovertebral angle is <50 degrees. This FHP causes the deep cervical flexors to become weak and excessive use of the sternocleidomastoid and anterior scalene muscle leads towards compromised respiratory functions. The diaphragm mobility is also reduced which effect the lung volume and capacities.
FHP is due to weak deep neck flexor muscles which are compensated by the over-activity of sternocleidomastoid and scalene muscle. This in turn leads to many musculoskeletal changes like muscular imbalance, changes in stress-strain curve due to over activity of cervical spine. FHP can badly effect thoracic expansion and alveolar ventilation which can reduce vital capacity, reduce lung volumes and lung capacities thus leading towards respiratory function weakening.
Prolonged FHP not only affect the muscles but also involve ligaments of the cervical and upper thoracic spine which cause the respiratory disorders and the end result of these changes shows that 83% of individuals with this forward head posture had altered breathing pattern. This shows that there is strong relation between cervical posture and respiratory parameters.
The respiratory function is usually affected by any change in muscle activity which is caused by pain in neck flexors or extensors and their reduced activity which causes changes in vicious circle of the neck. For improvements in such forward head posture and its related problems many therapeutic and rehabilitative techniques have been used such as Kinesio tapping, myofascial release, and Mckenzie exercises.All of these showed positive impact in improving the forward head posture and reducing impairments. Some of the previous exercises mentioned showed the positive combined effects of breathing exercises and therapeutic exercises
- Conditions
- Forward Head Posture
- Being tested
- Diaphragmatic Breathing Exercise Group, Thoracic Extension Exercise Group
- Keywords
- Forward Head Posture, Diaphragmatic breathing exercise, Thoracic Extension Exercise, Cardiorespiratory parameters, Craniovertebral Angle
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Diaphragmatic Breathing Exercise GroupOther
The subjects in this group will perform Diaphragmatic Breathing Exercise Group
Thoracic Extension Exercise GroupOther
The subjects in this group will perform Thoracic Extension Exercise Group
| Study group | Role | What they receive |
|---|---|---|
| Diaphragmatic Breathing Exercise Group | Experimental | This group will perform baseline treatment along with balloon breathing exercises also known as diaphragmatic breathing exercise for pulmonary function improvement and FHP Diaphragmatic breathing is done slowly and deeply through nose with minimum usage of chest movement. Only diaphragm is used for breathing in supine lying position with one hand placed on chest and other hand is placed on abdomen. Focus should be on the contraction of diaphragm that can be checked by hand placed on abdomen while there is as little movement in chest as possible which is also checked by hand placed on chest. Inhalation and exhalation should be for 6 second approximately. Each exercise session consist of 4 sets and each set has 4 complete breathing breaks. Will be done 2 times a day and 3 times per week for total of 8 weeks. Receives: Other: Diaphragmatic Breathing Exercise Group |
| Thoracic Extension Exercise Group | Active comparator | This group along with baseline treatment will do Thoracic Extension Exercises (TEE) for FHP and Pulmonary function improvements. This is done in 3 steps. The restricted upper thoracic area is placed on foam roller with subject lying supine with knees flexed, buttock slightly lifted up from the floor and crossed hands on the chest. Roll the foam roller slightly up and down. Swiss ball is place in front of the subject who is sitting with knees flexed and then the ball is pushed slightly forward with both hands placed on it. While lying prone lift up and then pushing down the upper body while the upper body is supported by elbows places just below shoulders. All these steps will be followed by 2 sets of 15 repetitions and holding 10 sec for each repetition. Receives: Other: Thoracic Extension Exercise Group |
What is being measured
The primary outcome is the main question the study is designed to answer.
Photogrammetry Method for Forward Head Posture Assessment
Photogrammetry is a reliable and accurate tool for measurement of angles. It is used to measure the FHP through measurement of Craniovertebral angle (CVA) measurement. CVA is the inner angle between the horizontal line drawn from C7 spinous process to the midpoint of the tragus. As the higher the CVA the higher the FHP. All measurements are done after taking a photograph via digital camera in lateral-view in standing position
Measured: Baseline; 6th Week; 12th Week
Spirometry for Pulmonary Function Test FEV1
Spirometry method is use to measure pulmonary functions by assessing the lung volumes and capacities. As these pulmonary values will changed after FHP as the mobility of cervical spine and diaphragm are compromised. Spirometry is a cost effect, environment friendly, noninvasive and sensitive tool which can easily help in assessment of pulmonary function
Measured: Baseline; 6th Week; 12th Week
Spirometry for Pulmonary Function Test FVC
Spirometry method is use to measure pulmonary functions by assessing the lung volumes and capacities. As these pulmonary values will changed after FHP as the mobility of cervical spine and diaphragm are compromised. Spirometry is a cost effect, environment friendly, noninvasive and sensitive tool which can easily help in assessment of pulmonary function
Measured: Baseline; 6th Week; 12th Week
Spirometry for Pulmonary Function Test FEV1/FVC ratio
Spirometry method is use to measure pulmonary functions by assessing the lung volumes and capacities. As these pulmonary values will changed after FHP as the mobility of cervical spine and diaphragm are compromised. Spirometry is a cost effect, environment friendly, noninvasive and sensitive tool which can easily help in assessment of pulmonary function
Measured: Baseline; 6th Week; 12th Week
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted14 Nov 2023
- Study start30 Oct 2023
- Primary completion30 Jan 2024
- Study completion28 Feb 2024
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Forward Head PostureStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Double blind
- Who is masked
- Participant, Outcomes assessor
- Enrolment
- 40 participants (actual)
Sponsor and investigators
- Lead sponsor
- Riphah International University
- Sponsor type
- University, hospital or other
- Responsible party
- Sponsor
- Investigators
- Danish Hassan, PhD*, Principal investigator, Riphah International University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT06131164
- Sponsor's protocol ID
- REC/RCR & AHS/23/0332
- Status last verified
- Apr 2024
- First submitted
- 9 Nov 2023
- Last updated
- 19 Apr 2024
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Study at a glance
From the registry record, last updated by the sponsor on 19 Apr 2024. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Effects Of Breathing Exercises On Cardiorespiratory Parameters In Subjects With Forward Head Posture
- ClinicalTrials.gov ID
- NCT06131164
- Acronym / sponsor ID
- REC/RCR & AHS/23/0332
- Conditions
- Forward Head Posture
- Keywords
- Forward Head Posture, Diaphragmatic breathing exercise, Thoracic Extension Exercise, Cardiorespiratory parameters, Craniovertebral Angle
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 40 participants (actual)
- Lead sponsor
- Riphah International UniversityUniversity, hospital or other
- Study start
- 30 Oct 2023 (actual)
- Primary completion
- 30 Jan 2024 (actual)
- Study completion
- 28 Feb 2024 (actual)
- First posted
- 14 Nov 2023 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The main objective of this study is to find the effects of breathing exercises on cardiorespiratory parameters in subjects with forward head posture. This will be a Randomized Clinical Trial study with two different breathing exercises which include Diaphragmatic Breathing Exercise (DBE) for Treatment group A individuals and Thoracic Extension Exercise (TEE) for Treatment Group B individuals will be performed along with ergometric advices. Each exercise session will be done three times per week for total over a period of 12 weeks. Outcomes will be measured at baseline, 6th and 12th week with photogrammetry method for craniovertebral angle (CVA) and spirometer for pulmonary function test values (PFTs).
Detailed description
The Forward Head Posture (FHP)is the poor posture alignment of the body in which the craniovertebral angle is <50 degrees. This FHP causes the deep cervical flexors to become weak and excessive use of the sternocleidomastoid and anterior scalene muscle leads towards compromised respiratory functions. The diaphragm mobility is also reduced which effect the lung volume and capacities.
FHP is due to weak deep neck flexor muscles which are compensated by the over-activity of sternocleidomastoid and scalene muscle. This in turn leads to many musculoskeletal changes like muscular imbalance, changes in stress-strain curve due to over activity of cervical spine. FHP can badly effect thoracic expansion and alveolar ventilation which can reduce vital capacity, reduce lung volumes and lung capacities thus leading towards respiratory function weakening.
Prolonged FHP not only affect the muscles but also involve ligaments of the cervical and upper thoracic spine which cause the respiratory disorders and the end result of these changes shows that 83% of individuals with this forward head posture had altered breathing pattern. This shows that there is strong relation between cervical posture and respiratory parameters.
The respiratory function is usually affected by any change in muscle activity which is caused by pain in neck flexors or extensors and their reduced activity which causes changes in vicious circle of the neck. For improvements in such forward head posture and its related problems many therapeutic and rehabilitative techniques have been used such as Kinesio tapping, myofascial release, and Mckenzie exercises.All of these showed positive impact in improving the forward head posture and reducing impairments. Some of the previous exercises mentioned showed the positive combined effects of breathing exercises and therapeutic exercises
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Double blind (participant, outcomes assessor)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Diaphragmatic Breathing Exercise Group | Experimental | Other: Diaphragmatic Breathing Exercise GroupThis group will perform baseline treatment along with balloon breathing exercises also known as diaphragmatic breathing exercise for pulmonary function improvement and FHP Diaphragmatic breathing is done slowly and deeply through nose with minimum usage of chest movement. Only diaphragm is used for breathing in supine lying position with one hand placed on chest and other hand is placed on abdomen. Focus should be on the contraction of diaphragm that can be checked by hand placed on abdomen while there is as little movement in chest as possible which is also checked by hand placed on chest. Inhalation and exhalation should be for 6 second approximately. Each exercise session consist of 4 sets and each set has 4 complete breathing breaks. Will be done 2 times a day and 3 times per week for total of 8 weeks. |
| Thoracic Extension Exercise Group | Active comparator | Other: Thoracic Extension Exercise GroupThis group along with baseline treatment will do Thoracic Extension Exercises (TEE) for FHP and Pulmonary function improvements. This is done in 3 steps. The restricted upper thoracic area is placed on foam roller with subject lying supine with knees flexed, buttock slightly lifted up from the floor and crossed hands on the chest. Roll the foam roller slightly up and down. Swiss ball is place in front of the subject who is sitting with knees flexed and then the ball is pushed slightly forward with both hands placed on it. While lying prone lift up and then pushing down the upper body while the upper body is supported by elbows places just below shoulders. All these steps will be followed by 2 sets of 15 repetitions and holding 10 sec for each repetition. |
Who may qualify
- Ages
- 30 to 45 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult
Key inclusion criteria (3 listed)
- Both Males and Females are included
- Age group: Middle age adult from 30 to 45 years are included
- Individuals with forward head posture and Craniovertebral Angle <50o
Key exclusion criteria (6 listed)
- Previous history of neck or back surgery or neurological signs
- Psoriatic arthritis or rheumatoid arthritis
- Currently using muscle relaxation medication
- Cervical fracture, trauma or tumor
- Unstable cardiac condition
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Diaphragmatic Breathing Exercise GroupThe subjects in this group will perform Diaphragmatic Breathing Exercise Group | Other | Diaphragmatic Breathing Exercise Group |
| Thoracic Extension Exercise GroupThe subjects in this group will perform Thoracic Extension Exercise Group | Other | Thoracic Extension Exercise Group |
Primary outcome
Photogrammetry Method for Forward Head Posture Assessment
Time frame: Baseline; 6th Week; 12th Week
Photogrammetry is a reliable and accurate tool for measurement of angles. It is used to measure the FHP through measurement of Craniovertebral angle (CVA) measurement. CVA is the inner angle between the horizontal line drawn from C7 spinous process to the midpoint of the tragus. As the higher the CVA the higher the FHP. All measurements are done after taking a photograph via digital camera in lateral-view in standing position
Spirometry for Pulmonary Function Test FEV1
Time frame: Baseline; 6th Week; 12th Week
Spirometry method is use to measure pulmonary functions by assessing the lung volumes and capacities. As these pulmonary values will changed after FHP as the mobility of cervical spine and diaphragm are compromised. Spirometry is a cost effect, environment friendly, noninvasive and sensitive tool which can easily help in assessment of pulmonary function
Spirometry for Pulmonary Function Test FVC
Time frame: Baseline; 6th Week; 12th Week
Spirometry method is use to measure pulmonary functions by assessing the lung volumes and capacities. As these pulmonary values will changed after FHP as the mobility of cervical spine and diaphragm are compromised. Spirometry is a cost effect, environment friendly, noninvasive and sensitive tool which can easily help in assessment of pulmonary function
Spirometry for Pulmonary Function Test FEV1/FVC ratio
Time frame: Baseline; 6th Week; 12th Week
Spirometry method is use to measure pulmonary functions by assessing the lung volumes and capacities. As these pulmonary values will changed after FHP as the mobility of cervical spine and diaphragm are compromised. Spirometry is a cost effect, environment friendly, noninvasive and sensitive tool which can easily help in assessment of pulmonary function
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 19 Apr 2024.
- Individual participant dataSharing planned: No
Related trials for Forward Head Posture
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Relationship of Forward Head Posture With Burnout and Quality of Life
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Comparative Effects of Pressure and Visual Biofeedback Training on Pain, Disability, Range of Motion Among Patients With Forward Head Posture Correction: A Randomized Controlled Trial
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Danish Hassan, PhD* principal investigator
Riphah International University
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Diaphragmatic Breathing Exercise Group and Thoracic Extension Exercise Group in people with Forward Head Posture, run by Riphah International University at 1 site in Pakistan.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 3 inclusion and 6 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 19 Apr 2024. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Pakistan. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Photogrammetry Method for Forward Head Posture Assessment (time frame: Baseline; 6th Week; 12th Week). The study lists 4 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 19 Apr 2024.