Forward Head PostureNCT06707766
Comparison of Oculomotor Exercises Versus Suboccipital METs on Visual Fatigue Among FHP
A study testing Oculomotor Exercise along with conventional Therapy and sub-occipital muscle energy technique along with Conventional Therapy in people with Forward Head Posture and Visual Fatigue, run by Riphah International University at 3 sites in Pakistan.
Trial summary
The aim of this research is to compare the effect of Oculomotor Exercises and Muscle energy technique on visual fatigue, proprioception, Craniovertebral angle among patients having Forward head posture.. Read more about this study
- Who is it for?
- Ages 20 to 50 years
- Conditions the study is for
- Forward Head Posture, Visual Fatigue
- What is being tested?
- Oculomotor Exercise along with conventional Therapy and sub-occipital muscle energy technique along with Conventional Therapy
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 44 participants
- Where
- 3 sitesPakistan
- Study dates
- 11 Nov 2024to 29 Aug 2025
- 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 20 to 50 years
- All sexes
- No healthy volunteers
- Adult
Who may be able to join
- Age 20-50 years
- Both Male and Female
- Diagnosed patients of Forward head posture, Craniovertebral Angle less than 50 degree.
- Patients having Asthenopia survey questionnaire (ASQ-17) score of 13 or higher.
Who cannot join
- Participant failing to fall in this category would be excluded of the study.
- Pre-existing medical conditions that cause visual issues such as conjunctivitis, cataract, Strabismus anomaly, glaucoma and those undergoing any eye treatment.
- Any previous neck and Eye surgery.
- Cervical conditions such as cervical radiculopathy, non-specific neck pain, and TMJ dysfunction that cause visual disturbances.
Trial locations and contacts
3 sites in 1 country.
Pakistan3 sites
Capital Diagnostic Center Islamabad
Islamabad, 44000
Care plus Medical Center
Islamabad, 44000
National Institute of Rehabilitation
Islamabad, 44000
About this study
Official title: Comparison of Oculomotor Exercises and Muscle Energy Technique on Visual Fatigue Among Patients Having Forward Head Posture
The aim of this research is to compare the effect of Oculomotor Exercises and Muscle energy technique on visual fatigue, proprioception, Craniovertebral angle among patients having Forward head posture.. It will raise awareness about the link between posture and visual health, encouraging early identification of visual symptoms associated with FHP, enhance recovery outcomes, improve functional performance, and promote a holistic treatment approach, ultimately provide benefit to population.
Read the detailed description
Studies have shown that integrating eye exercises with neck strengthening exercises has a significant effect in managing symptoms associated with visual disturbances and neck pain. For instance, a study conducted in 2024 to investigate the effect of oculomotor exercises in patients having chronic neck pain. Based on the result, they found that incorporating oculomotor exercises along with conventional exercises into treatment plan can significantly improve gaze stability, proprioception, visual acuity and fatigue in chronic neck pain patients. In 2023 study investigate the effectiveness of manual techniques for the management of FHP. They found that sub-occipital muscle energy technique is effective in improving CVA, cervical range of motion and postural alignment. study conducted in 2023 investigated the comparative effect sub-occipital muscle energy technique vs sub-occipital release in mechanical neck pain and FHP population. They concluded that group receiving MET show significant improvement in CVA, NDI and Cervical ROMs. Another research concluded that Sub-occipital muscle energy technique incorporating with proprioceptive training are effective in improving joint position sense (proprioception) and CVA in FHP population. A study evaluate the effectiveness of eye exercises on computer vision syndrome. They concluded the ocular exercises are effective in reducing visual fatigue symptoms such as eye itching, dryness and headache.
This research is innovative as it explores the interconnected roles of ocular muscles and sub-occipital muscles on visual fatigue, proprioception, and postural imbalances, particularly in FHP patients. As Literature suggest that tightness of suboccipital affect somatosensory input and proprioceptive information crucial for head and eye coordination. Thus, offering a comprehensive view of how FHP and visual fatigue are interconnected. Furthermore, the integration of oculomotor exercises in managing FHP-related visual fatigue is an underexplored as the existing literature primarily focuses on the musculoskeletal consequences of forward head posture and ocular exercises for visual disturbance without exploring the interaction between these factors. This research aimed to bridge the existing gap in literature by providing evidence-based guidance on the effectiveness of METs and oculomotor exercises in the management of visual symptoms associated FHP.
- Conditions
- Forward Head Posture, Visual Fatigue
- Being tested
- Oculomotor Exercise along with conventional Therapy, sub-occipital muscle energy technique along with Conventional Therapy
- Keywords
- forward head posture, visual fatigue, Craniovertebral angle, proprioception, suboccipital muscles, , oculomotor exercises, muscle energy technique (PIR, VOR(vestibulo- ocular reflex), cervical spine.
- Medical subject headings
- Asthenopia
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Oculomotor Exercise along with conventional TherapyOther
Oculomotor Exercises: Saccadic eye movement, Smooth pursuit, Adaptation X1, Adaptation X2.
Time duration will be 2 minutes for each exercise.
conventional therapy: hot pack 20 mins Kendall exercises: Strengthening the deep cervical flexor, Stretching the cervical extensors, Strengthening shoulder retraction, Stretching of the pectoralis major muscle strengthening exercise: 12 repetitions* 3 sets, 2-8 sec hold stretching exercise was: 3 reps* 30 seconds' hold
Total duration of treatment would be 4 weeks, 3 days a week with total 12 sessions.
sub-occipital muscle energy technique along with Conventional TherapyOther
Sub-occipital muscle energy technique (PIR) 3 rep * 1 set with 20 sec hold
conventional therapy: hot pack 20 mins Kendall exercises: Strengthening the deep cervical flexor, Stretching the cervical extensors, Strengthening shoulder retraction, Stretching of the pectoralis major muscle
strengthening exercise: 12 repetitions* 3 sets, 2-8 sec hold stretching exercise was: 3 reps* 30 seconds' hold
Total duration of treatment would be 4 weeks, 3 days a week with total 12 sessions.
| Study group | Role | What they receive |
|---|---|---|
| oculomotor exercises along with conventional therapy | Experimental | oculomotor exercises along with conventional therapy Receives: Other: Oculomotor Exercise along with conventional Therapy |
| sub-occipital muscle energy technique along with Conventional Therapy | Experimental | Sub-occipital muscle energy technique (PIR) 3 reps * 1 set conventional therapy: Hot pack 20 minutes
Kendall exercises were performed as follows:
strengthening exercise: 12 repetitions* 3 sets, 2-8 sec hold stretching exercise was: 3 reps* 30 seconds' hold
1. Strengthening the deep cervical flexors
2. Stretching the cervical extensors
3. Strengthening shoulder retraction
4. Stretching of the pectoralis major muscle Receives: Other: sub-occipital muscle energy technique along with Conventional Therapy |
What is being measured
The primary outcome is the main question the study is designed to answer.
visual fatigue
; Visul fatigue can be assessed by using Asthenopia Survey Questionnaire (ASQ-17). Responses are marked using four-point Likert scale with total score 51. Score range from 0-13 indicates no asthenopia, whereas the score range between 13-51 indicate asthenopia and need medical attention
Measured: 4 weeks
propioception
cervical proprioception can be assed Cervical Joint Position Error (JPE) Test. Values > 4.5 degree indicate proprioception deficit
Measured: 4 weeks
Craniovertebral Angle
Craniovertebral Angle can be measured by usng ON PROTRACTOR google App. Craniovertebral angle (CVA) values for individuals with moderate-severe forward head posture ranged from 40.7° to 43.2°, and for those with mild FHP, values ranged from 46.9° to 49.1 FHP. However, angle between 50- 57 degree is consider as normal.
Measured: 4 weeks
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted27 Nov 2024
- Study start11 Nov 2024
- Primary completion28 Aug 2025
- Study completion29 Aug 2025
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.
- More trials run by Riphah International UniversityThe sponsor's other registered studies.
- 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, Investigator
- Enrolment
- 44 participants (actual)
Sponsor and investigators
- Lead sponsor
- Riphah International University
- Sponsor type
- University, hospital or other
- Responsible party
- Sponsor
- Investigators
- Dr Aneela Zia, ms-ompt, Principal investigator, Riphah International University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT06707766
- Sponsor's protocol ID
- REC/02020 Amna Rashid.
- Status last verified
- Sep 2025
- First submitted
- 25 Nov 2024
- Last updated
- 3 Sep 2025
- Results posted
- 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 3 Sep 2025. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Comparison of Oculomotor Exercises and Muscle Energy Technique on Visual Fatigue Among Patients Having Forward Head Posture
- ClinicalTrials.gov ID
- NCT06707766
- Acronym / sponsor ID
- REC/02020 Amna Rashid.
- Conditions
- Forward Head Posture, Visual Fatigue
- Keywords
- forward head posture, visual fatigue, Craniovertebral angle, proprioception, suboccipital muscles, , oculomotor exercises, muscle energy technique (PIR, VOR(vestibulo- ocular reflex)
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 44 participants (actual)
- Lead sponsor
- Riphah International UniversityUniversity, hospital or other
- Study start
- 11 Nov 2024 (actual)
- Primary completion
- 28 Aug 2025 (actual)
- Study completion
- 29 Aug 2025 (actual)
- First posted
- 27 Nov 2024 (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 aim of this research is to compare the effect of Oculomotor Exercises and Muscle energy technique on visual fatigue, proprioception, Craniovertebral angle among patients having Forward head posture.. It will raise awareness about the link between posture and visual health, encouraging early identification of visual symptoms associated with FHP, enhance recovery outcomes, improve functional performance, and promote a holistic treatment approach, ultimately provide benefit to population.
Detailed description
Studies have shown that integrating eye exercises with neck strengthening exercises has a significant effect in managing symptoms associated with visual disturbances and neck pain. For instance, a study conducted in 2024 to investigate the effect of oculomotor exercises in patients having chronic neck pain. Based on the result, they found that incorporating oculomotor exercises along with conventional exercises into treatment plan can significantly improve gaze stability, proprioception, visual acuity and fatigue in chronic neck pain patients. In 2023 study investigate the effectiveness of manual techniques for the management of FHP. They found that sub-occipital muscle energy technique is effective in improving CVA, cervical range of motion and postural alignment. study conducted in 2023 investigated the comparative effect sub-occipital muscle energy technique vs sub-occipital release in mechanical neck pain and FHP population. They concluded that group receiving MET show significant improvement in CVA, NDI and Cervical ROMs. Another research concluded that Sub-occipital muscle energy technique incorporating with proprioceptive training are effective in improving joint position sense (proprioception) and CVA in FHP population. A study evaluate the effectiveness of eye exercises on computer vision syndrome. They concluded the ocular exercises are effective in reducing visual fatigue symptoms such as eye itching, dryness and headache.
This research is innovative as it explores the interconnected roles of ocular muscles and sub-occipital muscles on visual fatigue, proprioception, and postural imbalances, particularly in FHP patients. As Literature suggest that tightness of suboccipital affect somatosensory input and proprioceptive information crucial for head and eye coordination. Thus, offering a comprehensive view of how FHP and visual fatigue are interconnected. Furthermore, the integration of oculomotor exercises in managing FHP-related visual fatigue is an underexplored as the existing literature primarily focuses on the musculoskeletal consequences of forward head posture and ocular exercises for visual disturbance without exploring the interaction between these factors. This research aimed to bridge the existing gap in literature by providing evidence-based guidance on the effectiveness of METs and oculomotor exercises in the management of visual symptoms associated FHP.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Double blind (participant, investigator)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| oculomotor exercises along with conventional therapy | Experimental | Other: Oculomotor Exercise along with conventional Therapyoculomotor exercises along with conventional therapy |
| sub-occipital muscle energy technique along with Conventional Therapy | Experimental | Other: sub-occipital muscle energy technique along with Conventional TherapySub-occipital muscle energy technique (PIR) 3 reps * 1 set conventional therapy: Hot pack 20 minutes Kendall exercises were performed as follows: strengthening exercise: 12 repetitions* 3 sets, 2-8 sec hold stretching exercise was: 3 reps* 30 seconds' hold 1. Strengthening the deep cervical flexors 2. Stretching the cervical extensors 3. Strengthening shoulder retraction 4. Stretching of the pectoralis major muscle |
Who may qualify
- Ages
- 20 to 50 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult
Key inclusion criteria (4 listed)
- Age 20-50 years
- Both Male and Female
- Diagnosed patients of Forward head posture, Craniovertebral Angle less than 50 degree.
- Patients having Asthenopia survey questionnaire (ASQ-17) score of 13 or higher.
Key exclusion criteria (4 listed)
- Participant failing to fall in this category would be excluded of the study.
- Pre-existing medical conditions that cause visual issues such as conjunctivitis, cataract, Strabismus anomaly, glaucoma and those undergoing any eye treatment.
- Any previous neck and Eye surgery.
- Cervical conditions such as cervical radiculopathy, non-specific neck pain, and TMJ dysfunction that cause visual disturbances.
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 |
|---|---|---|
| Oculomotor Exercise along with conventional TherapyOculomotor Exercises: Saccadic eye movement, Smooth pursuit, Adaptation X1, Adaptation X2. Time duration will be 2 minutes for each exercise. conventional therapy: hot pack 20 mins Kendall exercises: Strengthening the deep cervical flexor, Stretching the cervical extensors, Strengthening shoulder retraction, Stretching of the pectoralis major muscle strengthening exercise: 12 repetitions* 3 sets, 2-8 sec hold stretching exercise was: 3 reps* 30 seconds' hold Total duration of treatment would be 4 weeks, 3 days a week with total 12 sessions. | Other | oculomotor exercises along with conventional therapy |
| sub-occipital muscle energy technique along with Conventional TherapySub-occipital muscle energy technique (PIR) 3 rep * 1 set with 20 sec hold conventional therapy: hot pack 20 mins Kendall exercises: Strengthening the deep cervical flexor, Stretching the cervical extensors, Strengthening shoulder retraction, Stretching of the pectoralis major muscle strengthening exercise: 12 repetitions* 3 sets, 2-8 sec hold stretching exercise was: 3 reps* 30 seconds' hold Total duration of treatment would be 4 weeks, 3 days a week with total 12 sessions. | Other | sub-occipital muscle energy technique along with Conventional Therapy |
Primary outcome
visual fatigue
Time frame: 4 weeks
; Visul fatigue can be assessed by using Asthenopia Survey Questionnaire (ASQ-17). Responses are marked using four-point Likert scale with total score 51. Score range from 0-13 indicates no asthenopia, whereas the score range between 13-51 indicate asthenopia and need medical attention
propioception
Time frame: 4 weeks
cervical proprioception can be assed Cervical Joint Position Error (JPE) Test. Values > 4.5 degree indicate proprioception deficit
Craniovertebral Angle
Time frame: 4 weeks
Craniovertebral Angle can be measured by usng ON PROTRACTOR google App. Craniovertebral angle (CVA) values for individuals with moderate-severe forward head posture ranged from 40.7° to 43.2°, and for those with mild FHP, values ranged from 46.9° to 49.1 FHP. However, angle between 50- 57 degree is consider as normal.
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 3 Sep 2025.
- Individual participant dataSharing planned: No
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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.
Dr Aneela Zia, ms-ompt principal investigator
Riphah International University
3 sites in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Oculomotor Exercise along with conventional Therapy and sub-occipital muscle energy technique along with Conventional Therapy in people with Forward Head Posture and Visual Fatigue, run by Riphah International University at 3 sites 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 4 inclusion and 4 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 3 Sep 2025. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 3 sites 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?
visual fatigue (time frame: 4 weeks). The study lists 3 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 3 Sep 2025.