Forward Head PostureNCT06883721
Pilates Effects on Forward Head Posture: A Clinical Trial
A study testing Pilates and Cervical stabilization exercise in people with Forward Head Posture, run by Bahçeşehir University at 1 site in Turkey (Türkiye).
Trial summary
This study aims to investigate and compare the effects of 8-week Pilates exercises and cervical stabilization exercises on pain, posture, range of motion, quality of life, and body composition in individuals with forward head posture (FHP). Read more about this study
- Who is it for?
- Ages 18 to 50 yearsHealthy volunteers can take part
- Conditions the study is for
- Forward Head Posture
- What is being tested?
- Pilates and Cervical stabilization exercise
- Type of treatment
- Lifestyle or therapy programme
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 36 participants
- Where
- 1 siteTurkey (Türkiye)
- Study dates
- 25 Jan 2023to 18 May 2023
- Phase
- Interventional
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 18 to 50 years
- All sexes
- Healthy volunteers accepted
- Adult
Who may be able to join
- Adults aged 18-50 years.
- Craniovertebral angle (CVA) < 54°
- Sedentary lifestyle
Who cannot join
- History of spinal surgery (cervical/thoracic/lumbar) or neurological disorders.
- Acute or severe cervical trauma (e.g., fractures, whiplash injuries).
- Spinal deformities (e.g., scoliosis, kyphosis).
- Recent physiotherapy/manual therapy (within the past 6 months).
- Regular use of analgesics, muscle relaxants, or steroids.
- Active participation in regular exercise
Trial locations and contacts
1 site in 1 country.
Turkey (Türkiye)1 site
Physiolab Physiotherapy Center
Antalya, Alanya, 07460
About this study
Official title: The Impact of Pilates Exercises on Pain, Posture, Range of Motion, Quality of Life, and Body Composition in Participants With Forward Head Posture: A Randomized Controlled Trial
This study aims to investigate and compare the effects of 8-week Pilates exercises and cervical stabilization exercises on pain, posture, range of motion, quality of life, and body composition in individuals with forward head posture (FHP). FHP is a common postural disorder characterized by the anterior displacement of the head relative to the cervical spine. This condition can lead to neck pain, muscle tension, and limited movement.
The study will include participants aged 18-50 years with FHP. Participants will be randomly assigned to one of two groups: the Pilates group or the cervical stabilization exercise group. The Pilates group will participate in Pilates exercises twice a week for 8 weeks under the supervision of a physiotherapist. The cervical stabilization exercise group will perform cervical stabilization exercises at home for the same duration.
Read more
The primary objective of this study is to compare the effects of Pilates and cervical stabilization exercises on FHP. Participants' posture, neck pain, range of motion, quality of life, and body composition will be measured before and after the 8-week intervention. These measurements will be used to evaluate and compare the effectiveness of the two exercise methods on FHP.
This study seeks to investigate the effectiveness of Pilates in the treatment of FHP and contribute to the scientific literature in this field. The findings may help determine the most appropriate exercise method for individuals with FHP.
Read the detailed description
This study will be designed as an 8-week randomized controlled trial (RCT) to compare the effects of Pilates and cervical stabilization exercises (CSE) on forward head posture (FHP) in adult participants. Based on the understanding that proper posture is essential to maintain musculoskeletal balance and minimize excessive mechanical strain, the study will address the increasing prevalence of FHP-a problem exacerbated by sedentary lifestyles, prolonged screen use, and occupational demands. In FHP, the head is displaced forward relative to the cervical spine, disrupting the natural spinal curvature, which can lead to neck pain and altered muscle activation patterns.
The trial will be conducted in a controlled clinical setting at a physiotherapy center in Antalya, Turkey, in accordance with CONSORT 2010 guidelines. Robust randomization and blinded outcome assessments will be employed to ensure methodological rigor, and quality assurance protocols-such as regular equipment calibration and data audits-will be implemented to maintain data integrity.
Participants randomized to the Pilates intervention will participate in supervised sessions twice per week, each lasting 60 minutes, consisting of a 10-minute warm-up, a graduated main exercise phase, and a 10-minute cool-down. During the first four weeks, sessions will emphasize mat-based exercises focusing on core engagement, controlled breathing, and alignment. Beginning in Week 2, additional equipment (e.g., Pilates balls and 1-kg dumbbells) will be introduced, with resistance bands incorporated from Week 4 and further modified in Week 6 to progressively challenge participants. The control group will perform a daily CSE regimen (including chin tuck, cervical extension, shoulder elevation, and scapular retraction) structured into two sets designed to support neuromuscular control and postural stability. Both groups will receive ergonomic guidelines for daily posture management.
Data collection will be managed by trained physiotherapists who will adhere to strict protocols and perform regular device calibrations. Data analysis will be conducted using IBM SPSS Statistics (v29.0), employing appropriate statistical tests and calculating effect sizes, with a 95% confidence interval (p < 0.05) determining statistical significance. A comprehensive quality assurance plan-including regular audits, predefined data validation rules, and a maintained data dictionary-will further ensure the robustness and reliability of the findings.
- Conditions
- Forward Head Posture
- Being tested
- Pilates, Cervical stabilization exercise
- Keywords
- Forward head posture, Pilates, Craniovertebral angle, Cervical stabilization, Randomized controlled trial, Neck pain, Posture, Rehabilitation
- Medical subject headings
- Neck Pain
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
PilatesBehavioural
Participants in this group performed Pilates exercises twice a week for 8 weeks. The exercises included mat and equipment-based exercises, focusing on core stabilization, breathing control, and postural alignment. Exercise difficulty was progressively increased throughout the intervention period.
Cervical stabilization exerciseBehavioural
Participants in this group performed cervical stabilization exercises at home twice daily for 8 weeks. The exercises included chin tucks, cervical extensions, shoulder elevations, and scapular retractions.
| Study group | Role | What they receive |
|---|---|---|
| Pilates Exercise Group | Experimental | Participants in this group performed Pilates exercises twice a week for 8 weeks. The exercises included mat and equipment-based exercises, focusing on core stabilization, breathing control, and postural alignment. Exercise difficulty was progressively increased throughout the intervention period. Receives: Behavioral: Pilates |
| Cervical Stabilization Exercise Group | Active comparator | Participants in this group performed cervical stabilization exercises at home twice daily for 8 weeks. Receives: Behavioral: Cervical stabilization exercise |
What is being measured
The primary outcome is the main question the study is designed to answer.
Craniovertebral Angle (CVA)
The craniovertebral angle (CVA), a key metric and a widely used measure for assessing forward head posture (FHP), will be evaluated using standardized digital photogrammetry. Lateral photographs will be captured using a Fujifilm XT-3 mirrorless camera equipped with a 35mm lens. The CVA will be calculated as the angle between a line connecting the tragus and C7 markers and a horizontal reference line parallel to the floor. Higher CVA values will indicate a less severe forward head posture, reflecting better postural alignment.
Measured: Baseline (week 0) and after the 8-week intervention (week 8).
Neck Pain Intensity
Neck pain intensity will be assessed using the Visual Analog Scale (VAS), a 10 cm line ranging from 0 (no pain) to 10 (unbearable/most severe pain). Participants will be instructed to rate their neck-specific discomfort on this scale. Lower scores will indicate less pain, while higher scores will indicate more severe pain.
Measured: Baseline (week 0) and after the 8-week intervention (week 8).
Secondary outcomes (8)
Posture
Posture will be assessed using the New York Posture Rating Scale (NYPRS). This method, also known as New York Posture Analysis Method (NYPAY), scores 13 body regions (head, neck, shoulders, back, waist, abdomen, pelvis, and feet) from posterior and lateral views. For each region, postural deviations will be scored observationally: 5 points for good posture, 3 points for moderately impaired posture, and 1 point for severely impaired posture. The body regions assessed include: head, neck, shoulders, back, waist, abdomen, pelvis, and feet. Total scores will be calculated by summing the scores across all 13 regions, resulting in a range from 13 (worst possible posture) to 65 (best possible posture). For interpretation, total NYPRS scores are categorized as follows: ≥45 points "very good", 40-44 points "good", 30-39 points "medium", 20-29 points "weak", and ≤19 points "bad" posture.. Therefore, higher total scores will indicate better overall posture.
Measured: Baseline (week 0) and after the 8-week intervention (week 8)
Cervical Range of Motion (ROM)
Cervical range of motion (ROM), encompassing flexion, extension, lateral flexion, and rotation, will be measured using a standard universal goniometer. Maximum ROM angles will be recorded in degrees. For cervical ROM, higher values will indicate a greater range of motion, which is generally considered a better outcome.
Measured: Baseline (week 0) and after the 8-week intervention (week 8)
SF-36 Quality of Life Questionnaire
Quality of life will be assessed using the Short Form-36 (SF-36) questionnairea comprehensive questionnaire evaluating different aspects of quality of life (physical, mental, social, etc.). This 36-item scale evaluates participants' health status over the past 4 weeks. The SF-36 includes eight subscales: physical functioning, role-physical, role-emotional, energy/vitality, mental health, social functioning, pain, and general health perceptions. Each subscale yields a score ranging from 0 to 100, where higher scores will indicate better quality of life in the respective domain.
Measured: Baseline (week 0) and after the 8-week intervention (week 8)
Body Mass Index (BMI)
Body mass index (BMI) is a measure of body fat based on height and weight. It is calculated as weight in kilograms divided by height in meters squared (kg/m²). Weight will be measured using a calibrated digital scale, and height will be measured using a stadiometer.
Measured: Baseline (week 0) and after the 8-week intervention (week 8)
Waist-to-hip ratio
The waist-to-hip ratio is calculated by dividing the waist circumference by the hip circumference (both measured in centimeters).
Measured: Baseline (week 0) and after the 8-week intervention (week 8)
Waist circumference
Waist circumference is measured in centimeters at the level of the narrowest point between the lower rib and the iliac crest using a standard measuring tape. Three measurements will be taken at this point, and the average of these measurements will be recorded.
Measured: Baseline (week 0) and after the 8-week intervention (week 8)
Hip circumference
Hip circumference is measured in centimeters at the level of the widest portion of the buttocks using a standard measuring tape. Three measurements will be taken at this point, and the average of these measurements will be recorded.
Measured: Baseline (week 0) and after the 8-week intervention (week 8)
Chest circumference
Chest circumference is measured in centimeters at the level of the nipples using a standard measuring tape during normal breathing. Three measurements will be taken at this level, and the average of these measurements will be recorded.
Measured: Baseline (week 0) and after the 8-week intervention (week 8)
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted19 Mar 2025
- Study start25 Jan 2023
- Primary completion18 May 2023
- Study completion18 May 2023
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
- Model description
- Participants were randomly assigned to either an experimental group (Pilates exercise group, n=18) or a control group (cervical stabilization exercise group, n=18) for an 8-week intervention period.
- Masking
- Single blind
- Who is masked
- Outcomes assessor
- Enrolment
- 36 participants (actual)
Sponsor and investigators
- Lead sponsor
- Bahçeşehir University
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, yusuf yaşasın, Bahçeşehir University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT06883721
- Sponsor's protocol ID
- 2023-02/02
- Status last verified
- Mar 2025
- First submitted
- 5 Mar 2025
- Last updated
- 19 Mar 2025
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- Yes: All anonymized individual participant data (IPD) collected in this study, including demographic details, clinical measurements (CVA, pain scores, cervical ROM), SF-36 quality-of-life outcomes, and body composition data, will be shared upon reasonable request. Data will exclude raw imaging files, identifiable personal information, and non-anonymized records. Access requires submission of a scientifically valid proposal, a signed data access agreement, and compliance with ethical guidelines. Shared data will be deposited in a secure, open-access repository (e.g., Zenodo) with a DOI assigned for long-term availability. Data will remain accessible for at least 5 years post-publication. Requests will be reviewed by an independent committee to ensure alignment with research ethics and participant privacy protections (GDPR/Helsinki Declaration compliant).