Forward Head PostureFHPNCT07086872
Impact of Adding Integrated Neuromuscular Inhibition Technique to Mulligan Therapy in Symptomatic Forward Head Posture
A study testing Integrated Neuromuscular Inhibition Technique and mulligan therapy, Integrated Neuromuscular Inhibition Technique and mulligan therapy in people with Forward Head Posture, run by Cairo University.
Trial summary
this study will be conducted to investigate the impact of adding integrated neuromuscular inhibition technique to mulligan therapy in symptomatic forward head posture. Read more about this study
- Who is it for?
- Ages 18 to 35 years
- Conditions the study is for
- Forward Head Posture
- What is being tested?
- Integrated Neuromuscular Inhibition Technique and mulligan therapy, Integrated Neuromuscular Inhibition Technique and mulligan therapy
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 120 participants
- Where
- No sites listed yet
- Study dates
- 30 Jul 2025to 20 Feb 2026
- Phase
- Interventional
- Are there results?
- Not yet: the study is under way
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 35 years
- All sexes
- No healthy volunteers
- Adult
Who may be able to join
- CVA equal or less than 50
- Had cervical pain for more than three months and had visited an orthopedist clinic
Who cannot join
- cervical spine spondylosis
- fractures or cervical spinal surgery
- Cervical or shoulder neurological movement disorder.
- Temporo-mandibular surgery, (5) Pathologic trauma
Trial locations and contacts
No sites are listed yet. Contact the study team or a site near you to ask about taking part.
About this study
this study will be conducted to investigate the impact of adding integrated neuromuscular inhibition technique to mulligan therapy in symptomatic forward head posture.
Read the detailed description
Forward head posture is anterior positioning of the cervical spine, which is regarded as a "bad" head posture and is commonly found in patients who experience problems with the head and neck. Particularly, forward head posture is frequently found in people sitting in front of a computer for prolonged periods. Load increases in the muscles and joints of the cervical spine as a result of forward head posture are considered a major cause of musculoskeletal disorders. INIT is effective as it causes sustained or intermittent compression which causes ischemia reduces local circulation until pressure is released, after which a flushing of fresh oxygenated blood occurs. Mechanoreceptors impulses interface with slower pain messages reducing amount of pain messges reaching the brain, releasing pain relieving hormones, decreasing myofascial pain. Stretches the taut bands of muscles fibers. INIT along with strengthening excercises proved to be beneficial in decreasing disability improving Range of motion. The concept of SNAG is to increase the treatment effects by having patients perform active movements while removing pain in the lesions by means of manipulative therapy. This is a new concept in the manipulative therapy field, and differs from traditional manipulative therapy by combining the active movements of the patients with additional passive movements performed with the aid of therapists
- Conditions
- Forward Head Posture
- Being tested
- Integrated Neuromuscular Inhibition Technique and mulligan therapy, Integrated Neuromuscular Inhibition Technique, mulligan therapy, postural correction exercises
- Keywords
- Integrated Neuromuscular Inhibition Technique, Mulligan Therapy, Forward Head Posture
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Integrated Neuromuscular Inhibition Technique and mulligan therapyOther
patients will receive Integrated Neuromuscular Inhibition Technique in the form of intermittent ischemic compression, strain counter strain and muscle energy technique and mulligan therapy for limited cervical range of motion
Integrated Neuromuscular Inhibition TechniqueOther
patients will receive Integrated Neuromuscular Inhibition Technique in the form of intermittent ischemic compression, strain counter strain and muscle energy technique
mulligan therapyOther
patients will receive mulligan therapy for limited cervical range of motion
postural correction exercisesOther
the patients will receive two strengthening exercises (deep cervical flexors and scapular retractors) and two stretching: cervical extensors (sub-occipital muscles) and pectoral muscles). The program was based on a program by Harman and Kendall
| Study group | Role | What they receive |
|---|---|---|
| Integrated Neuromuscular Inhibition Technique and mulligan therapy | Experimental | thirty patients will receive Integrated Neuromuscular Inhibition Technique and mulligan therapy three times a weeks for six weeks+postural correction exercises Receives: Other: Integrated Neuromuscular Inhibition Technique and mulligan therapy; Other: postural correction exercises |
| Integrated Neuromuscular Inhibition Technique | Experimental | thirty patients will receive Integrated Neuromuscular Inhibition Technique+postural correction exercises three times a weeks for six weeks Receives: Other: Integrated Neuromuscular Inhibition Technique; Other: postural correction exercises |
| mulligan therapy | Experimental | thirty patients will receive mulligan Technique+postural correction exercises three times a weeks for six weeks Receives: Other: mulligan therapy; Other: postural correction exercises |
| postural correction exercises | Active comparator | thirty patients will receive postural correction exercises three times a weeks for six weeks Receives: Other: postural correction exercises |
What is being measured
The primary outcome is the main question the study is designed to answer.
pain intensity
visual analogue scale will be used to asses pain intensity which patient will be instructed to put point on line from no pain to tolerable pain. The scale consists of a line, usually 100 mm long, ranging from no pain or discomfort (zero) , to the worst pain that could possibly feel
Measured: up to six weeks
Secondary outcomes (4)
neck disability
will be measured by Arabic neck disability index. It contains ten category/classes. Each category contains six choices (zero-five).Score from zero to four no disability, from five to 15 this is mild, From 15 to 24 this is moderate, from 25 to 34 this is severe, more than 34 this is a complete disability
Measured: up to 6 weeks
pressure pain threshold
pressure pain threshold pressure pain threshold will be assessed by commander algometer
Measured: up to six weeks
cervical range of motion
range of motion will be measured by inclinometer CROM. The CROM (deluxe version - Performance Attainment Associates, Roseville, MN, USA) measures the cervical range of motion5- for fexion, extension, lateral fexion, and rotation using separate inclinometers. These inclinometers are attached to a frame similar to that for eyeglasses one in the sagittal plane for fexion - extension, second in the frontal plane for lateral fexion and a third in the horizontal plane for rotation.
Measured: up to six weeks
craniovertebral angle
The craniovertebral angle is identified as the intersection of a horizontal line passing through the C7 spinous process and a line joining the midpoint of the tragus of the ear to the skin overlying the C7 spinous process. it measured by photogrametric methods. when the angle less than or equal 50 degree
Measured: up to six weeks
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted25 Jul 2025
- Study start30 Jul 2025 (estimated)
- Primary completion20 Feb 2026 (estimated)
- Study completion20 Feb 2026 (estimated)
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 Cairo 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
- Model description
- integrated neuromuscular inhibition and mulligan
- Masking
- Single blind
- Who is masked
- Outcomes assessor
- Enrolment
- 120 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Cairo University
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Al Shaymaa Shaaban Abd El Azeim, Cairo University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07086872
- Sponsor's protocol ID
- P.T.REC/012/005806
- Acronym
- FHP
- Status last verified
- Jul 2025
- First submitted
- 18 Jul 2025
- Last updated
- 25 Jul 2025
- Results posted
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
Study at a glance
From the registry record, last updated by the sponsor on 25 Jul 2025. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Impact of Adding Integrated Neuromuscular Inhibition Technique to Mulligan Therapy in Symptomatic Forward Head Posture
- ClinicalTrials.gov ID
- NCT07086872
- Acronym / sponsor ID
- FHP / P.T.REC/012/005806
- Conditions
- Forward Head Posture
- Keywords
- Integrated Neuromuscular Inhibition Technique, Mulligan Therapy, Forward Head Posture
- Study type
- Interventional
- Recruitment status
- Not yet recruiting
- Enrolment
- 120 participants (estimated)
- Lead sponsor
- Cairo UniversityUniversity, hospital or other
- Study start
- 30 Jul 2025 (estimated)
- Primary completion
- 20 Feb 2026 (estimated)
- Study completion
- 20 Feb 2026 (estimated)
- First posted
- 25 Jul 2025 (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.
this study will be conducted to investigate the impact of adding integrated neuromuscular inhibition technique to mulligan therapy in symptomatic forward head posture.
Detailed description
Forward head posture is anterior positioning of the cervical spine, which is regarded as a "bad" head posture and is commonly found in patients who experience problems with the head and neck. Particularly, forward head posture is frequently found in people sitting in front of a computer for prolonged periods. Load increases in the muscles and joints of the cervical spine as a result of forward head posture are considered a major cause of musculoskeletal disorders. INIT is effective as it causes sustained or intermittent compression which causes ischemia reduces local circulation until pressure is released, after which a flushing of fresh oxygenated blood occurs. Mechanoreceptors impulses interface with slower pain messages reducing amount of pain messges reaching the brain, releasing pain relieving hormones, decreasing myofascial pain. Stretches the taut bands of muscles fibers. INIT along with strengthening excercises proved to be beneficial in decreasing disability improving Range of motion. The concept of SNAG is to increase the treatment effects by having patients perform active movements while removing pain in the lesions by means of manipulative therapy. This is a new concept in the manipulative therapy field, and differs from traditional manipulative therapy by combining the active movements of the patients with additional passive movements performed with the aid of therapists
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind (outcomes assessor)
- Number of arms
- 4
- Model description
- integrated neuromuscular inhibition and mulligan
| Arm | Type | Receives |
|---|---|---|
| Integrated Neuromuscular Inhibition Technique and mulligan therapy | Experimental | Other: Integrated Neuromuscular Inhibition Technique and mulligan therapy, Other: postural correction exercisesthirty patients will receive Integrated Neuromuscular Inhibition Technique and mulligan therapy three times a weeks for six weeks+postural correction exercises |
| Integrated Neuromuscular Inhibition Technique | Experimental | Other: Integrated Neuromuscular Inhibition Technique, Other: postural correction exercisesthirty patients will receive Integrated Neuromuscular Inhibition Technique+postural correction exercises three times a weeks for six weeks |
| mulligan therapy | Experimental | Other: mulligan therapy, Other: postural correction exercisesthirty patients will receive mulligan Technique+postural correction exercises three times a weeks for six weeks |
| postural correction exercises | Active comparator | Other: postural correction exercisesthirty patients will receive postural correction exercises three times a weeks for six weeks |
Who may qualify
- Ages
- 18 to 35 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult
Key inclusion criteria (2 listed)
- CVA equal or less than 50
- Had cervical pain for more than three months and had visited an orthopedist clinic
Key exclusion criteria (4 listed)
- cervical spine spondylosis
- fractures or cervical spinal surgery
- Cervical or shoulder neurological movement disorder.
- Temporo-mandibular surgery, (5) Pathologic trauma
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 |
|---|---|---|
| Integrated Neuromuscular Inhibition Technique and mulligan therapypatients will receive Integrated Neuromuscular Inhibition Technique in the form of intermittent ischemic compression, strain counter strain and muscle energy technique and mulligan therapy for limited cervical range of motion | Other | Integrated Neuromuscular Inhibition Technique and mulligan therapy |
| Integrated Neuromuscular Inhibition Techniquepatients will receive Integrated Neuromuscular Inhibition Technique in the form of intermittent ischemic compression, strain counter strain and muscle energy technique | Other | Integrated Neuromuscular Inhibition Technique |
| mulligan therapypatients will receive mulligan therapy for limited cervical range of motion | Other | mulligan therapy |
| postural correction exercisesthe patients will receive two strengthening exercises (deep cervical flexors and scapular retractors) and two stretching: cervical extensors (sub-occipital muscles) and pectoral muscles). The program was based on a program by Harman and Kendall | Other | Integrated Neuromuscular Inhibition Technique, Integrated Neuromuscular Inhibition Technique and mulligan therapy, mulligan therapy, postural correction exercises |
Primary outcome
pain intensity
Time frame: up to six weeks
visual analogue scale will be used to asses pain intensity which patient will be instructed to put point on line from no pain to tolerable pain. The scale consists of a line, usually 100 mm long, ranging from no pain or discomfort (zero) , to the worst pain that could possibly feel
4 secondary outcomes
neck disability
Time frame: up to 6 weeks
pressure pain threshold
Time frame: up to six weeks
cervical range of motion
Time frame: up to six weeks
craniovertebral angle
Time frame: up to six weeks
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 25 Jul 2025.
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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.
Questions about this trial
What is this clinical trial studying?
A study testing Integrated Neuromuscular Inhibition Technique and mulligan therapy, Integrated Neuromuscular Inhibition Technique and mulligan therapy in people with Forward Head Posture, run by Cairo University.
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 2 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: opening soon, as of the sponsor's last update on 25 Jul 2025. Status can change between updates, so confirm with the study contact before making plans.
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?
This study is still under way. Results are not available in the source record yet.
How can a doctor refer a patient or contact the research team?
Contact alshaymaa abd elazeim, phd (01033771553, alshaymaa.shaaban@pt.cu.edu.eg), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
pain intensity (time frame: up to six weeks). 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 25 Jul 2025.