Neck PainNCT07669844
Effect of Bruegger's Exercise in Chronic Mechanical Neck Pain With Forward Head Posture
A study testing Core stability exercise and Bruegger's training in people with Neck Pain, run by Cairo University at 1 site in Egypt.
Trial summary
The purpose of the study is to investigate the effect of adding Bruegger's exercises on conventional exercise program in treatment of forward head posture. Read more about this study
- Who is it for?
- Ages 18 to 35 years
- Conditions the study is for
- Neck Pain
- What is being tested?
- Core stability exercise and Bruegger's training
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 24 participants
- Where
- 1 siteEgypt
- Study dates
- 1 Jul 2026to 16 Sep 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
- Participant with neck pain and craniovertebral angle value lower than 50°.
- Numeric pain rating score above 3.
- More than 10 on neck disability index.
Who cannot join
- Arthritis (or other inflammatory diseases).
- Locoregional tumor or metastasis .
- Myopathy .
- Severe psychiatric disorders.
- Previous neck surgery.
- Fibromyalgia.
Trial locations and contacts
1 site in 1 country. Contact the study team or a site near you to ask about taking part.
About this study
The purpose of the study is to investigate the effect of adding Bruegger's exercises on conventional exercise program in treatment of forward head posture.
Read the detailed description
Forward head posture, head-on-trunk misalignment, leads to increased lordosis of the lower cervical spine as well as rounded shoulders accompanied by increased kyphosis of the thoracic spine. These musculoskeletal disorders change the balance of the muscles around the neck.
Bruegger's postural relief position is one such self-care exercise that works in order to reverse Forward head posture (FHP) by strengthening the scapular retractors meanwhile stretching the protractors. This exercise helps in aligning the spine in correct position through isometric co-contraction of scapular muscles, thereby improving scapular stabilization. The exercise helped in strengthening the weak deep cervical flexor muscles since it includes isometric contraction of neck muscles through chin tuck.
Although Bruegger's exercises has been widely suggested or advised clinically by the physiotherapists, there is a lack of research-based evidence/data which proves regarding its effect in the correction of FHP. Hence, it was hypothesized that the Bruegger's exercises will show favorable results in the correction of FHP and craniovertebral angle (CVA).
This study may benefit physical therapists by providing a new and easy approach in treating FHP.
- Conditions
- Neck Pain
- Being tested
- Core stability exercise, Bruegger's training
- Medical subject headings
- Neck Pain
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Core stability exerciseOther
The participants will be treated with conventional core stability exercise; Neck Stability Exercises-Free exercise for cervical spine, Neck isometric exercises (flexion, extension, lateral flexion, rotation), Wall angle exercises for lower trapezius, Chin tuck, Chin tuck into the towel
Bruegger's trainingOther
Bruegger's Position of external arm rotation, shoulder abduction and retraction of the scapulae . This position with simultaneous head and neck retraction is a strengthening exercise for deep neck flexors and lower scapular stabilizers. The subjects are instructed to place their feet on the floor completely and keep their knee joints 10 ㎝ below the hip joints in 45° of abduction. The subjects sit hitting their ischial tuberosity on the chair and maintained their physiological curvature for the TL spine. Following external rotation of the glenohumeral joints, tension is relaxed with each inhalation, and depression and retraction of the shoulder girdle are performed with each exhalation.
| Study group | Role | What they receive |
|---|---|---|
| Core stability exercises | Active comparator | The participants will receive conventional core stability exercise for 12 sessions (3 sessions per week for four weeks). Receives: Other: Core stability exercise |
| Bruegger's training and core stability exercises | Experimental | will receive a program of Bruegger's training plus conventional core stability exercise for 4 weeks, 3 sessions per week, total 12 sessions, with about 30:45 minutes per session. Receives: Other: Core stability exercise; Other: Bruegger's training |
What is being measured
The primary outcome is the main question the study is designed to answer.
Assessment of pain intensity
The numerical pain rating scale will be used to assess pain intensity. It is 11-point numeric scale ranges from '0' representing one pain extreme (e.g. "no pain") to '10' representing the other pain extreme (e.g. "pain as bad as you can imagine" or "worst pain imaginable.
Measured: 4 weeks
Assessment of craniocervical angle (CVA)
The CVA will be evaluated with forward head posture (FHP) application on a Xiaomi® MiA2.
Two markers are placed on the ground separated by 1.5 m, where the camera or smart phone and the subject are located. Reference markers are placed on the spinous process of C7 and in the swallow of the subjects' ears, which were identified through palpation. The subject is placed on the floor mark, barefoot and standing, lateral to the evaluator.
The application provides the complement to the CVA, thus making further calculation necessary. To determine the CVA, it is necessary to subtract the angle provided by the application from 360°.
The presence of FHP will be determined by an angle value lower than 50°, and the absence of FHP if the angle value is greater than or equal to 50°
Measured: 4 weeks
Assessment of craniocervical flexion endurance
Craniocervical flexion endurance test (CCFE test) will be used. The position of the participant is supine with cervical spine in the neutral position. The PBU is placed between the plinth and the posterior neck just below the occiput. The cuff is then inflated to a baseline of 20 mmHg. The participant was then asked to avoid head lift during CCFE test, thereby reducing the recruitment of superficial flexors.
Each participant will be asked to perform the neck flexion movement at five different pressure levels (22, 24, 26, 28, and 30 mmHg) with 10 s hold at each level and 30 s rest between each level.
The test is terminated if the subject is not able to hold the position of the neck for 10 s at a specific pressure level or if the maximum level of 30 mmHg is achieved.
Measured: 4 weeks
Secondary outcomes (1)
Assessment of function disability
Arabic version of neck disability index will be used to assess function disability.
Questions include activities of daily living, such as personal care, lifting, reading, work, driving, sleeping, recreational activities, pain intensity, concentration, and headache. Each question is measured on a scale from 0(no disability) to 5, and an overall score out of 100 is calculated by adding each item score together and multiply in it by two. A higher NDI score means the greater a patient's perceived disability due to neck pain.
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 posted25 Jun 2026
- Study start1 Jul 2026 (estimated)
- Primary completion1 Sep 2026 (estimated)
- Study completion16 Sep 2026 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Neck PainStudies 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
- Masking
- Single blind
- Who is masked
- Outcomes assessor
- Enrolment
- 24 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Cairo University
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Hadeer Salaheldin Mahmoud Morsi, Cairo University
- Investigators
- Salwa Abd E-Majeed, Professor, Study chair, Cairo University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07669844
- Sponsor's protocol ID
- P.T.REC/012/004505
- Status last verified
- Jun 2026
- First submitted
- 21 Jun 2026
- Last updated
- 25 Jun 2026
- 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 Jun 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Effect of Bruegger's Exercise in Chronic Mechanical Neck Pain With Forward Head Posture
- ClinicalTrials.gov ID
- NCT07669844
- Acronym / sponsor ID
- P.T.REC/012/004505
- Conditions
- Neck Pain
- Study type
- Interventional
- Recruitment status
- Not yet recruiting
- Enrolment
- 24 participants (estimated)
- Lead sponsor
- Cairo UniversityUniversity, hospital or other
- Study start
- 1 Jul 2026 (estimated)
- Primary completion
- 1 Sep 2026 (estimated)
- Study completion
- 16 Sep 2026 (estimated)
- First posted
- 25 Jun 2026 (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 purpose of the study is to investigate the effect of adding Bruegger's exercises on conventional exercise program in treatment of forward head posture.
Detailed description
Forward head posture, head-on-trunk misalignment, leads to increased lordosis of the lower cervical spine as well as rounded shoulders accompanied by increased kyphosis of the thoracic spine. These musculoskeletal disorders change the balance of the muscles around the neck.
Bruegger's postural relief position is one such self-care exercise that works in order to reverse Forward head posture (FHP) by strengthening the scapular retractors meanwhile stretching the protractors. This exercise helps in aligning the spine in correct position through isometric co-contraction of scapular muscles, thereby improving scapular stabilization. The exercise helped in strengthening the weak deep cervical flexor muscles since it includes isometric contraction of neck muscles through chin tuck.
Although Bruegger's exercises has been widely suggested or advised clinically by the physiotherapists, there is a lack of research-based evidence/data which proves regarding its effect in the correction of FHP. Hence, it was hypothesized that the Bruegger's exercises will show favorable results in the correction of FHP and craniovertebral angle (CVA).
This study may benefit physical therapists by providing a new and easy approach in treating FHP.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind (outcomes assessor)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Core stability exercises | Active comparator | Other: Core stability exerciseThe participants will receive conventional core stability exercise for 12 sessions (3 sessions per week for four weeks). |
| Bruegger's training and core stability exercises | Experimental | Other: Core stability exercise, Other: Bruegger's trainingwill receive a program of Bruegger's training plus conventional core stability exercise for 4 weeks, 3 sessions per week, total 12 sessions, with about 30:45 minutes per session. |
Who may qualify
- Ages
- 18 to 35 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult
Key inclusion criteria (3 listed)
- Participant with neck pain and craniovertebral angle value lower than 50°.
- Numeric pain rating score above 3.
- More than 10 on neck disability index.
Key exclusion criteria (6 listed)
- Arthritis (or other inflammatory diseases).
- Locoregional tumor or metastasis .
- Myopathy .
- Severe psychiatric disorders.
- Previous neck surgery.
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 |
|---|---|---|
| Core stability exerciseThe participants will be treated with conventional core stability exercise; Neck Stability Exercises-Free exercise for cervical spine, Neck isometric exercises (flexion, extension, lateral flexion, rotation), Wall angle exercises for lower trapezius, Chin tuck, Chin tuck into the towel | Other | Bruegger's training and core stability exercises, Core stability exercises |
| Bruegger's trainingBruegger's Position of external arm rotation, shoulder abduction and retraction of the scapulae . This position with simultaneous head and neck retraction is a strengthening exercise for deep neck flexors and lower scapular stabilizers. The subjects are instructed to place their feet on the floor completely and keep their knee joints 10 ㎝ below the hip joints in 45° of abduction. The subjects sit hitting their ischial tuberosity on the chair and maintained their physiological curvature for the TL spine. Following external rotation of the glenohumeral joints, tension is relaxed with each inhalation, and depression and retraction of the shoulder girdle are performed with each exhalation. | Other | Bruegger's training and core stability exercises |
Primary outcome
Assessment of pain intensity
Time frame: 4 weeks
The numerical pain rating scale will be used to assess pain intensity. It is 11-point numeric scale ranges from '0' representing one pain extreme (e.g. "no pain") to '10' representing the other pain extreme (e.g. "pain as bad as you can imagine" or "worst pain imaginable.
Assessment of craniocervical angle (CVA)
Time frame: 4 weeks
The CVA will be evaluated with forward head posture (FHP) application on a Xiaomi® MiA2. Two markers are placed on the ground separated by 1.5 m, where the camera or smart phone and the subject are located. Reference markers are placed on the spinous process of C7 and in the swallow of the subjects' ears, which were identified through palpation. The subject is placed on the floor mark, barefoot and standing, lateral to the evaluator. The application provides the complement to the CVA, thus making further calculation necessary. To determine the CVA, it is necessary to subtract the angle provided by the application from 360°. The presence of FHP will be determined by an angle value lower than 50°, and the absence of FHP if the angle value is greater than or equal to 50°
Assessment of craniocervical flexion endurance
Time frame: 4 weeks
Craniocervical flexion endurance test (CCFE test) will be used. The position of the participant is supine with cervical spine in the neutral position. The PBU is placed between the plinth and the posterior neck just below the occiput. The cuff is then inflated to a baseline of 20 mmHg. The participant was then asked to avoid head lift during CCFE test, thereby reducing the recruitment of superficial flexors. Each participant will be asked to perform the neck flexion movement at five different pressure levels (22, 24, 26, 28, and 30 mmHg) with 10 s hold at each level and 30 s rest between each level. The test is terminated if the subject is not able to hold the position of the neck for 10 s at a specific pressure level or if the maximum level of 30 mmHg is achieved.
1 secondary outcome
Assessment of function disability
Time frame: 4 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 Jun 2026.
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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.
Salwa Abd E-Majeed, Professor study chair
Cairo 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 Core stability exercise and Bruegger's training in people with Neck Pain, run by Cairo University at 1 site in Egypt.
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: opening soon, as of the sponsor's last update on 25 Jun 2026. 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 Egypt. 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?
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 Hadeer Morsi, Master (01157677014, happypt91@gmail.com), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Assessment of pain intensity (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 25 Jun 2026.