Upper cervical and upper thoracic spine mobilization versus deep cervical flexors exercise in individuals with forward head posture: A randomized clinical trial investigating their effectiveness

Article type: Research Article

Authors: Cho, Juchul^{a; b} | Lee, Eunsang^a | Lee, Seungwon^{c; *}

Affiliations: [a] Department of Physical Therapy, Graduate School of Sahmyook University, Seoul, Korea | [b] Department of Rehabilitation Medicine, Wellciti Hospital, Daejeon, Korea | [c] Department of Physical Therapy, Sahmyook University, Seoul, Korea

Correspondence: [*] Corresponding author: Seungwon Lee, Department of Physical Therapy, Sahmyook University, 815 Hwarang-ro, Nowon-gu, 01795 Seoul, Korea. Tel.: +82 2 3399 1630; Fax: +82 2 3399 1639; E-mail: swlee@syu.ac.kr.

Abstract: BACKGROUND: Although commonly utilized treatments, no study has directly compared the effectiveness of joint mobilization and stabilization exercise in individuals with forward head posture (FHP). OBJECTIVE:This study aimed to investigate the effects of upper cervical and upper thoracic spine mobilization versus deep cervical flexors exercise (DCFE) in individuals with FHP. METHODS: Thirty-one participants with FHP were randomized into the mobilization (n= 15) or exercise (n= 16) group. The treatment period was 4 weeks with follow-up assessment at 4 weeks and 6 weeks after the initial examination. Outcomes assessed included the craniovertebral angle (CVA), numeric pain rating scale (NPRS), respiratory function, and the global rating of change (GRC). RESULTS:Participants in the mobilization group demonstrated significant improvements (p< 0.05) in CVA, NPRS, and respiratory function, as compared to those in the exercise group. In addition, 9 of 15 (60%) participants in the mobilization group, as compared to 4 of 16 participants (25%) in the exercise group, had a GRC score of +4 or higher. CONCLUSIONS:The combination of upper cervical and upper thoracic spine mobilization indicated better overall short-term outcomes in CVA, NPRS, respiratory function, and GRC compared with DCFE in individuals with FHP.

Keywords: Forward head posture, mobilization, exercise, neck pain, respiration

DOI: 10.3233/BMR-181228

Journal: Journal of Back and Musculoskeletal Rehabilitation, vol. 32, no. 4, pp. 595-602, 2019