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THE EFFECTS OF EDUCATION OR CORRECTIVE EXERCISE ON FORWARD HEAD POSTURE - A RANDOMIZED CONTROLLED TRIAL

Abstract

David Titcomb1,,2, Bridget Melton3, Theresa Miyashita2, Helen Bland3. 1Liberty University, Lynchburg, VA. 2Concordia University Chicago, River Forest, IL. 3Georgia Southern University, Statesboro, GA.

BACKGROUND: If forward head posture (FHP) is not addressed during young adulthood, it may persist throughout life as a result of spinal remodeling and degenerative musculoskeletal pathology. As optimal programming to improve FHP in individuals without pathology is unclear, the purpose of this study was to compare the effects of three different intervention strategies, postural education (PE) and two corrective exercise programs (CEPs), on the craniovertebral angle (CVA) in healthy young adults with FHP. METHODS: A prospective four-arm parallel randomized controlled trial with repeated measures was performed. Seventy-nine healthy young adults (55 women, 24 men; mean age: 20.08 ± 2.19 y) with FHP were randomized into four groups: PE group, self-myofascial release + stretching group (SMRS), self-myofascial release + stretching + strengthening group (SMRSS), and a control group (CG). Participant CVA (°) was assessed before and after a 4-week intervention. RESULTS: Seventy-two participants completed the trial. Within-group comparisons of pre- vs. post-intervention CVA outcomes revealed a significantly greater post-intervention CVA in the PE (45.1 ± 5.9° vs. 48.1 ± 5.9°, p<0.001), SMRS (47.4 ± 5.2° vs. Post: 51.2 ± 4.0°, p<0.001), SMRSS (47.1 ± 3.9° vs. 51.4 ± 5.4°, p<0.001), and CG (46.9 ± 4.4° vs. 47.8 ± 5.0°, p=0.04). Post-hoc comparisons indicated post-intervention mean CVA change in the SMRS group (3.8 ± 3.3°); and the SMRSS group (4.4 ± 3.1°); was significantly greater (p=0.003) than the CG (0.8 ± 1.7°). CONCLUSIONS: All three interventions appear to be effective techniques for improving FHP in healthy young adults, however CEPs may provide superior outcomes than PE alone. A 4-week CEP consisting of self-myofascial release + stretching may yield similar CVA enhancements as a CEP consisting of self-myofascial release + stretching + strengthening. Study findings can assist fitness professionals in designing evidence-based FHP intervention programs for young adults without musculoskeletal pathology. Funding: This study was funded by the National Academy of Sports Medicine and Liberty University Center for Research & Scholarship.

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