Effectiveness of Proprioception versus Craniocervical Flexion Training Exercises in Forward Head Posture Patients: A Research Protocol for a Randomised Controlled Trial

Vollständiger Abstract

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Introduction: Forward Head Posture (FHP) is a forward inclination with increased flexion of the lower cervical and the upper thoracic regions, increased extension of the upper cervical vertebra and extension of the occiput on C1. Commonest impairments in subjects with FHP are neck pain, reduced cervical joint position sense, reduced strength of Deep Cervical Flexor (DCF) muscles and scapular muscle weakness. Need of the study: Proprioception training improves cervical joint position sense and Craniovertebral Angle (CVA) by activating suboccipital muscles and enhancing head–eye coordination. Craniocervical flexion training strengthens DCFs, reduces overactivity of superficial neck muscles and improves posture. Although both treatments show benefits in FHP, there is limited literature directly comparing their effectiveness. This gap highlights the need for present study to evaluate and contrast these interventions for evidence-based clinical practice. Aim: This study aims to compare the effectiveness of proprioception vs. craniocervical flexion training exercises in patients with FHP. Materials and Methods: A single-blinded randomised three-arm parallel trial will be conducted at YMT College of Physiotherapy Kharghar, Navi Mumbai, Maharashtra, India from January 2023 to June 2026. Total 114 subjects will be randomly allotted to three groups with a 1:1:1 ratio. The first group will receive Proprioception training exercises along with conventional exercises, the second group will receive Craniocervical flexion training exercises along with conventional exercises and the third group will receive conventional exercises. Effect on pain, CVA, DCF activation and on cervical proprioception will be assessed after six weeks of intervention and statistical evaluation will be conducted using repeated measures of Analysis of Variance (ANOVA) or Friedman’s test. A p