SIB # 472 -Forward Head Posture- An Expanded Approach to Rehab

The Study: Effects of a combination of scapular stabilization and thoracic extension exercises for office workers with forward head posture on the craniovertebral angle, respiration, pain, and disability: A randomized-controlled trial 

Overview: The study is a randomized control trial to investigate how exercise programs, not directly applied to the cervical spine, might benefit Forward Head Posture (FHP) and associated problems.

 Key Points:

 ·        32 office workers with FHP (13 males, 19 females; mean age 36 years) were randomized either to experimental (n=16) or control groups (n=16). 

·        The experimental group performed both scapular stabilization and thoracic extension exercises both of which had been examined in previous studies. 

·        The control group performed cervical stabilization and neck stretching exercise. 

·        Both groups performed their respective activities for 40 minutes, 3 days weekly for a total of six weeks 

·        Scapular Stabilization Exercises consisted of four separate movements which are described in detail and photos in the full text.  

·        Thoracic Extension Exercise consisted of three separate movements which are also described in the full text. 

·        Primary outcomes (Cranio-vertebral angle, forced respiration, pain levels and neck disability) were assessed both Pre and Post intervention.  

·        Both groups showed similar improvements in Forward Head Posture, Pain and Neck Disability. 

·        Both groups also showed improvement in Respiration although the Scapular Stabilization Exercise/Thoracic Extension Exercise group improved significantly more than the control group which only performed cervical stabilization and neck stretching exercise.

Author’s Conclusions: “A combination of SSE (scapular stabilization exercise) and TEE (thoracic extension exercise), used in this study, improves the imbalance of respiratory muscles due to FHP and positively affects the alignment of the cervical and thoracic spine so that the respiratory function is enhanced.”

(Parenthesis/Italics ours)

Reviewer's Comments: I liked this study because it confirms the interrelationships between forward head posture and the postural dynamics of both the thoracic spine and the scapula.  I strongly encourage the interested reader to review the full text to better understand the exact exercises used. 

Reviewer:  Mark R. Payne DC 

Reference:  Na-Yeon Kang, Sang-Cheol Im, and Kyoung Kim.  Effects of a combination of scapular stabilization and thoracic extension exercises for office workers with forward head posture on the craniovertebral angle, respiration, pain, and disability: A randomized-controlled trial Turk J Phys Med Rehabil. 2021 Sep; 67(3): 291–299. Published online 2021 Sep 1

Link to Full Text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8606989/