Comparative Analysis of Artificial Intelligence-Generated and Studio-Based Reformer Pilates Interventions for Forward Head Posture

Posture is the alignment of body segments. While ideal posture places minimal stress on the joints, poor posture increases joint stress. Forward head posture (FHP) is a common postural abnormality characterized by the anterior displacement of the head in the sagittal plane. This condition may lead to muscle imbalances, pain, reduced cervical range of motion (ROM), decreased quality of life, and spinal degeneration.

The most common method for evaluating FHP is the craniovertebral angle (CVA). Causes of FHP include excessive smartphone and computer use, mouth breathing, carrying heavy bags, and rounded shoulders. Cervical stabilization exercises and holistic approaches are recommended for prevention and treatment.

Pilates, developed by Joseph Pilates, especially in its clinical form, has been shown to improve posture, strengthen core muscles, and enhance quality of life. Literature indicates that stretching- and strengthening-based exercise programs targeting FHP positively affect CVA, neck pain, and ROM.

In recent years, artificial intelligence (AI) has gained importance in physiotherapy as a diagnostic and therapeutic support tool. Its potential in generating exercise prescriptions is being explored, though whether AI can replace physiotherapists remains debated.

The aim of this study is to compare the effectiveness of an AI-generated reformer Pilates protocol and a studio-based reformer Pilates protocol in individuals with FHP. Hypotheses:

H0: The studio-based reformer Pilates protocol has no effect on CVA, ROM, pain, muscle endurance, or quality of life in individuals with FHP.

H1: The studio-based reformer Pilates protocol has a positive effect on these parameters.