Comparative Effects of Blackburn and Egoscue Exercises to Improve CVA in Individuals With Forward Head Posture

Forward head posture represents a common cervical spinal deviation characterized by hyperextension of the upper cervical vertebrae combined with hyperflexion of the lower cervical region, ultimately producing excessive lordosis within the cervical spine. As a consequence, affected individuals experience difficulties performing their routine daily functions due to premature muscular fatigue in the neck region, diminished cervical stability, cervicogenic headache, and compromised postural regulation. The trial aims to evaluate and compare the therapeutic outcomes of Blackburn and Egoscue exercise interventions in managing forward head posture.The study will be conducted as a Randomized Clinical Trial enrolling subjects diagnosed with forward head posture. Participants of both sexes will be eligible provided they present with a Craniovertebral Angle (CVA) ranging between 30 and 45 degrees, a Neck Disability Index (NDI) score indicating moderate to severe impairment, and pain levels rated as moderate to severe on the Numeric Pain Rating Scale (NPRS). Individuals currently wearing orthotic devices or having a history of recent trauma or fractures will be ineligible for participation. Written as well as verbal informed consent shall be obtained from each participant prior to enrollment. A total of 28 subjects will be distributed across 2 groups, each comprising 14 individuals, with allocation performed through randomization. Group A will undertake Blackburn exercise protocols while Group B will follow Egoscue method exercises. Transcutaneous Electrical Nerve Stimulation (TENS), isometric exercises, and thermotherapy via hot pack will serve as baseline interventions for both cohorts alongside cervical isometrics. The complete intervention protocol will span 24 sessions administered across 3 sessions weekly on alternate days. The principal outcomes assessed will include pain severity, craniovertebral alignment, and functional disability. Assessment instruments will comprise the Craniovertebral Angle measurement, Neck Disability Index, and Numeric Pain Rating Scale. Baseline measurements will be recorded at the start, pain will be documented before and after every treatment session, whereas forward head posture assessment and neck disability evaluations will be conducted both at baseline and upon completion of the 8-week protocol. Statistical processing of data will utilize SPSS version 23.

Inclusion criteria

• Age range: 25 to 45 years (Mahmoud et al., 2019).
• Individuals demonstrating a Craniovertebral Angle between 30 and 45 degrees.
• Individuals reporting pain levels classified as moderate to severe on the NPRS.
• Individuals demonstrating moderate to severe disability as measured by the Neck Disability Index.
• Both male and female participants will be considered eligible.

Exclusion criteria

• Individuals currently receiving any physical therapy intervention targeting the neck or shoulder regions.
• Individuals utilizing cervical or lumbar orthotic devices.
• Individuals taking prescribed pain medications.
• Individuals with a formally diagnosed psychological condition.
• Any recent bone fracture.
• Any recently sustained trauma or injury.
• Formally diagnosed neurological signs or symptoms.
• Burns or open wounds.
• Formally diagnosed vestibular pathology.