Body posture and fascial balance are closely associated with musculoskeletal health and biomechanical alignment. Impairments in postural alignment may contribute to abnormal loading patterns, muscular imbalance, fascial tension, and compensatory movement strategies throughout the body. Recent fascial theories suggest that fascial continuity may influence not only spinal and extremity alignment but also craniofacial structures and facial symmetry. Increased fascial tension, particularly in the cervical and thoracic regions, may alter soft tissue mechanics and contribute to asymmetrical facial appearance.
Myofascial release therapy is a manual therapy approach commonly used in physiotherapy to improve fascial mobility, decrease tissue restriction, reduce pain, and optimize postural alignment. Although previous studies have investigated the effects of myofascial interventions on musculoskeletal pain and posture, limited evidence exists regarding their influence on facial symmetry and facial anthropometric characteristics.
The present study is designed as a randomized controlled trial to evaluate the effects of myofascial release therapy on body posture and facial symmetry in healthy individuals. A total of 60 participants will be recruited and randomly allocated into intervention and control groups using a stratified randomization method based on dominant side characteristics. The intervention group will receive myofascial release therapy twice weekly for 6 weeks, whereas the control group will undergo only observation and assessment procedures during the same period.
The myofascial intervention protocol will include standardized manual therapy techniques targeting cervical, thoracic, shoulder, and fascial regions. The techniques will consist of single arm pull, lateral neck shoulder release, thoracic transverse plane technique, and anterior cervical fascial release applications performed by a trained physiotherapist.
Body posture assessment will be performed using the validated PostureScreen Mobile application. Standardized anterior, posterior, and lateral photographs will be analyzed to evaluate postural alignment parameters including forward head posture, shoulder asymmetry, spinal alignment, pelvic tilt, thoracic kyphosis, lumbar lordosis, and lower extremity alignment characteristics.
Facial symmetry assessment will be conducted using standardized digital facial photographs obtained under controlled environmental conditions. Anthropometric facial landmarks including exocanthion, endocanthion, alare, cheilion, zygion, and gonion points will be identified. Linear, proportional, and angular measurements will be calculated to determine facial asymmetry levels. Directional asymmetry scores will also be calculated to quantitatively evaluate right-left facial asymmetry.
Primary outcome measures will include changes in facial directional asymmetry scores and postural alignment parameters after the intervention period. Secondary analyses will investigate the relationship between postural characteristics, dominant side, physical activity habits, and facial symmetry variables.
The findings of this study may contribute to understanding the biomechanical relationship between fascial interventions, posture, and craniofacial symmetry. Additionally, the results may provide preliminary evidence for the use of fascial-based physiotherapy approaches in postural rehabilitation and facial asymmetry management.
