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NCT Number: NCT07039565

Efficacy of Combined Manual Diaphragm Release Technique and Neck Exercises in Adolescents With Forward Head Posture

* Due to the heavy use of smartphones among adolescents the cervical spine destabilizes and moves forward, so do the vital structures (nerves, arteries, veins) within the neck undergo torsion, stretch and compression including the autonomic nervous system nerves (which can cause dysfunction in heart rate, digestion, breathing among other symptoms). * Forward head posture (FHP) puts more compressive strain on the cervical spine's tissues, especially the ligaments and facet joints. Because FHP weakens the respiratory muscles, it has a significant impact on respiratory function. Static balance may be negatively impacted by FHP. * FHP is effectively treated by a proper and suitable physical therapy program.

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This study is active but is not currently recruiting participants.

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Key information

Conditions

Forward Head Posture

Age range

17 year–18 year

Sex eligibility

Male

Study type

Interventional

Phase

Not applicable

Primary location

Pharos University in Alexandria

Alexandria, Egypt

About this study

In the past few years, the number of smart phone users has progressively increased worldwide. With the growing use of smart phones, concerns have also increased about musculoskeletal problems associated with the prolonged use of smart phones.

Concerns have also increased about musculoskeletal problems associated with the prolonged use of smartphones. Recent investigations have shown that smartphone users tend to report pain in the neck, shoulder, and thumb, and the severity of the symptoms as the total time spent using the smartphone increases.

One of the most overspread postural abnormalities is forward head posture (FHP) and it is described as head projection anteriorly in relation to the trunk which appears mainly in sagittal plane. When using a smartphone, people usually flex their neck downwards to stare at the lowered object and maintain the head in a forward position for long periods of time, the maintenance of a head-forward posture decreases cervical lordosis of the lower cervical vertebrae and creates a posterior curve in the upper thoracic vertebrae to maintain balance; this is known as the forward head posture (FHP) that causes shortening of the extensors of the neck and producing chronic neck pain.

The weight supported by the spine dramatically increases when flexing the head forward at varying degrees. An adult head weighs 10-12 pounds in the neutral position. As the head tilts forward, the forces felt by the neck surge to 27 pounds at 15 degrees, 40 pounds at 30 degrees, 49 pounds at 45 degrees, and 60 pounds at 60 degrees. At 90 degrees, the model prediction was not reliable.

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Male students their age ranged from 17 to 18 years.
  • Has Body Mass Index (BMI) = 5th percentile to less than the 85th percentile.

_ has forward head posture

  • Studying at any faculty at Pharos University in Alexandria.
  • Cooperative and followed the instructions.

Exclusion criteria

  • - Subjects were excluded from the study if the student had visual or hearing defects.
  • Overweight, obese or cachexic students.
  • Had any neurological disorders.
  • Had musculoskeletal problems.
  • Had any congenital abnormalities that might affect the study.

Treatment and study plan

stretching and strengthening exercises

Other

Strengthening exercises were progressively performed for three sets, with 10 to 15 repetitions. The stretching part of the exercises was done with the purpose of increasing the flexibility of the pectoralis and the cervical neck extensors muscles (pectoralis stretch, chin tuck). Exercises have been approved to be effective on the lengthening of the pectoralis minor, activation of the lower trapezius/middle trapezius, serratus anterior, and improvement of the posture

Diaphragm release technique

Other

the patient will positioned in the supine position. The therapist stand at the head of the patient. The therapist make manual contact bilaterally under the costal cartilages of the lower ribs (7th to 10th ) with hypothenar regions of the hands and last three fingers. During the patient's inspiration, the therapist is gently pulling the points of hands contacts toward the head and slightly laterally, while elevating the ribs simultaneously

Primary outcomes

  1. craniovertebral angle (CVA) Forward head posture

    Time frame: 12 weeks

    The angle formed by a horizontal line crossing c7 and a line crossing c7 to the tragus of the ear is known as the CVA

  2. Vertical head alignment (VHA)

    Time frame: 12 weeks

    Angle between right tragus, right acromion and vertical.

Sponsors and collaborators

Lead sponsor

Pharos University in Alexandria

Other

Registry information

Official study title

Efficacy of Combined Manual Diaphragm Release Technique and Neck Exercises in Adolescents With Forward Head Posture: a Randomized Controlled Trial

Acronym: CVA

Important dates

Study start
2025
Primary completion
2025
Study completion
2025
First posted
Jun 26, 2025
Registry last updated
Jul 9, 2025

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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