Skip to main content
OpenTrials
Completed

NCT Number: NCT06711497

Global Postural Reeducation Exercises Versus Deep Neck Flexor Activation on Non Specific Neck Pain With Forward Head Posture

this study will be conducted to compare between global postural reeducation (GPR) and deep neck flexors (DNF) activation in patients with chronic nonspecific neck pain (NSNP) on pain, disability, forward head posture and deep neck flexors endurance

Completed

Looking for future studies?

Notify Me

Key information

Conditions

Non Specific Neck Pain Forward Head Posture

Age range

18 year–24 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

October 6 University

Giza, October 6, 3220001, Egypt

About this study

Neck pain (NP) is highly prevalent and is the sixth largest cause of disability in the world, causing considerable economic impact. Between 50% and 75% of people will not recover from an acute episode and will experience recurrent neck pain within the next 1 to 5 years, approximately 68% of people will develop persistent and chronic neck pain.Forward head posture (FHP) is a common posture malalignment which characterized by increased craniocervical angle more than 50 degrees. There is a significant association between neck pain and forward head posture. According to previous studies, it has been proven that an average of 60% of patients with neck pain have a forward head posture.Cranio-cervical flexor muscles training focuses on the deep flexor muscles such as longus capitis and longus colli muscles, which flex the neck, not the head. Also, these low-load exercises train the deep cervical flexors more specifically, rather than all the neck flexors involved in the head-lifting exercise.Global postural reeducation (GPR) is a method of physiotherapy, developed by Phillipe Souchard in the 1950s.Its therapeutic approach depends on causality, and globality and is based on the hypothesis that the muscular system is organized into muscle chains, which can be shortened because of musculoskeletal disorders and constitutional, behavioral and psychological factors. forty four patients will be assigned randomly into two equal groups; fist one will receive global postural reeducation plus active neck exercise and the other will receive deep neck flexor exercises plus active neck exercise

Who can participate

Healthy volunteers accepted: No

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

Inclusion criteria

  • Adult physiotherapists with mechanical neck pain and base line score of at least 3 out of 10 pain intensity on VAS .
  • Adult physiotherapists with FHP and CVA less than 50 as a reference angle
  • Adult physiotherapists aged from 18 to 24.

Exclusion criteria

  • Specific cause of neck pain as (rheumatic ,sytemic ,neuromuscular diseases ).
  • Cognitive impairment .
  • Cervical radiculopathy .
  • Cervical spondylolisthesis

Treatment and study plan

global postural reeducation exercises

Other

Subjects will be trained on global postural reeducation exercises (GPR) and active neck exercises. At each session, they will maintain two different lying postures to stretch anterior and posterior muscle chain and one standing posture to integrate the postural correction into activity of daily living (ADL.Initially, without gravity load, a lying posture was applied to the anterior muscle chain for approximately 15 min, then another lying posture to the posterior muscle chain for other 15 min, and finally the patients worked in a standing posture for postural integration under a gravity load for 5 min.

deep neck flexor activation exercise

Other

Subjects will be trained on deep neck flexor activation using pressure biofeedback and active neck exercises . The pressure sensor will be put under the neck and will be asked to de gentle nod as if saying "yes" so that the pressure sensor measures 2mmHg above baseline (20mmHg), then 4mmHg, followed by 6mmHg,8mmHg, and 10 mmHg without rests in between. the pressure sensor should read 30mmHg at the end of the movement sequence. Patient will hold each increment for 2 seconds, 10 seconds total after all 5 increments. Highest level achieved will be repeated with the correct form until a total of 10 reps with 10-second holds will be achieved in three series with 30 seconds of interval between the series plus active neck flexor exercise

Primary outcomes

  1. neck disability

    Time frame: up to four weeks

    neck disability will be measured by the Arabic version of neck disability index. NDI is a self-reported questionnaire that consists of 10 questions: pain intensity, personal care, lifting, reading, headaches, concentration, work, driving, sleeping, and recreation. Each item is scored from 0 (no disability) to 5 (total disability). The maximum possible score is 50. However, the NDI is frequently normalized to 100 and reported as percent Because the questionnaire is straightforward, most of the patients need approximately 5 minutes to complete it

Secondary outcomes

  1. pain intensity

    Time frame: up to four weeks

    pain intensity will be measured by visual analogue scale. The VAS tool is a very simple tool as the therapist asks the patient to express how potent he/she feels current pain or last 24 hours' pain through choosing a point on a100 mm line drawn between two ends one end refer to absence of pain and the other the worst intense pain

  2. Craniovertebral Angle

    Time frame: up to four weeks

    The Craniovertebral Angle will be measured using a digital imagining technique (kinovea software). The craniovertebral angle is measured by calculating the angle found at the intersection of a line drawn from the tragus of the ear through the spinous process of C7 Vertebra and a horizontal line through C7 Vertebra.

  3. deep neck flexors endurance

    Time frame: up to four weeks

    deep neck flexor endurance will be measured by pressure biofeedback device. The pressure biofeedback unit will be centered just below the occiput between the plinth and the back of the neck and inflated to a baseline of 20 mmHg. Each subject was asked to execute the head nodding action gently and slowly (as if they said yes) at five different levels of pressure (22, 24, 26, 28 and 30 mmHg) and to maintain each level for 10 seconds There was a 30-second rest period between each level. The test protocol will end when the subject will be unable to hold the same pressure level for 10 sec or will reach a peak level of 30mmHg

Sponsors and collaborators

Lead sponsor

October 6 University

Other

Registry information

Acronym: GPR

Important dates

Study start
2024
Primary completion
2025
Study completion
2025
First posted
Dec 2, 2024
Registry last updated
May 15, 2026

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.

Related clinical trials

Published trials that share one or more normalized conditions with this study.