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Completed

NCT Number: NCT07298226

Immediate Effects of Atlanto-Occipital Mobilization on Head Posture, Respiratory Function, and Neck Mobility in Forward Head Posture

The purpose of this study is to investigate the immediate effects of atlanto-occipital joint mobilization on head posture, respiratory function, and cervical range of motion in healthy individuals with forward head posture.

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Key information

Conditions

Forward Head Posture Pathologic Processes Pathological Conditions, Signs and Symptoms Respiration Disorders Respiratory Aspiration Respiratory Tract Diseases

Age range

18 year–45 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Department of Physiotherapy and Rehabilitation, Ankara Yıldırım Beyazıt University

Ankara, 06000, Turkey (Türkiye)

About this study

Forward head posture (FHP) is a common postural disorder characterized by the anterior displacement of the head relative to the shoulders. The estimated prevalence of FHP among individuals who use electronic devices frequently is reported to be high, affecting a significant portion of the general population. While postural correction exercises and ergonomic education are generally the first-line management strategies for FHP, manual therapy techniques (such as joint mobilizations and soft tissue therapy) are often recommended as an adjunct treatment. Additionally, various physiotherapy approaches, including stretching of the posterior cervical muscles, strengthening of the deep neck flexors, and respiratory exercises, can also be utilized. Specific mobilization of the atlanto-occipital joint is theorized to normalize arthrokinematics and reduce fascial restrictions in the suboccipital region. This is said to decrease neuromuscular tension, improve proprioceptive input, and restore optimal alignment, resulting in positive effects on head posture, cervical mobility, and respiratory function.

Who can participate

Healthy volunteers accepted: No

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

Inclusion criteria

  • Volunteering to participate in the study.
  • Being between the ages of 18 and 45.
  • Having forward head posture according to craniovertebral angle measurement.

Exclusion criteria

  • History of cervical surgery or trauma.
  • Diagnosed cervical disc herniation or cervical stenosis.
  • Presence of a diagnosed neurological and/or rheumatological disorder.
  • Pregnancy.
  • Presence of malignancy.

Treatment and study plan

Atlanto-occipital joint mobilization

Other

The intervention group will receive a single session of atlanto-occipital joint mobilization.

Sham application

Other

The control group will receive a single session of sham intervention.

Primary outcomes

  1. Craniovertebral Angle (CVA) for Forward Head Posture

    Time frame: Assessments will be performed at baseline (before the application) and immediately following the single-session intervention.

    Forward head posture will be assessed by measuring the craniovertebral angle (CVA) using a goniometer. The CVA is the angle between the horizontal line passing through the C7 spinous process and the line from the tragus of the ear to the C7 spinous process.

  2. Respiratory Function assessed by Spirometry (FVC, FEV1, FEV1/FVC, PEF, FEF25-75%)

    Time frame: Assessments will be performed at baseline (before the application) and immediately following the single-session intervention.

    Respiratory function will be assessed using a spirometry device. The following parameters will be recorded and analyzed: Forced Vital Capacity (FVC), Forced Expiratory Volume in one second (FEV1), the FEV1/FVC ratio, Peak Expiratory Flow (PEF), and Forced Expiratory Flow at 25-75% of FVC (FEF25-75%).

  3. Cervical mobility (Cervical Range of Motion (CROM)) assessed by Bubble Inclinometer

    Time frame: Assessments will be performed at baseline (before the application) and immediately following the single-session intervention.

    Cervical mobility (range of motion) will be assessed using a bubble inclinometer. Active range of motion will be measured in degrees for the movements of flexion, extension, lateral flexion (left/right), and rotation (left/right).

Sponsors and collaborators

Lead sponsor

Bitlis Eren University

Other

Registry information

Official study title

An Investigation Into the Immediate Effects of Atlanto-Occipital Joint Mobilization on Head Posture, Respiratory Function, and Cervical Range of Motion in Individuals With Forward Head Posture

Important dates

Study start
2025
Primary completion
2026
Study completion
2026
First posted
Dec 23, 2025
Registry last updated
Mar 12, 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.

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