Neck Exercises for Improving Pelvic Alignment and Low Back Pain

This study aimed to investigate whether a three-dimensional nuchal exercise program is associated with changes in pelvic alignment and low back pain in adults.

Thirty participants with low back pain performed a structured cervical exercise program for four weeks, including horizontal, sagittal, and diagonal movements. Pelvic tilt angle and pain intensity were measured before and after the intervention.

The findings of this study may provide preliminary evidence supporting a potential relationship between cervical movement and pelvic alignment, contributing to the understanding of regional interdependence in musculoskeletal rehabilitation.

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Key information

Conditions

Low Back Pain Back Pain Neurologic Manifestations Pain Pathological Conditions, Signs and Symptoms Pelvic Malalignment Postural Imbalance Signs and Symptoms

Age range

30 year–60 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Yuanpei University of Medical Technology

Hsinchu, 30015, Taiwan

About this study

Low back pain is a common musculoskeletal condition that can lead to functional limitation and reduced quality of life. Traditional rehabilitation approaches often focus on the lumbar and pelvic regions; however, emerging evidence suggests that different body regions may be functionally interconnected.

The concept of regional interdependence proposes that impairments in one anatomical region may contribute to dysfunction in another. The cervical spine plays an important role in postural control due to its rich proprioceptive input and its interaction with visual and vestibular systems. Therefore, cervical movement may influence postural alignment and neuromuscular control throughout the body.

This study was designed as a single-group, pre-post interventional study to explore the effects of a three-dimensional nuchal exercise program on pelvic alignment and pain intensity. Participants with low back pain were instructed to perform a structured exercise program consisting of horizontal rotation, sagittal flexion-extension, and diagonal (star-pattern) cervical movements.

Pelvic alignment was assessed using photographic analysis, and pain intensity was measured using a visual analog scale (VAS). Measurements were conducted before and after the intervention period.

This study is considered a preliminary (pilot) investigation. The results may provide initial evidence for cervico-pelvic interaction and inform the design of future controlled trials.

Who can participate

Healthy volunteers accepted: No

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

Inclusion criteria

Adults aged 30 to 60 years
Individuals who reported experiencing low back pain within the previous 6 months
Ability to stand independently and perform exercise tasks
Willingness to participate and provide written informed consent-

Exclusion criteria

- History of severe head or neck injury
Previous spinal surgery
Active infectious disease or uncontrolled malignancy
Cognitive impairment affecting the ability to follow instructions
Any condition affecting the ability to stand or walk independently

Treatment and study plan

Three-Dimensional Nuchal Exercise Program

Behavioral

A structured cervical exercise program consisting of three components: horizontal rotation, sagittal flexion-extension, and diagonal (star-pattern) movements. Participants performed 20 repetitions for each movement while maintaining an upright posture. The program was performed over a four-week period.

Primary outcomes

Pelvic Tilt Angle

Time frame: Baseline and after 4 weeks of intervention

Pelvic alignment was assessed by measuring the pelvic tilt angle using digital photographic analysis. The angle was defined as the deviation from horizontal alignment based on anatomical landmarks.

Sponsors and collaborators

Lead sponsor

Yuanpei University of Medical Technology

Other

Registry information

Official study title

Effects of a Three-Dimensional Nuchal Exercise Program on Pelvic Alignment and Low Back Pain in Adults

Acronym: NEPAL

Important dates

Study start: 2018
Primary completion: 2018
Study completion: 2018
First posted: May 7, 2026
Registry last updated: May 7, 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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Completed