Virtual Reality Exercises Versus Motor Control Training in Symptomatic Forward Head Posture

Thirty one subjects will receive virtual reality exercises by VR Training using Xbox Kinect. The Kinect sensor is an infrared camera that can recognize the positions and motions of the player without the need for special controller. The console controls the various games .For the VR training, the Xbox Kinect, console, and monitor will set up in a dedicated space. The patient will placed 1.5-2 m away from the Kinect sensor. Before the start of the training session, the research assistant adjusted the position of the sensor while the patient is sitting to ensure optimal position and motion capture, and loaded games into the system. After the setup is completed, the research assistant demonstrated games included in the Kinect adventure

Thirty one subjects will receive motor control training two times a week for eight weeks in form of deep cervical flexors strengthening using pressure biofeedback unit (craniocervical flexor exercise) :Pressure biofeedback unit will be used to perform Cranio-cervical flexor muscle training. Through which an endurance and isometric exercise for DNFs in progressive range positions will be performed each session, the PBU's air bag will be positioned below the occiput, and the inflatable cuff pressure sensor will be inflated to a baseline of 20 mmHg. Participants will instruct to target five pressure levels between 22 and 30 mmHg by nodding. scapular exercises .With patient in prone position, pillow under the chest and upper limb in varying degree of shoulder abduction, the participant lifts the hand toward the ceiling while retracting the scapula

Thirty one subjects will receive conventional treatment for 3 times per week for 4 weeks. Conventional treatment will include the following:

1-Posture correction (chin tuck exercise) Stand with the upper back against the wall, with the feet shoulder-width apart. Tuck the chin in and hold for 5 seconds 10 repetitions .Return to the starting position and repeat a number of times. This can help stretch the muscles in the upper neck 2. Stretching exercise: Self-stretching exercise for most common tight muscles. These muscles include upper trapezius (by contralateral side bending), levator scapulae (flexion, contralateral side bending and rotation) and sternocleidomastoid muscle (slight flexion with ipsilateral side bending and rotation). Each position should be maintained for 30 seconds and repeated for 3 times.