Assessment of the effects of cervical stabilization exercises and proprioception training on balance and posture in individuals with forward head posture


Özalp M., TALU B., Kayabinar E.

BMC Musculoskeletal Disorders, cilt.26, sa.1, 2025 (SCI-Expanded, Scopus) identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 26 Sayı: 1
  • Basım Tarihi: 2025
  • Doi Numarası: 10.1186/s12891-025-09259-7
  • Dergi Adı: BMC Musculoskeletal Disorders
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, CINAHL, EMBASE, MEDLINE, Directory of Open Access Journals
  • Anahtar Kelimeler: Balance, Cervical proprioception exercises, Cervical stabilization exercises, Forward head posture
  • İnönü Üniversitesi Adresli: Evet

Özet

Background: The increasing use of smartphones and other digital devices has contributed to a rise in forward head posture (FHP) among younger populations due to prolonged poor neck positioning. The aim of this study was to evaluate the effect of cervical stabilization exercises (CSE) and cervical proprioception training (CPT) on FHP. Methods: In this single-blinded randomized controlled trial, where only the outcome assessors were blinded, 99 participants (aged 18–24) with FHP were randomly allocated into three groups: Group-I (n = 32), which received no exercises; Group-II (n = 34), which received CSE; and Group-III (n = 33), which received both CSE and CPT. Groups II and III performed the exercises three times per week for six weeks. The joint position error (JPE) test was used to assess proprioception, the craniovertebral angle (CVA) was used to evaluate posture, and the Stork and Y Balance tests were used to assess balance at baseline and after six weeks. Results: The study included 99 participants (mean age: 18.1–19.6 years; BMI: 21.4–23.1 kg/m²). Technology usage analysis revealed that 19.2% of participants reported > 7 h/day of phone use, while the majority (80.8%) used computers for ≤ 1 h/day. Significant group × time interactions were found for JPE (flexion/extension/rotation, p < 0.001), with Group III showing superior gains versus Group II and controls (p ≤ 0.001). Dynamic balance improved in intervention groups (p ≤ 0.04), and CVA increased significantly in Group II/III (p ≤ 0.03). Static balance improved over time (p < 0.001) but without intergroup differences. No sex-based effects were observed (p > 0.05) Conclusions: The addition of CPT to CSE was found to be more effective than CSE alone in restoring proper proprioception and balance and in reducing poor posture in individuals with FHP. Trial registration: This study is registered with ClinicalTrials.gov website with registration no: NCT06932965, date: 10/04/2025. Retrospectively registered.