Effectiveness of corrective exercise program on alignment, muscle activation and biomechanical properties in forward head posture: a randomized controlled trial

Purpose: The aim of this study was to investigate the effects of supervised corrective exercise program on craniovertebral angle (CVA), shoulder protraction angle (SPA), and activity/biomechanical properties of cervicothoracic muscles in medical students with forward head posture (FHP). Materials and Methods: Thirty-six medical students with FHP were allocated to an exercise group (n=18) or a control group (n=18). The participants in the exercise group followed an 8-week supervised corrective exercise program. CVA and SPA were evaluated with photogrammetry and activity and biomechanical chracteristics of the servicothoracic muscles were assessed with surface electromyography and myotonometry at baseline and after supervised exercise program. Results: Data of thirty-two participants (16 for both groups) were analyzed. A significant improvement of CVA [Mean Difference (MD) 95% Confidence Interval (CI): 7.8 (5.2 to 10.5)] and SPA [MD 95%CI: 3.7 (0.2 to 7.2)] was observed in the exercise group compared to the control group. Multiple regression analysis revealed that a reduction in right upper trapezius stiffness had a significant effect on CVA (B= 0.047, Adjusted R2= 0.61), and the change in the tone of the right lower trapezius (B= 2.85, Adjusted R2= 0.64) had a significant effect on SPA. Conclusion: An eight-week corrective exercise program improved cervicothoracic alignment in FHP. Streching exercises that reduce the stiffness of the upper trapezius and strengthening exercises that increase the tone of the lower trapezius can be prioritized in the management of FHP.