Impact of adding scapular stabilization to postural correctional exercises on symptomatic forward head posture: a randomized controlled trial

BACKGROUND: One of the most overspread postural abnormalities is forward head posture (FHP) and it is described as head projection anteriorly in relation to the trunk which appears mainly in sagittal plane. Scapular stabilization exercise (SSE) is capable of restoring each of thoracic cage and head neutral optimum position by neck and shoulder muscles interactions and through controlling scapular position and movement AIM: This study was conducted to investigate the impact of adding scapular stabilization (SSE) to postural correctional exercises (PCE) on symptomatic FHP. DESIGN: The pre-post single-masking (assessor) randomized experimental trial. SETTING: Participants with postural dysfunction in form of FHP admitted to outer clinic of the Faculty of Physical Therapy. POPULATION: Sixty participants (20 to 35 years) with symptomatic FHP and recruited from outer clinic at faculty of physical therapy. METHODS: Participants were allocated randomly by opaque sealed envelope to two groups who are referred from an orthopedist: Group “A” received SSE and postural correction exercises, whereas Group “B” received only postural correctional exercises; treatments were performed three times/week for 10 weeks. The craniovertebral angle, pressure pain threshold, cervical flexor and extensor muscles endurance, Arabic neck disability index, upper trapezius and sternocleidomastoid muscle root mean square during rest and activity were used to evaluate the patients’ pretreatment and post-treatment. RESULTS: within group analysis for sixty participants reported statistical significant difference between baseline and post-treatment as P value <0.05 with more refinement in stabilization exercise group. CONCLUSIONS: Adding SSEs to PCEs is more effective method than PCEs seldom for the management of FHP patients. CLINICAL REHABILITATION IMPACT: Both scapular stabilization and postural correction exercise increase craniovertebral angle and pressure pain threshold (PPT) and decrease muscle activity and disability. Scapular stabilization alone increase craniovertebral angle and PPT and decrease muscle activity and disability more than postural correction exercise. In addition of statistical significant difference in all variables but there were clinical change in disability only.