Immediate Effect of Cervico-thoracic Mobilization on Deep Neck Flexors Strength in Individuals with Forward Head Posture: A Randomized Controlled Trial

ABSTRACT

Introduction

Forward head posture is the most frequently observed postural deviations and is said to be associated with shortening of posterior cervical extensors and weakening of the anterior deep cervical flexors. Manual therapy has the potential to achieve reflexogenic changes in muscle and enhance the motor activity and strength.

Purpose of the study

To evaluate the immediate effect of grade IV cervicothoracic Maitland mobilization on deep neck flexors strength in individuals with forward head posture.

Study design

A Single-blinded randomized placebo-controlled trial.

Method

Sixty individuals were randomly divided into two groups. Placebo-controlled (PBO) group (n = 30) received the grade I and experimental (EXP) group (n = 30) received grade IV posteroanterior central and unilateral Maitland mobilization from the upper cervical to the upper thoracic spine. Outcome measure: Clinical Cranio-cervical flexion test (CCFT) was used to measure the motor activity and the strength of deep neck flexors.

Results

The strength of deep neck flexors effectively increased (p = <0.0001) after advocating grade IV mobilization.

Conclusion

This study concluded that grade IV central and unilateral posteroanterior Maitland mobilization demonstrated significant increase in the deep neck flexors strength in individuals with forward head posture.

KEYWORDS:

• Maitland mobilization
• arthrokinetic reflex (AKR)
• forward Head Posture (FHP)
• deep neck flexors (DNF), craniocervical flexion test (CCFT).

Disclosure statement

The authors have no conflicts of interest to declare.

Legal Registration

Registered under Clinical Trials Registry - India (ICMR-NIMS) (CTRI/2019/07/019966).

Supplementary material

Supplemental data for this article can be accessed here.

Additional information

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Notes on contributors

Gauri Milind Ghan

Gauri Milind Ghan is a physical therapist who specializes in diagnosis and management of musculoskeletal conditions. She completed her undergraduation from MGM's Institute of Physiotherapy, Aurangabad which is affiliated to Maharashtra University of Health Sciences in 2017 (BPTH) and her Masters (Graduation) from the same Institute in the year 2020 (MPT in Musculoskeletal Sciences). This article reports on work conducted as her Master's Dissertation.

V. Sarath Babu

Dr. Sarath Babu,  Ph.D is a professor in the department of Sports Physiotherapy and offciates as Principal, MGM Institute of Physiotherapy affiliated to Maharashtra University of Health Sciences, Nashik. He also heads one of the sophisticated physiotherapy clinical centre of excellence-MGM Physiotherapy & Rehabilitation Fitness Centre, Aurangabad, Maharashtra. His core area of interests are manual therapy and evidence based clinical reasoning skills. He is also a reviewer of a leading pubmed indexed scientific Physiotherapy journal.