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The role of forward head correction in management of adolescent idiopathic scoliotic patients: a randomized controlled trial [with consumer summary]
Diab AA
Clinical Rehabilitation 2012 Dec;26(12):1123-1132
clinical trial
7/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: Yes; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: Yes; Intention-to-treat analysis: Yes; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

OBJECTIVE: To investigate the effectiveness of forward head correction on three-dimensional posture parameters and functional level in adolescent idiopathic scoliotic patients. DESIGN: A randomized controlled study with three-month follow-up. SETTING: University research laboratory. SUBJECTS: Seventy-six adolescent idiopathic scoliotic patients with Cobb angle ranged from 10 degrees to 30 degrees and craniovertebral angle less than 50 degrees were randomly assigned to a study or a control group. INTERVENTIONS: All the patients (n = 76) received traditional treatment in the form of stretching and strengthening exercises. In addition, patients in the study group (n = 38) received a forward head posture corrective exercise programme. OUTCOME MEASURES: Craniovertebral angle, Functional Rating Index and posture parameters, including: lumbar lordosis, thoracic kyphosis, trunk inclination, trunk imbalance, lateral deviation, surface rotation and pelvis torsion were measured before treatment, after 10 weeks, and at three-month follow-up. RESULTS: There was a significant difference between the study and control groups adjusted to baseline values at 10 weeks post treatment with respect to the following parameters: craniovertebral angle (p = 0.006), trunk inclination (p = 0.005), lordosis (p = 0.01), kyphosis (p = 0.001), trunk imbalance (p = 0.001), lateral deviation (p = 0.001), pelvic torsion (p = 0.004) and surface rotation (p = 0.013). At three-month follow-up, there were still significant differences in all the previous variables (p < 0.005). In contrast, while there was no significant difference with respect to Functional Rating Index at 10 weeks (p = 0.8), the three-month follow-up showed a significant difference (p = 0.001). CONCLUSION: A forward head corrective exercise programme combined with conventional rehabilitation improved three-dimensional scoliotic posture and functional status in patients with adolescent idiopathic scoliosis.

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