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Impact of adding scapular stabilization to postural correctional exercises on symptomatic forward head posture: randomized trials [with consumer summary]
Abd El Azeim AS, Mahmoud AG, Mohamed MT, Elkhateeb YS
European Journal of Physical and Rehabilitation Medicine 2022 Oct;58(5):757-766
clinical trial
7/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: Yes; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: Yes; Adequate follow-up: Yes; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

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 forward head posture. DESIGN: The pre-post single-masking (assessor) randomized experimental trial. SETTING: Participants with postural dysfunction in form of forward head posture 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 Scapular stabilization exercises 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' pre-treatment 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 Scapular Stabilization exercises to postural correctional exercises is more effective method than postural correctional exercises seldom for the management of forward head posture patients.

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