Effect of Bruegger's Exercise in Chronic Mechanical Neck Pain With Forward Head Posture

Overview

The purpose of the study is to investigate the effect of adding Bruegger's exercises on conventional exercise program in treatment of forward head posture.

Detailed description

Forward head posture, head-on-trunk misalignment, leads to increased lordosis of the lower cervical spine as well as rounded shoulders accompanied by increased kyphosis of the thoracic spine. These musculoskeletal disorders change the balance of the muscles around the neck.

Bruegger's postural relief position is one such self-care exercise that works in order to reverse Forward head posture (FHP) by strengthening the scapular retractors meanwhile stretching the protractors. This exercise helps in aligning the spine in correct position through isometric co-contraction of scapular muscles, thereby improving scapular stabilization. The exercise helped in strengthening the weak deep cervical flexor muscles since it includes isometric contraction of neck muscles through chin tuck.

Although Bruegger's exercises has been widely suggested or advised clinically by the physiotherapists, there is a lack of research-based evidence/data which proves regarding its effect in the correction of FHP. Hence, it was hypothesized that the Bruegger's exercises will show favorable results in the correction of FHP and craniovertebral angle (CVA).

This study may benefit physical therapists by providing a new and easy approach in treating FHP.

Interventions

• Other Core stability exercise
  The participants will be treated with conventional core stability exercise; Neck Stability Exercises-Free exercise for cervical spine, Neck isometric exercises (flexion, extension, lateral flexion, rotation), Wall angle exercises for lower trapezius, Chin tuck, Chin tuck into the towel
• Other Bruegger's training
  Bruegger's Position of external arm rotation, shoulder abduction and retraction of the scapulae . This position with simultaneous head and neck retraction is a strengthening exercise for deep neck flexors and lower scapular stabilizers. The subjects are instructed to place their feet on the floor completely and keep their knee joints 10 ㎝ below the hip joints in 45° of abduction. The subjects sit hitting their ischial tuberosity on the chair and maintained their physiological curvature for the T

Primary outcome measures

• Assessment of pain intensity [Time frame: 4 weeks]
• Assessment of craniocervical angle (CVA) [Time frame: 4 weeks]
• Assessment of craniocervical flexion endurance [Time frame: 4 weeks]

Secondary outcome measures (1)

• Assessment of function disability [Time frame: 4 weeks]

Eligibility criteria

Inclusion criteria

• Participant with neck pain and craniovertebral angle value lower than 50°.
• Numeric pain rating score above 3.
• More than 10 on neck disability index.

Exclusion criteria

• Arthritis (or other inflammatory diseases).
• Locoregional tumor or metastasis .
• Myopathy .
• Severe psychiatric disorders.
• Previous neck surgery.
• Fibromyalgia.

Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.

Healthy volunteers: No

Study design

Allocation

Randomized

Model

Parallel assignment

Masking

Single blind

Primary purpose

Treatment

Study locations

Egypt · 1 center

• Hadeer SalahEldin Mahmoud — Cairo

Identifiers

NCT: NCT07669844 · P.T.REC/012/004505

Primary sources (government registries)

• ClinicalTrials.gov (US NIH)

View this study on ClinicalTrials.gov ↗