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RecruitingNCT07780396Updated Aug 21, 2026

Electromyographic Effects of Postural Correction Exercises in Individuals With Forward Head Posture

An interventional study of Specific strengthening and stretching exercise and General Exercise in Forward Head Posture, sponsored by Cairo University. Recruiting at 1 site in Lebanon. Open to participants aged 18 Years to 30 Years. Per ClinicalTrials.gov, last updated 2026-08-21.

Sponsored by Cairo University · Not applicable, Interventional, and Treatment

Phase
Not applicable
Study type
Interventional
Enrollment
60
Allocation
Randomized
Ages
18 Years to 30 Years
Sex
All
01

Study summary

This study investigates the effects of specific corrective exercises on EMG of masticatory and cervical muscles in individuals with forward head posture. The study's design will be a retrospective, double- blinded, randomized controlled trial. The participants will be randomly allocated to one of two groups: the exercise group and the control group. The training groups will perform a program consisting of two strengthening (deep cervical flexors and shoulder retractors) and two stretchings (cervical extensors and pectoral muscles) exercises. This exercise program will be repeated 4 times per week for 10 weeks, and each session lasted 30 minutes.

The pre/post assessment of forward head posture will measure by using craniovertebral angle CVA. While the muscle activity EMG of the masseter, temporalis, splenius, upper trapezius, and SCM will measure pre and post-assessment using a biopic data acquisition system.

Read the detailed description

Forward head posture (FHD) is a common habitual faulty posture exists in the surrounding that can alter the resting position of the mandible and may affect the masticatory muscle activity.

The aim of this study is to investigate the effect of postural correction on masticatory and cervical muscle activity and mandibular opening in forward-head posture patients.

Materials and Methods:

Cranio-vertebral angle measurement CVA EMG activity of masseter, temporalis, splenius, upper trapezius and SCM BAU - Institutional Review Board (Form H-II) \| BEIRUT ARAB UNIVERSITY

-Electrodes will be placed on the muscle belly parallel to the direction of muscle fibers. The distance between the two electrodes was 2 cm. The subjects will be instructed to complete maximum voluntary contraction (MVC) of clenching the teeth for 3 s and repeating twice. The average of the two trials of MVC will be used for further analysis. The subjects will be seated comfortably in a chair.

02

Conditions studied

  • Forward Head Posture
03

Who can participate

Ages eligible
18 Years to 30 Years
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  • 1. Participants aged 18- 30 years. 2. Presence of forward head posture, defined as CVA of less than 50° with no symptoms of neck pain [18, 19]. 3. No treatment for TMD or cervical symptoms (e.g., medication, physical therapy, or intra-articular injection) within the previous 2 weeks.

Exclusion criteria

Exclusion Criteria:

  • 1. Current or previous diagnosis of temporomandibular disorder (TMD), or the presence of TMD-related signs or symptoms (e.g., joint sounds, restricted mouth opening, or orofacial pain) during screening.

    2. History of TMJ subluxation or dislocation that could interfere with mouth opening.

    3. History of recent head or neck trauma. 4. Angle Class II or Class III malocclusion. 5. Postural abnormalities secondary to structural spinal deformities (e.g., scoliosis or kyphosis), rheumatic diseases, or other medical conditions affecting posture.

    6. Missing posterior teeth, recent orthodontic treatment (within the previous 12 months), or dental restorations that altered occlusion.

04

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Double (Participant, Outcomes assessor)
Enrollment
60 participants (estimated)

Study arms

  • Experimental
    Specific strengthening and stretching exercise

    Other: Specific strengthening and stretching exercise

  • Active comparator
    General exercises

    Other: General Exercise

Interventions

  • OtherSpecific strengthening and stretching exercise

    The program consisted of two strengthening (deep cervical flexors and shoulder retractors) and two stretching (cervical extensors and pectoral muscles) exercises based on Harman and Mostafa et al's approach. This exercise program will be repeated 4 times per week for 10 weeks, and each session lasted for 30 minutes.

  • OtherGeneral Exercise

    The program will consist of regular general postural exercises such as postural awareness exercises as well as general strengthening exercises such as range of motion exercises for the upper quadrant. The program will also be repeated 4 times per week for 10 weeks, with each session lasting 30 minutes

05

What researchers measure

Primary outcomes

  1. EMG activity

    Electrodes will be placed on the muscle belly parallel to the direction of muscle fibers. The distance between the two electrodes was 2 cm. The subjects will be instructed to complete maximum voluntary contraction (MVC) of clenching the teeth for a period of 3 s and repeated twice. The average of the two trials of MVC will be used for further analysis. The subjects will be seated comfortably in a chair (---cm height).

    Time frame: 10 weeks

Secondary outcomes

  1. craniovertebral angle

    Forward head posture will be assess by the craniovertebral angle, one of the most reliable tool for evaluating the FHP. The examiner takes 2 lateral photographs of the subject in standing position, according to Shaghayegh fard et al. A digital camera will be positioned on a tripod at a distance of 0.8m from the subject at shoulder height. Two land mark will be taken, the spinous process of C7 and the tragus of ear. A horizontal line will be drawn passing through C7 making a right angle with the vertical. Then, the angle between the line connecting C7 spinous process with the tragus of the ear and the horizontal line.

    Time frame: 10 weeks

06

Study locations

1 of 1 sites recruiting
  • Physical therapy outpatient clinic
    Beirut, Lebanon
    Recruiting
07

References and documents

Publications

  • Kim SD. Effects of yoga exercises for headaches: a systematic review of randomized controlled trials. J Phys Ther Sci. 2015 Jul;27(7):2377-80. doi: 10.1589/jpts.27.2377. Epub 2015 Jul 22. PubMed 26311986 ↗
  • Lee SM, Lee CH, O'Sullivan D, Jung JH, Park JJ. Clinical effectiveness of a Pilates treatment for forward head posture. J Phys Ther Sci. 2016 Jul;28(7):2009-13. doi: 10.1589/jpts.28.2009. Epub 2016 Jul 29. PubMed 27512253 ↗
  • Quek J, Pua YH, Clark RA, Bryant AL. Effects of thoracic kyphosis and forward head posture on cervical range of motion in older adults. Man Ther. 2013 Feb;18(1):65-71. doi: 10.1016/j.math.2012.07.005. Epub 2012 Sep 5. PubMed 22959228 ↗
  • Lee KJ, Han HY, Cheon SH, Park SH, Yong MS. The effect of forward head posture on muscle activity during neck protraction and retraction. J Phys Ther Sci. 2015 Mar;27(3):977-9. doi: 10.1589/jpts.27.977. Epub 2015 Mar 31. PubMed 25931773 ↗
  • Zabihhosseinian M, Holmes MW, Ferguson B, Murphy B. Neck muscle fatigue alters the cervical flexion relaxation ratio in sub-clinical neck pain patients. Clin Biomech (Bristol). 2015 Jun;30(5):397-404. doi: 10.1016/j.clinbiomech.2015.03.020. Epub 2015 Mar 27. PubMed 25843481 ↗
  • Shaghayegh Fard B, Ahmadi A, Maroufi N, Sarrafzadeh J. Evaluation of forward head posture in sitting and standing positions. Eur Spine J. 2016 Nov;25(11):3577-3582. doi: 10.1007/s00586-015-4254-x. Epub 2015 Oct 17. PubMed 26476717 ↗

Individual participant data

Plan to share: No — Any study records that identify patient will be kept confidential. The records from the participation may be reviewed by people responsible for making sure that research is done properly, including members of the BAU Institutional Review Board. All of these people are required to keep their identities confidential. Otherwise, records that identify patients will be available only to people working on the study. • The investigators will use a code of numbers and alphabets rather than participants' names on data sheets, keeping records in a safe place.

08

Registry details

Key details

Study ID
NCT07780396
Lead sponsor
Cairo University
Responsible party
Ahmed ElMelhat (Assist.Prof, Cairo University) — Principal investigator
First posted
Aug 21, 2026
Start date
May 15, 2026
Primary completion
Oct 15, 2026 (estimated)
Completion
Oct 30, 2026 (estimated)
Last update
Aug 21, 2026

Study contacts

Ahmed M Elsayed, PhD
Contact
ahmed.elmelhat@cu.edu.eg
00201027943622
Ahmed El-Melhat, PhD
Contact
a.melhat@bau.edu.lb
0096181437072

Oversight

Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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