Upper cervical and upper thoracic spine mobilization versus deep cervical flexors exercise in individuals with forward head posture: A randomized clinical trial investigating their effectiveness

BACKGROUND: Although commonly utilized treatments, no study has directly compared the effectiveness of joint mobilization and stabilization exercise in individuals with forward head posture (FHP). OBJECTIVE: This study aimed to investigate the effects of upper cervical and upper thoracic spine mobilization versus deep cervical flexors exercise (DCFE) in individuals with FHP. METHODS: Thirty-one participants with FHP were randomized into the mobilization (n = 15) or exercise (n = 16) group. The treatment period was 4 weeks with follow-up assessment at 4 weeks and 6 weeks after the initial examination. Outcomes assessed included the craniovertebral angle (CVA), numeric pain rating scale (NPRS), respiratory function, and the global rating of change (GRC). RESULTS: Participants in the mobilization group demonstrated significant improvements (p < 0.05) in CVA, NPRS, and respiratory function, as compared to those in the exercise group. In addition, 9 of 15 (60%) participants in the mobilization group, as compared to 4 of 16 participants (25%) in the exercise group, had a GRC score of +4 or higher. CONCLUSIONS: The combination of upper cervical and upper thoracic spine mobilization indicated better overall short-term outcomes in CVA, NPRS, respiratory function, and GRC compared with DCFE in individuals with FHP.