Muscle Energy Technique of Lower Limb Muscles in Forward Head Posture

NCT ID: NCT06325124

Last Updated: 2024-04-03

Basic Information

• Recruitment Status: RECRUITING
• Clinical Phase: NA
• Total Enrollment: 36 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2024-03-26
• Study Completion Date: 2025-04-20

Brief Summary

The aim of this randomized controlled trial is to find the effect of muscle energy technique of muscles involved in lower limb superficial backline (hamstring and Gastro-soleus) on improving craniovertebral angle and cervical proprioception and minimizing pain among patients with forward head posture

Detailed Description

Forward head posture (FHP) is a common postural disorder (66%), occurring when the head is anterior to a vertical line passing through the center of gravity. This malalignment causes muscle weakness in deep cervical flexors and shortened opposing cervical extensor muscles. This posture increases lordosis in the lower cervical spine, leading to increased extension over upper, and flexion over the lower cervical spine. Abnormal postures can lead to headaches, myofascial pain syndrome, abnormal scapular movement, temporomandibular disorders, and limited cervical range of motion.

Muscles of the neck, back and lower limb are interconnected through myofascial called superficial backline. Prolonged forward head posture affects muscles and involved in superficial backline. So remote muscle stretching has a same effect on local neck muscles.

Muscle energy technique is a soft tissue technique designed to improve musculoskeletal function through stretching tight muscles and fascia, to reduce pain and improve circulation. MET is characterized by a patient-induced skeletal muscle contraction against physiotherapist resistance in a controlled direction and position. Pathological barrier of a muscle is located through joint positioning which is followed by active muscle contraction by the patient moving away from the resistance followed by relaxation of the muscle. A new pathological barrier is located through passive movement and process is repeated. The rationale for the use of these techniques is to identify the effects of MET of lower limb superficial backline muscles which are interconnected with cervical muscles through myofacial chain, on cervical pain ROM, craniovertebral angle , disability and cervical proprioception.

Conditions

Forward Head Posture

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: TREATMENT
• Blinding Strategy: SINGLE

Study Groups

Muscle Energy Technique of Calf and hamstrings

Muscle Energy Technique of Calf and hamstrings (soft tissue technique)

Group Type: ACTIVE_COMPARATOR

Muscle energy technique

Intervention Type: OTHER

They would be receiving treatment as follow:

Muscle energy technique of hamstring and gastro-soleus. Frequency: 10 reps 3 times/week for 4 consecutive weeks Intensity starting from 20% to 50% resistance across barrier provided by Physical therapist Conventional PT including 1-cervical isometric exercises 2-Transcutaneous Electrical Nerve Stimulation (TENS) for 1o minutes 3-hot pack for 10 minutes 4-Stretching exercise for suboccipitals, sternocleidomastoid 5-gentle stretching of calf and hamstrings.

Conventional PT

Cervical isometric exercises Hot pack

Group Type: OTHER

Conventional PT

Intervention Type: OTHER

They would be receiving treatment as follow:

Conventional PT including 1-cervical isometric exercises 2-Transcutaneous Electrical Nerve Stimulation (TENS) for 1o minutes 3-hot pack for 10 minutes 4-Stretching exercise for suboccipitals, sternocleidomastoid 5-gentle stretching of calf and hamstrings.

Interventions

Muscle energy technique

They would be receiving treatment as follow:

Muscle energy technique of hamstring and gastro-soleus. Frequency: 10 reps 3 times/week for 4 consecutive weeks Intensity starting from 20% to 50% resistance across barrier provided by Physical therapist Conventional PT including 1-cervical isometric exercises 2-Transcutaneous Electrical Nerve Stimulation (TENS) for 1o minutes 3-hot pack for 10 minutes 4-Stretching exercise for suboccipitals, sternocleidomastoid 5-gentle stretching of calf and hamstrings.

Intervention Type: OTHER

Conventional PT

They would be receiving treatment as follow:

Conventional PT including 1-cervical isometric exercises 2-Transcutaneous Electrical Nerve Stimulation (TENS) for 1o minutes 3-hot pack for 10 minutes 4-Stretching exercise for suboccipitals, sternocleidomastoid 5-gentle stretching of calf and hamstrings.

Intervention Type: OTHER

Eligibility Criteria

Inclusion Criteria

• Age between 20 and 35 years
• Both Genders
• Craniovertebral angle <49.9 degrees
• History of neck pain >3 months
• Patients with hamstring tightness(Inability to achieve greater than 160° of knee extension with hip at 90° of flexion)
• Patients with calf muscle tightness(The Taloche Sign (Maestro) If a patient with a tight gastrocnemius tries to stand on an inclined plane, it is immediately evident that it is impossible for the patient to be stable in this position)

Exclusion Criteria

• Patient with recent injuries or surgeries in and around the neck region
• Vertigo
• radiating pain in upper limb
• spinal deformities
• malignancy in and around the neck region
• cervical instabilities
• fibromyalgia
• patients with any lower limb or lower back pathology(e.g arthritis)

• Minimum Eligible Age: 20 Years
• Maximum Eligible Age: 35 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Riphah International University

OTHER

Sponsor Role: lead

Responsible Party

Responsibility Role: SPONSOR

Principal Investigators

KINZA ANWAR, MS-OMPT

Role: PRINCIPAL_INVESTIGATOR

RIPHAH INTERNATIONAL UNIVERSITY,ISLAMABAD,PAKISTAN

Locations

We Care Physical Therapy Clinic street 13 phase 4A, Ghouri town Islamabad

Islamabad, Punjab Province, Pakistan

Site Status: RECRUITING

Countries

Pakistan

Central Contacts

KINZA ANWAR, MS-OMPT

Role: CONTACT

kinza.anwar@riphah.edu.pk

+92-3239735427

Facility Contacts

KINZA ANWAR, MS-OMPT

Role: primary

kinza.anwar@riphah.edu.pk

+92-3239735427

MARIA NAWAZ, MS-OMPT*

Role: backup

+92-3435625466

Other Identifiers

REC/01805 MARIA NAWAZ

Identifier Type: -

Identifier Source: org_study_id