COMPARATIVE EFFECTIVENESS OF POSTURAL CORRECTION EXERCISES IN SMARTPHONE AND LAPTOP USERS WITH FORWARD HEAD POSTURE: A RANDOMIZED CONTROLLED TRIAL

Abstract

Background: Forward Head Posture (FHP) is a common musculoskeletal deviation increasingly observed among young adults due to prolonged smartphone and laptop use. It is commonly quantified using the Craniovertebral Angle (CVA), with reduced values indicating anterior head translation. FHP is strongly associated with mechanical neck pain, decreased deep cervical flexor endurance, and functional disability. Evidence suggests that interventions targeting postural motor control may provide superior correction compared with traditional strengthening programs.

Objective: To compare the effectiveness of posture correction exercises and strengthening–stretching exercises in improving craniovertebral angle, neck pain intensity, neck disability, and deep neck flexor endurance in young adult digital device users with FHP.

Methods: This randomized controlled trial included 58 university students aged 18–25 years with clinically confirmed FHP. Participants were randomly allocated to Group A (posture correction exercises, n = 29) or Group B (strengthening–stretching exercises, n = 29). Both groups received supervised sessions three times weekly for six weeks, along with a daily home program. Outcomes were assessed at baseline, week 3, and week 6. Primary outcome was CVA. Secondary outcomes included Numeric Pain Rating Scale (NPRS), Neck Disability Index (NDI), and Deep Neck Flexor Endurance Test (DNFET). Statistical analysis was performed using independent and paired t-tests with significance set at p < 0.05.

Results: Baseline characteristics were comparable (p > 0.05). CVA improved from 47.2 ± 2.8° to 54.6 ± 2.4° in Group A and from 47.5 ± 3.0° to 52.1 ± 2.5° in Group B, with significant between-group difference at week 6 (p < 0.01). NPRS scores decreased from 6.2 ± 1.1 to 2.1 ± 0.9 in Group A and from 6.0 ± 1.2 to 2.9 ± 1.0 in Group B (p < 0.01). NDI reduced from 24.6 ± 4.8 to 11.2 ± 3.9 in Group A and from 25.1 ± 5.0 to 14.6 ± 4.2 in Group B (p < 0.01). DNFET improved from 18.4 ± 5.6 seconds to 34.8 ± 6.2 seconds in Group A and from 19.1 ± 5.3 seconds to 29.6 ± 5.9 seconds in Group B (p < 0.01).

Conclusion: Both interventions were effective; however, posture correction exercises based on motor control principles demonstrated superior improvements in cervical alignment, pain reduction, disability, and muscle endurance. These findings support the integration of posture-focused motor control strategies into rehabilitation programs for digital device users with FHP.