Ahmed · Journal of manipulative and physiological therapeutics 2025 · Randomized controlled trial · n=60

Effect of Including Cervical Stability Training with Treatment Modalities for Patients with Forward Head Posture and Chronic Neck Pain: a Randomized Trial.

Level 2 - randomized trial

Individual randomized controlled trial

PubMed 41241867 · doi:10.1016/j.jmpt.2025.10.025 · record verified 2026-08-26

What was done

Sixty patients with forward head posture (FHP) and chronic mechanical neck pain (CMNP) were randomized into two groups for an 8-week intervention (3 sessions per week). Group A received cervical stability training (CST) combined with a battery of standard treatment modalities, while Group B received the modalities alone. The primary outcomes measured were somatosensory evoked potentials (SSEP) and the craniovertebral angle (CVA). Secondary outcomes included pain intensity (visual analog scale), functional disability (Arabic Neck Disability Index), neck flexor and extensor endurance, craniocervical flexion test performance, cervical lordotic curvature via lateral radiography, and cervical range of motion using a smartphone clinometer.

What was found

Post-treatment evaluations showed statistically significant differences favoring the CST group (P < .05). The between-group mean difference was 1.83 (95% CI: 1.63 to 2.03) for SSEP and 7.37 (95% CI: 6.49 to 8.25) for CVA. Numerical findings for secondary outcomes (pain, disability, endurance, range of motion) were not provided in the abstract.

Why it matters

This study indicates that adding cervical stabilization exercises to passive modalities provides greater improvement in neurophysiological processing (SSEP) and postural alignment than modalities alone for chronic neck pain.

Limits

The sample size was small (n = 60) and only short-term post-treatment effects were assessed, without long-term follow-up. The abstract omits numerical data for secondary clinical outcomes and does not detail the specific treatment modalities used.

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