Assesment of effect of cervical stabilization exercises and proprioseption training on balance and posture in individuals with forward head posture

Aim: The aim of this study is to evaluate the effect of cervical stabilization exercises and cervical proprioception training on balance and posture in university students with 18 to 25 years old forward head posture (FHP) presence. Materials and Methods: 99 individuals with FHP were included the study. The mean age of the examined individuals was 18.77 ± 1.08 (min: 18-max: 24) years and 36.4% (n = 36) were male and 63.6% (n = 63) were female. Individual body lengths and body weights were measured and body mass indexes (BMI) were calculated. Daily telephone and computer usage times were recorded. The cases were seperated into three groups as Group I (n=32), cervical stabilization exercise Group II (n=34) and stabilization and proprioception training Group III (n=33) with randomization. The training was administered three times a week for six weeks. The exercise program was not given to the control group. Joint position error test, craniovertebral angle (CVA), New York Posture Assessment Scale, Stork Test for static balance and Y Balance Test for dynamic balance were were assessed in the pre-treatment and post-treatment. Results: As a result of the 6-week exercise program for joint position sense error, the Group III showed a significant improvement in all directions (p<0.05). Group II showed a significant improvement in the direction of flexion and left rotation (p<0.05), no significant difference was observed in the other directions (p>0.05). The direction of Group I extension worsened with the sense of joint position, no significant difference was found in the other directions in the Group I (p>0.05). When the three groups compared for joint position sense error after the treatment, there was no significant difference between Group II and Group III in the direction of the flexion (p>0.05), whereas the Group III was superior to the other two groups in directions of extension, left rotation and right rotation (p<0.05). A significant improvement was observed in Group II and Group III in the intra-group comparison of CVA and New York Posture Scale (p<0.05), and improvements in the Group III were found to be more effective. There was a significant difference between Group II and Group III compared to before treatment in static stability stork test (p<0.05), but no superiority was found between these groups (p>0.05). Y-balance evaluation for dynamic balance, there was a significant difference in the Group III only in anterior left and anterior right directions after intra-group treatment (p<0.05), but no significant difference was found in other directions in all groups (p>0.05). Conclusion: Stabilization exercises and additional proprioceptive training have been shown to be useful in order to maintain the cervical posture in rehabilitation programme. The proprioceptive exercises combined with the stabilization exercises showed more effective results on balance and posture development. Key words: Balance, Forward Head Posture, Proprioception, Cervical, Stabilization Exercises.