The study aims are: 1. To investigate the effect of electrical stimulation (interferential current) on forward head posture and protracted shoulder in adolescents. 2. To investigate the effect of electrical stimulation on cervical pain, cervical ROM, neck muscle strength, and quality of life in adolescents with forward head posture and protracted shoulder.
Forward head posture (FHP) is commonly defined as the protrusion of the head in the sagittal plane so that the head is placed anterior to the trunk. It can occur because of anterior translation of the head, and it is claimed to be associated with an increase in upper cervical extension, lower cervical flexion, or both. Patients with FHP often experience neck pain and disability, it is associated with shortening of the upper trapezius, the posterior cervical extensor muscles, the sternocleidomastoid muscle, and levator scapulae muscle. Thus, FHP may contribute to neck and shoulder pain. The prolonged uses of mobile phones and computers have led to a variety of musculoskeletal disorders, especially related to the neck as: Forward Head Posture (FHP), rounded shoulders (RS), upper cross syndrome, mechanical neck pain etc. FHP is one in which the upper cervical convexity is increased and the lower cervical convexity is decreased causing anterior weight bearing of the cervical spine. It is also known as Scholar's neck or Reading neck. Electrical muscle stimulation (EMS) has been used as a complementary training method, applied either locally or to the whole body. It activates muscles artificially through various electrical current forms, which are delivered through electrodes on the target muscles. Interferential current (IFC) is an established therapy which is used to treat pain and also effective for providing relaxation of muscles. The application of IFC at the medium frequency which suggests higher penetration of the electrical stimulation in the tissue by reducing tissue impedance
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
40
muscle stimulant device
neck exercises
Faculty of Physical Therapy
Dokki, Giza Governorate, Egypt
shoulder angle (SA)
To measure Shoulder Angle (SA) of rounded shoulder, a line from anterolateral aspect of acromion to C7 will be taken and a horizontal line from anterolateral aspect of acromion , it will be considered as forward shoulder when the angle is 52 degree or less.
Time frame: From enrollment to the end of treatment at 8 weeks
craniovertebral angle (CVA)
To measure Craniovertebral Angle (CVA) of forward head posture, a line from C7 to tragus of the ear will be taken and a horizontal line from C7 (the normal CVA more than 50 degree).
Time frame: From enrollment to the end of treatment at 8 weeks
head tilt angle (HTA)
To measure head tilt angle (HTA) or cranial angle (CA) the angle of the line between the canthus of the eye and horizontal line from the tragus, the head tilt angles is 17.74 ± 4.9 degrees in people with normal head posture.
Time frame: From enrollment to the end of treatment at 8 weeks
head position angle (HPA)
To measure head position angle (HPA) angle between the tragus manubrium line and the line extending from the center point of chin to the tragus, the angle is 38.1 ± 4.9 degrees in people with normal head posture.
Time frame: From enrollment to the end of treatment at 8 weeks
Pain sensation
pain will be measured by visual analogue scale (VAS) , it is a numeric scale where 0 means no pain and 10 mean maximum pain.
Time frame: From enrollment to the end of treatment at 8 weeks
cervical range of motion
cervical rang of motion will be measured by goniometer, where the normal angles for each movement are Flexion 60 degree , Hyperextension 75 degree, Lateral Flexion 45 degree, Rotation 80 degree.
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Time frame: From enrollment to the end of treatment at 8 weeks
neck muscles strength
neck muscles strength will be measured by hand held dynamometer, strength is measured in units of force per unit area. The unit is kilogram (force) per square cm (kg/cm\^2)
Time frame: From enrollment to the end of treatment at 8 weeks