Neck pain and forward head posture (FHP) are typical in prolonged smartphone users and need to be targeted for treatment. We aimed to compare the effect of a routine therapeutic program with and without respiratory exercises on smartphone users with FHP and non-specific chronic neck pain (NSCNP). Sixty patients (aged 24.7 ± 2.1 years) with FHP and NSCNP were randomly assigned to the routine therapeutic program (n = 20), combined respiratory exercises with a routine therapeutic program (n = 20), or control (n = 20) groups. At baseline, there was no difference among groups at all variables. Each programme was implemented three times a week for eight weeks. Primary Outcome was pain measured by visual analogue scale (VAS), and secondary ones were forward head angle, the activity of specific muscles, and respiratory patterns, measured by photogrammetry, electromyography and manual, respectively. All outcomes were measured at baseline and eight weeks post-treatment. We used the repeated measures analysis of variance to examine the interaction between time and group, paired t-test for intragroup comparison, one-way analysis of variance for intergroup comparison, and Tukey post hoc test at a significant level 95% was used. There were significant differences in the combined group compared with the routine therapeutic group (P = 0.03) for diaphragm muscle activation, respiratory balance (P = 0.01), and the number of breaths (P = 0.02). There were significant within-group changes from baseline to post-treatment in the combined group for all outcomes above, but no changes in the therapeutic exercise routine group. Despite respiratory pattern, none of the secondary outcomes proved to be superior in the combination group compared to the routine therapeutic program in smartphone users with FHP and NSCNP. Future studies with longer follow-up assessments could strengthen these results.Trial registration: Current Controlled Trials using the IRCT website with ID number of, IRCT20200212046469N1 “Prospectively registered” at 04/03/2020.
Background: Neck pain and forward head posture are common in prolonged smartphone users and need to be targeted for treatment. We aimed to compare the effect of adding respiratory exercises to the therapeutic routine in smartphone users with forward-head posture and non-specific chronic neck pain.Mehods: Sixty patients (aged 24.7±2.1 years), were randomly assigned to the therapeutic routine (n=20), combined respiratory-exercises with therapeutic routine (n=20), or control groups (n=20). Each programme was implemented three times a week for 8 weeks. Forward head angle, pain, electromyographic activity, and respiratory patterns were measured at baseline and at 8-weeks’ post-treatment. Results: There were significant improvements in the combined group compared with the therapeutic routine group (p=0.03) for diaphragm muscle activation, (p=0.03), neck erector spinae activity (p=0.04), respiratory balance (p=0.04), and number of breaths (p=0.02). There were significant within-group changes from baseline to post-treatment in the combined group for all outcomes above, but no changes in the therapeutic exercise routine group. Outcomes for the combined group were superior to the control group in every variable. Conclusion: Combination treatment is more effective than the standard therapeutic routine. These results could be strengthened by more studies with longer follow-up assessments.Trial registration: Current Controlled Trials using the IRCT website with ID number of, IRCT20200212046469N1 “Prospectively registered” at 2020/03/04.
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