<clinical_study>
  <!-- This xml conforms to an XML Schema at:
    https://clinicaltrials.gov/ct2/html/images/info/public.xsd -->
  <required_header>
    <download_date>ClinicalTrials.gov processed this data on September 20, 2023</download_date>
    <link_text>Link to the current ClinicalTrials.gov record.</link_text>
    <url>https://clinicaltrials.gov/ct2/show/NCT03006497</url>
  </required_header>
  <id_info>
    <org_study_id>PHYSMSC1</org_study_id>
    <nct_id>NCT03006497</nct_id>
  </id_info>
  <brief_title>Exercise Program Based on Motor Learning and Forward Head Posture Correction</brief_title>
  <official_title>The Efficacy of Exercise Program Based on Motor Learning Principles in Correction of Forward Head Posture</official_title>
  <sponsors>
    <lead_sponsor>
      <agency>Eleni Kapreli</agency>
      <agency_class>Other</agency_class>
    </lead_sponsor>
  </sponsors>
  <source>Technological Education Institute of Sterea Ellada</source>
  <oversight_info>
    <has_dmc>No</has_dmc>
  </oversight_info>
  <brief_summary>
    <textblock>
      The aim of this study is to investigate the efficiency of an exercise program based on&#xD;
      principles of motor learning in correction of Forward Head Position (FHP) in asymptomatic&#xD;
      patients.&#xD;
    </textblock>
  </brief_summary>
  <detailed_description>
    <textblock>
      Epidemiological studies have shown that bad posture and poor body control occurs at puberty,&#xD;
      with forward head posture (FHP) and rounded shoulders being the most common biomechanical&#xD;
      deviations in sagittal plane. The FHP is defined as an anterior displacement of the head with&#xD;
      hyperextension of the cervical spine and this is associated with a reduction in the length of&#xD;
      the upper portion of the trapezius, posterior portion of the cervical extensor muscles, the&#xD;
      sternocleidomastoid and the levator scapulae. FHP can be evaluated by measuring&#xD;
      craniovertebral angle (CVA) which is defined as the angle between a horizontal line passing&#xD;
      through C7 and a line extending from the tragus of the ear to C7.&#xD;
&#xD;
      CVA, smaller than 50 degrees, constitute a criterion of abnormal posture of cervical spine,&#xD;
      suggesting FHP. People with FHP present incomplete balance control, thereby affecting the&#xD;
      position of the center of gravity and motor control of the body. The establishment of altered&#xD;
      motor control strategies could lead to balance disorders, neck muscle imbalances, chronic&#xD;
      neck pain and even respiratory dysfunction.&#xD;
&#xD;
      Despite the efforts of researchers to create effective treatment programs based on strength&#xD;
      training and stretching exercises, positive long-term results have been a problem in FHP&#xD;
      correction. For this reason, re-education of posture and body alignment, through exercise&#xD;
      programs based on motor learning, with cognitive elements (attention, motivation, feedback,&#xD;
      reasoning), could be proved a more effective therapeutic strategy.&#xD;
    </textblock>
  </detailed_description>
  <overall_status>Completed</overall_status>
  <start_date>January 2017</start_date>
  <completion_date type="Actual">December 30, 2017</completion_date>
  <primary_completion_date type="Actual">May 2017</primary_completion_date>
  <phase>N/A</phase>
  <study_type>Interventional</study_type>
  <has_expanded_access>No</has_expanded_access>
  <study_design_info>
    <allocation>Randomized</allocation>
    <intervention_model>Parallel Assignment</intervention_model>
    <primary_purpose>Treatment</primary_purpose>
    <masking>Single (Outcomes Assessor)</masking>
  </study_design_info>
  <primary_outcome>
    <measure>Change in Static Forward Head Posture (sFHP)</measure>
    <time_frame>Change from Baseline sFHP at 4 weeks and Change from Baseline sFHP at 6 weeks</time_frame>
    <description>The sFHP will be assessed by calculating the craniovertebral angle through lateral photographs in standing. The craniovertebral angle is the angle between the line extending from the tragus of the ear to the 7th cervical vertebra (C7) spinous process and the horizontal line through C7. The calculation of the angle on the photographs will be carried out using AutoCAD software. A performance curve will be developed using the measurements during the 4 weeks practice and 2 weeks after the end of protocol (retension test).</description>
  </primary_outcome>
  <primary_outcome>
    <measure>Change of Dynamic Forward Head Posture (dFHP)</measure>
    <time_frame>Change from Baseline dFHP t at 4 weeks and Change from Baseline dFHP at 6 weeks</time_frame>
    <description>The dFHP will be assessed by calculating the craniovertebral angle through video motion during walking. The craniovertebral angle is the angle between the line extending from the tragus of the ear to the 7th cervical vertebra (C7) spinous process and the horizontal line through C7. The calculation of the angle The calculation of the angle will be carried out using Kinovea and AutoCAD softwares. dFHP will be regarded as a transfer test. Transfer tests are tests involving some novel situation, so that people must adapt the skill they have been practicing to the characteristics of this new situation.</description>
  </primary_outcome>
  <secondary_outcome>
    <measure>Overall self-esteem</measure>
    <time_frame>Baseline; week 4; week 6</time_frame>
    <description>Sorensen self-esteem test will be used which has been translated into Greek and has been tested for its reliability and validity.</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Mood</measure>
    <time_frame>Baseline; week 4; week 6</time_frame>
    <description>A ten point Visual Analogue Scale (VAS) will be used</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Overall physical fatigue</measure>
    <time_frame>Baseline; week 4; week 6</time_frame>
    <description>A ten point VAS scale will be used</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Overall mental fatigue</measure>
    <time_frame>Baseline; week 4; week 6</time_frame>
    <description>A ten point VAS scale will be used</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Attention-concentration</measure>
    <time_frame>Baseline; week 4; week 6</time_frame>
    <description>Attention- concentration questionnaire will be used. It has been developed in Greek language and has been tested for its reliability and validity.</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Verbal Comprehension index</measure>
    <time_frame>Baseline</time_frame>
    <description>The Wechsler Adult Intelligence Scale (WAIS-IV) (similarities) will be used. Participants will be given a number of pairs of words or concepts and have to describe how they are similar.</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Perceptual Organization Index</measure>
    <time_frame>Baseline</time_frame>
    <description>The WAIS-IV (Matrix Reasoning) will be used. Participants will be given pictures of sets of drawings and have to choose the correct drawing that is missing from each set.</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Change in Deep neck flexors endurance</measure>
    <time_frame>Change from Baseline Deep neck flexors endurance at 4 weeks and Change from Baseline Deep neck flexors endurance at 6 weeks</time_frame>
    <description>The first stage of the test allows for the quantification of the performance of craniocervical flexion action, while the second stage examines the isometric endurance of deep neck flexors, during which the participant adopts the crook lying position. The air chamber of a pressure biofeedback device is positioned under the cervical area and the participant is asked to perform a head nod action at five different pressure levels (22, 24, 26, 28 and 30 mmHg). The test is initially performed at a pressure level of 22 mmHg and proceeds to the next pressure level if the participant is able to maintain in the position for 10 seconds on three separate occasions. The Chattanooga stabilizer pressure biofeedback will be used.</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Change in Discomfort</measure>
    <time_frame>Change from Baseline discomfort at 4 weeks and Change from Baseline discomfort at 6 weeks</time_frame>
    <description>The Discomfort will be assessed using a ten point grade VAS scale, where 0 is no pain and 10 worst pain.</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Change in Area of Discomfort</measure>
    <time_frame>Change from Baseline discomfort at 4 weeks and Change from Baseline discomfort at 6 weeks</time_frame>
    <description>The Discomfort (Head, Neck, Shoulders and upper arms, Middle back, Lower back, Forearms and Wrists/hands areas) will be assessed using a body chart</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Weight</measure>
    <time_frame>Baseline</time_frame>
    <description>Measurement of weight with scale (kilograms)</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Height</measure>
    <time_frame>Baseline</time_frame>
    <description>Measurement of height (cm)</description>
  </secondary_outcome>
  <number_of_arms>2</number_of_arms>
  <enrollment type="Actual">52</enrollment>
  <condition>Musculoskeletal Abnormalities</condition>
  <condition>Deformity</condition>
  <arm_group>
    <arm_group_label>Control</arm_group_label>
    <arm_group_type>No Intervention</arm_group_type>
    <description>The control group will not participate in any exercise program. However, at the end, home based exercises and special advice will be given to the participants.</description>
  </arm_group>
  <arm_group>
    <arm_group_label>Intervention</arm_group_label>
    <arm_group_type>Experimental</arm_group_type>
    <description>The intervention group will participate in an exercise program based on motor learning principles for 4 weeks/3 sessions per week, for a total of 12 sessions of 30-45 minutes each.</description>
  </arm_group>
  <intervention>
    <intervention_type>Other</intervention_type>
    <intervention_name>Exercise program based on motor learning principles</intervention_name>
    <description>The exercise program will include simple activities exposing volunteers in various environmental conditions with a view to adjust their head posture in such conditions. The progressiveness of exercises will be based on the two-dimensional classification system of Gentile (1987). Furthermore, external attentional focus will be used.</description>
    <arm_group_label>Intervention</arm_group_label>
  </intervention>
  <eligibility>
    <criteria>
      <textblock>
        Inclusion Criteria:&#xD;
&#xD;
          -  Students at Technological Educational Institute of Sterea Ellada,&#xD;
&#xD;
          -  Aged 18-26 years old&#xD;
&#xD;
          -  Males and females&#xD;
&#xD;
          -  Craniocervical angle &lt; 50 degrees (statical Forward Head Posture in standing position)&#xD;
&#xD;
        Exclusion Criteria:&#xD;
&#xD;
          -  Injury or surgery in cervical spine&#xD;
&#xD;
          -  Accompanying neurologic, musculoskeletal or mental problems&#xD;
&#xD;
          -  Any medical administration&#xD;
&#xD;
          -  Intense continuous or intermittent neck pain&#xD;
&#xD;
          -  BMI &gt;25&#xD;
&#xD;
          -  Participation in any rehabilitation or physiotherapy sessions considering neck&#xD;
             dysfunction the last 6 months&#xD;
&#xD;
          -  Change in physical activities during the research period of 6 weeks&#xD;
      </textblock>
    </criteria>
    <gender>All</gender>
    <minimum_age>18 Years</minimum_age>
    <maximum_age>26 Years</maximum_age>
    <healthy_volunteers>Accepts Healthy Volunteers</healthy_volunteers>
  </eligibility>
  <overall_official>
    <last_name>Eleni V Kapreli, MSc, PhD</last_name>
    <role>Study Chair</role>
    <affiliation>Technological Educational Institute of Sterea Ellada</affiliation>
  </overall_official>
  <overall_official>
    <last_name>Stefani Argyrou, BSc</last_name>
    <role>Principal Investigator</role>
    <affiliation>Technological Educational Institute of Sterea Ellada</affiliation>
  </overall_official>
  <reference>
    <citation>Christakou A, Zervas Y, Psychountaki M, Stavrou NA. Development and validation of the attention questionnaire of rehabilitated athletes returning to competition. Psychol Health Med. 2012;17(4):499-510. doi: 10.1080/13548506.2011.630402. Epub 2011 Nov 25.</citation>
    <PMID>22114988</PMID>
  </reference>
  <reference>
    <citation>Dimitriadis Z, Kapreli E, Strimpakos N, Oldham J. Respiratory weakness in patients with chronic neck pain. Man Ther. 2013 Jun;18(3):248-53. doi: 10.1016/j.math.2012.10.014. Epub 2012 Nov 28.</citation>
    <PMID>23199797</PMID>
  </reference>
  <reference>
    <citation>Dimitriadis Z, Kapreli E, Strimpakos N, Oldham J. Reliability of the chin tuck neck flexion test for assessing endurance of short neck flexors in healthy individuals. Physiother Theory Pract. 2015 May;31(4):299-302. doi: 10.3109/09593985.2014.1002874. Epub 2015 Jan 14.</citation>
    <PMID>25585517</PMID>
  </reference>
  <reference>
    <citation>Han J, Park S, Kim Y, Choi Y, Lyu H. Effects of forward head posture on forced vital capacity and respiratory muscles activity. J Phys Ther Sci. 2016 Jan;28(1):128-31. doi: 10.1589/jpts.28.128. Epub 2016 Jan 30.</citation>
    <PMID>26957743</PMID>
  </reference>
  <reference>
    <citation>Kang JH, Park RY, Lee SJ, Kim JY, Yoon SR, Jung KI. The effect of the forward head posture on postural balance in long time computer based worker. Ann Rehabil Med. 2012 Feb;36(1):98-104. doi: 10.5535/arm.2012.36.1.98. Epub 2012 Feb 29.</citation>
    <PMID>22506241</PMID>
  </reference>
  <reference>
    <citation>Kapreli E, Vourazanis E, Strimpakos N. Neck pain causes respiratory dysfunction. Med Hypotheses. 2008;70(5):1009-13. doi: 10.1016/j.mehy.2007.07.050. Epub 2007 Oct 23.</citation>
    <PMID>17959320</PMID>
  </reference>
  <reference>
    <citation>Rosario JL, Diogenes MS, Mattei R, Leite JR. Can sadness alter posture? J Bodyw Mov Ther. 2013 Jul;17(3):328-31. doi: 10.1016/j.jbmt.2012.12.001. Epub 2012 Dec 23.</citation>
    <PMID>23768277</PMID>
  </reference>
  <reference>
    <citation>Ruivo RM, Carita AI, Pezarat-Correia P. The effects of training and detraining after an 8 month resistance and stretching training program on forward head and protracted shoulder postures in adolescents: Randomised controlled study. Man Ther. 2016 Feb;21:76-82. doi: 10.1016/j.math.2015.05.001. Epub 2015 May 13.</citation>
    <PMID>26028408</PMID>
  </reference>
  <reference>
    <citation>Silva AG, Johnson MI. Does forward head posture affect postural control in human healthy volunteers? Gait Posture. 2013 Jun;38(2):352-3. doi: 10.1016/j.gaitpost.2012.11.014. Epub 2012 Dec 7.</citation>
    <PMID>23219786</PMID>
  </reference>
  <reference>
    <citation>Wulf G, Mercer J, McNevin N, Guadagnoli MA. Reciprocal influences of attentional focus on postural and suprapostural task performance. J Mot Behav. 2004 Jun;36(2):189-99. doi: 10.3200/JMBR.36.2.189-199.</citation>
    <PMID>15130869</PMID>
  </reference>
  <verification_date>January 2019</verification_date>
  <study_first_submitted>December 3, 2016</study_first_submitted>
  <study_first_submitted_qc>December 29, 2016</study_first_submitted_qc>
  <study_first_posted type="Estimate">December 30, 2016</study_first_posted>
  <last_update_submitted>January 8, 2019</last_update_submitted>
  <last_update_submitted_qc>January 8, 2019</last_update_submitted_qc>
  <last_update_posted type="Actual">January 9, 2019</last_update_posted>
  <responsible_party>
    <responsible_party_type>Sponsor-Investigator</responsible_party_type>
    <investigator_affiliation>Technological Education Institute of Sterea Ellada</investigator_affiliation>
    <investigator_full_name>Eleni Kapreli</investigator_full_name>
    <investigator_title>Associate Professor, Physiotherapy Department</investigator_title>
  </responsible_party>
  <keyword>neck</keyword>
  <keyword>motor control</keyword>
  <keyword>motor learning</keyword>
  <condition_browse>
    <!-- CAUTION:  The following MeSH terms are assigned with an imperfect algorithm            -->
    <mesh_term>Musculoskeletal Abnormalities</mesh_term>
  </condition_browse>
  <patient_data>
    <sharing_ipd>Undecided</sharing_ipd>
    <ipd_description>Individual Participant Data (IPD) are to be shared with other researchers, when it will be available</ipd_description>
  </patient_data>
  <!-- Results have not yet been posted for this study                                          -->
</clinical_study>


download date: ClinicalTrials.gov processed this data on September 20, 2023
link text: Link to the current ClinicalTrials.gov record.
url: https://clinicaltrials.gov/ct2/show/NCT03006497
org study id: PHYSMSC1
nct id: NCT03006497
lead sponsor: 
has dmc: No
The aim of this study is to investigate the efficiency of an exercise program based on
      principles of motor learning in correction of Forward Head Position (FHP) in asymptomatic
      patients.
Epidemiological studies have shown that bad posture and poor body control occurs at puberty,
      with forward head posture (FHP) and rounded shoulders being the most common biomechanical
      deviations in sagittal plane. The FHP is defined as an anterior displacement of the head with
      hyperextension of the cervical spine and this is associated with a reduction in the length of
      the upper portion of the trapezius, posterior portion of the cervical extensor muscles, the
      sternocleidomastoid and the levator scapulae. FHP can be evaluated by measuring
      craniovertebral angle (CVA) which is defined as the angle between a horizontal line passing
      through C7 and a line extending from the tragus of the ear to C7.

      CVA, smaller than 50 degrees, constitute a criterion of abnormal posture of cervical spine,
      suggesting FHP. People with FHP present incomplete balance control, thereby affecting the
      position of the center of gravity and motor control of the body. The establishment of altered
      motor control strategies could lead to balance disorders, neck muscle imbalances, chronic
      neck pain and even respiratory dysfunction.

      Despite the efforts of researchers to create effective treatment programs based on strength
      training and stretching exercises, positive long-term results have been a problem in FHP
      correction. For this reason, re-education of posture and body alignment, through exercise
      programs based on motor learning, with cognitive elements (attention, motivation, feedback,
      reasoning), could be proved a more effective therapeutic strategy.
allocation: Randomized
intervention model: Parallel Assignment
primary purpose: Treatment
masking: Single (Outcomes Assessor)
measure: Change in Static Forward Head Posture (sFHP)
time frame: Change from Baseline sFHP at 4 weeks and Change from Baseline sFHP at 6 weeks
description: The sFHP will be assessed by calculating the craniovertebral angle through lateral photographs in standing. The craniovertebral angle is the angle between the line extending from the tragus of the ear to the 7th cervical vertebra (C7) spinous process and the horizontal line through C7. The calculation of the angle on the photographs will be carried out using AutoCAD software. A performance curve will be developed using the measurements during the 4 weeks practice and 2 weeks after the end of protocol (retension test).
measure: Change of Dynamic Forward Head Posture (dFHP)
time frame: Change from Baseline dFHP t at 4 weeks and Change from Baseline dFHP at 6 weeks
description: The dFHP will be assessed by calculating the craniovertebral angle through video motion during walking. The craniovertebral angle is the angle between the line extending from the tragus of the ear to the 7th cervical vertebra (C7) spinous process and the horizontal line through C7. The calculation of the angle The calculation of the angle will be carried out using Kinovea and AutoCAD softwares. dFHP will be regarded as a transfer test. Transfer tests are tests involving some novel situation, so that people must adapt the skill they have been practicing to the characteristics of this new situation.
measure: Overall self-esteem
time frame: Baseline; week 4; week 6
description: Sorensen self-esteem test will be used which has been translated into Greek and has been tested for its reliability and validity.
measure: Mood
time frame: Baseline; week 4; week 6
description: A ten point Visual Analogue Scale (VAS) will be used
measure: Overall physical fatigue
time frame: Baseline; week 4; week 6
description: A ten point VAS scale will be used
measure: Overall mental fatigue
time frame: Baseline; week 4; week 6
description: A ten point VAS scale will be used
measure: Attention-concentration
time frame: Baseline; week 4; week 6
description: Attention- concentration questionnaire will be used. It has been developed in Greek language and has been tested for its reliability and validity.
measure: Verbal Comprehension index
time frame: Baseline
description: The Wechsler Adult Intelligence Scale (WAIS-IV) (similarities) will be used. Participants will be given a number of pairs of words or concepts and have to describe how they are similar.
measure: Perceptual Organization Index
time frame: Baseline
description: The WAIS-IV (Matrix Reasoning) will be used. Participants will be given pictures of sets of drawings and have to choose the correct drawing that is missing from each set.
measure: Change in Deep neck flexors endurance
time frame: Change from Baseline Deep neck flexors endurance at 4 weeks and Change from Baseline Deep neck flexors endurance at 6 weeks
description: The first stage of the test allows for the quantification of the performance of craniocervical flexion action, while the second stage examines the isometric endurance of deep neck flexors, during which the participant adopts the crook lying position. The air chamber of a pressure biofeedback device is positioned under the cervical area and the participant is asked to perform a head nod action at five different pressure levels (22, 24, 26, 28 and 30 mmHg). The test is initially performed at a pressure level of 22 mmHg and proceeds to the next pressure level if the participant is able to maintain in the position for 10 seconds on three separate occasions. The Chattanooga stabilizer pressure biofeedback will be used.
measure: Change in Discomfort
time frame: Change from Baseline discomfort at 4 weeks and Change from Baseline discomfort at 6 weeks
description: The Discomfort will be assessed using a ten point grade VAS scale, where 0 is no pain and 10 worst pain.
measure: Change in Area of Discomfort
time frame: Change from Baseline discomfort at 4 weeks and Change from Baseline discomfort at 6 weeks
description: The Discomfort (Head, Neck, Shoulders and upper arms, Middle back, Lower back, Forearms and Wrists/hands areas) will be assessed using a body chart
measure: Weight
time frame: Baseline
description: Measurement of weight with scale (kilograms)
measure: Height
time frame: Baseline
description: Measurement of height (cm)
arm group label: Control
arm group type: No Intervention
description: The control group will not participate in any exercise program. However, at the end, home based exercises and special advice will be given to the participants.
arm group label: Intervention
arm group type: Experimental
description: The intervention group will participate in an exercise program based on motor learning principles for 4 weeks/3 sessions per week, for a total of 12 sessions of 30-45 minutes each.
intervention type: Other
intervention name: Exercise program based on motor learning principles
description: The exercise program will include simple activities exposing volunteers in various environmental conditions with a view to adjust their head posture in such conditions. The progressiveness of exercises will be based on the two-dimensional classification system of Gentile (1987). Furthermore, external attentional focus will be used.
arm group label: Intervention
criteria: 
gender: All
minimum age: 18 Years
maximum age: 26 Years
healthy volunteers: Accepts Healthy Volunteers
last name: Eleni V Kapreli, MSc, PhD
role: Study Chair
affiliation: Technological Educational Institute of Sterea Ellada
last name: Stefani Argyrou, BSc
role: Principal Investigator
affiliation: Technological Educational Institute of Sterea Ellada
citation: Christakou A, Zervas Y, Psychountaki M, Stavrou NA. Development and validation of the attention questionnaire of rehabilitated athletes returning to competition. Psychol Health Med. 2012;17(4):499-510. doi: 10.1080/13548506.2011.630402. Epub 2011 Nov 25.
PMID: 22114988
citation: Dimitriadis Z, Kapreli E, Strimpakos N, Oldham J. Respiratory weakness in patients with chronic neck pain. Man Ther. 2013 Jun;18(3):248-53. doi: 10.1016/j.math.2012.10.014. Epub 2012 Nov 28.
PMID: 23199797
citation: Dimitriadis Z, Kapreli E, Strimpakos N, Oldham J. Reliability of the chin tuck neck flexion test for assessing endurance of short neck flexors in healthy individuals. Physiother Theory Pract. 2015 May;31(4):299-302. doi: 10.3109/09593985.2014.1002874. Epub 2015 Jan 14.
PMID: 25585517
citation: Han J, Park S, Kim Y, Choi Y, Lyu H. Effects of forward head posture on forced vital capacity and respiratory muscles activity. J Phys Ther Sci. 2016 Jan;28(1):128-31. doi: 10.1589/jpts.28.128. Epub 2016 Jan 30.
PMID: 26957743
citation: Kang JH, Park RY, Lee SJ, Kim JY, Yoon SR, Jung KI. The effect of the forward head posture on postural balance in long time computer based worker. Ann Rehabil Med. 2012 Feb;36(1):98-104. doi: 10.5535/arm.2012.36.1.98. Epub 2012 Feb 29.
PMID: 22506241
citation: Kapreli E, Vourazanis E, Strimpakos N. Neck pain causes respiratory dysfunction. Med Hypotheses. 2008;70(5):1009-13. doi: 10.1016/j.mehy.2007.07.050. Epub 2007 Oct 23.
PMID: 17959320
citation: Rosario JL, Diogenes MS, Mattei R, Leite JR. Can sadness alter posture? J Bodyw Mov Ther. 2013 Jul;17(3):328-31. doi: 10.1016/j.jbmt.2012.12.001. Epub 2012 Dec 23.
PMID: 23768277
citation: Ruivo RM, Carita AI, Pezarat-Correia P. The effects of training and detraining after an 8 month resistance and stretching training program on forward head and protracted shoulder postures in adolescents: Randomised controlled study. Man Ther. 2016 Feb;21:76-82. doi: 10.1016/j.math.2015.05.001. Epub 2015 May 13.
PMID: 26028408
citation: Silva AG, Johnson MI. Does forward head posture affect postural control in human healthy volunteers? Gait Posture. 2013 Jun;38(2):352-3. doi: 10.1016/j.gaitpost.2012.11.014. Epub 2012 Dec 7.
PMID: 23219786
citation: Wulf G, Mercer J, McNevin N, Guadagnoli MA. Reciprocal influences of attentional focus on postural and suprapostural task performance. J Mot Behav. 2004 Jun;36(2):189-99. doi: 10.3200/JMBR.36.2.189-199.
PMID: 15130869
responsible party type: Sponsor-Investigator
investigator affiliation: Technological Education Institute of Sterea Ellada
investigator full name: Eleni Kapreli
investigator title: Associate Professor, Physiotherapy Department
mesh term: Musculoskeletal Abnormalities
sharing ipd: Undecided
ipd description: Individual Participant Data (IPD) are to be shared with other researchers, when it will be available