Effects of Feldenkrais Approach in Cases With Forward Head Posture

Condition(s) studied

Investigational drug(s) / intervention(s)

Strength and Feldenkrais Exercise: This is a behavioral, non-drug and non-device-based intervention combining somatic awareness through Feldenkrais principles with neuromuscular re-education. Movements emphasize minimal effort, reduced muscle tension, and improved self-perception of posture. The approach supports individualized progression and complements conventional physiotherapy without the use of pharmacological agents or medical equipment.

Strength Exercise: This is a non-drug, non-device corrective exercise program tailored for adults with forward head posture. It includes postural muscle strengthening and stretching, such as deep neck flexor activation, scapular retraction, and pectoral stretching. Additionally, participants perform diaphragmatic and thoracic breathing exercises.

Study summary

It is thought that adding approaches that increase posture awareness to corrective exercise programs will contribute to the treatment. The aim of the study is to evaluate the effect of adding the Feldenkrais method to the corrective exercise program applied to individuals with forward head posture on cervical joint position sense, muscle strength, joint range of motion and posture parameters.

Eligibility

Primary outcome measure(s)

• Cervical Joint Position Sense — 8 weeks
  Cervical joint position sense was assessed using a laser pointer-based method to evaluate proprioceptive accuracy. A laser device was securely mounted on the participant's head, and a neutral head position was established as a reference. Participants were instructed to move their heads in specific directions (flexion, extension, lateral flexion, or rotation) and, with eyes closed, return to the starting position. The laser beam projected onto a target screen allowed measurement of repositioning error-the distance between the original and returned laser point. Each direction was tested once, followed by three recorded trials, with the average used for analysis.
• Cervical Muscle Strength — 8 weeks
  Cervical muscle strength was assessed isometrically using the Lafayette Manual Muscle Tester. Participants were seated upright in a backless, armless chair with feet flat on the floor. Initial calibration involved maximal voluntary isometric contraction with hands pressed together in front of the body. Measurements were then taken with the neck in a neutral position, applying resistance to the forehead (flexion), occiput (extension), lateral head (lateral flexion), and chin (rotation). Three trials were recorded per direction, with averages used for analysis. A 3-minute rest was provided between attempts. Participants could stop at any time if discomfort occurred.
• Cervical Range of Motion — 8 weeks
  Cervical range of motion (ROM) was measured using the Baseline Digital Absolute+Axis Goniometer, a reliable and clinically validated tool for assessing cervical spine movements. Active cervical motions-including flexion, extension, right/left lateral flexion, and right/left rotation-were measured following standardized procedures defined by Norkin et al. Participants performed each movement actively while seated in an upright position. The goniometer provided objective angular measurements. This tool has demonstrated good to excellent intrarater reliability (ICC: 0.70-0.93) in previous research, confirming its suitability for both clinical and research purposes.
• Postural Assessment — 8 weeks
  Postural parameters were assessed using the PostureScreen Mobile (PSM) application, a validated digital tool for quantifying postural deviations. Static posture images were taken from anterior, posterior, and lateral views while participants stood in a relaxed upright position. Key anatomical reference points were marked within the app, which then calculated deviations from ideal posture in degrees or centimeters. This method allows for objective and reliable analysis of head, shoulder, and spinal alignment, providing quantifiable data to track changes over time and inform targeted corrective interventions.

Trial sites (2)

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