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. 2025 Sep 18;20(9):e0330665.
doi: 10.1371/journal.pone.0330665. eCollection 2025.

V体育安卓版 - Exercise therapy to improve cervical proprioception in individuals with asymptomatic forward head posture: A systematic review of randomized controlled trials

Ali Asghar Norasteh  1 , Kimia Karimi  2 , Shabnam Faraji  3 , Fereshteh Ejlali  4 , Mohammad Alghosi  2   5 , Mohammad Alimoradi  6 , Hamed Zarei  2
Affiliations

Exercise therapy to improve cervical proprioception in individuals with asymptomatic forward head posture: A systematic review of randomized controlled trials

Ali Asghar Norasteh et al. PLoS One. .

"VSports" Abstract

Background: Forward head posture (FHP) is a common musculoskeletal condition associated with impaired cervical proprioception, which compromises postural control and neuromuscular function VSports手机版. Exercise-based interventions have been proposed to address proprioceptive deficits in FHP, but their effectiveness remains unclear. This systematic review aimed to evaluate the impact of exercise programs on cervical proprioception in individuals with FHP. .

Methods: A systematic search of PubMed, Scopus, and Web of Science was conducted up to April 20, 2025 V体育安卓版. Randomized controlled trials (RCTs) assessing exercise interventions on cervical proprioception in FHP were included. Risk of bias was assessed using the RoB-2 tool. Due to heterogeneity in outcome measures, a narrative synthesis was conducted, supported by effect size (ES) calculations. .

Results: Nine RCTs involving 367 participants were included. Interventions ranged from cervical stabilization exercises (most common) to whole-body vibration, backward walking, and muscle energy techniques V体育ios版. ESs varied from trivial to nearly perfect, with trivial-to-very-large improvements observed in joint position sense and joint position error. While cervical stabilization exercises demonstrated positive outcomes in rotation and flexion tasks across some studies, the limited number and heterogeneity of studies on alternative interventions precluded a definitive comparison of consistency or effectiveness. Risk of bias was generally rated as "some concerns" due to lack of blinding and variability in outcome measures. .

Conclusion: Current evidence suggests cervical stabilization exercises, the most studied intervention for FHP, may improve cervical proprioception VSports最新版本. However, methodological heterogeneity and diagnostic inconsistencies, such as variations in craniovertebral angle thresholds used to define FHP, limit the ability to draw definitive conclusions. Future studies should standardize diagnostic criteria, outcome assessments, and investigate long-term effects across diverse populations. .

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VSports手机版 - Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 flow diagram for new systematic reviews, including searches of databases and registers.
Fig 2
Fig 2. Effect sizes (Cohen’s d) of interventions on JPS and JPE.
Black circles (●) indicate individual effect sizes from each study, including those with the smallest and largest values. Horizontal lines (—) represent the mean effect size within each intervention category. Abbreviations: JPS: joint position sense, JPE: joint position error, FC: flexion changes, EC: extension changes, RRC: right rotation changes, LRC: left rotation changes, RFC: right flexion changes, LFC: left flexion changes, and JR: joint relocation.
Fig 3
Fig 3. Risk of bias summary for randomized controlled trials evaluated with RoB-2.
See this image and copyright information in PMC

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