A Systematic Literature Review of the Effects of Strengthening and Stretching Exercise on Forward Head Posture

: Forward Head Posture (FHP) is a prevalent musculoskeletal deviation characterized by anterior head translation, often associated with modern sedentary lifestyles and extensive screen usage. FHP can lead to cervical spine dysfunction, muscular imbalance, pain, and functional limitations. Physiotherapy-based interventions, especially strengthening and stretching exercises, have been widely recommended for its correction. This systematic literature review aims to synthesize current evidence on the effectiveness of strengthening and stretching exercises in managing FHP, highlighting clinical outcomes, therapeutic strategies, and research gaps. A systematic search was conducted using PRISMA guidelines across five databases—PubMed, Scopus, Web of Science, ScienceDirect, and Google Scholar—for studies published between January 2005 and January 2024. A total of 437 records were initially identified, and after duplicates were removed and full-text screenings conducted, 27 studies met the inclusion criteria. Studies were evaluated using the PEDro scale and JBI checklist for methodological quality. Evidence across randomized controlled trials and systematic reviews supports the efficacy of targeted exercises in improving craniovertebral angle (CVA), neck disability index (NDI), range of motion, and muscle activation patterns. Strengthening deep cervical flexors and scapular stabilizers, combined with stretching of the pectoralis major/minor, levator scapulae, and SCM, significantly reduced symptoms and improved postural alignment. Combined interventions yielded superior outcomes compared to single-modality protocols. Strengthening and stretching exercises are effective, non-invasive strategies for correcting FHP. Their integration into clinical and preventive physiotherapy protocols is recommended. However, high-quality longitudinal studies are needed to establish standardized exercise protocols and long-term efficacy.