Effects of hip extensor exercises on neck disability, cervical alignment, muscle imbalance, and blood flow in forward head posture

Background Forward head posture (FHP) is a common disorder worsened by prolonged use of electronic devices, causing increased neck load and musculoskeletal issues. While McKenzie neck exercises (MNE) are widely used to address FHP, the potential benefits of hip extensor exercises (HEE) remain underexplored. Objective This study aims to compare the effects of MNE and HEE on neck disability index (NDI), craniovertebral angle (CVA), cranial rotation angle (CRA), and the thickness of the LC muscle and carotid artery (CA) in individuals with FHP. Methods Twenty participants with FHP were randomly assigned to either the MNE or HEE group, undergoing their respective exercises for 20 min per session, three times a week for two weeks. Pre- and post-intervention assessments included NDI questionnaire, CVA, CRA measurements, and ultrasonographic evaluation of LC muscle and CA thickness. Results Both MNE and HEE groups showed significant improvements in NDI, CVA, CRA, and LC muscle thickness post-intervention (P < 0.05), with no significant group differences (P > 0.05). CA thickness increased in both groups, though not significantly. Conclusions Both MNE and HEE effectively improved symptoms and alignment associated with forward head posture. These findings suggest that hip extensor exercises may be a beneficial approach to mitigating FHP, similar to MNE.