The Benefits of a 12-Week Corrective Exercise Program on Postural Alignment and Cervical Endurance Improvement in Forward Head Posture

Introduction: Forward head posture (FHP) is a prevalent musculoskeletal disorder. This study investigated the effects of a 12-week phased corrective exercise program on craniovertebral angle (CVA) and deep cervical flexor (DCF) endurance in individuals with FHP. Methods: This assessor-blinded randomized clinical trial included 48 participants aged 20–35 years with forward head posture (CVA < 50°). Participants were randomly allocated into two groups: a corrective exercise group (n = 24) and a control group (n = 24). The primary outcome was the craniovertebral angle (CVA), and the secondary outcome was deep cervical flexor (DCF) endurance. The intervention group followed a 12-week phased corrective exercise program performed three sessions per week, progressively focusing on neuromuscular coordination, endurance, and strength. Craniovertebral angle was measured using photogrammetry, while DCF endurance was evaluated with the Cranio-Cervical Flexion Test (CCFT). Data were analyzed using paired and independent samples t-tests, with significance set at P < 0.05. Results: Mixed ANOVA revealed a significant Time × Group interaction for CVA (F = 35.18, P < 0.001, ηp² = 0.37) and DCF endurance (F = 28.63, P < 0.001, ηp² = 0.39). In the exercise group, CVA significantly increased from 44.41 ± 3.17° to 49.50 ± 2.16° (P = 0.012, d = 1.21), and DCF endurance improved from 13.25 ± 4.31 to 20.50 ± 4.60 seconds (P = 0.001, d = 1.18). No significant changes were observed in the control group or for the Sagittal Head Angle (SHA) (P > 0.05). Conclusion: A 12-week phased corrective exercise program effectively improved craniovertebral angle and deep cervical flexor endurance in individuals with FHP, supporting its use in postural rehabilitation.