Effects of Postural Corrective Exercise Combined with Extracorporeal Shockwave Therapy on Muscle Activity, Neck Function and Pain in Adults with Forward Head Posture

Objective: Long-term imbalances in the muscles around the neck could the functional resting length of the muscles, resulting in a chronic forward head posture. This study aimed to assess the effects of combining posture correction exercises with extracorporeal shockwave therapy on muscle activity, neck function and pain in adults with forward head posture. Design: Pretest-posttest two groups design. Methods: A total of 22 adults, diagnosed with forward head posture, participated in the study. Random assignment allocated 11 participants to the posture correction exercise (PCE) group, while the other 11 were assigned to the posture correction exercise group combined with extracorporeal shockwave therapy (ESWT). In the combined group, ESWT was administered twice a week for four weeks, delivering 1,000 impulses in a radial pattern to the levator scapulae and upper trapezius muscles. The PCE group performed a exercise program for approximately 30 minutes, three times a week, over the same four-week period. The PCE focused on strengthening weakened muscles and stretching of shortened muscles. Results: Both the PCE group and the combined group with ESWT exhibited a significant increase in lower trapezius muscle activity within groups (p<0.05). Moreover, the craniovertebral angle and neck disability index showed significant improvements in both groups (p<0.05). While the pressure pain thresholds tended to increase only in the combined group, the difference was not statistically significant (p>0.05). Conclusions: This suggests that both the PCE program and the combination with ESWT can be effective in enhancing posture and reducing pain in individuals with forward head posture.