The role of forward head correction in management of adolescent idiopathic scoliotic patients: a randomized controlled trial

Objective: To investigate the effectiveness of forward head correction on three-dimensional posture parameters and functional level in adolescent idiopathic scoliotic patients. Design: A randomized controlled study with three-month follow-up. Setting: University research laboratory. Subjects: Seventy-six adolescent idiopathic scoliotic patients with Cobb angle ranged from 10 degrees to 30 degrees and craniovertebral angle less than 50 degrees were randomly assigned to a study or a control group. Interventions: All the patients (n = 76) received traditional treatment in the form of stretching and strengthening exercises. In addition, patients in the study group (n = 38) received a forward head posture corrective exercise programme. Outcome measures: Craniovertebral angle, Functional Rating Index and posture parameters, including: lumbar lordosis, thoracic kyphosis, trunk inclination, trunk imbalance, lateral deviation, surface rotation and pelvis torsion were measured before treatment, after 10 weeks, and at three-month follow-up. Results: There was a significant difference between the study and control groups adjusted to baseline values at 10 weeks post treatment with respect to the following parameters: craniovertebral angle (P = 0.006), trunk inclination (P = 0.005), lordosis (P = 0.01), kyphosis (P = 0.001), trunk imbalance (P = 0.001), lateral deviation (P = 0.001), pelvic torsion (P = 0.004) and surface rotation (P = 0.013). At three-month follow-up, there were still significant differences in all the previous variables (P < 0.005). In contrast, while there was no significant difference with respect to Functional Rating Index at 10 weeks (P = 0.8), the three-month follow-up showed a significant difference (P = 0.001). Conclusion: A forward head corrective exercise programme combined with conventional rehabilitation improved three-dimensional scoliotic posture and functional status in patients with adolescent idiopathic scoliosis.