Effects of Exercise Type on Neck Disability, Pain, and Postural Changes in Subjects with Forward Head Posture: Systematic Review and Meta-Analysis

Abstract

| Abstract |1) PURPOSE: This study was conducted to investigate the effects of type of exercise on neck disability, pain, and postural changes in subjects with forward head posture. METHODS: Two independent researchers conducted a search using KISS, RISS, DBpia (domestic), PubMed, OVID, and Science Direct (overseas) databases. We selected randomized controlled clinical trials by searching using the terms "forward head posture", "exercise therapy", and "therapeutic exercise". Studies published from 2007 to December 2017 were included. PEDro Scale was used to evaluate the quality of the selected studies, and meta-analysis was conducted using the CMA program. This review was registered at PROSPERO (CRD42018068633). RESULTS: Of the total 13768 studies searched, 17 were selected. Positive effects on neck disability were achieved †Corresponding Author : Han-Suk Lee leehansuk21@naver.com, http://orcid.org/0000-0002-9336-0894 This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. with the base and biomechanical elements (ES=1.63, 95% confidence interval [CI] .49 to 2.75) as well as base, modulator, and biomechanical elements (ES=1.50, 95% [CI] .69 to 2.30). Neck pain improved with the base, modulator, and biomechanical elements (ES=1.96, 95% [CI] 1.08 to 2.82), while postural changes improved with biomechanical elements (ES=1.45, 95% [CI] .64 to 2.25). Additionally, type of exercise had a positive effect. CONCLUSION: The most effective exercises for neck disability are of the base and biomechanical elements, while the most effective types for neck pain are of the base, modulator, and biomechanical elements and the most effective exercise for posture is of biomechanical elements. Combined exercises targeting biomechanical elements were effective at treating disability, pain, and postural changes.