Comparative effectiveness of posture correction exercises versus postural awareness on forward head posture, protruded shoulder and thoracic kyphosis in 13-15 year old smartphone users: a randomized controlled trial intervention protocol
DOI:
https://doi.org/10.18203/2349-3259.ijct20252199Keywords:
Kyphosis, Smartphone, Posture, Awareness, Randomized control trialAbstract
Background: Rise in smartphone use among high school students aged 13-15 has leads to musculoskeletal issues like forward head posture (FHP), protruded shoulders, and thoracic kyphosis. To prevent these problems, it's essential to teach students proper posture exercises and raise their awareness about maintaining good posture. Primary objective of this study is to determine the efficacy of posture correction exercises and postural awareness techniques on FHP, protruded shoulder, and thoracic kyphosis.
Methods: This randomized clinical trial will assess the impact of an intervention on FHP, protruded shoulders, and thoracic kyphosis in 170 smartphone addicted participants who will be randomly allocated to control and interventional group. Smartphone addiction will be measured using the smartphone addiction scale-short version (SAS-SV), and postural changes will be evaluated with cranio vertebral angle (CVA), the supine method, and an inclinometer measurement before and after the intervention. Follow up will be done after 3- and 6-months post intervention. If data is normally distributed, paired ‘t’ test and independent ‘t’ test will be used for in group and between group analysis, ANOVA with post-hoc test (Bonferroni-t test) for follow up analysis otherwise non parametric equivalent tests will be used. The results will be presented in the form of 95% CI and with p≤0.05.
Conclusions: If postural correction exercises and awareness effectively reduce FHP, protruded shoulders, and thoracic kyphosis in 13-15-year-old smartphone users, integrating these techniques into daily routines could prevent future postural issues related to smartphone addiction.
Trial registration: This randomized clinical trial registered prospectively. Registration Number: CTRI/2024/07/ 069802.
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References
Ojha R, Sindhu B, Sen S. Effects of smartphone addiction on sitting neck posture and hand discomfort: A cross sectional study. Int J Health Sci. 2022;6(2):13642-650. DOI: https://doi.org/10.53730/ijhs.v6nS2.8595
Alonazi A, Daher N, Alismail A, Nelson R, Almutairi W, Bains G. The Effects Of Smartphone Addiction on Children’s Cervical Posture and Range of Motion. Int J Physiother. 2019;6(2):32-9. DOI: https://doi.org/10.15621/ijphy/2019/v6i2/181910
Sheikhhoseini R, Shahrbanian S, Sayyadi P, O’Sullivan K. Effectiveness of Therapeutic Exercise on Forward Head Posture: A Systematic Review and Meta-analysis. J Manipulative Physiol Ther. 2018;41(6):530-39. DOI: https://doi.org/10.1016/j.jmpt.2018.02.002
Feng Q, Wang M, Zhang Y, Zhou Y. The effect of a corrective functional exercise program on postural thoracic kyphosis in teenagers: a randomized controlled trial. Clin Rehabil. 2018;32(1):48-56. DOI: https://doi.org/10.1177/0269215517714591
Kanaparthy A, Kanaparthy R, Boreak N. Postural awareness among dental students in Jizan, Saudi Arabia. J Int Soc Prev Community Dent. 2015;5(8):107. DOI: https://doi.org/10.4103/2231-0762.172950
Kwon M, Kim DJ, Cho H, Yang S. The Smartphone Addiction Scale: Development and Validation of a Short Version for Adolescents. PloS One. 2013;8:e83558. DOI: https://doi.org/10.1371/journal.pone.0083558
Torres-Cusihuaman L, Bravo-Cucci S. Association between Thoracic Kyphosis and Forward Head Posture in Teenagers: An Analytical Cross-Sectional Study. Middle East J Rehabil Health Stud. 2023;10(4):e134579. DOI: https://doi.org/10.5812/mejrh-134579
Bomen BB, Kulkarni S. The Relationship between Addiction to Smartphone Usage and Protracted Shoulders, Forward Head Posture and Thoracic Kyphosis in College Students. Int J Health Sci Res. 2022;12(2):220-6. DOI: https://doi.org/10.52403/ijhsr.20220231
Fontenele TMDO, Nunes PPDB, Silva FVM, Catarina NBM, de Andrade RF, Daniela GBM, et al. Smartphone addiction and postural alterations in the cervical region in adolescents. Rev Paul Pediatr. 2024;42:e2023051. DOI: https://doi.org/10.1590/1984-0462/2024/42/2023051
Verma S, Shaikh J, Mahato R, Sheth M. Prevalence of forward head posture among 12-16 year old school going students-A cross sectional study. Appl Med Res. 2018;4(1):18. DOI: https://doi.org/10.5455/amr.20180805064752
Sirajudeen MS, Alzhrani M, Alanazi A, Mazen A, Mohamed W, Radhakrishnan U, et al. Prevalence of text neck posture, smartphone addiction, and its association with neck disorders among university students in the Kingdom of Saudi Arabia during the COVID-19 pandemic. PeerJ. 2022;10:e14443. DOI: https://doi.org/10.7717/peerj.14443
Mangalore Metropolitan Urban Region Population 2011-2024 Census. Available at: https://www.census2011.co.in/census/metropolitan/391-mangalore.html. Accessed on 22 March 2025.
Singla D, Veqar Z. Association Between Forward Head, Rounded Shoulders, and Increased Thoracic Kyphosis: A Review of the Literature. J Chiropr Med. 2017;16(3):220-9. DOI: https://doi.org/10.1016/j.jcm.2017.03.004
Abdollahzade Z, Shadmehr A, Malmir K, Ghotbi N. Research Paper: Effects of 4 Week Postural Corrective Exercise on Correcting Forward Head Posture. 2017;11(2):85-92.