تأثیر تمرینات اصلاحی بر پوسچر سر به جلو: مرور نظام‌مند و متاآنالیز

Abstract

Purpose:
Forward Head Posture (FHP) is one of the common musculoskeletal abnormalities associated with neck pain, reduced craniovertebral angle (CVA), and neuromuscular dysfunction. This study aimed to evaluate the effectiveness of corrective exercises on FHP and related variables such as CVA, neck pain, and muscular performance.
Methods:
This systematic review and meta-analysis was conducted according to PRISMA guidelines. A comprehensive search was performed in both Persian and English across databases, including PubMed, Scopus, Web of Science, ScienceDirect, Google Scholar, SID, and Magiran, up to the end of March 2025. The keywords used included “Forward Head Posture,” “Craniovertebral Angle,” “Corrective Exercises,” “Therapeutic Exercise,” and “Postural Correction.” The quality of the included studies was assessed using the PEDro scale.
Results:
Out of 850 identified records, 28 studies met the inclusion criteria. The corrective exercises used in these studies included stretching, strengthening, stabilization, and combined interventions, which in most cases led to significant improvements in indicators related to FHP, such as CVA, neck pain, muscular performance, and joint position sense. The duration of most interventions ranged from 4 to 12 weeks. Combined exercises, such as NASM-based programs, postural training, stretching, myofascial release, core stabilization, and aquatic training, showed greater effectiveness compared to single interventions. In total, 15 studies had sufficient data to be included in the meta-analysis. The results showed that corrective exercises significantly reduced the forward head angle compared to control groups (SMD = -1.52; 95% CI: -2.47 to -0.57; p = 0.002; I² = 91%). In contrast, meta-analysis results showed that NASM-based exercises were not significantly different from the control group. (MD = -1.82; 95% CI: -5.95 to 2.31; p = 0.39; I² = 94%). Corrective exercises also significantly improved head and neck angles (SMD = 1.49; 95% CI: 0.68 to 2.30; p = 0.0003; I² = 81%).
Conclusion:
Based on this systematic review and meta-analysis, corrective exercises—especially combined programs—showed the greatest effectiveness in improving FHP, reducing neck pain, and enhancing shoulder alignment. However, the results of the meta-analysis indicated that NASM-based exercises did not show a significant difference. Due to the high heterogeneity among studies and the moderate quality of some research, results should be interpreted with caution. Future studies with RCT design, larger sample sizes, and long-term follow-up are recommended to strengthen the evidence.