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IRCT20241004063260N2 IRCT 2025-04-02 Shiraz University of Medical Sciences The effects of adding subscapularis muscle dry needling to exercise therapy on symptoms of individuals with forward head posture Investigating the added effects of subscapularis muscle dry needling to exercise therapy on pain, kinematics, and cervical position sense in individuals with forward head posture 2025-04-09 anticipated 32 Complete https://irct.ir/trial/82387 interventional Randomization: Randomized, Blinding: Double blinded, Placebo: Not used, Assignment: Parallel, Purpose: Treatment, Randomization description: The random allocation method in this study is permutation (block) randomization. Considering 8 blocks of 4 in two groups and adding individuals with an allocation ratio of 1:1 in each group, 32 patients are studied in two groups of 16. Randomization is performed using a random number table, Blinding description: In this study, assessment and treatment are performed separately by two physiotherapists, with the assessing physiotherapist blinded to the participants' treatment. Also statistical analysis is performed by a statistician who is blinded to the participants' allocation to groups. N/A Forward head posture. Intervention 1: Intervention group: Dry needling of the subscapularis muscle combined with exercise therapy. Individuals in this group will undergo 10 sessions of treatment, 3 sessions per week. The exercises will include stretching and strengthening exercises, and at the end of sessions one, three, five, seven, and nine, individuals will undergo dry needling of the subscapularis muscle. To perform dry needling, the participant is asked to lie supine, with the shoulder in 90 degrees of abduction and 90 degrees of external rotation. The therapist uses one hand to pull the participant's shoulder further outward, palpating the outer edge of the scapula. The latissimus dorsi tendon is identified and lifted using a pincer grip to provide better access to the muscle. The needle is then inserted parallel to the chest and perpendicular to the anterior surface of the scapula. The needle entry site is cleaned with alcohol and cotton. Dry needling is performed on the muscle at three points, each point for 1 minute using a fast in-fast out method. A Chinese-made Huan Qiu needle, 30 mm in diameter and 50 mm in height, is used. Assessments will be conducted before treatment, immediately after treatment, and two weeks later. Intervention 2: Control group: Exercise therapy. Individuals in this group will undergo 10 sessions of therapy, 3 sessions per week. The exercises in this group are exactly the same as those in the intervention group and include stretching and strengthening exercises. Assessments will be conducted before treatment, immediately after treatment, and two weeks later. Yes - There is a plan to make this available What will be shared: Data collection form including primary and secondary outcomes, informed consent form, and SPSS file When: After the publication of the study results To whom: Researchers working in academic and scientific institutions Conditions: Only for recording information in scientific databases Where to obtain: Correspondence with the project manager via email yazdani_far@sums.ac.ir How to obtain: Maximum one month after sending the request via email Comments:
public Farzaneh Yazdani
School of Rehabilitation Sciences, Shahid Doran Campus, after Amir-al-momenin Burn Hospital, Sadra Town Road
Shiraz Iran (Islamic Republic of) 7198754361 +98 71 3212 2600 yazdani_far@sums.ac.ir Shiraz University of Medical Sciences scientific Farzaneh Yazdani
School of Rehabilitation Sciences, Shahid Doran Campus, after Amir-al-momenin Burn Hospital, Sadra Town Road
Shiraz Iran (Islamic Republic of) 7198754361 +98 71 3212 2600 yazdani_far@sums.ac.ir Shiraz University of Medical Sciences Iran (Islamic Republic of) Women and men between the ages of 18 and 50 Craniovertebral angle less than 50 degrees Shoulder angle less than 52 degrees 18 years 50 years Both Having central nervous system problems Having musculoskeletal problems Having congenital neck problems Having spondylolisthesis Taking any pharmacological or non-pharmacological treatment for neck pain and postural disorders Having any mental disorder such as anxiety and depression Cancer Pregnancy The patient's fear of needles The patient's reluctance and negative beliefs about this method The patient's inability to obtain consent (cognitive problems and advanced age) The patient has a medical emergency or acute medical condition The patient has lymphedema in a region or an organ The patient has severe neutropenia or thrombocytopenia R29.3 Abnormal posture Treatment - Other Treatment - Other Intervention group: Dry needling of the subscapularis muscle combined with exercise therapy. Individuals in this group will undergo 10 sessions of treatment, 3 sessions per week. The exercises will include stretching and strengthening exercises, and at the end of sessions one, three, five, seven, and nine, individuals will undergo dry needling of the subscapularis muscle. To perform dry needling, the participant is asked to lie supine, with the shoulder in 90 degrees of abduction and 90 degrees of external rotation. The therapist uses one hand to pull the participant's shoulder further outward, palpating the outer edge of the scapula. The latissimus dorsi tendon is identified and lifted using a pincer grip to provide better access to the muscle. The needle is then inserted parallel to the chest and perpendicular to the anterior surface of the scapula. The needle entry site is cleaned with alcohol and cotton. Dry needling is performed on the muscle at three points, each point for 1 minute using a fast in-fast out method. A Chinese-made Huan Qiu needle, 30 mm in diameter and 50 mm in height, is used. Assessments will be conducted before treatment, immediately after treatment, and two weeks later. Control group: Exercise therapy. Individuals in this group will undergo 10 sessions of therapy, 3 sessions per week. The exercises in this group are exactly the same as those in the intervention group and include stretching and strengthening exercises. Assessments will be conducted before treatment, immediately after treatment, and two weeks later. Craniovertebral angle. Timepoint: Before the start of the intervention, after the intervention and two weeks after the intervention. Method of measurement: The craniovertebral angle is the angle between two anatomical landmarks (the spinous process of the seventh cervical vertebra and the outer part of the tragus of the ear) that is examined with the Kinovea software. Shoulder angle. Timepoint: Before the intervention, after the intervention, and two weeks after the intervention. Method of measurement: The shoulder angle is the angle formed by the intersection between the horizontal line passing through the acromion and the line connecting the spinous process of the seventh cervical vertebra to the acromion, and is measured with the Kinovea software. Pain. Timepoint: Before the intervention, after the intervention, and two weeks after the intervention. Method of measurement: Visual Analogue Scale. Cervical positioning sense. Timepoint: Before the intervention, after the intervention, and two weeks after the intervention. Method of measurement: Joint position error test. Cervical range of motion. Timepoint: Before the intervention, after the intervention, and two weeks after the intervention. Method of measurement: Goniometry. Shiraz University of Medical Sciences Approved 2025-02-05 Research Ethics Committees of Shiraz School of Rehabilitation Sciences Ethics Committee, Vice President for Research, School of Rehabilitation Sciences, Shahid Doran Campus, after Amir-al-momenin Burn Hospital, Sadra Town Road Shiraz Fars Iran (Islamic Republic of)