Comparative Effects of Suboccipital Muscle Inhibition vs Instrument Assisted Soft Tissue Mobilization in Forward Head Posture

Forward Head Posture (FHP) is a prevalent postural dysfunction characterized by anterior displacement of the head relative to the shoulder line. It is often linked to musculoskeletal pain, restricted cervical mobility, and altered muscle activation patterns. The condition manifests with shortening of the upper trapezius, suboccipital muscles, semispinalis, splenius capitis, Sternocleidomastoid (SCM), and levator scapulae. Concurrently, there is weakness or inhibition in the deep cervical flexors, resulting in an imbalance between the cervical flexor and extensor muscle groups. These muscular imbalances contribute to dysfunctional cervical movement patterns, altered proprioception, and increased joint loading, particularly at the atlanto-occipital and cervico-thoracic junctions. The objective of this randomized controlled trial is to compare the effectiveness of Sub-Occipital Muscle Inhibition (SMI) and Instrument Assisted Soft Tissue Mobilization (IASTM) in improving postural alignment, reducing pain, and enhancing cervical range of motion in individuals with Forward Head Posture. It will address a common postural and musculoskeletal problem that affects a large portion of the population which will contribute to a more effective management approach for Forward Head Posture and will guide clinicians in selecting targeted, evidence-based therapies for their patients with FHP. As there is a lack of comparative studies assessing their relative effectiveness specifically for FHP, it will contribute novel data to the field of physiotherapy and rehabilitation science. A total of 38 participants with FHP will be randomly assigned into two equal groups (n=19). Group A will receive conventional physiotherapy along with Sub-Occipital Muscle Inhibition, while Group B will receive conventional physiotherapy combined with Instrument Assisted Soft Tissue Mobilization. Both groups will undergo 18 treatment sessions over six weeks, administered on alternate days. Both interventions are expected to show positive outcomes in improving FHP; however, the study aims to determine which technique is more effective. The results will help clinicians understand which manual therapy methods work best. This can make it easier for them to choose the right treatment for Forward Head Posture. Using proven techniques can improve patient comfort and recovery. In the end, it will help to provide advance approach and more personalised care for the patients.

NCT Number	NCT07593235
Lead Sponsor	Foundation University Islamabad
Conditions	Forward Head Posture, Occipital Muscle Inhibition Technique
Enrollment	38 participants
Start Date	2026-05-13
Primary Completion	2026-07-01 (estimated)
Study Completion	2026-07-15 (estimated)
Updated on ClinicalTrials.gov	2026-05-18