Background: The progressive digitalization of contemporary life, coupled with prolonged sedentary behavior, has contributed to the widespread occurrence of forward head posture (FHP) in the general population. Among the various exercise interventions aimed at correcting FHP, stretching exercises and proprioceptive training have garnered significant attention. Objectives: To investigate the effects of stretching exercises and proprioceptive training on craniovertebral angle (CVA), an indicator of forward head posture (FHP), and on the muscle tone of the suboccipital muscles. Design: Randomized controlled trial. Methods: Thirty participants were randomly assigned to either the stretching exercise group (n=15) or the proprioceptive training group (n=15), and each group underwent intervention three times per week for six weeks. CVA and muscle tone of the suboccipital muscles were measured before and after the six-week intervention, and the results were statistically analyzed for comparison. Results: Both groups showed a significant increase in CVA after the intervention (P<.05), with no significant difference between the groups. The muscle tone of the suboccipital muscles did not show statistically significant changes either within or between the groups. Conclusion: Six weeks of stretching exercise and proprioceptive training both resulted in a significant increase in CVA, demonstrating that both interventions are effective in improving FHP. However, neither intervention produced significant changes in the muscle tone of the suboccipital muscles.

Background: For the treatment of forward head posture (FHP) and forward shoulder posture, methods for strengthening scapular retractors and deep cervical flexors and stretching pectoralis and upper cervical extensors are generally used. No study has yet assessed whether suboccipital release (SR) followed by cranio-cervical flexion exercise (CCFE) (SR-CCFE) will result in a positive change in the shoulders and neck, showing a “downstream” effect. Objects: The purpose of this study was to investigate the immediate effects of SR-CCFE on craniovertebral angle (CVA), shoulder abduction range of motion (ROM), shoulder pain, and muscle activities of upper trapezius (UT), lower trapezius (LT), and serratus anterior (SA) and LT/UT and SA/UT muscle activity ratios during maximal shoulder abduction in subjects with FHP. Methods: In total, 19 subjects (7 males, 12 females) with FHP were recruited. The subject performed the fifth phase of CCFE immediately after receiving SR. CVA, shoulder abduction ROM, shoulder pain, muscle activities of UT, LT, and SA, and LT/UT and SA/UT muscle activity ratios during maximal shoulder abduction were measured immediately after SR-CCFE. A paired t-test and Wilcoxon signed-rank test were used to determine the significance of differences in scores between pre- and post-intervention in the same group. Results: The CVA (p<.001) and shoulder abduction ROM (p<.001) were increased significantly postversus pre-intervention. Shoulder pain was decreased significantly (p<.001), and LT (p<.05) and SA (p<.05) muscle activities were increased significantly post- versus pre-intervention. The LT/UT muscle activity ratio was increased significantly post- versus pre-intervention (p<.05). However, there was no significant change in UT muscle activity and SA/UT muscle activity ratio between pre- and post-intervention (p˃.05). Conclusion: SR-CCFE was an effective intervention to improve FHP and induce downstream effect from the neck to the trunk and shoulders in subjects with FHP.