Added value of diaphragm myofascial release on forward head posture and chest expansion in women with symptomatic...

This study aimed to assess how diaphragm myofascial release affects forward head posture (FHP), chest expansion (CE), and disability in patients with symptomatic FHP, as research on this technique's impact remains limited.

In this randomized controlled trial, 46 women aged 18-45 with symptomatic FHP were randomly assigned to two groups. The intervention group received four weekly diaphragm myofascial release techniques for four weeks. Both groups completed the same neck exercise program three times a week for four weeks. FHP, CE, and neck functional disability were assessed using CVA, cloth tape measurement, and CNFDS before and one day after treatment.

A significantly greater CVA (mean difference: 1.47 ± 0.55, CI: 0.36-2.58, P = 0.01) and CE (mean difference: 0.81 ± 0.35, CI: 0.09-1.53, P = 0.03) were observed in the intervention group compared to controls post-intervention. No between-group difference was found for CNFDS. Significant increases in CVA (control: 2.13 ± 0.49, P < 0.001; intervention: 3.61 ± 0.17, P < 0.001) and CE (control: 0.77 ± 0.21, P = 0.001; intervention: 1.59 ± 0.44, P < 0.001), along with a significant decrease in functional disability score (control: -4 ± 1.09, P = 0.001; intervention: -4.50 ± 1.50, P < 0.001), were found in both groups. All statistically significant differences were clinically meaningful (effect size >0.8).

Adding diaphragm myofascial release to neck exercises led to significantly greater improvements in FHP and CE compared to neck exercises alone. Thus, it is recommended for managing patients with symptomatic FHP.

IRCT20191116045461N1 (Iranian Registry of Clinical Trials); registered on December 23, 2019 (https://irct.behdasht.gov.ir/trial/43741).