Effects of cervical stability exercises using proprioceptive neuromuscular facilitation on physical function and activity in patients with neck pain and forward head posture : A randomized controlled trial
- 1Department of Physical Therapy, Jainplus Hospital, Jeonju-si, Republic of Korea.
Abstract
Background:: We investigated the effects of proprioceptive neuromuscular facilitation cervical stability exercises (PNFCSEs) on pain intensity, craniocervical flexor endurance (CCFE), forward head posture (FHP), and neck disability in patients with neck pain and FHP.
Methods:: Patients were randomly allocated to 3 groups using a randomized controlled trial. The PNFCSE (n = 23), CSEs (n = 23), and traditional physical therapy (TPT; n = 21) groups received TPT, which included a hot pack, interferential current therapy, and ultrasound. In addition, the PNFCSE group received CSE using PNF, while the CSE group received CSE using a pressure biofeedback unit. Interventions were conducted thrice weekly for 6 weeks. Pain intensity and CCFE were measured before and after the intervention. FHP and neck disability level were also measured before and after the intervention. A total of 67 participants (35 women, 32 men; mean age 45.7–47.4 years across groups) completed the study.
Results:: A 3 × 2 (group × time) mixed analysis of variance showed significant group × time interactions for pain intensity, craniovertebral angle (CVA), CCFE, and neck disability level (all P < .001). All 4 outcomes changed significantly over time within each group (all P < .001, except TPT-group CVA, P = .003): pain intensity and disability level were reduced, and CVA and CCFE were increased. Post hoc comparisons of the pre-to-post change scores showed significantly greater improvements in the PNFCSE and CSE groups than in the TPT group for all 4 outcomes (all P < .05), and a significantly greater increase in CCFE in the PNFCSE group than in the CSE group (P = .022); no other differences were found between the PNFCSE and CSE groups.
Conclusion:: In patients with neck pain and FHP, PNFCSEs significantly reduced pain intensity and neck disability and improved CCFE and FHP, with greater improvements than TPT alone and a greater gain in CCFE than CSE using pressure biofeedback. CSEs based on the PNF concept may be an effective intervention to reduce pain and neck disability in patients with neck pain and FHP.
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BibTeX
@article{kim2026effects,
title = {{Effects of cervical stability exercises using proprioceptive neuromuscular facilitation on physical function and activity in patients with neck pain and forward head posture : A randomized controlled trial}},
author = {Beom Ryong Kim},
journal = {Medicine},
year = {2026},
month = oct,
doi = {10.1097/md.0000000000051431},
url = {https://europepmc.org/article/PMC/PMC13727183},
note = {CC BY-NC},
}
RIS
TY - JOUR
TI - Effects of cervical stability exercises using proprioceptive neuromuscular facilitation on physical function and activity in patients with neck pain and forward head posture : A randomized controlled trial
AU - Beom Ryong Kim
PY - 2026
DA - 2026/10/30
JO - Medicine
DO - 10.1097/md.0000000000051431
UR - https://europepmc.org/article/PMC/PMC13727183
AB - Background:: We investigated the effects of proprioceptive neuromuscular facilitation cervical stability exercises (PNFCSEs) on pain intensity, craniocervical flexor endurance (CCFE), forward head posture (FHP), and neck disability in patients with neck pain and FHP. Methods:: Patients were randomly allocated to 3 groups using a randomized controlled trial. The PNFCSE (n = 23), CSEs (n = 23), and traditional physical therapy (TPT; n = 21) groups received TPT, which included a hot pack, interferential current therapy, and ultrasound. In addition, the PNFCSE group received CSE using PNF, while the CSE group received CSE using a pressure biofeedback unit. Interventions were conducted thrice weekly for 6 weeks. Pain intensity and CCFE were measured before and after the intervention. FHP and neck disability level were also measured before and after the intervention. A total of 67 participants (35 women, 32 men; mean age 45.7–47.4 years across groups) completed the study. Results:: A 3 × 2 (group × time) mixed analysis of variance showed significant group × time interactions for pain intensity, craniovertebral angle (CVA), CCFE, and neck disability level (all P < .001). All 4 outcomes changed significantly over time within each group (all P < .001, except TPT-group CVA, P = .003): pain intensity and disability level were reduced, and CVA and CCFE were increased. Post hoc comparisons of the pre-to-post change scores showed significantly greater improvements in the PNFCSE and CSE groups than in the TPT group for all 4 outcomes (all P < .05), and a significantly greater increase in CCFE in the PNFCSE group than in the CSE group (P = .022); no other differences were found between the PNFCSE and CSE groups. Conclusion:: In patients with neck pain and FHP, PNFCSEs significantly reduced pain intensity and neck disability and improved CCFE and FHP, with greater improvements than TPT alone and a greater gain in CCFE than CSE using pressure biofeedback. CSEs based on the PNF concept may be an effective intervention to reduce pain and neck disability in patients with neck pain and FHP.
SN - 0304-5412
SN - 1536-5964
SN - 0025-7974
ER -