Supplementary materials for Comparative Exercise Physiology: Comparing callisthenic and motor control exercises for forward head posture on craniovertebral angle and postural stability: a randomised clinical trial

Forward head posture (FHP) is a prevalent adaptive postural malalignment caused due to poor working and leisure habits. Prolonged FHP eventually leads to muscle imbalance, postural instability, and can advance the progression of cervical disorders. Early intervention through screening may help to prevent this posture from being symptomatic. Therefore, correction of FHP through exercise regimen is necessary. Callisthenic exercises (CE) and motor control exercises (MCE) are known to improve muscle imbalance. Hence, it was hypothesised that CE and MCE would have positive effects on craniovertebral angle (CVA) and postural stability in asymptomatic FHP. This randomised clinical trial recruited 30 individuals aged between 18 and 40 years with asymptomatic FHP. The CE group received callisthenic exercises whereas MCE group received motor control exercises, thrice weekly for 4 weeks. The outcome measures were CVA, postural stability [risk of fall (ROF), stability index (SI), and anterio-posterior sway (AP sway)] and craniocervical flexion endurance (CCFE), which were assessed using photographic method, TETRAX, and pressure biofeedback unit (PBU) respectively. Paired t-test for within group analysis showed statistically significant improvement in all the outcomes for both the groups (P <0.05). Between group analysis by independent t-test revealed that both groups had similar improvement in CVA (P = 1.00) and CCFE (P = 0.08) but CE showed better improvement for postural stability (P <0.05) than MCE. CE and MCE are effective in improving CVA, postural stability, and CCFE in individuals with asymptomatic FHP. However, CE has a superior effect on postural stability over MCE.