Radiographic and clinical effects of core stabilization on cervical pain and sagittal balance in forward head posture: a randomized controlled trial

STUDY DESIGN: Randomized controlled trial with a pretest-posttest control group design. PURPOSE: To investigate the radiographic and clinical effects of core stabilization exercises (CSEs) on cervical sagittal alignment and pain in individuals with forward head posture (FHP). OVERVIEW OF LITERATURE: FHP is a common postural disorder increasingly linked to prolonged screen use. Conventional rehabilitation primarily targets cervical musculature, whereas the role of core stabilization in influencing cervical alignment remains underexplored. METHODS: Forty patients (aged 20-40 years) with FHP (craniovertebral angle ≤50°) were randomly assigned to two groups: group A received CSEs combined with postural correction exercises (PCEs), and group B received PCEs alone. Interventions were delivered 3 times per week for 6 weeks. The primary outcomes were T1 slope (T1S), spino-cranial angle (SCA), and pain intensity measured using the Pain Rating Scale (PRS). RESULTS: Thirty-six participants completed the intervention. A two-way mixed-design multivariate analysis of variance revealed a significant main effect of time (F =19.461, p