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IRCT20260421069127N1 IRCT 2026-04-30 Urmia University Effectiveness of corrective exercise with and without the Alexander technique on forward head, round shoulder and function in violin players Effectiveness of corrective exercise with and without the Alexander technique on forward head, round shoulder and function in violin players: a randomized control trial 2026-04-28 anticipated 66 Complete https://irct.ir/trial/89639 interventional Randomization: Randomized, Blinding: Single blinded, Placebo: Not used, Assignment: Parallel, Purpose: Supportive, Randomization description: A total of 66 eligible violinists participated in the study. Participants were allocated to the study groups using a computer‑based randomization procedure. A random sequence generator available at https://www.randomizer.org was used to generate the allocation sequence, according to which participants were randomly assigned to one of three groups: a corrective exercise group, a corrective exercise plus Alexander Technique group, and a control group. The randomization list was stored on a password‑protected computer and was accessible only to the researcher responsible for participant allocation. Recruitment personnel and others involved in the enrollment process did not have access to this information, Blinding description: Single‑blind design Participants: blinded to group allocation. N/A Forward head posture (forward head angle abnormality). Intervention 1: Intervention group: Participants assigned to the Corrective Exercise Group will perform an 8‑week corrective exercise program designed to address forward head posture and rounded shoulder posture. Each training session will last approximately 60 minutes and will include 5–10 minutes of general warm‑up, 20–40 minutes of corrective stretching and strengthening exercises targeting cervical, thoracic, and scapular muscles, and 5–10 minutes of cool‑down.The program will be performed three times per week throughout the 8‑week period.The progressive protocol consists of a series of ten corrective exercises, including deep cervical flexor activation, pectoralis minor stretching, scapular retraction strengthening, thoracic extension mobility, and shoulder girdle stabilization tasks. Exercise sets and repetitions are adjusted based on weekly progression while ensuring proper technique and postural alignment under researcher supervision. Intervention 2: Intervention group: Participants assigned to this group will receive both the corrective exercise program and the Alexander Technique instructional protocol.Each training session will last 60 minutes and will be structured as follows:5–10 minutes of general warm‑up5–10 minutes of Alexander Technique instruction focusing on inhibition, primary control (head–neck–spine coordination), and conscious direction of movements, based on a 19‑item standardized protocol20–40 minutes of corrective stretching and strengthening exercises (identical to those in the corrective exercise group)5–10 minutes of cool‑downThe intervention will be performed three times per week for 8 weeks. Throughout the Alexander Technique component, participants are guided to maintain optimal head–neck alignment, reduce unnecessary muscular tension, and perform movements with improved postural awareness. Intervention 3: Control group: Participants in the control group will not receive any structured training or therapeutic intervention during the 8‑week study period. They will be instructed to continue their routine daily activities without initiating new exercise programs. Yes - There is a plan to make this available What will be shared: Some of the images used in the study will be corrupted. When: from 29/06/2026 to 6 months later To whom: Researcher Conditions: An official email should be used to contact the corresponding author Where to obtain: corresponding author How to obtain: official email Comments:
public Ebrahim Mohammad ali nasab firouzjah
Urmia University, Kilometer 11 Serow Road
Urmia Iran (Islamic Republic of) 5756151818 +98 44 3275 2741 Ebrahim.mzb@gmail.com Urmia University scientific Faeze Mehdipour
Urmia University, Kilometer 11 Serow Road
Urmia Iran (Islamic Republic of) 5756151818 +98 44 3275 2741 faezemehdipour8@gmail.com Urmia University Iran (Islamic Republic of) Forward head angle greater than 46° and rounded shoulder angle greater than 52° At least three years of playing experience No concurrent use of other corrective or therapeutic interventions Not engaged in occupations involving prolonged postures or repetitive movements No history of fractures, surgery, or joint disorders affecting the spine or shoulder girdle No structural or functional shortening greater than 2 cm in either upper limb No participation in regular exercise programs 18 years 35 years Both Failure to complete the training program in accordance with the study objectives or unwillingness of the participant to continue the program Observation of any pathological symptoms during the training sessions Absence from more than three training sessions M40.0 Postural kyphosis Rehabilitation Rehabilitation Other Intervention group: Participants assigned to the Corrective Exercise Group will perform an 8‑week corrective exercise program designed to address forward head posture and rounded shoulder posture. Each training session will last approximately 60 minutes and will include 5–10 minutes of general warm‑up, 20–40 minutes of corrective stretching and strengthening exercises targeting cervical, thoracic, and scapular muscles, and 5–10 minutes of cool‑down.The program will be performed three times per week throughout the 8‑week period.The progressive protocol consists of a series of ten corrective exercises, including deep cervical flexor activation, pectoralis minor stretching, scapular retraction strengthening, thoracic extension mobility, and shoulder girdle stabilization tasks. Exercise sets and repetitions are adjusted based on weekly progression while ensuring proper technique and postural alignment under researcher supervision. Intervention group: Participants assigned to this group will receive both the corrective exercise program and the Alexander Technique instructional protocol.Each training session will last 60 minutes and will be structured as follows:5–10 minutes of general warm‑up5–10 minutes of Alexander Technique instruction focusing on inhibition, primary control (head–neck–spine coordination), and conscious direction of movements, based on a 19‑item standardized protocol20–40 minutes of corrective stretching and strengthening exercises (identical to those in the corrective exercise group)5–10 minutes of cool‑downThe intervention will be performed three times per week for 8 weeks. Throughout the Alexander Technique component, participants are guided to maintain optimal head–neck alignment, reduce unnecessary muscular tension, and perform movements with improved postural awareness. Control group: Participants in the control group will not receive any structured training or therapeutic intervention during the 8‑week study period. They will be instructed to continue their routine daily activities without initiating new exercise programs. The primary outcome in this record is the forward head angle. This variable represents the alignment of the head in the sagittal plane and indicates the degree of anterior displacement of the head relative to the trunk. It is selected as a primary outcome to evaluate the postural alignment of violin players and to determine whether the eight‑week intervention leads to measurable changes in head posture. Timepoint: The forward head angle will be measured at two time points: at baseline before the beginning of the intervention, and after completion of the eight‑week intervention period. Method of measurement: The forward head angle will be measured using digital photogrammetry in the sagittal plane. Standardized lateral photographs will be obtained from each participant, and the images will be analyzed using Kinovea motion analysis software to calculate the two‑dimensional forward head angle. The primary outcome in this record is the rounded shoulder angle. This variable reflects the anterior displacement and protraction of the shoulder girdle in the sagittal plane. It has been selected as a primary outcome to evaluate postural alignment of the shoulder girdle in violin players and to determine whether the eight‑week intervention leads to improvement in shoulder posture. Timepoint: The rounded shoulder angle will be measured at two time points: at baseline before the beginning of the intervention, and after completion of the eight‑week intervention period. Method of measurement: The rounded shoulder angle will be measured using digital photogrammetry in the sagittal plane. Standardized lateral photographs will be taken from each participant, and the images will be analyzed using Kinovea motion analysis software to calculate the two‑dimensional rounded shoulder angle. The primary outcome in this record is upper extremity function. This variable reflects the functional status of the arm, shoulder, and hand during daily and instrumental activities. It has been selected as a primary outcome to evaluate whether the eight‑week intervention leads to improvements in upper limb functional capacity in violin players. Timepoint: Upper extremity function will be evaluated at two time points: at baseline before the beginning of the intervention, and after completion of the eight‑week intervention period. Method of measurement: Upper extremity function will be assessed using the full Persian version of the Disabilities of the Arm, Shoulder and Hand questionnaire. This validated questionnaire will be completed by participants to determine their level of functional limitation in the upper limb. Urmia University Approved 2026-04-20 Research Ethics Committees of Sport Sciences Research Institute (SSRI) Tehran Province, Tehran, District 7, 5th Dead End Tehran Tehran Iran (Islamic Republic of)