Effect of integrated neuromuscular inhibition technique on subjects with neck pain and forward head posture: a randomized controlled trial

ObjectiveForward head posture (FHP) and neck pain are common musculoskeletal complaints. This study aimed to evaluate the effect of the Integrated Neuromuscular Inhibition Technique (INIT) on the range of motion (ROM) and craniovertebral angle (CVA) in individuals with FHP and neck pain.MethodsA total of 40 physical therapy participants (26 females and 14 males), aged 18 to 23 years (mean age: 20 +/- 1.71 years), participated in this study. They were randomized into two groups: Group A received conventional therapy combined with Integrated Neuromuscular Inhibition Technique (INIT) targeting the upper trapezius and suboccipital muscles, while Group B received conventional therapy consisting of strengthening and stretching exercises only. The treatment was administered three times per week for one month.Photographic sessions were conducted using a mobile phone. A Realme 7 Pro camera and CorelDRAW software were employed to analyze the craniovertebral angle (CVA). A pressure algometer was used to measure the pressure pain threshold (PPT), while a visual analogue scale (VAS) was utilized to assess pain severity. Additionally, a clinometer application on an Android device was used to evaluate cervical range of motion (ROM).MethodsA total of 40 physical therapy participants (26 females and 14 males), aged 18 to 23 years (mean age: 20 +/- 1.71 years), participated in this study. They were randomized into two groups: Group A received conventional therapy combined with Integrated Neuromuscular Inhibition Technique (INIT) targeting the upper trapezius and suboccipital muscles, while Group B received conventional therapy consisting of strengthening and stretching exercises only. The treatment was administered three times per week for one month.Photographic sessions were conducted using a mobile phone. A Realme 7 Pro camera and CorelDRAW software were employed to analyze the craniovertebral angle (CVA). A pressure algometer was used to measure the pressure pain threshold (PPT), while a visual analogue scale (VAS) was utilized to assess pain severity. Additionally, a clinometer application on an Android device was used to evaluate cervical range of motion (ROM).ResultsBoth groups demonstrated significant improvements in craniovertebral angle (CVA) and visual analogue scale (VAS) scores, with Group A showing a 16.12% improvement in CVA and a 75.61% reduction in VAS, compared to a 7.20% improvement in CVA and a 57.14% reduction in VAS in Group B.Group A also showed a significantly greater post-treatment increase in CVA (p = 0.01), cervical range of motion (ROM) for flexion (p = 0.002), extension (p = 0.005), right bending (p = 0.001), left bending (p = 0.001), right rotation (p = 0.001), and left rotation (p = 0.001). Additionally, Group A exhibited a significantly greater decrease in VAS (p = 0.003) compared to Group B following treatment.ResultsBoth groups demonstrated significant improvements in craniovertebral angle (CVA) and visual analogue scale (VAS) scores, with Group A showing a 16.12% improvement in CVA and a 75.61% reduction in VAS, compared to a 7.20% improvement in CVA and a 57.14% reduction in VAS in Group B.Group A also showed a significantly greater post-treatment increase in CVA (p = 0.01), cervical range of motion (ROM) for flexion (p = 0.002), extension (p = 0.005), right bending (p = 0.001), left bending (p = 0.001), right rotation (p = 0.001), and left rotation (p = 0.001). Additionally, Group A exhibited a significantly greater decrease in VAS (p = 0.003) compared to Group B following treatment. ConclusionThe Integrated Neuromuscular Inhibition (INI) technique, which combines ischemic compression, strain-counterstrain, and muscle energy techniques, yields superior outcomes compared to conventional therapy alone for individuals with forward head posture (FHP) and neck pain. It is particularly effective in improving craniovertebral angle (CVA), reducing pain levels, and enhancing cervical range of motion (ROM).