| CTRI Number |
CTRI/2026/02/103394 [Registered on: 09/02/2026] Trial Registered Prospectively |
| Last Modified On: |
05/02/2026 |
| Post Graduate Thesis |
Yes |
| Type of Trial |
Interventional |
|
Type of Study
|
Physiotherapy (Not Including YOGA) |
| Study Design |
Randomized, Parallel Group, Active Controlled Trial |
|
Public Title of Study
|
Effect of Graded Motor Imagery versus Proprioceptive Neuromuscular Facilitation on fear of movement, Joint Position Sense, Posture, and Pain in Forward Head Posture with Chronic Non-Specific Neck Pain |
|
Scientific Title of Study
|
Effect of Graded Motor Imagery versus Proprioceptive Neuromuscular Facilitation on Kinesiophobia, Proprioception, Posture, and Pain in Forward Head Posture with Chronic Non-Specific Neck Pain: A Randomized Clinical Trial |
| Trial Acronym |
NIL |
|
Secondary IDs if Any
|
| Secondary ID |
Identifier |
| NIL |
NIL |
|
|
Details of Principal Investigator or overall Trial Coordinator (multi-center study)
|
| Name |
Ashwin Protasio Barreto |
| Designation |
Postgraduate student (Orthopaedic Physiotherapy) |
| Affiliation |
KAHER Institute of Physiotherapy, Belagavi |
| Address |
KLES Dr. Prabhakar Kore Hospital and MRC, Advanced Physiotherapy Centre Orthopaedic Physiotherapy
Department Room No. 18, Nehru Nagar, Belagavi, Karnataka-590010
Belgaum
KARNATAKA
590010
India
Belgaum
KARNATAKA
590010
India |
| Phone |
8208316916 |
| Fax |
|
| Email |
ashwinbarreto6@gmail.com |
|
Details of Contact Person
Scientific Query
|
| Name |
Dr Aarti Welling |
| Designation |
Associate Professor, Department of Orthopaedic Physiotherapy |
| Affiliation |
KAHER Institute of Physiotherapy, Belagavi |
| Address |
KLES Dr. Prabhakar Kore Hospital and MRC, Advanced Physiotherapy Centre Orthopaedic Physiotherapy
Department Room No. 18, Nehru Nagar, Belagavi, Karnataka-590010
Belgaum
KARNATAKA
590010
India
Belgaum
KARNATAKA
590010
India |
| Phone |
9448814569 |
| Fax |
|
| Email |
aartiwell88@gmail.com |
|
Details of Contact Person
Public Query
|
| Name |
Dr Aarti Welling |
| Designation |
Associate Professor, Department of Orthopaedic Physiotherapy |
| Affiliation |
KAHER Institute of Physiotherapy, Belagavi |
| Address |
KLES Dr. Prabhakar Kore Hospital and MRC, Advanced Physiotherapy Centre Orthopaedic Physiotherapy
Department Room No. 18, Nehru Nagar, Belagavi, Karnataka-590010
Belgaum
KARNATAKA
590010
India
Belgaum
KARNATAKA
590010
India |
| Phone |
9448814569 |
| Fax |
|
| Email |
aartiwell88@gmail.com |
|
|
Source of Monetary or Material Support
|
|
|
Primary Sponsor
|
| Name |
Ashwin Protasio Barreto |
| Address |
KAHER Institute of Physiotherapy, Nehru Nagar, Belagavi, Karnataka-590010 |
| Type of Sponsor |
Other [Self] |
|
|
Details of Secondary Sponsor
|
| Name |
Address |
| Dr Aarti Welling |
KAHER Institute of Physiotherapy, Nehru Nagar, Belagavi, Karnataka-590010 |
|
|
Countries of Recruitment
|
India |
|
Sites of Study
|
| No of Sites = 1 |
| Name of Principal
Investigator |
Name of Site |
Site Address |
Phone/Fax/Email |
| Dr Aarti Welling |
KLES Dr. Prabhakar Kore Hospital and MRC Nehru Nagar, Belagavi, 590010 |
KLES Dr. Prabhakar Kore Hospital and MRC, Advanced Physiotherapy Centre Orthopaedic Physiotherapy Department Room No. 18, Nehru Nagar, Belagavi, Karnataka 590010
Belgaum
KARNATAKA |
9448814569
aartiwell88@gmail.com |
|
|
Details of Ethics Committee
|
| No of Ethics Committees= 1 |
| Name of Committee |
Approval Status |
| Research and Ethical Committe, KLEU Institute of Physiotherapy, Belagavi |
Approved |
|
|
Regulatory Clearance Status from DCGI
|
|
|
Health Condition / Problems Studied
|
| Health Type |
Condition |
| Patients |
(1) ICD-10 Condition: M542||Cervicalgia, |
|
|
Intervention / Comparator Agent
|
| Type |
Name |
Details |
| Intervention |
Graded Motor Imagery combined with Conventional Physiotherapy |
Participants will receive graded motor imagery training consisting of laterality recognition, motor imagery, and mirror therapy, combined with conventional physiotherapy. Conventional physiotherapy will include moist hot pack application over the cervical region and transcutaneous electrical nerve stimulation (TENS) for pain relief. All interventions will be administered under physiotherapist supervision. 3 sessions per week will be administered for 4 weeks by a trained physiotherapist. |
| Comparator Agent |
Proprioceptive Neuromuscular Facilitation combined with Conventional Physiotherapy |
Participants will receive proprioceptive neuromuscular facilitation techniques for the cervical region combined with conventional physiotherapy. Conventional physiotherapy will include moist hot pack application over the cervical region and transcutaneous electrical nerve stimulation (TENS) for pain relief. All interventions will be administered under physiotherapist supervision. 3 sessions per week will be administered for 4 weeks by a trained physiotherapist. |
|
|
Inclusion Criteria
|
| Age From |
18.00 Year(s) |
| Age To |
30.00 Year(s) |
| Gender |
Both |
| Details |
1. Individuals of all genders aged 18 to 30 years with forward head posture, as identified by a craniovertebral angle of at least 50 degrees.
2. Diagnosed with chronic non specific neck pain lasting at least 3 months.
3. Presence of mild to moderate pain, with a Numeric Pain Rating Scale score of 3 to 7.
4. Participants with a Kyphotic Index more than 13 measured using a flexicurve ruler.
5. Able to understand and follow instructions for Graded Motor Imagery and PNF exercises.
6. Willing to provide informed consent for participation. |
|
| ExclusionCriteria |
| Details |
1. History of trauma or surgery to the cervical spine.
2. Presence of specific neck pathology such as cervical radiculopathy, myelopathy, or inflammatory disorders.
3. Neurological disorders affecting motor control or proprioception.
4. Current physiotherapy treatment for neck pain or previous experience with GMI or PNF within the last 6 months.
5. Individuals with vestibular disorders or dizziness affecting balance or head repositioning accuracy.
6. Pregnant individuals. |
|
|
Method of Generating Random Sequence
|
Computer generated randomization |
|
Method of Concealment
|
Sequentially numbered, sealed, opaque envelopes |
|
Blinding/Masking
|
Outcome Assessor Blinded |
|
Primary Outcome
|
| Outcome |
TimePoints |
1. Kinesiophobia related to the neck movement measured using the Tampa Scale of Kinesiophobia.
2. Cervical Proprioception using the Cervical Repositioning Error Test (Laser Pointer Method). |
1. Kinesiophobia will be assessed at baseline and four weeks.
2. Proprioception will be assessed at baseline and four weeks. |
|
|
Secondary Outcome
|
| Outcome |
TimePoints |
1. Craniovertebral angle measured using the Kinovea Software.
2. Kyphotic index measured using a flexicurve ruler.
3. Pain measured using the Numeric Pain Rating Scale. |
1. Craniovertebral angle will be assessed at baseline & four weeks.
2. Kyphotic index will be assessed at baseline & four weeks.
3. Pain will be assessed at baseline & four weeks. |
|
|
Target Sample Size
|
Total Sample Size="36"
Sample Size from India="36"
Final Enrollment numbers achieved (Total)= "Applicable only for Completed/Terminated trials"
Final Enrollment numbers achieved (India)="Applicable only for Completed/Terminated trials" |
|
Phase of Trial
|
N/A |
|
Date of First Enrollment (India)
|
16/02/2026 |
| Date of Study Completion (India) |
Applicable only for Completed/Terminated trials |
| Date of First Enrollment (Global) |
Date Missing |
| Date of Study Completion (Global) |
Applicable only for Completed/Terminated trials |
|
Estimated Duration of Trial
|
Years="1"
Months="0"
Days="0" |
|
Recruitment Status of Trial (Global)
|
Not Applicable |
| Recruitment Status of Trial (India) |
Not Yet Recruiting |
|
Publication Details
|
N/A |
|
Individual Participant Data (IPD) Sharing Statement
|
Will individual participant data (IPD) be shared publicly (including data dictionaries)?
Response - NO
|
|
Brief Summary
|
Forward head posture is a common postural deviation associated with chronic non-specific neck pain in young adults and is often accompanied by pain, impaired proprioception, altered posture, and fear of movement. Both graded motor imagery and proprioceptive neuromuscular facilitation are established physiotherapy approaches used in the management of chronic musculoskeletal pain; however, evidence directly comparing their effects in individuals with forward head posture is limited. This randomized clinical trial aims to compare the effects of graded motor imagery and proprioceptive neuromuscular facilitation, when combined with conventional physiotherapy, on pain, posture, proprioception, and kinesiophobia in young adults aged 18–30 years with forward head posture and chronic non-specific neck pain. A total of 36 participants will be randomly allocated into two groups, with one group receiving graded motor imagery combined with conventional physiotherapy and the other group receiving proprioceptive neuromuscular facilitation combined with conventional physiotherapy. Interventions will be administered three times per week for four weeks, and outcomes will be assessed before and after the intervention period using validated outcome measures. The findings of this study may help identify an effective physiotherapy approach for improving clinical and functional outcomes in this population. |