Neuro-physiological Effects of Forward Head Posture on Cervical Proprioception and Muscle Activation in University Students

Abstract

Background: Forward head posture (FHP) is a musculoskeletal status that has obtained increasing attention among youth, especially students enrolled in academic programs that require sitting for long periods and intensive use of .digital devices Objective: The goal of this work is to also explores the relationship between FHP and several postural abnormalities including general postural deviation, head tilt, shoulder asymmetry, pelvic tilt, knee asymmetry and foot asymmetry .in university students Methods: One hundred students participants have FHP symptoms were assessed using the AI Posture Evaluation and Correction System (APECS) to evaluate postural alignment deviations and the FHP app to measure the forward head angle (FHA). Pearson correlation coefficients, multiple regression analysis and factor analysis used to .determine the main factors and interrelation Results: Strong correlations were observed between FHA and the body alignment deviations (R²=79.2%), head tilt (R²=77.4%) and also shoulder alignment deviation (R²=75.7%), suggesting that these variables play a key role in overall postural integrity. Pelvic tilt (R²=67.2%), knee asymmetry (R²=36.0%) and feet asymmetry (R²=32.5%) also showed moderate associations. Factor analysis further indicated that body alignment deviation was the strongest .predictor of FHA, followed by head tilt and shoulder alignment deviation Conclusion: FHA play an important role in maintaining postural integrity and significantly influences postural alignment deviations. It is also associated with pelvic tilt, knee asymmetry and foot asymmetry, reflecting its impact across the kinetic chain. Body alignment emerged as the strongest predictor of FHA, suggesting that assessing FHA .is essential for preventing potential musculoskeletal complications