Selection criteria for studies.

BackgroundForward head posture (FHP) is a common musculoskeletal condition associated with impaired cervical proprioception, which compromises postural control and neuromuscular function. Exercise-based interventions have been proposed to address proprioceptive deficits in FHP, but their effectiveness remains unclear. This systematic review aimed to evaluate the impact of exercise programs on cervical proprioception in individuals with FHP.MethodsA systematic search of PubMed, Scopus, and Web of Science was conducted up to April 20, 2025. Randomized controlled trials (RCTs) assessing exercise interventions on cervical proprioception in FHP were included. Risk of bias was assessed using the RoB-2 tool. Due to heterogeneity in outcome measures, a narrative synthesis was conducted, supported by effect size (ES) calculations.ResultsNine RCTs involving 367 participants were included. Interventions ranged from cervical stabilization exercises (most common) to whole-body vibration, backward walking, and muscle energy techniques. ESs varied from trivial to nearly perfect, with trivial-to-very-large improvements observed in joint position sense and joint position error. While cervical stabilization exercises demonstrated positive outcomes in rotation and flexion tasks across some studies, the limited number and heterogeneity of studies on alternative interventions precluded a definitive comparison of consistency or effectiveness. Risk of bias was generally rated as “some concerns” due to lack of blinding and variability in outcome measures.ConclusionCurrent evidence suggests cervical stabilization exercises, the most studied intervention for FHP, may improve cervical proprioception. However, methodological heterogeneity and diagnostic inconsistencies, such as variations in craniovertebral angle thresholds used to define FHP, limit the ability to draw definitive conclusions. Future studies should standardize diagnostic criteria, outcome assessments, and investigate long-term effects across diverse populations.

背景：头前伸体态（Forward Head Posture, FHP）是一种常见的肌肉骨骼疾病，常伴随颈部本体感觉受损，进而损害姿势控制与神经肌肉功能。学界已提出基于运动的干预方案以改善头前伸体态患者的本体感觉缺陷，但其临床有效性仍不明确。本系统综述旨在评估运动干预对头前伸体态患者颈部本体感觉的影响。
方法：本研究于2025年4月20日前对PubMed、Scopus及Web of Science数据库开展系统性检索。纳入评估运动干预对头前伸体态患者颈部本体感觉效果的随机对照试验（Randomized Controlled Trials, RCTs）。采用偏倚风险评估工具2.0（RoB-2）对纳入研究的偏倚风险进行评价。由于结局指标存在异质性，本研究采用叙述性合成法，并辅以效应量（Effect Size, ES）计算。
结果：本研究共纳入9项随机对照试验，涉及367名受试者。干预手段涵盖颈部稳定训练（最为常见）、全身振动训练、倒走训练及肌肉能量技术等。效应量取值范围从极小至近乎完美，关节位置觉与关节位置误差均呈现出极小至极大程度的改善。尽管部分研究显示颈部稳定训练在旋转与屈曲任务中可取得积极效果，但针对其他干预手段的研究数量有限且异质性较强，无法明确比较其效果一致性与有效性。由于盲法缺失及结局指标存在变异，纳入研究的偏倚风险整体被评为“存在部分担忧”。
结论：现有证据表明，作为头前伸体态研究最广泛的干预手段，颈部稳定训练或可改善颈部本体感觉。但由于研究方法存在异质性，且诊断标准不一致（例如界定头前伸体态的颅颈角阈值存在差异），目前无法得出确定性结论。未来研究应统一诊断标准与结局评估方案，并针对不同人群探究干预的长期效果。