Summary of effect sizes by intervention type.

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.研究背景：头前伸姿势（Forward head posture, FHP）是一种常见的肌肉骨骼疾病，与颈部本体感觉受损相关，会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手段以改善头前伸姿势患者的本体感觉缺陷，但其有效性仍未明确。本系统综述旨在评估运动干预对头前伸姿势患者颈部本体感觉的影响。 研究方法：本研究于2025年4月20日前对PubMed、Scopus及Web of Science数据库进行系统性检索。纳入评估头前伸姿势患者运动干预对颈部本体感觉影响的随机对照试验（Randomized controlled trials, RCTs）。采用RoB-2工具评估偏倚风险。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。 研究结果：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、倒步走及肌肉能量技术。效应量范围从微小至近乎完美，在关节位置觉与关节位置误差方面可见微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取得了积极效果，但针对其他干预手段的研究数量有限且存在异质性，无法对其一致性或有效性进行明确对比。由于未实施盲法且结局指标存在差异，偏倚风险整体被评为“存在一些担忧”。 研究结论：现有证据表明，作为头前伸姿势研究最多的干预手段，颈部稳定训练或可改善颈部本体感觉。但由于方法学异质性及诊断标准不统一，例如用于定义头前伸姿势的颅椎角阈值存在差异，目前难以得出明确结论。未来研究应统一诊断标准与结局评估方式，并针对不同人群探究长期干预效果。