Effects of forward head posture on cervical proprioception, muscle endurance, and cardiopulmonary function during cognitive-motor tasks among university students: a cross-sectional study

Authors

  • Faten Mohamed Mohamed Elnozhe Elnozhe ssociate Professor of Physical Therapy for Internal Medicine, chest and cardioligy, Faculty of allied medical science, Department of physical therapy,Al Aqaba Technology University, Jordan. https://orcid.org/0009-0002-6157-5361
  • Amira Ezzat Assistant professor of physical therapy, Rehabilitation sciences Department, Faculty of Applied Medical Sciences, Al al-BAYT University, El Mafraq, Jordon https://orcid.org/0009-0001-5000-5729
  • Abeer Yousef  Basic Science Department, Faculty of Physical Therapy, Cairo University, Egypt  Department of Physical Therapy, College of Applied Medical Sciences, Qassim University, Buraidah 51452, Saudi Arabia. https://orcid.org/0000-0002-2926-7660
  • Abeer A Mohammed Lecturer at Department of Physical Therapy, Faculty of Allied Medical Sciences, Isra University, Amman, Jordan Lecturer, Department of Neuromuscular Disorder, Faculty of Physical Therapy, Cairo University, Cairo, Egypt https://orcid.org/0009-0006-3939-5435
  • Amira. H Mohammed Department of Physical Therapy, College of Applied Medical Sciences , Qassim University, Buraydah, Saudi Arabia Department of Physical Therapy for Pediatrics, Faculty of Physical Therapy, Delta University for Science and Technology, Gamasa, Egypt https://orcid.org/0000-0002-6018-9138
  • Ashwaq Alqahtani Department of Physical Therapy, College of Applied Medical Sciences, Qassim University, Buraidah 51452, Saudi Arabia. https://orcid.org/0009-0009-4884-2251
  • Zeinab M Abdelrehim Assistant Professor at the Department of Physical Therapy, Faculty of Allied Medical Sciences, Aqaba University of Technology, Jordan. https://orcid.org/0000-0002-1841-5218
  • Mohamed Abdel-Latif Department of Orthopedic Physical Therapy, College of Physical Therapy Misr University for Science and Technology, Egypt. https://orcid.org/0000-0003-4583-2487
  • Amr Elkhodary Lecturer of Physical Therapy for Internal Medicine and Geriatrics, Faculty of physical therapy, Kafrelsheikh  University  https://orcid.org/0000-0003-2212-1519

DOI:

https://doi.org/10.47197/retos.v76.118550

Keywords:

Head Posture, Cervical Pro-prioception, Cogni-tive-Motor Tasks, Muscle Endur-ance, Cardiopulmonary

Abstract

Background: Forward head posture (FHP) has become a common problem among university students, Mainly due to prolonged use of digital device and long periods of sedentary study. This postural deviation can affect cervical proprioception, deep cervical muscle endurance, and cardiopulmonary responses. However, there are limited researches has discussed these collected variables during functionally demanding, dual-task tasks.

Purpose: The aim of this study is to investigate the relationship between FHP severity and (1) cervical joint position error, (2) Endurance of deep cervical flexor and extensors muscles, and (3) heart rate and respiratory rate during a cognitive-motor situations.

Methods: Eighty students in the age from 18 to 26 were divided into two groups, FHP and normal posture groups according to craniovertebral angle (CVA). Joint position sense, muscle endurance, and cardiopulmonary responses during a stepping–arithmetic dual-task were assessed.

Results: Significant differences were found. Comparison between FHP and normal posture groups was showed greater joint position error, reduced cervical muscle endurance, and higher cardiopulmonary strain during dual-tasking with those with FHP compared to normal posture Students. CVA showed meaningful correlations with proprioceptive accuracy and muscle endurance, and both joint position error and flexor endurance predicted cardiopulmonary strain.

Conclusion: Students who experienced FHP have a functional implication of FHP, Therefore there is an significant importance of early screening and targeted rehabilitation for students exhibiting this postural deviation.

Author Biographies

  • Faten Mohamed Mohamed Elnozhe Elnozhe, ssociate Professor of Physical Therapy for Internal Medicine, chest and cardioligy, Faculty of allied medical science, Department of physical therapy,Al Aqaba Technology University, Jordan.

    Faten Mohamed Mohamed Elnozhe Associate Professor of Physical Therapy for Internal Medicine, chest and cardioligy, Faculty of allied medical science, Department of physical therapy,Al Aqaba Technology University, Jordan.
    fatenelnozhe12@gmail.com
    01002554332

  • Abeer Yousef,  Basic Science Department, Faculty of Physical Therapy, Cairo University, Egypt  Department of Physical Therapy, College of Applied Medical Sciences, Qassim University, Buraidah 51452, Saudi Arabia.

    Abeer  M.Yousef

     Basic Science Department, Faculty of Physical Therapy, Cairo University, Egypt

     Department of Physical Therapy, College of Applied Medical Sciences, Qassim University, Buraidah 51452, Saudi Arabia.

    a.aboelaish@qu.edu.sa

     https://orcid.org/ 0000-0002-2926-7660

  • Abeer A Mohammed, Lecturer at Department of Physical Therapy, Faculty of Allied Medical Sciences, Isra University, Amman, Jordan Lecturer, Department of Neuromuscular Disorder, Faculty of Physical Therapy, Cairo University, Cairo, Egypt

    Abeer A Mohammed

    Lecturer at Department of Physical Therapy, Faculty of Allied Medical Sciences, Isra University, Amman, Jordan

    Lecturer, Department of Neuromuscular Disorder, Faculty of Physical Therapy, Cairo University, Cairo, Egypt

    Email

    abeer.abdrabo@iu.edu.jo

    My orcid number

    0009-0006-3939-5435

  • Amira. H Mohammed, Department of Physical Therapy, College of Applied Medical Sciences , Qassim University, Buraydah, Saudi Arabia Department of Physical Therapy for Pediatrics, Faculty of Physical Therapy, Delta University for Science and Technology, Gamasa, Egypt

    Department of Physical Therapy, College of Applied Medical Sciences , Qassim University, Buraydah, Saudi Arabia Department of Physical Therapy for Pediatrics, Faculty of Physical Therapy, Delta University for Science and Technology, Gamasa, Egypt

    51452
    P.O. Box 6666
    .Email: a.ebermbaly@qu.edu.sa
    . E-mail: amira_hussin77@yahoo.com, amira.hussien@deltauniv.edu.eg. https://orcid.org/0000-0002-6018-9138

  • Ashwaq Alqahtani, Department of Physical Therapy, College of Applied Medical Sciences, Qassim University, Buraidah 51452, Saudi Arabia.

     Ashwaq Alqahtani

    A.alqahtani@qu.edu.sa

    Orcid: 0009-0009-4884-2251

     Department of Physical Therapy, College of Applied Medical Sciences, Qassim University, Buraidah 51452, Saudi Arabia.

  • Zeinab M Abdelrehim, Assistant Professor at the Department of Physical Therapy, Faculty of Allied Medical Sciences, Aqaba University of Technology, Jordan.

    Zeinab M Abdelrehim

    Assistant Professor at the Department of Physical Therapy, Faculty of Allied Medical Sciences, Aqaba University of Technology, Jordan.

    Zeinababdelrehim5@gmail.com

    ORCID: https://orcid.org/0000-0002-1841-5218

  • Mohamed Abdel-Latif, Department of Orthopedic Physical Therapy, College of Physical Therapy Misr University for Science and Technology, Egypt.

    Mohamed Farouk Abdel-Latif

    Department of Orthopedic Physical Therapy, College of Physical Therapy
    Misr University for Science and Technology, Egypt.

    mfarouk@must.edu.eg

    ORCID: 0000-0003-4583-2487

  • Amr Elkhodary, Lecturer of Physical Therapy for Internal Medicine and Geriatrics, Faculty of physical therapy, Kafrelsheikh  University 

    Amr Ali Ali Elkhodary
    Lecturer of Physical Therapy for Internal Medicine and Geriatrics, Faculty of physical therapy, Kafrelsheikh  University 
    The street behind Matobis Parking  , Fowa City 
    Kafrelsheikh governorate ,Egypt   
    E-mail: aelkhodry88@gmail.com         
    Telephone : 00201097374325

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Published

02-03-2026

Issue

Vol. 76 (2026)

Section

Original Research Article

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Copyright (c) 2025 Faten Mohamed Mohamed Elnozhe Elnozhe, Amira Ezzat, Abeer Yousef, Abeer A Mohammed, Amira. H Mohammed, Ashwaq Alqahtani, Zeinab M Abdelrehim, Mohamed Abdel-Latif, Amr Elkhodary

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How to Cite

Elnozhe, F. M. M. E., Ezzat, A., Yousef, A., Mohammed, A. A., Mohammed, A. H., Alqahtani, A., Abdelrehim, Z. M., Abdel-Latif, M., & Elkhodary, A. (2026). Effects of forward head posture on cervical proprioception, muscle endurance, and cardiopulmonary function during cognitive-motor tasks among university students: a cross-sectional study. Retos, 76, 782-789. https://doi.org/10.47197/retos.v76.118550