EFFECTS OF CERVICAL MANUAL THERAPY ON BALANCE PERFORMANCE IN INDIVIDUALS WITH PARKINSON’S DISEASE AND FORWARD HEAD POSTURE

People with Parkinson’s disease (PD) commonly exhibit postural abnormalities, including forward head posture, which alters muscle length-tension relationships and sensory inputs which may further compromise balance control. Cervical manual therapy (CMT) has been shown to improve forward head posture and balance in healthy adults, however, its effects in individuals with PD remain unclear. This study aimed to investigate the effects of CMT on balance performance in individuals with PD and forward head posture. A double-blinded randomized controlled trial was conducted. Inclusion criteria were: (1) age 18–80 years, (2) idiopathic PD, (3) Hoehn and Yahr stage < 4 and craniovertebral angle < 50°, (4) independent ambulation, and (5) Mini-Mental State Examination score ≥ 24. Participants were randomly assigned to either a CMT group or a sham CMT. Both groups received interventions (CMT or sham CMT), 45-min per session, 2-3 sessions a week, 4-6 weeks, for a total of 12 sessions. Outcome measures included craniovertebral angle, cervical range of motion, Limits of Stability, and the Mini-Balance Evaluation Systems Test. The CMT group demonstrated significant within-group improvements in craniovertebral angle, cervical range of motion (flexion and right and left rotation), and Limits of Stability (anterior, affected side, and overall scores). Significant group-by-time interaction effects favored the CMT group. No significant interaction effects were found for cervical extension range of motion or Limits of Stability in the posterior and non-affected directions. In conclusion, CMT improved balance, forward head posture, and cervical mobility in individuals with PD and forward head posture.