Safety and Efficacy of a Novel Therapy Collar for Forward Head Posture and Chronic Neck Pain in Active Duty Service Members
Authors: Marin Smith1,2,3, Nathan Hogaboom4,5, Ron Dellanno6, Matthew St Laurent2, Xiaoning Yuan1,2, Michelle Nordstrom1,2
1Uniformed Services University of the Health Sciences; Bethesda, MD
2Walter Reed National Military Medical Center; Bethesda, MD
3The Geneva Foundation; Tacoma, WA
4Kessler Foundation; West Orange, NJ
5Rutgers New Jersey Medical School; Newark, NJ
6Cervigard Spinal Bracing Corporation; Bloomfield, NJ
Objectives:
1. Describe the impact of forward head posture (FHP) on neck pain.
2. Compare pain, function, and radiographic outcomes following FHP therapy collar to no collar use.
3. Discuss the safety and efficacy of the novel FHP therapy collar to improve chronic neck pain and operational readiness within the military population.
Introduction:
Chronic neck pain impacts active duty Service Members (ADSMs) across all occupational specialties. Reduction of cervical lordosis in forward head posture (FHP) can lead to muscular imbalances, degenerative spinal changes, and increased neck pain. This study investigated the safety and efficacy of a novel, non-invasive therapy collar to improve FHP and neck pain among ADSMs.
Methods:
This single-site, randomized, waitlist-controlled trial at WRNMMC was approved by the Institutional Review Board (WRNMMC-2021-0347). ADSMs (18-55 years) with chronic neck pain and FHP were enrolled and randomized into one of two groups: Immediate Treatment (IT) or 6-Week Waitlist-Control (WC). Participants were instructed to wear the collar for 20 minutes daily for 6 weeks.
Patient-reported outcome measures [Numerical Pain Rating Scale (NPRS), Neck Disability Index (NDI)] and radiographs [Cobb Angle, C2-C7 Sagittal Vertical Axis (SVA)] were collected at baseline, 6 weeks, and 12 weeks post-enrollment. Compliance with collar use was collected during 6-week trial.
Two-way mixed analysis of variance models tested the interaction between group and time for NPRS, NDI, Cobb angle, and SVA. Following a significant interaction effect observed between group and time on NPRS, NDI, and Cobb angles, pairwise comparisons (Bonferroni corrections) were conducted to evaluate within-group differences.
Results:
To date, 13 participants (IT: n = 7; 85.0% F, 34.2 ± 3.9 years; WC: n = 6; 50% F, 34.7 ± 5.8 years) have completed the 6-week trial. At 6 weeks, IT demonstrated improvement on the NPRS (-2.6 ± 2.2) and NDI (-2.0 ± 3.5) while wearing the collar for 6.1 ± 1.4 days per week. In contrast, WC demonstrated increases on the NPRS (+0.5 ± 0.8) and NDI (+2.8 ± 3.5), indicative of worsening pain and function. NPRS scores and Cobb angles significantly decreased (p<0.05) in the IT group after 6 weeks, while no changes were observed in the WC group.
Conclusion:
Recent literature suggests current treatment strategies for neck pain may not be as effective for the active duty population, given their occupational, training, and external load carriage requirements. Therefore, evaluating the effects of a wearable, take-home device for neck pain due to FHP is highly relevant to ADSMs. Preliminary results suggest donning a non-invasive therapy collar for 6 weeks can yield pain reduction and postural improvement compared to conventional treatment.
Disclaimer: The identification of specific products or scientific instrumentation is considered an integral part of the scientific endeavor and does not constitute endorsement or implied endorsement on the part of the author(s), DoD, or any component agency. The views expressed in this abstract are those of the author(s) and do not necessarily reflect the official policy of the Department of Defense or the U.S. Government.
The opinions and assertions expressed herein are those of the author(s) and do not necessarily reflect the official policy or position of the Uniformed Services University or the Department of Defense.
The authors do not have any COIs to disclose except for Dr. Ronald Dellanno, whom is the President of the CervigardTM Spinal Bracing Corporation and inventor. He was not involved in any recruitment, treatment, or data analysis.
Acknowledgements: This research was supported by the Uniformed Services University, Department of Physical Medicine & Rehabilitation, Musculoskeletal Injury Rehabilitation Research for Operational Readiness (HU00011920011).
