Discussion
CM
This is the first study to evaluate the effectiveness of a four-week rehabilitation program including TTM, SSE, and CM on FHA, FVC, and cervical flexion among individuals with FHP. Within group analysis found that in the CTSC group, remarkable and statistically significant improvements were seen in FHA and cervical flexion after receiving the treatment program. These improvements were maintained for one month following the treatment program. At Week 4 and Week 8, FVC had not significantly improved. When comparing between the groups, significant differences in FHA and cervical flexion were observed at Week 4 and Week 8. These findings extend the recommendations of Ruivo et al. [These results are compatible with those of Harman et al. [The improvements in FHA and cervical flexion in the current study may be due to the treatment program provided in this study, perhaps correcting the patterns of muscle imbalances between opposing muscle groups caused by FHP [Unexpectedly, a significant change in FVC post-treatment (Week 4) and at follow-up (Week 8) was not observed. This finding is inconsistent with those of previous studies. Pawaria et al. [Some limitations in this study should be acknowledged. First, the treatment program was conducted for only four weeks, which might be inadequate to draw a conclusion regarding the changes in FVC after participants received CTSC. In future studies, this treatment program should be provided for longer periods. Second, it is difficult to generalize the findings of the current study given that it involved only young participants. The treatment effects found in this study might not extend to an older population. Further studies should involve participants of different ages. Finally, although a research assistant who assessed all outcomes was unaware of the assigned groups of the participants, blinding of the participants was not possible.