1Intern, Krishna College of Physiotherapy, Krishna Vishwa Vidyapeeth, Deemed to Be University, Karad, Maharashtra, India. Email: tanayakaranjkar01@gmail.com
2Professor, HOD, Department of Orthopedic Manual Therapy, Krishna College of Physiotherapy, Krishna Vishwa Vidyapeeth, Deemed to Be University, Karad, Maharashtra, India. Email: radds2009@gmail.com
Background: Prolonged smartphone use is associated with forward head posture, reduced cervical muscle endurance, and altered upper-limb function in young adults. Postural correction exercises are commonly prescribed; however, the additional effect of distal strengthening on cervical endurance and postural alignment remains unclear.
Aim: To evaluate the combined effect of Bruegger's exercise and hand-grip training on postural correction and cervical endurance in chronic smartphone users.
Objective: To compare the effectiveness of Brugger's exercise alone and Brugger's exercise combined with hand-grip training on cervical muscle endurance, craniovertebral angle, and hand-grip strength in young adults with chronic smartphone use.
Methods: A single-blinded, parallel-group randomized controlled trial was conducted among 30 participants aged 18–30 years with forward head posture and smartphone use of ≥4 hours/day. Participants were randomly allocated into Group A (Brugger's exercise) and Group B (Brugger's exercise combined with hand-grip training). The intervention was performed five days per week for four weeks. Neck flexor endurance (primary outcome), craniovertebral angle, and hand-grip strength (secondary outcomes) were assessed at baseline and post-intervention. Within-group comparisons were performed using paired t-tests, and between-group comparisons of mean change scores were performed using independent t-tests. Effect size was calculated using Cohen's d.
Results: Both groups showed significant improvement in all outcome measures (p < 0.05). However, the combined intervention group demonstrated significantly greater improvement compared to the Brugger's exercise-only group in neck flexor endurance (mean difference = 6.7 seconds; p < 0.001), craniovertebral angle (mean difference = 4.4°; p = 0.002), and hand-grip strength (mean difference = 4.0 kg; p = 0.001). Large effect sizes were observed for neck flexor endurance (d = 1.2) and craniovertebral angle (d = 0.95), and a moderate-to-large effect size for hand-grip strength (d = 0.88). High adherence and no serious adverse events were reported.
Conclusion: Brugger's exercise combined with hand-grip training is more effective than Brügger's exercise alone in improving cervical muscle endurance, postural alignment, and hand-grip strength in young adults with prolonged smartphone use. A multimodal approach targeting both proximal postural muscles and distal strength may be recommended for rehabilitation of smartphone-related postural dysfunction.
Keywords: Forward head posture; Brugger's exercise; hand-grip strength; cervical muscle endurance; smartphone use; randomized controlled trial.
How to cite this article: Karanjkar T, Chintamani R. Combined Effect of Bruegger's Exercise and Hand Grip Training on Postural Correction and Cervical Endurance in Chronic Smartphone Users. Int J Drug Deliv Technol. 2026;16(8s): 1001-1010; DOI: 10.25258/ijddt.16.8s.113
Source of support: Nil.
Conflict of interest: None