Twelve-Month Outcomes of a Randomized Controlled Trial to Investigate Efficacy of a Novel Orthosis for Neck Pain Associated with Forward Head Posture in Active Duty Service Members- ACRM 2026

N Hogaboom, m smith, v morris, x yuan, m nordstrom

Abstract accepted for poster presentation at the 2026 American Congress of Rehabilitation Medicine Annual Conference

Research Objective: Neck pain is a significant problem among active duty Service Members (ADSMs). A novel orthosis was designed to correct forward head posture (FHP) and reduce associated neck pain. Initial trial results demonstrated that 6 weeks of collar use was effective in reducing neck pain. This secondary analysis describes pain and function outcomes 12 months after this initial 6-week intervention. 

Design: Randomized waitlist-controlled trial with 12-month follow-up 

Setting: Military Outpatient Rehabilitation Clinics.

Participants: 40 ADSMs (18-55 years old) who had been experiencing moderate-to-severe neck pain (≥4 on a 0-10 numeric pain rating scale [NPRS]) from FHP for at least three months despite conservative treatment.

Interventions: Participants were instructed in daily collar use (20 minutes) for 6 consecutive weeks, with reducing frequency out to 6 months within tolerance.

Main Outcome Measures: 11-point NPRS (0=no pain, 10=worst pain imaginable); Neck Disability Index (NDI); adherence indicated by days per week of collar usage between 3 and 12 months. Two linear mixed-models were built with NPRS and NDI outcomes at each time point (6 weeks, 12 weeks, 12 months) and age as a covariate.

Results: Thirty-three participants completed the 12-month follow-up. After controlling for age, NPRS scores significantly decreased relative to baseline at 6 weeks (2.0 points, p < .001), 12 weeks (1.6 points, p <.001), and 12 months (1.3 points, p < .01). NDI scores significantly decreased at 12 weeks (5.4 points, p <.05), but no other timepoints. High compliance (>80% of subjects continuously using the device) was reported during 3-6 months. 

Conclusions: Results indicate prolonged pain reductions after completion of initial 6-week intervention, with no changes in neck function. It is unclear how additional treatment adherence affected outcomes.