Upper Cross Syndrome
Conditions
Brief summary
This randomized controlled trial aims to evaluate the effectiveness of rib mobilization combined with postural correction exercises in reducing pain, improving cervical posture, and enhancing rib and thoracic mobility among individuals with Upper Crossed Syndrome (UCS). A total of 64 participants aged 20-45 years will be recruited and randomly assigned to two groups: Group A (rib mobilization + postural correction) and Group B (postural correction only). Intervention will be provided for 4-6 weeks, three sessions per week. Outcomes will include pain (VAS), cervical posture (inclinometer), and rib/thoracic mobility (tape measure). Data will be analyzed using SPSS version 26.
Detailed description
Upper Crossed Syndrome (UCS) is a common musculoskeletal disorder that arises from sustained poor posture, leading to muscular imbalance and functional impairment in the upper body. The syndrome is characterized by forward head posture, increased cervical lordosis, and thoracic kyphosis caused by tightness in the upper trapezius, levator scapulae, and pectoralis muscles, and weakness in the deep cervical flexors, lower trapezius, and serratus anterior. This imbalance not only affects spinal alignment but also restricts rib mobility and thoracic extension, contributing to chronic neck and upper back pain. Rib mobilization techniques focus on restoring the normal motion of the ribs and thoracic spine, improving chest expansion and flexibility. When combined with postural correction exercises, these interventions may correct alignment, reduce pain, and enhance thoracic mobility. Postural correction exercises aim to stretch overactive muscles and strengthen weakened ones to restore functional balance. Together, these methods are hypothesized to provide superior outcomes compared to postural exercises alone. Previous studies have demonstrated the efficacy of either rib mobilization or postural correction in isolation. However, limited evidence exists regarding their combined use for UCS. This study seeks to fill this gap by examining the synergistic effects of both interventions on pain relief, postural correction, and thoracic mobility. Findings may contribute to developing an evidence-based rehabilitation protocol for UCS.
Interventions
BEHAVIORALRib Mobilization and Postural Correction Exercises
Participants will receive Grade I-III rib mobilizations at the costovertebral and costotransverse joints (ribs 2-6) along with thoracic central posterior-anterior mobilizations. In addition, postural correction exercises including scapular retraction, deep neck flexor training, pectoralis stretching, and thoracic extension exercises will be performed. Each session will last 30-40 minutes, three times per week for 4-6 weeks.
OTHERPostural Correction Exercises Only
Participants will perform only postural correction exercises, including scapular retraction, deep neck flexor training, pectoralis stretching, and thoracic extension exercises. Sessions will last 30-40 minutes, three times per week for 4-6 weeks.
Sponsors
Riphah International University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Subject)
Eligibility
Sex/Gender
ALL
Age
20 Years to 45 Years
Healthy volunteers
No
Inclusion criteria
* Age between 20 to 45 years * Forward head posture (craniovertebral angle \< 50°) * Cervical pain or discomfort for ≥4 weeks * Moderate pain intensity (VAS 3-6) * Willingness to participate and provide informed consent * Clinically diagnosed Upper Crossed Syndrome (UCS) * Meets Asian Fitness Society diagnostic criteria for UCS
Exclusion criteria
* History of trauma or surgery to cervical/thoracic spine * Cervical disc herniation, radiculopathy, or neurological deficits * Structural deformities (scoliosis, Scheuermann's disease) * Systemic musculoskeletal disorders (e.g., rheumatoid arthritis) * Vestibular, balance, or visual disorders * Recent similar therapy within 3 months * Pregnancy or contraindication to manual therapy * Ongoing use of pain medications or muscle relaxants
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Pain Intensity | 1 year | 1\. Pain Intensity - Measured using the Visual Analog Scale (VAS) ranging from 0 (no pain) to 10 (worst pain). |
| Cervical Posture | 1 year | Cervical Posture - Measured using an inclinometer to determine the craniovertebral angle. |
| Rib/Thoracic Mobility | 1 year | Rib/Thoracic Mobility - Measured using a tape measure and inclinometer to assess rib cage expansion and thoracic extension. |
Countries
Pakistan
Contacts
CONTACTAltamash Hussain Khan, DPT
PRINCIPAL_INVESTIGATORAttiq Ur Rehman, MS
Riphah International University
Outcome results
None listed