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Dynamic Neuromuscular Stabilization Versus Corrective Exercises in Upper Cross Syndrome

Effect of Dynamic Neuromuscular Stabilization Versus Corrective Exercises on Pain, Functional Disability, and Postural Alignment in Upper Crossed Syndrome.

Status
Not yet recruiting
Phases
Unknown
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT07698392
Acronym
DNS/NASM
Enrollment
45
Registered
2026-07-13
Start date
2026-11-01
Completion date
2028-09-30
Last updated
2026-07-13

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Upper Crossed Syndorme, Upper Crossed Syndrome, Upper Cross Syndrome

Brief summary

The purpose of the study will be to investigate dynamic neuromuscular stabilization versus National American Academy of Sports Medicine (NASM) corrective exercises on pain, functional disability, cranio-vertebral angle, forward shoulder angle, and thoracic kyphosis in upper cross syndrome.

Detailed description

Upper Cross Syndrome (UCS) is a frequent condition that is most commonly encountered in musculoskeletal disorders, showing a typical pattern of imbalance in muscles and neck and shoulder region joint dysfunction. It causes pain in shoulders, upper back, thoracic and cervical spine. It is frequently associated with inadequate posture or forward head position, muscular weakness, and alterations in movement patterns, leading to pain, restricted mobility, and dysfunction in the affected areas of patients suffering from UCS. Dynamic Neuromuscular Stabilization (DNS) is a developing rehabilitation approach based on reflex locomotion. The idea of reflex locomotion describes particular involuntary motor reactions/movement patterns that occur when firm pressure is applied to specific muscle zones. These movement patterns are standard and referred to as "global patterns". The global pattern generated from the prone position is known as "reflex creeping," whereas the one from the supine or side lying posture is known as "reflex rolling". Furthermore, some motor motions such as gripping, turning, crawling, and eventually walking occur automatically without the need for specific training in normal babies. The National American Academy of Sports Medicine (NASM) provided a corrective exercise protocol for postural malalignment. It includes 4 steps: inhibition (self-mobilization release technique targeting trigger points), lengthening (stretching techniques for tight muscles), third: activation (strengthening techniques for weak muscles), and integration (retraining all muscles through functionally progressive movements). It was successful in treating UCS.

Interventions

Dynamic neuromuscular stabilization involves precise co-activation of the intrinsic muscles of the spine which forms the Integrated spinal stabilization system (ISSS) and includes cervical flexors and extensors, diaphragm, transverses abdominis, multifidus and pelvic floor.

OTHERNASM corrective exercises

It is corrective exercise protocol, which includes four phases, i.e. inhibit, lengthen, activate, and integrate stage

Sponsors

Cairo University
Lead SponsorOTHER

Study design

Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE

Eligibility

Sex/Gender
ALL
Age
20 Years to 40 Years
Healthy volunteers
No

Inclusion criteria

1. Having non-specfic neck Pain. 2. Patients having a CVA of \< 52 . 3. Forward shoulder angle \> 52 degrees.

Exclusion criteria

* Participants having conditions such as osteoporosis, blood disease, congestive heart disease, cancer, severe skin sensitization, major mental disease, and frozen shoulder, will be excluded from the study. Neck pain has a specific underlying pathology such as fractures, rheumatoid arthritis, osteoporosis, or whiplash injuries as well as neck pain associated with radiculopathy.

Design outcomes

Primary

MeasureTime frameDescription
Neck pain intensityAt baseline at the first session and reassessed at the end of six weeks of intervention.Neck pain intensity will be measured through Numerical pain rating scale. A scale from 0 to 10, with 0 indicating no pain and 10 signifying excruciating pain.

Secondary

MeasureTime frameDescription
Neck disabilityAt baseline at the first session and after 6 weeks of intervention.The patient will be asked to fill the 10- section of the questionnaire. Higher score indicate higher disability.
Craniovertebral angleAt baseline and after 6 weeks of interventioncraniovertebral angle will be measured using Kinovea software to assess forward head posture
Forward shoulder angleAt baseline and after 6 weeks of interventionForward shoulder angle will be measured using Kinovea software to assess rounded shoulder posture
Thoracic kyphosis angleAt baseline and after 6 weeks of interventionThoracic kyphosis angle will be measured using a bubble inclinometer

Countries

Egypt

Contacts

CONTACTPassant M Assistant lecturer, MSc
passant.moustafa@cu.edu.eg01004139949
CONTACTNesreen F Lecturer, PhD
dr_nesreenfawzy@cu.edu.eg01127283925
PRINCIPAL_INVESTIGATORKarima A Hassan, PhD

Cairo University

Outcome results

None listed

Source: ClinicalTrials.gov · Data processed: Jul 14, 2026