Upper Crossed Syndrome
Conditions
Keywords
Upper Cross Syndrome, Janda's Approach, McKenzie Exercises, Craniovertebral Angle, Neck Disability, Forward Head Posture
Brief summary
This study was conducted compare the effect Janda's Approach and Mckenzie Excercises in patients with Upper Crossed Syndrome
Interventions
OTHERMcKenzie Treatment
* Cervical Retraction (Chin Tucks) and Basic Postural Drills: 5-10 reps for, 3-4 times/day. * Cervical Extension in lying and Thoracic Extension: 10-15 reps for 30-35 minutes. * Shoulder Retraction, Prone Scapular Squeeze and Wall Angels: 5-10 sec hold, more sets. * Standing Shoulder Rows (with resistance band) and Neck Isometrics: Functional drills for 40 mins. * Sitting Posture Drills and Computer Ergonomics Practice: Stimulate workstation posture tasks for 40-45 minutes. * Full McKenzie Cervical Series and Posture Checklist: Emphasize home program, relapse prevention for 45 minutes.
OTHERJanda's Approach
Week 1: * Chin Tucks (Deep Neck Flexors): 3 sets x 10-12 reps * Scapular Retraction (Low Resistance):3 sets x 10-12 reps * Pectoralis Stretch (Doorway Stretch): 30 seconds x 2 * Upper Trapezius Stretch (Lateral Neck Flexion): 30 seconds x 2 * Educate on sitting posture and workstation ergonomics Week 2: * Chin Tucks: 3 sets x 12-15 reps * Prone Y/T/W: 3 sets x 10-12 reps * Levator Scapulae Stretch: 30 seconds x 2 * Pectoralis Stretch: 30 seconds x 2 * Begin postural correction during daily activities (sitting, standing) Week 3: * Chin Tucks: 3 sets x 15 reps * Prone Y/T/W: 3 sets x 15 reps * Upper Trapezius Stretch: 45 seconds x 2 * Levator Scapulae Stretch: 45 seconds x 2 * Correct head positioning during tasks like typing or sitting Week 4: * Scapular Retraction with Resistance Bands: 3 sets x 10 reps * Shoulder Retraction: 3 sets x 10-12 reps * Pectoralis Stretch: 45 seconds x 2 * Upper Trapezius Stretch: 45 seconds x 2 * Focus on functional postural exercises (standing rows)
OTHERBaseline Treatment
* Application of a heating pad for muscle relaxation (10 minutes) * TENS therapy (10 minutes) to alleviate pain * Range-of-motion exercises for the cervical spine and shoulders to maintain flexibility. * Stretching exercises targeted the upper trapezius, levator scapulae, and pectoralis muscles
Sponsors
Riphah International University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
20 Years to 35 Years
Healthy volunteers
No
Inclusion criteria
* Both male and females * Age between 20-35 years * Excessive Forward Head \> 46 * Excessive Forward shoulder \> 52 * Excessive kyphosis \> 42 * Neck pain scores 4-8 on NPRS * Sedentary or moderately active individuals with prolonged desk/workstation use * Functional disability ≥10% on the Neck Disability Index
Exclusion criteria
* Cervical and upper limb fracture history. * Has vertebrobasilar insufficiency. * History of surgery to the cervical spine. * Infections or neoplastic processes of the spine. * Diagnosed cases of osteoporosis. * Rheumatoid or other inflammatory arthritis. * Pregnancy * Neurological disorder
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Numeric Pain Rating Scale | From enrollment to the end of treatment at 6 weeks. | The 11-point Numeric Pain Rating Scale (NPRS) ranged from 0 to 10, with 10 denoting "the highest level of pain imaginable" and 0 denoting "no pain". It was a simple indicator of pain intensity since patients chose the number that most accurately represented their level of pain. |
| Neck Disability Index | From enrollment to the end of treatment at 6 weeks | The Neck Disability Index (NDI) was a standardized, self-administered questionnaire used to evaluate how neck pain affected a person's ability to perform everyday activities. It consisted of 10 items that assessed different aspects of life impacted by neck pain, including pain intensity, personal care, lifting, reading, headaches, concentration, work, driving, sleeping, and recreation. Each item was scored on a scale from 0 to 5, where higher scores indicated greater disability. The total score could range from 0 to 50 and was often converted into a percentage to interpret the level of disability. A score between 0-8% suggested no disability, 10-28% indicated mild disability, 30-48% moderate disability, 50-64% severe disability, and 70% or higher reflected complete disability. |
| Photogrammetry Method for Craniovertebral Angle | From enrollment to the end of treatment at 6 weeks | A photogrammetric method was used to evaluate forward head posture (craniovertebral angle), rounded shoulders, and thoracic kyphosis from a lateral view. Key anatomical landmarks-tragus, acromion, C7, and T12-were marked on participants. Individuals stood in a natural posture, barefoot, on a marked board while facing forward. A digital camera, placed 265 cm away, captured three side-view photographs. The images were analyzed using USC software, which measured: * Forward head angle: angle between the line from tragus to C7 and the vertical. * Rounded shoulder angle: angle from acromion to the vertical. * Kyphosis angle: arc between C7 and T12. |
| ROM Cervical Spine (Flexion) | From enrollment to the end of treatment at 6 weeks | Changes in cervical spine flexion ROM at baseline and 6th week of intervention was measured using goniometer. |
| ROM Cervical Spine (Extension) | From enrollment to the end of treatment at 6 weeks | Changes in cervical spine extension ROM at baseline and 6th week of intervention was measured using goniometer. |
| ROM Cervical Spine (Lateral Flexion) Right Side | From enrollment to the end of treatment at 6 weeks | Changes in cervical spine lateral flexion on right side ROM at baseline and 6th week of intervention was measured using goniometer. |
| ROM Cervical Spine (Lateral Flexion) Left Side | From enrollment to the end of treatment at 6 weeks | Changes in cervical spine lateral flexion on left side ROM at baseline and 6th week of intervention was measured using goniometer. |
| ROM Cervical Spine (Rotation) Right Side | From enrollment to the end of treatment at 6 weeks | Changes in cervical spine rotation on right side ROM at baseline and 6th week of intervention was measured using goniometer. |
| ROM Cervical Spine (Rotation) Left Side | From enrollment to the end of treatment at 6 weeks | Changes in cervical spine rotation on left side ROM at baseline and 6th week of intervention was measured using goniometer. |
Countries
Pakistan
Contacts
PRINCIPAL_INVESTIGATORAnum Manzoor, MS (OMPT)
Riphah International University
Outcome results
None listed