Upper cross syndrome is a common postural dysfunction that is caused due to alternating tightness and weakness in the opposite muscle groups of the neck, shoulders and upper back which results in abnormal postural deviations. The aim of the study will be to compare the effects of Egoscue exercises and Feldenkrais exercises on pain, craniovertebral angle and functional disability in upper cross syndrome.
A Randomized clinical trial will be conducted at Ghurki Trust Teaching Hospital, Lahore and Riphah clinic, Lahore through non probability convenience sampling technique on 54 patients which will be allocated using simple random sampling through sealed opaque envelop into Group A and Group B. Group A will be treated with Egoscue exercises and conventional therapy and Group B will be treated with Feldenkrais exercises and conventional therapy at the frequency of 3 sets with 10 repetitions thrice a week. Outcome measures will be conducted through pain, craniovertebral angle and functional disability after 4 weeks. Data will be analyzed with SPSS software version 26. After assessing the normality of data by Shapiro-Wilk test, it will be decided either parametric or non- parametric will be used within the group or between the groups.
Age 25 to 45 years
Both genders (male and female)
Chronic neck pain for more than three months - NPRS (3 to 7)
Craniovertebral angle less than 50 degrees
Any malignancy related to soft tissue and shoulder joint
Congenital joint deformity
Recent fractures to joint
Recent surgery of shoulder joint or associated structures
Parallel
Egoscue exercises
Other intervention* Static Back (for 5 - 10 minutes) * Cervical retractions (10- 15 reps) * Wall Angels (2 sets of 10) * Standing arm circles (40 forward reps \& 40 backward reps) * Static wall (for 5-8 minutes) * Modified pre stretch on wall (Hold for 30- 45 secs on each side) * Air bench (for 1- 2 minutes) * Tower shoulder rolls (stay for 10 minutes)
Feldenkrais exercises
Other intervention* Shoulder Circles with awareness * Head Rolls with Breath awareness * Arm Clock (Arm circles on the floor) * Scapular Glides * Pelvic clock with shoulder integration * Shoulder blades and arm lifting
Disability Index (DNI)
This questionnaire will be used to asses disability. It comprises of 10 items; 7 related to daily living activities; 2 related to pain and 1 related to concentration. Each item is scored from 0 to 5. Total score is expressed as a percentage, with higher scores related to greater disability. Minimum detectable change measurements vary from 4.2 to 13.4, and minimum clinically important differences vary from 5 and 9.5
Craniovertebral angle (CVA)
Craniovertebral angle can be measured with Image J software. If the angle is less than 50 degrees (\< 50 degree). The angle will be between tragus of the ear to cervical spinous process C7.
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