The goal of this clinical trial is to learn the comparative effects of Global postural re-education (GPR) and National Academy of Sports Medicine (NASM) based corrective exercises in participants with upper cross syndrome (UCS). The main questions it aims to answer:
* Is there any difference between the effects of GPR and NASM-based corrective exercises in decreasing pain and disability and improving endurance in participants with upper cross syndrome? * Is there any difference between the effects of GPR and NASM-based corrective exercises in improving cranio-vertebral angle of participants with upper cross syndrome? Researchers will compare GPR and NASM-based corrective exercises to see if there is difference between the two treatments in decreasing pain, disability and improving endurance and cranio-vertebral angle.
Participants will be:
* Given treatment 3 times a week for 8 weeks. * Assessed before first treatment session (baseline), at 4th week of intervention and at the end of last treatment session (8th week).
Age between 20-45 years
Pain in the upper back and neck region.
Both male and female patients
Rounded shoulders
History of spinal surgery
Neurological deficits (radiculopathy, myelopathy, disc herniation)
Severe scoliosis or structural deformity
Active cervical spine pathology (spondylosis, stenosis and fracture)
Parallel
Global Postural Re-education
Other interventionGlobal Postural Re-education 1st position: Patient will lie in supine, shoulders abducted to 30°, forearms supinated and the pelvis will be kept in a neutral position, while the lumbar spine remain supported. This position is characterized by a progression from flexion to extension of both hips and knees. 2nd position: Patient will remain in supine with their hips at 90° of flexion and perform gradual knee extensions. The participants will remain between 15 \& 20 min in each of these two positions. Under the supervision and verbal and/or manual guidance of the physiotherapist performing the intervention, they will perform 5-10s isomet contractions of the antagonist muscles of the muscle chain targeted by each posture. Subjects can also make active adjustments to their position, the physiotherapist can favor with some manual contact, sustained stretching and some joint traction to complete the session, the participants will be requested to maintain an upright posture in standing for 5min
NASM-based Corrective exercises
Other interventionNASM-based Corrective Exercises The four-stage exercise for UCS begins with preventing or reducing excessive muscle contraction (frequent foam wrapping), relaxing these same muscles, which fully eliminates dysfunctional muscles, and finally restores functional mobility. Step 1: inhibit or self-myofascial release overactive muscles: It includes the levator scapulae, trapezius (upper fibre), and sternocleidomastoid muscles. Hold pressure will be applied for 30 s on the tender spots. Step 2: Lengthen/ Static stretch. Upper trapezius Levator scapulae Sternocleidomastoid (SCM) Step 3: Activate/Strengthen. Chin tucks Floor Cobra Step 4: Integrate. Ball combination A routine/conventional evidence based physiotherapy treatment will also be given to both arms.
Mean change in endurance from baseline on Progressive iso-inertial lifting evaluation (PILE) test at 4 weeks and 8 weeks
Progressive iso-inertial lifting evaluation (PILE) test has been recommended as a functional test to measure muscle endurance and involves lifting weights from waist to shoulder height (30-54 in.). Participants will begin with an 8- pound load and a 13-pound load for females and males respectively. Weight will be subsequently increased at a rate equal to the initial free weight every 20 s. Four lifting movements will actually performed at 20-s intervals. The test end-point will be established when aerobic capacity or neuromuscular fatigue being felt.
Mean change in pain score from baseline on Numeric Pain Rating Scale (NPRS) at 4 weeks and 8 weeks
The NPRS is an 11-point scale (0, no pain; 10, worst imaginable pain) used to assess the intensity of pain. Participants will be asked to rate their pain from 0 to 10.
Mean change in disability score from baseline on Neck Disability Index (NDI) at 4 weeks and 8 weeks
The NDI is 10 questions and each question has a possible total score of zero to 5. The total score from all 10 questions is divided by 50, the maximum score possible, with total scores expressed in percentage. Higher percentage scores indicate a worst disability.
Mean change in the Craniovertebral angle from baseline at 4 weeks and 8 weeks
The angle formed between the oblique line connecting right tragus to C7 and the vertical line will be measured as craniovertebral angle. Lesser the angle, more is the forward head posture and upper cross syndrome.
Map coordinates are unavailable for these locations. Locations are shown below instead.
PakistanClick on the lead sponsor to view all of their trials.
Rehana Hayat
Lead sponsor
Superior University
Sponsor institution
