This study will be a randomized clinical trial and will be conducted in Younus Hospital, Tehsil headquarters hospital Daska, and Riphah Rehabilitation Clinic Lahore. Non-probability consecutive sampling will be used to collect the data. A sample size of 40 subjects with an age group between 18-65 years will be taken. Data will be collected from the patients having present complaints of Neck pain associated with upper cross syndrome. Outcome measures will be taken using the Numeric Rating Pain Scale (NRPS) for pain and the Neck disability index (NDI) for neck functional health and craniovertebral angle for posture. An informed consent will be taken. Subjects will be selected based on inclusion and exclusion criteria and will be equally divided into two groups by a random number generator table. Both Groups will receive Moist Hot Pack, Cervical segmental mobilizations, and Free Neck Exercises (AROMs), while Group A will receive Muscle energy technique(eccentric muscle energy technique for the cervical spine with Mets for upper trapezius, Suboccipitalis and pectoralis muscle), and Group B will receive cervical and scapulothoracic stabilization exercises(axial elongation exercise, craniocervical flexion, cervical extension and Cervico-scapulothoracic stabilization exercises). Outcome measures will be measured at baseline and after 4 weeks. Data analysis will be done by SPSS version 25.
Both gender diagnosed with upper crossed syndrome
Patient having neck pain of 4 to 12 weeks
Pain reported on NRPS score ˃6/10 in the neck region
Subjects agree to sign the written consent form.
Exclusion criteria Patients were excluded if they were diagnosed with the following conditions for ˃6 months
Tuberculosis, carcinoma, heart disease, and osteoporosis
Neural disorders due to prolapsed intervertebral disc
Any trauma or localized infection in neck region
Parallel
Muscle Energy Technique
Other interventionEccentric muscle energy technique was applied to subjects' cervical spine. The cervical spine will brought to the barrier of motion in each plane i.e. flexion/extension, lateral bending and rotation. Then subjects will asked to push their heads into the direction opposite that of the barrier. The therapist provided isometric resistance for 3- 5 seconds, after which the subjects relaxed their muscles completely and the therapist applied stretch.
Eccentric muscle energy technique
Other interventionEccentric muscle energy technique was applied to subjects' cervical spine. The cervical spine will brought to the barrier of motion in each plane i.e. flexion/extension, lateral bending and rotation. Then subjects will asked to push their heads into the direction opposite that of the barrier. The therapist provided isometric resistance for 3- 5 seconds, after which the subjects relaxed their muscles completely and the therapist applied stretch. Three to five repetitions will performed.
Numeric Rating Pain Scale (NRPS)
The patient's level of pain will be assessed using this scale. This scale ranges from 0 to 10. 0 indicates "no pain" and 10 indicates "worst pain".
Neck disability index (NDI)
The Neck Disability Index (NDI) is a 10-item questionnaire that measures a patient's self-reported neck pain-related disability
Craniovertebral angle (CVA)
The craniovertebral angle is identified as the intersection of a horizontal line passing through the C7 spinous process and a line joining the midpoint of the tragus of the ear to the skin overlying the C7 spinous process
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