The Effect of Integrating a Smartphone Application with Global Postural Re-education on Cervical Proprioception in Patients with Upper Cross Syndrome
Design:
Randomized Controlled Trial (RCT).
Procedures:
Patients with cervical pain resulting from Upper Cross Syndrome (UCS), recruited from El Amal Clinic in Fayoum, will be randomly assigned to one of three groups:
Group A: Receives experimental interventions for 50 minutes per day, 4 days per week, over 8 weeks. The exercises are assisted by a smartphone application designed to support the intervention.
Group B: Receives the same interventions as Group A but without the use of the smartphone application. The exercises focus on stretching the anterior and posterior muscle chains.
Control Group: Receives conventional physiotherapy for 50 minutes per day, 4 days per week, over 8 weeks. This includes postural correction, neck education, and exercise therapy.
Inclusion Criteria:
Office workers aged between 28 and 48 years.
Chronic nonspecific neck pain with a Visual Analog Scale (VAS) score between 3 and 8.
Persistent pain for more than 3 months.
Absence of cognitive impairments and the ability to safely participate in an exercise program.
Postural changes characteristic of UCS, such as forward head posture and elevated shoulders.
Exclusion Criteria:
Specific causes of neck pain, such as systemic diseases or neurological signs.
History of spinal surgery or physical therapy treatments within the last 6 months.
Failure to attend three consecutive sessions or four non-consecutive sessions.
Instrumentation:
Assessment Tools:
Visual Analog Scale (VAS) to measure cervical pain.
Cervical Range of Motion (CROM) device to assess cervical range of motion and proprioception.
Neck Disability Index (NDI) to evaluate neck function.
Treatment Tools:
Smartphone application named "Kyphosis and Rounded Back."
Global Postural Reeducation methods.
Traditional physiotherapy techniques.
aged between 28 and 48years,
NP between 3 and 8 cm on a visual analog scale(VAS) (from 0 indicating no pain at all to 10 indicating unbearable pain),
Chronic non specific neck pain lasting for more than 3 months (Fathollahnejad et al., 2019).
• Specific causes of NP (e.g., systemic, rheumatic, neuromuscular diseases), central or peripheral neurological signs, cognitive impairment, spinal surgery, or physical therapy treatments in the last 6 months prior to the baseline assessment.
Participants would be also excluded if they missed at least three consecutive or four non consecutive sessions (Fathollahnejad et al., 2019).
Parallel
Conventional physical therapy
Other interventionincluding strengthening exercises for deep neck flexors, rhomboids, lower trapezius and serratus anterior, (2 sets of 10 repetitions per day) and stretching exercises for pectoralis muscles (20seconds hold, 5 repetition.
lying posture with progression
Other interventionExercise 1, the lying posture with leg extension progression, was aimed to stretch the anterior muscle chain (diaphragm, pectoralis minor, scalene, sternocleidomastoid, intercostalis, iliopsoas, arm, forearm, and hand flexors)(Bonetti et al., 2010). Exercise 2, the lying posture with flexion of the thighs, was intended to stretch the posterior chain (upper trapezius, levator scapulae, suboccipital, erector spinae, gluteus maximus, ischiotibial, triceps surae, and foot intrinsic muscles).
smartphone app exercises
Other interventionabout 50 min a day, 4 days a week for an 8-week period also, performed exercises which were reminded by a smartphone app at predetermined times.
VAS (visual analogue scale)
1\. VAS (visual analogue scale) to assess cervical pain.
Cervical ROM
CROM device to assess cervical ROM and to assess cervical propioception.
Neck disability index (NDI)
Neck disability index (NDI): to assess neck function.
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