Upper Cross Syndrome

This study aims to explore the relationship between spinal alignment and functional performance in individuals with upper cross syndrome following a combined breathing and manual therapy program. It is designed as a secondary analysis of data obtained from a previously conducted randomized controlled trial, with the addition of objective spinal measurements using the Spinal Mouse device. Functional performance will be assessed using standardized tests such as the 6-minute walk test and the timed up and go test. Statistical analysis will include correlation and regression models to determine whether spinal alignment parameters can predict functional outcomes. The findings are expected to provide insight into the biomechanical role of posture in functional recovery among individuals with upper cross syndrome.

Upper Cross Syndrome (UCS) is a prevalent musculoskeletal disorder characterized by a specific pattern of muscular imbalance and postural dysfunction. This condition arises from prolonged poor posture. The resulting imbalance often manifests as visible postural changes, including rounded shoulders, forward head posture, and increased thoracic kyphosis. UCS is characterized by tightness and weakness of the neck, shoulders, and upper back muscles that cross between the dorsal and the ventral sides of the body. Postural abnormalities associated with UCS include a forward head posture (FHP), cervical lordosis, thoracic hyper kyphosis, protracted and elevated shoulders (round shoulders), and scapular winging with increased internal rotation and abduction. In UCS, neck and chest muscles, such as the sternocleidomastoid (SCM), levator scapulae, Pectoralis major and minor, Scalenes, and Upper Trapezius (UT), are tightened or shortened, whereas muscles of the neck and posterior upper back, such as the Deep Neck Flexors (DNFs), Serratus Anterior (SA), Rhomboids, Middle Trapezius (MT), and Lower Trapezius (LT), are weakened, stretched, and restrained. Opposite-group muscle imbalances in UCS bring postural disturbances, misalignments in the upper limbs, and atlanto-occipital, cervicothoracic, and glenohumeral joint dysfunction. The muscular imbalances may also lead to various musculoskeletal symptoms, such as headaches, neck pain, chest pain, upper back pain, tingling in the upper arms, or a limited range of motion in the neck or shoulders. The alteration in scapula muscles in UCS affects the movement of the scapula, which acts as a bridge and provides mobility and stability to the shoulders and neck. A proper posture is necessary for optimal functional performance in daily activities. The awkward positions put constant pressure on the joints, and degenerative changes in joints progress rapidly when exposed to sustained pressure, causing muscle imbalances and pain. If a muscle imbalance continues and progresses, this may lead to altered movement patterns and joint damage, creating further dysfunction. The main risk factor for developing UCS is maintaining an abnormal posture for a prolonged duration. Some daily activities that involve bad postures are often occupation-related. Repetitive tasks or continuous work for long hours can aggravate postural deviations. For example, patients with improper postures are more prone to musculoskeletal injuries after handling or lifting heavy objects than others with a proper posture. Musculoskeletal pain, most commonly neck pain, may present as the main symptom of UCS. Musculoskeletal pain may increase in relation to standing continuously or improperly sitting for long hours.

Upper Crossed Syndrome (UCS) is a postural imbalance in the upper body characterized by shortened and tight muscles in the front and upper back, while weak muscles in the back and neck are stretched and underactive. This imbalance can lead to forward head posture, rounded shoulders, and increased spinal curves, causing pain, headaches, and reduced range of motion. The study aims to compare the effects of Kendall exercises with Janda's Approach along with Diaphragmatic breathing exercises on pain, chest expansion, craniovertebral angle, and disability in upper crossed syndrome.

The purpose of the study will be to investigate dynamic neuromuscular stabilization versus National American Academy of Sports Medicine (NASM) corrective exercises on pain, functional disability, cranio-vertebral angle, forward shoulder angle, and thoracic kyphosis in upper cross syndrome.

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.

This randomized controlled trial aims to compare the effects of Maitland mobilization combined with Kendall exercises versus Kendall exercises alone on pain and postural alignment in adults with Upper Cross Syndrome (UCS). Upper Cross Syndrome is characterized by muscle imbalance leading to forward head posture, rounded shoulders, and increased thoracic kyphosis. The study will evaluate pain intensity, craniovertebral angle, thoracic kyphosis, and rounded shoulder posture

This randomized controlled trial aims to evaluate the effectiveness of rib mobilization combined with postural correction exercises in reducing pain, improving cervical posture, and enhancing rib and thoracic mobility among individuals with Upper Crossed Syndrome (UCS). A total of 64 participants aged 20-45 years will be recruited and randomly assigned to two groups: Group A (rib mobilization + postural correction) and Group B (postural correction only). Intervention will be provided for 4-6 weeks, three sessions per week. Outcomes will include pain (VAS), cervical posture (inclinometer), and rib/thoracic mobility (tape measure). Data will be analyzed using SPSS version 26.

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).

This study was conducted to determine the effects of Klapp Method on posture, craniovertebral angle and disability in upper cross syndrome patients.

This study is a randomised control trial and the purpose of this study is to determine the "Effects of Neuromuscular Reeducation Versus Post Facilitation Stretch Technique for Upper Cross Syndrome among IT professionals

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.

Correlation Between Upper Cross Syndrome and Neck Proprioception Hypothesis: No statistically significant relationship exists between upper cross syndrome and neck proprioception. Study Design: Randomized Controlled Trial Participants: Office workers (≥4h computer use/day) Age: 28-48 years Chronic nonspecific neck pain (\>3 months) Forward head posture (FHP) \<46° VAS score: 3-8 cm No cognitive impairments affecting participation Exclusion Criteria: Systemic, rheumatic, or neuromuscular diseases Neurological signs, spinal surgery, or recent physical therapy Missing ≥3 consecutive or 4 nonconsecutive sessions

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.

Nowadays, bad habits brought about by technology such as overuse of mobile phones, televisions, computers, and tablets, resulted in negative impacts on health. Bending in abnormal positions while using these devices causes various mechanical loads on the neck and upper back area, rounded shoulders from increased thoracic kyphosis etc., and this leads to poor posture that can cause UCS. Because of high prevalence of RSP especially in modern societies , proper treatment of this problem is necessary for prevention of further complications.There are different exercise regimes for RSP such as strengthening of lengthened muscles, scapular stabilizers, stretching of shorten muscles especially pectoral muscles, and soft tissue mobilization but Whole-Body Vibration (WBV) is a new method introduced since the last decade and there is no comparison available in the literature of upper cross syndrome between WBV with Pilate exercises on postural correction The aim of the study is to compare effects Comparison of pilot exercises with and without whole body vibration on posture , disability and pain in patients with upper cross syndrome A randomized clinical trial will be conducted at PESSI.. Non-probability convenience sampling will be used, and 56 subjects, age 20-40 years will be randomly allocated into two groups by lottery method after meeting the inclusion criteria. Both groups will receive hot pack for 15-20 minutes and Pilate exercise perform both group as common treatment. Group A will be treated with pilate exercises and Group B will be treated with pilate exercise with whole body vibration Both groups received two sessions per week for four consecutive weeks by another well trained physical therapist. Session duration for both groups ranged from 55 minutes to 1 hour. 2 sessions per week and total 8 sessions for 4 weeks. The outcome measures will be conducted through NPRS,NDI,RSP WAS MEASURED IN SUPINE POSITION AND THEN PML AND TSD before and after 4 weeks. Data will be analyzed using SPSS software version 26.

The purpose of this study is to investigate if there is any effect of the respiratory training on cardiopulmonary functions in patients with upper cross syndrome post-cardiac surgery. Hypothesis: Null hypothesis: There is no effect of the respiratory training on pulmonary functions in patients with upper cross syndrome post-cardiac surgery.

This study is a randomised control trial and the purpose of this study is to determine the "Effects of Neuromuscular Reeducation Versus Post Facilitation Stretch Technique for Upper Cross Syndrome among IT professionals .