Neck PainNCT06460129
Effects of Bruegger's Versus Kendall Exercises in Cervical Postural Syndrome
A study testing Brugger's Exercises and Kendal Exercise in people with Neck Pain, run by Riphah International University at 1 site in Pakistan.
Trial summary
Cervical Postural Syndrome is an uncomfortable and painful condition characterized by a protruding chin and rounded shoulders, commonly resulting from poor posture in the neck, middle back, and shoulders. Read more about this study
- Who is it for?
- Ages 20 to 40 years
- Conditions the study is for
- Neck Pain
- What is being tested?
- Brugger's Exercises and Kendal Exercise
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 26 participants
- Where
- 1 sitePakistan
- Study dates
- 15 Dec 2024to 7 May 2025
- Phase
- Interventional
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 20 to 40 years
- All sexes
- No healthy volunteers
- Adult
Who may be able to join
- Age range: 20-40
- A patient who has neither "specific pain" nor "poor posture."
- A cranio-vertebral angle (CVA) of less than 52 degrees
- A Numeric Pain Rating Scale (NPRS) score of fewer than 7
- A Neck Disability Index score of greater than 10 (NDI)
Who cannot join
- Surgery on the neck or back
- Recent trauma history
- Malignancy
- Cervical dysfunction-related neurological symptoms
- Temporomandibular joint surgery
- Recent fractures or injuries
Trial locations and contacts
1 site in 1 country.
About this study
Official title: Effects of Bruegger's Versus Kendall Exercises on Pain, Range of Motion, Craniovertebral Angle and Functional Disability in Patients With Cervical Postural Syndrome
Cervical Postural Syndrome is an uncomfortable and painful condition characterized by a protruding chin and rounded shoulders, commonly resulting from poor posture in the neck, middle back, and shoulders. This syndrome often leads to an excessive forward curvature of the upper back, causing the chin to jut forward and the shoulders to hunch forward. A prevalent cervical abnormality associated with this condition is the forward head position, which increases the risk of neck pain. The entire clinical condition is referred to as "sterno-symphyseal syndrome" by Bruegger. He describes the muscles involved as "painfully tense and painfully weak." Bruegger's exercises are designed to align the spine correctly by strengthening the scapular and neck muscles. Similarly, Kendall's exercises focus on restoring cervical spine alignment, particularly for individuals with forward head posture, by targeting the shoulder extensors and deep neck flexors. While numerous studies have examined the direct effects of forward head posture on the cervical spine, there is limited research comparing the effectiveness of Bruegger's exercises and Kendall's exercises, particularly regarding exercises that do not directly target the neck.
Read the detailed description
Cervical Postural Syndrome is a common and painful condition characterized by a projecting chin and rounded shoulders, resulting from poor posture in the neck, middle back, and shoulders. This syndrome often causes an exaggerated forward curvature of the upper back, leading to a forward-protruding chin and forward-sitting shoulders. The forward head position is a prevalent cervical issue that increases the risk of neck pain. Bruegger refers to this condition as "sterno-symphyseal syndrome," describing the involved muscles as "painfully tense and painfully weak." Bruegger's exercises aim to correct spinal alignment by strengthening the scapular and neck muscles. Kendall's exercises focus on restoring cervical spine alignment, especially for those with forward head posture, by strengthening the shoulder extensors and deep neck flexors. While many studies have examined the direct impact of forward head posture on the cervical spine, there is limited research comparing the effectiveness of Bruegger's exercises and Kendall's exercises, particularly for exercises that do not directly target the neck.
The objective of this study will be to compare the effects of Bruegger's exercises and Kendall's exercises on pain, range of motion, craniovertebral angle, and functional disability in patients with Cervical Postural Syndrome.
A randomized clinical trial will be conducted at Rasheed Hospital, using a non-probability convenient sampling technique on 36 patients who will be divided into two groups. One group will follow the Bruegger's exercises protocol, while the other group will follow Kendall's exercises. The protocol duration will be six weeks, with sessions three times a week. Each session will consist of one set of 10 repetitions for each movement, repeated for three sets, with a 10-second rest per repetition, a one-minute rest after each set, and a three-minute rest between each movement. Outcome measures will include pain, range of motion, craniovertebral angle, and functional disability. Data will be collected before and after the training sessions. The data will be entered and analyzed using SPSS version 25, and the Shapiro-Wilk test will be applied to determine the normality of the data.
- Conditions
- Neck Pain
- Being tested
- Brugger's Exercises, Kendal Exercise
- Keywords
- Bruegger's exercises, Kendal exercises, Forward Neck Posture, Mobile Posture
- Medical subject headings
- Neck Pain
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Brugger's ExercisesOther
- The participant will sit upright and wrap an elastic resistance band around each hand, leaving the palms open. They will perform thumb and finger abduction and extension, wrist extension, and forearm supination. This will be followed by scapular retraction with shoulder external rotation, elbow extension, shoulder abduction, and extension, holding this position for 10 seconds.
- In both sitting and standing positions, the participant will sit at the edge of a seat, naturally lifting the sternum, with legs spread at a 45-degree angle and feet slightly turned out. Shoulders should be relaxed, chin tucked, and elbows fully extended. The participant will keep their shoulders down, imagining the scapulae pressing together and downward into a V shape, with thumbs turned out, palms up, and fingers spread. This position is held for 10 seconds.
Kendal ExerciseOther
- In a supine position, the participant will place a towel around their neck. With their head on the floor, they will tuck their chin and use the towel to apply gentle resistance, holding for 10 seconds to strengthen the deep flexor muscles of the cervical spine.
- In a prone position, the participant will point their thumbs toward the ceiling and extend their arms fully while leaning forward, then return to the starting position. They will then extend their arms horizontally and hold for 10 seconds.
- The participant will place both hands on the back of their head, lift their elbows upward, pull them back, and simultaneously spread their arms out to the side. This position will be held for 10 seconds before returning to the starting position.
| Study group | Role | What they receive |
|---|---|---|
| Brugger's Exercises | Experimental | Participants will receive Burger Exercise Receives: Other: Brugger's Exercises |
| KENDALL EXERCISE | Active comparator | Participants will receive Kendal Exercise Receives: Other: Kendal Exercise |
What is being measured
The primary outcome is the main question the study is designed to answer.
Pain level
A numerical pain rating scale is a quantitative tool for determining how much pain is experienced. This scale is trustworthy and valid for measuring pain. Its measurement ranges from 0 to 10. I mean that when the numbers go from 0 to 10, the pain is more intense. O denotes "no pain," 1-3 indicate "mild pain," 4-6 indicate "moderate pain," 7-9 indicate "severe pain," and 10 indicate the worst pain. Dependability
Measured: 6th week
Range of Motion
Range of movement refers to the area that a joint can cover while moving. We utilize a universal goniometer to measure the range of motion (ROM). A scale called a universal goniometer is used to measure the range of quantitative values. The universal goniometer is also a useful and trustworthy instrument for ROM measurement. For cervical range of motion and cranio-vertebral angle, therefore, we use it.
Measured: 6th week
limited function
Disability is the inability of an individual to accomplish a goal or to carry out a daily activity. The Neck Disability Index (NDI) is the main tool used in neck assessments. The NDI is a scale used to assess a joint's limited range of motion or to measure the
useful action. This scale has ten items that are linked to carrying out an activity. The neck impairment can be measured using this accurate and trustworthy scale. Dependability
Measured: 6th week
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted14 Jun 2024
- Study start15 Dec 2024
- Primary completion15 Apr 2025
- Study completion7 May 2025
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (5)Papers the sponsor has linked to this study.
- Other trials for Neck PainStudies of the same condition, open and under way.
- More trials run by Riphah International UniversityThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind
- Who is masked
- Outcomes assessor
- Enrolment
- 26 participants (actual)
Sponsor and investigators
- Lead sponsor
- Riphah International University
- Sponsor type
- University, hospital or other
- Responsible party
- Sponsor
- Investigators
- Arslan Qaramat, DPT, Principal investigator, Riphah International University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT06460129
- Sponsor's protocol ID
- REC/RCR&AHS/23/01105
- Status last verified
- May 2025
- First submitted
- 11 Jun 2024
- Last updated
- 22 May 2025
- Results posted
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Publications
Avaghade RR, Shinde SB, Dhane SB. Effectiveness of McKenzie approach and segmental spinal stabilization exercises on neck pain in individuals with cervical postural syndrome: An experimental study. J Educ Health Promot. 2023 Jul 29;12:225. doi: 10.4103/jehp.jehp_239_23. eCollection 2023.
PubMed 37727425Abdel-Aziem AA, Abdel-Ghafar MA, Ali OI, Abdelraouf OR. Effects of smartphone screen viewing duration and body position on head and neck posture in elementary school children. J Back Musculoskelet Rehabil. 2022;35(1):185-193. doi: 10.3233/BMR-200334.
PubMed 34092602Kazeminasab S, Nejadghaderi SA, Amiri P, Pourfathi H, Araj-Khodaei M, Sullman MJM, Kolahi AA, Safiri S. Neck pain: global epidemiology, trends and risk factors. BMC Musculoskelet Disord. 2022 Jan 3;23(1):26. doi: 10.1186/s12891-021-04957-4.
PubMed 34980079Al-Khazali HM, Younis S, Al-Sayegh Z, Ashina S, Ashina M, Schytz HW. Prevalence of neck pain in migraine: A systematic review and meta-analysis. Cephalalgia. 2022 Jun;42(7):663-673. doi: 10.1177/03331024211068073. Epub 2022 Feb 15.
PubMed 35166137Richards KV, Beales DJ, Smith AL, O'Sullivan PB, Straker LM. Is Neck Posture Subgroup in Late Adolescence a Risk Factor for Persistent Neck Pain in Young Adults? A Prospective Study. Phys Ther. 2021 Mar 3;101(3):pzab007. doi: 10.1093/ptj/pzab007.
PubMed 33444448
Study at a glance
From the registry record, last updated by the sponsor on 22 May 2025. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Effects of Bruegger's Versus Kendall Exercises on Pain, Range of Motion, Craniovertebral Angle and Functional Disability in Patients With Cervical Postural Syndrome
- ClinicalTrials.gov ID
- NCT06460129
- Acronym / sponsor ID
- REC/RCR&AHS/23/01105
- Conditions
- Neck Pain
- Keywords
- Bruegger's exercises, Kendal exercises, Forward Neck Posture, Mobile Posture
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 26 participants (actual)
- Lead sponsor
- Riphah International UniversityUniversity, hospital or other
- Study start
- 15 Dec 2024 (actual)
- Primary completion
- 15 Apr 2025 (actual)
- Study completion
- 7 May 2025 (actual)
- First posted
- 14 Jun 2024 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
Cervical Postural Syndrome is an uncomfortable and painful condition characterized by a protruding chin and rounded shoulders, commonly resulting from poor posture in the neck, middle back, and shoulders. This syndrome often leads to an excessive forward curvature of the upper back, causing the chin to jut forward and the shoulders to hunch forward. A prevalent cervical abnormality associated with this condition is the forward head position, which increases the risk of neck pain. The entire clinical condition is referred to as "sterno-symphyseal syndrome" by Bruegger. He describes the muscles involved as "painfully tense and painfully weak." Bruegger's exercises are designed to align the spine correctly by strengthening the scapular and neck muscles. Similarly, Kendall's exercises focus on restoring cervical spine alignment, particularly for individuals with forward head posture, by targeting the shoulder extensors and deep neck flexors. While numerous studies have examined the direct effects of forward head posture on the cervical spine, there is limited research comparing the effectiveness of Bruegger's exercises and Kendall's exercises, particularly regarding exercises that do not directly target the neck.
Detailed description
Cervical Postural Syndrome is a common and painful condition characterized by a projecting chin and rounded shoulders, resulting from poor posture in the neck, middle back, and shoulders. This syndrome often causes an exaggerated forward curvature of the upper back, leading to a forward-protruding chin and forward-sitting shoulders. The forward head position is a prevalent cervical issue that increases the risk of neck pain. Bruegger refers to this condition as "sterno-symphyseal syndrome," describing the involved muscles as "painfully tense and painfully weak." Bruegger's exercises aim to correct spinal alignment by strengthening the scapular and neck muscles. Kendall's exercises focus on restoring cervical spine alignment, especially for those with forward head posture, by strengthening the shoulder extensors and deep neck flexors. While many studies have examined the direct impact of forward head posture on the cervical spine, there is limited research comparing the effectiveness of Bruegger's exercises and Kendall's exercises, particularly for exercises that do not directly target the neck.
The objective of this study will be to compare the effects of Bruegger's exercises and Kendall's exercises on pain, range of motion, craniovertebral angle, and functional disability in patients with Cervical Postural Syndrome.
A randomized clinical trial will be conducted at Rasheed Hospital, using a non-probability convenient sampling technique on 36 patients who will be divided into two groups. One group will follow the Bruegger's exercises protocol, while the other group will follow Kendall's exercises. The protocol duration will be six weeks, with sessions three times a week. Each session will consist of one set of 10 repetitions for each movement, repeated for three sets, with a 10-second rest per repetition, a one-minute rest after each set, and a three-minute rest between each movement. Outcome measures will include pain, range of motion, craniovertebral angle, and functional disability. Data will be collected before and after the training sessions. The data will be entered and analyzed using SPSS version 25, and the Shapiro-Wilk test will be applied to determine the normality of the data.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind (outcomes assessor)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Brugger's Exercises | Experimental | Other: Brugger's ExercisesParticipants will receive Burger Exercise |
| KENDALL EXERCISE | Active comparator | Other: Kendal ExerciseParticipants will receive Kendal Exercise |
Who may qualify
- Ages
- 20 to 40 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult
Key inclusion criteria (5 listed)
- Age range: 20-40
- A patient who has neither "specific pain" nor "poor posture."
- A cranio-vertebral angle (CVA) of less than 52 degrees
- A Numeric Pain Rating Scale (NPRS) score of fewer than 7
- A Neck Disability Index score of greater than 10 (NDI)
Key exclusion criteria (6 listed)
- Surgery on the neck or back
- Recent trauma history
- Malignancy
- Cervical dysfunction-related neurological symptoms
- Temporomandibular joint surgery
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Brugger's Exercises1. The participant will sit upright and wrap an elastic resistance band around each hand, leaving the palms open. They will perform thumb and finger abduction and extension, wrist extension, and forearm supination. This will be followed by scapular retraction with shoulder external rotation, elbow extension, shoulder abduction, and extension, holding this position for 10 seconds. 2. In both sitting and standing positions, the participant will sit at the edge of a seat, naturally lifting the sternum, with legs spread at a 45-degree angle and feet slightly turned out. Shoulders should be relaxed, chin tucked, and elbows fully extended. The participant will keep their shoulders down, imagining the scapulae pressing together and downward into a V shape, with thumbs turned out, palms up, and fingers spread. This position is held for 10 seconds. | Other | Brugger's Exercises |
| Kendal Exercise1. In a supine position, the participant will place a towel around their neck. With their head on the floor, they will tuck their chin and use the towel to apply gentle resistance, holding for 10 seconds to strengthen the deep flexor muscles of the cervical spine. 2. In a prone position, the participant will point their thumbs toward the ceiling and extend their arms fully while leaning forward, then return to the starting position. They will then extend their arms horizontally and hold for 10 seconds. 3. The participant will place both hands on the back of their head, lift their elbows upward, pull them back, and simultaneously spread their arms out to the side. This position will be held for 10 seconds before returning to the starting position. | Other | KENDALL EXERCISE |
Primary outcome
Pain level
Time frame: 6th week
A numerical pain rating scale is a quantitative tool for determining how much pain is experienced. This scale is trustworthy and valid for measuring pain. Its measurement ranges from 0 to 10. I mean that when the numbers go from 0 to 10, the pain is more intense. O denotes "no pain," 1-3 indicate "mild pain," 4-6 indicate "moderate pain," 7-9 indicate "severe pain," and 10 indicate the worst pain. Dependability
Range of Motion
Time frame: 6th week
Range of movement refers to the area that a joint can cover while moving. We utilize a universal goniometer to measure the range of motion (ROM). A scale called a universal goniometer is used to measure the range of quantitative values. The universal goniometer is also a useful and trustworthy instrument for ROM measurement. For cervical range of motion and cranio-vertebral angle, therefore, we use it.
limited function
Time frame: 6th week
Disability is the inability of an individual to accomplish a goal or to carry out a daily activity. The Neck Disability Index (NDI) is the main tool used in neck assessments. The NDI is a scale used to assess a joint's limited range of motion or to measure the useful action. This scale has ten items that are linked to carrying out an activity. The neck impairment can be measured using this accurate and trustworthy scale. Dependability
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 22 May 2025.
- Background: PubMed 37727425Avaghade RR, Shinde SB, Dhane SB. Effectiveness of McKenzie approach and segmental spinal stabilization exercises on neck pain in individuals with cervical postural syndrome: An experimental study. J Educ Health Promot. 2023 Jul 29;12:225. doi: 10.4103/jehp.jehp_239_23. eCollection 2023.
- Background: PubMed 34092602Abdel-Aziem AA, Abdel-Ghafar MA, Ali OI, Abdelraouf OR. Effects of smartphone screen viewing duration and body position on head and neck posture in elementary school children. J Back Musculoskelet Rehabil. 2022;35(1):185-193. doi: 10.3233/BMR-200334.
- Background: PubMed 34980079Kazeminasab S, Nejadghaderi SA, Amiri P, Pourfathi H, Araj-Khodaei M, Sullman MJM, Kolahi AA, Safiri S. Neck pain: global epidemiology, trends and risk factors. BMC Musculoskelet Disord. 2022 Jan 3;23(1):26. doi: 10.1186/s12891-021-04957-4.
- Background: PubMed 35166137Al-Khazali HM, Younis S, Al-Sayegh Z, Ashina S, Ashina M, Schytz HW. Prevalence of neck pain in migraine: A systematic review and meta-analysis. Cephalalgia. 2022 Jun;42(7):663-673. doi: 10.1177/03331024211068073. Epub 2022 Feb 15.
- Background: PubMed 33444448Richards KV, Beales DJ, Smith AL, O'Sullivan PB, Straker LM. Is Neck Posture Subgroup in Late Adolescence a Risk Factor for Persistent Neck Pain in Young Adults? A Prospective Study. Phys Ther. 2021 Mar 3;101(3):pzab007. doi: 10.1093/ptj/pzab007.
- Individual participant dataSharing planned: No
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Arslan Qaramat, DPT principal investigator
Riphah International University
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Brugger's Exercises and Kendal Exercise in people with Neck Pain, run by Riphah International University at 1 site in Pakistan.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 5 inclusion and 6 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 22 May 2025. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Pakistan. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Pain level (time frame: 6th week). The study lists 3 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT06460129, which also lists 5 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 22 May 2025.