Upper Crossed SyndromeNCT06509594
Scapular Stabilization Exercises Versus Eccentric Muscle Energy Techniques in Patients With Upper Crossed Syndrome
A study testing Protocol of Scapular Stabilization Exercises; and Protocol of Muscle Energy technique; in people with Upper Crossed Syndrome, run by Riphah International University at 1 site in Pakistan.
Trial summary
This study will be a Randomized Clinical Trial in which Scapular Stabilization Exercises and Eccentric Muscle Energy technique will be applied on the individuals with upper crossed syndrome and changes will be recorded using different method and tools. Convenient sampling technique will be used to collect the data. Read more about this study
- Who is it for?
- Ages 18 to 35 years
- Conditions the study is for
- Upper Crossed Syndrome
- What is being tested?
- Protocol of Scapular Stabilization Exercises; and Protocol of Muscle Energy technique;
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 34 participants
- Where
- 1 sitePakistan
- Study dates
- 23 Nov 2023to Sep 2024
- 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 18 to 35 years
- All sexes
- No healthy volunteers
- Adult
Who may be able to join
- • Age: participants having range 18-35 years both male and female are included.
- Craniovertebral angle<52
- NPRS>3 and NDI>10
- Patients having neck pain during movements.
- Patients having neck pain due to sustained posture and after activity
Who cannot join
- Inflammation malignancy, neurological disorder
- Metabolic disorders
- Neck pain radiating into arms and upper extremity
- Neck pain associated with headache and facial pain
- Recent surgery
- History of recent trauma and fractures of cervical spine
- Patients having any other therapeutic intervention or medical treatment.
Trial locations and contacts
1 site in 1 country.
Pakistan1 site, 1 recruiting
- Recruiting
Faisal masaood teaching hospital Sargodha
Sargodha, Punjab Province, 40100
Hajira Anwer, DPT, 03347052438, hajiraanwer@riphah.edu.pk
Shams Fiaz, MS ompt
About this study
Official title: Effects of Scapular Stabilization Exercises Versus Eccentric Muscle Energy Techniques on Pain, Functional Disability and Postural Alignment in Patients With Upper Crossed Syndrome
This study will be a Randomized Clinical Trial in which Scapular Stabilization Exercises and Eccentric Muscle Energy technique will be applied on the individuals with upper crossed syndrome and changes will be recorded using different method and tools. Convenient sampling technique will be used to collect the data. The sample size of 34 patients will be recruited. Patients will be randomly allocated into two different groups through sealed envelope method. 17 patients will be allocated in each group. Group A will be treated with Scapular Stabilization Exercises along with hot pack; Group B will be treated with Eccentric Muscle Energy Technique along with hot pack. Craniovertebral Angle (CVA), Numeric Pain Rating Scale (NPRS), and Neck Disability Index (NDI) will be used as Data collecting tools.
Read the detailed description
Upper Crossed Syndrome is defined byJanda as the involvement of different muscles of skeletal system which leads to shortness and tightness of anterior and upper trunk or weakness of posterior part of skeletal muscles. Alteration of muscles activity such as facilitation of different muscles as levator scapula, sternocleidomastoid, pectoralis muscles and inhibition of cervical flexors, serratus anterior The muscular imbalance occurs because of weak/tight and tonic muscles. Neck pain is the most frequent problem in developed countries. The prevalence of neck pain is approximately 10-15%. Neck pain is the most common reason for patients visiting healthcare professionals. Poor posture typically causes upper cross syndrome (UCS), resulting in neck pain. This syndrome can cause dysfunctional tone in posture and muscular disparity of head, neck and shoulder region.
- Conditions
- Upper Crossed Syndrome
- Being tested
- Protocol of Scapular Stabilization Exercises;, Protocol of Muscle Energy technique;
- Keywords
- Upper Crossed Syndrome, Scapular Stabilization Exercises, Eccentric Muscle Energy technique, Pain, Functional disability
- Medical subject headings
- Oculocerebral hypopigmentation syndrome type Preus, Pain
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Protocol of Scapular Stabilization Exercises;Other
Exercise for the middle trapezius and rhomboid muscles: Participants were instructed to stand with their arms hanging beside their bodies. Then, they were instructed to flex their elbows 90◦ holding an elastic band and performing an external rotation of the shoulder, pulling both scapula together. Subsequently, they returned to a neutral shoulder position with elbow flexion.
Exercise for the lower trapezius muscle: Participants were instructed to lie down in a prone position while holding an elastic band attached at one end under a mattress. They were then instructed to raise their shoulder 140◦.
Exercise for the serratus anterior muscle: Participants were instructed to stand and flex their elbows 90◦ while holding an elastic band fixed behind the participants. Next, they were instructed to move the arm forward with a protracted scapula.
Protocol of Muscle Energy technique;Other
During upper trapezius stretching, the participants were in seated position by holding the chair with one arm, and laterally tilted the head to the opposite side with the other hand pushing the head to increase lateral stretch.
For pectoralis muscle stretch, participants were asked to stand in front of the Doorframe with elbow bent at 90 degree and was asked to lean forward without Taking a step forward. The stretch is felt across the anterior chest, which is held for 15-30 seconds with 2-3 repetitions. For levator scapulae stretch, the subjects were asked to take the seated position while holding the chair with one hand in order to maintain shoulder depression, then To flex and rotate neck to the opposite side by placing the other hand at the back of their head and to slowly pull it down toward the armpit.
| Study group | Role | What they receive |
|---|---|---|
| Group A will be treated with Scapular Stabilization Exercises along with hot pack; | Active comparator | Participants in the exercise group performed three scapular stabilization exercises at 3 sets of 10 repetitions, holding 10 seconds per one repetition, 5 days per week for 4 weeks under supervision. The exercises included: Receives: Other: Protocol of Scapular Stabilization Exercises; |
| Group B will be treated with Eccentric Muscle Energy Technique along with hot pack. | Active comparator | Eccentric muscle energy technique was applied to subjects' cervical spine. The Cervical spine was brought to the barrier of motion in each plane i.e. Flexion/extension, lateral bending and rotation. Then subjects were asked to push their heads into the direction opposite that of the barrier. The therapist provided Isometric resistance for 7-10 seconds, after which the subjects relaxed their muscles completely and the therapist applied stretch. Three to five repetitions were performed(2). We will apply protocol for 4 weeks 20 Sessions (5 sessions in a week) and 10 sec rest between each segment with 3-5 time's repetition than their will 7-10 sec Isometric contraction followed by 5 sec relaxation than 30 sec hold for MET stretch. Receives: Other: Protocol of Muscle Energy technique; |
What is being measured
The primary outcome is the main question the study is designed to answer.
Numeric pain rating scale (NPRS)
The NPRS was used to capture the patient's level of pain. Patients were asked to indicate the intensity of their current pain level using an 11-point scale, ranging from 0 (no pain) to 10 (worst pain imaginable)(8).
0 = no pain
1 to 4 indicate mild pain 5 or 6 indicate moderate pain 7 to 10 indicate severe pain NPRS exhibited moderate reliability (ICC = 0.67) in t
Measured: 4 weeks
Secondary outcomes (1)
Neck Disability Index (NDI)
The NDI consists of ten items. Each item has six different assertions expressing progressive levels of pain or limitation in activities. Item scores range from 0 (no pain or limitation) to 5 (as much pain as possible or maximal limitation). The total NDI score ranges from 0 to 5 points.
Measured: 4 weeks
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted19 Jul 2024
- Study start23 Nov 2023
- Primary completionAug 2024 (estimated)
- Study completionSep 2024 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (10)Papers the sponsor has linked to this study.
- Other trials for Upper Crossed SyndromeStudies of the same condition, open and under way.
- 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
- Double blind
- Who is masked
- Participant, Investigator
- Enrolment
- 34 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Riphah International University
- Sponsor type
- University, hospital or other
- Responsible party
- Sponsor
- Investigators
- Dr hajira Anwer, M.S, Principal investigator, Riphah International University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT06509594
- Sponsor's protocol ID
- REC/RCR & AHS/23/01111
- Status last verified
- Jul 2024
- First submitted
- 15 Jul 2024
- Last updated
- 19 Jul 2024
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Publications
Salahzadeh Z, Maroufi N, Ahmadi A, Behtash H, Razmjoo A, Gohari M, Parnianpour M. Assessment of forward head posture in females: observational and photogrammetry methods. J Back Musculoskelet Rehabil. 2014;27(2):131-9. doi: 10.3233/BMR-130426.
PubMed 23963268Gillani SN, Ain Q-, Rehman SU, Masood T. Effects of eccentric muscle energy technique versus static stretching exercises in the management of cervical dysfunction in upper cross syndrome: a randomized control trial. J Pak Med Assoc. 2020 Mar;70(3):394-398. doi: 10.5455/JPMA.300417.
PubMed 32207413Kang JI, Choi HH, Jeong DK, Choi H, Moon YJ, Park JS. Effect of scapular stabilization exercise on neck alignment and muscle activity in patients with forward head posture. J Phys Ther Sci. 2018 Jun;30(6):804-808. doi: 10.1589/jpts.30.804. Epub 2018 Jun 12.
PubMed 29950768Ali S, Ahmad S, Jalal Y, Shah B. Effectiveness of Stretching Exercises Versus Muscle Energy Techniques in the Management of Upper Cross Syndrome: JRCRS. 2017; 5 (1): 12-16. Journal Riphah College of Rehabilitation Sciences. 2017;5(1):12-6.
Sasidharan S. Comparing the effectiveness of muscle energy technique and static stretching in upper crossed syndrome on IT professionals: City University.
IBRAHIM ME, HANAN SE-S, ABDELSALAM S. Cervical Stabilization Exercises Versus Scapular Stabilization Exercises in Treatment of Chronic Mechanical Neck Pain. The Medical Journal of Cairo University. 2022;90(9):1729-35.
Sakshi N, Suman M, Geetanjali S. Effect of muscle energy technique and deep neck flexors exercise on pain, disability and forward head posture in patients with chronic neck pain. National Editorial Advisory Board. 2014;8(4):43.
Young IA PT, DSc, Dunning J PT, DPT, Butts R PT, PhD, Mourad F PT, DPT, Cleland JA PT, PhD. Reliability, construct validity, and responsiveness of the neck disability index and numeric pain rating scale in patients with mechanical neck pain without upper extremity symptoms. Physiother Theory Pract. 2019 Dec;35(12):1328-1335. doi: 10.1080/09593985.2018.1471763. Epub 2018 Jun 1.
PubMed 29856244Jorritsma W, Dijkstra PU, de Vries GE, Geertzen JH, Reneman MF. Detecting relevant changes and responsiveness of Neck Pain and Disability Scale and Neck Disability Index. Eur Spine J. 2012 Dec;21(12):2550-7. doi: 10.1007/s00586-012-2407-8. Epub 2012 Jul 3.
PubMed 22752592Nitayarak H, Charntaraviroj P. Effects of scapular stabilization exercises on posture and muscle imbalances in women with upper crossed syndrome: A randomized controlled trial. J Back Musculoskelet Rehabil. 2021;34(6):1031-1040. doi: 10.3233/BMR-200088.
PubMed 34151819
Study at a glance
From the registry record, last updated by the sponsor on 19 Jul 2024. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Effects of Scapular Stabilization Exercises Versus Eccentric Muscle Energy Techniques on Pain, Functional Disability and Postural Alignment in Patients With Upper Crossed Syndrome
- ClinicalTrials.gov ID
- NCT06509594
- Acronym / sponsor ID
- REC/RCR & AHS/23/01111
- Conditions
- Upper Crossed Syndrome
- Keywords
- Upper Crossed Syndrome, Scapular Stabilization Exercises, Eccentric Muscle Energy technique, Pain, Functional disability
- Study type
- Interventional
- Recruitment status
- Unknown status
- Enrolment
- 34 participants (estimated)
- Lead sponsor
- Riphah International UniversityUniversity, hospital or other
- Study start
- 23 Nov 2023 (actual)
- Primary completion
- Aug 2024 (estimated)
- Study completion
- Sep 2024 (estimated)
- First posted
- 19 Jul 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.
This study will be a Randomized Clinical Trial in which Scapular Stabilization Exercises and Eccentric Muscle Energy technique will be applied on the individuals with upper crossed syndrome and changes will be recorded using different method and tools. Convenient sampling technique will be used to collect the data. The sample size of 34 patients will be recruited. Patients will be randomly allocated into two different groups through sealed envelope method. 17 patients will be allocated in each group. Group A will be treated with Scapular Stabilization Exercises along with hot pack; Group B will be treated with Eccentric Muscle Energy Technique along with hot pack. Craniovertebral Angle (CVA), Numeric Pain Rating Scale (NPRS), and Neck Disability Index (NDI) will be used as Data collecting tools.
Detailed description
Upper Crossed Syndrome is defined byJanda as the involvement of different muscles of skeletal system which leads to shortness and tightness of anterior and upper trunk or weakness of posterior part of skeletal muscles. Alteration of muscles activity such as facilitation of different muscles as levator scapula, sternocleidomastoid, pectoralis muscles and inhibition of cervical flexors, serratus anterior The muscular imbalance occurs because of weak/tight and tonic muscles. Neck pain is the most frequent problem in developed countries. The prevalence of neck pain is approximately 10-15%. Neck pain is the most common reason for patients visiting healthcare professionals. Poor posture typically causes upper cross syndrome (UCS), resulting in neck pain. This syndrome can cause dysfunctional tone in posture and muscular disparity of head, neck and shoulder region.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Double blind (participant, investigator)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Group A will be treated with Scapular Stabilization Exercises along with hot pack; | Active comparator | Other: Protocol of Scapular Stabilization Exercises;Participants in the exercise group performed three scapular stabilization exercises at 3 sets of 10 repetitions, holding 10 seconds per one repetition, 5 days per week for 4 weeks under supervision. The exercises included: |
| Group B will be treated with Eccentric Muscle Energy Technique along with hot pack. | Active comparator | Other: Protocol of Muscle Energy technique;Eccentric muscle energy technique was applied to subjects' cervical spine. The Cervical spine was brought to the barrier of motion in each plane i.e. Flexion/extension, lateral bending and rotation. Then subjects were asked to push their heads into the direction opposite that of the barrier. The therapist provided Isometric resistance for 7-10 seconds, after which the subjects relaxed their muscles completely and the therapist applied stretch. Three to five repetitions were performed(2). We will apply protocol for 4 weeks 20 Sessions (5 sessions in a week) and 10 sec rest between each segment with 3-5 time's repetition than their will 7-10 sec Isometric contraction followed by 5 sec relaxation than 30 sec hold for MET stretch. |
Who may qualify
- Ages
- 18 to 35 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult
Key inclusion criteria (5 listed)
- • Age: participants having range 18-35 years both male and female are included.
Key exclusion criteria (7 listed)
- Inflammation malignancy, neurological disorder
- Metabolic disorders
- Neck pain radiating into arms and upper extremity
- Neck pain associated with headache and facial pain
- Recent 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 |
|---|---|---|
| Protocol of Scapular Stabilization Exercises;Exercise for the middle trapezius and rhomboid muscles: Participants were instructed to stand with their arms hanging beside their bodies. Then, they were instructed to flex their elbows 90◦ holding an elastic band and performing an external rotation of the shoulder, pulling both scapula together. Subsequently, they returned to a neutral shoulder position with elbow flexion. Exercise for the lower trapezius muscle: Participants were instructed to lie down in a prone position while holding an elastic band attached at one end under a mattress. They were then instructed to raise their shoulder 140◦. Exercise for the serratus anterior muscle: Participants were instructed to stand and flex their elbows 90◦ while holding an elastic band fixed behind the participants. Next, they were instructed to move the arm forward with a protracted scapula. | Other | Group A will be treated with Scapular Stabilization Exercises along with hot pack; |
| Protocol of Muscle Energy technique;During upper trapezius stretching, the participants were in seated position by holding the chair with one arm, and laterally tilted the head to the opposite side with the other hand pushing the head to increase lateral stretch. For pectoralis muscle stretch, participants were asked to stand in front of the Doorframe with elbow bent at 90 degree and was asked to lean forward without Taking a step forward. The stretch is felt across the anterior chest, which is held for 15-30 seconds with 2-3 repetitions. For levator scapulae stretch, the subjects were asked to take the seated position while holding the chair with one hand in order to maintain shoulder depression, then To flex and rotate neck to the opposite side by placing the other hand at the back of their head and to slowly pull it down toward the armpit. | Other | Group B will be treated with Eccentric Muscle Energy Technique along with hot pack. |
Primary outcome
Numeric pain rating scale (NPRS)
Time frame: 4 weeks
The NPRS was used to capture the patient's level of pain. Patients were asked to indicate the intensity of their current pain level using an 11-point scale, ranging from 0 (no pain) to 10 (worst pain imaginable)(8). 0 = no pain 1 to 4 indicate mild pain 5 or 6 indicate moderate pain 7 to 10 indicate severe pain NPRS exhibited moderate reliability (ICC = 0.67) in t
1 secondary outcome
Neck Disability Index (NDI)
Time frame: 4 weeks
Results and safety
Results are not available in the source record.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 19 Jul 2024.
- Background: PubMed 23963268Salahzadeh Z, Maroufi N, Ahmadi A, Behtash H, Razmjoo A, Gohari M, Parnianpour M. Assessment of forward head posture in females: observational and photogrammetry methods. J Back Musculoskelet Rehabil. 2014;27(2):131-9. doi: 10.3233/BMR-130426.
- Background: PubMed 32207413Gillani SN, Ain Q-, Rehman SU, Masood T. Effects of eccentric muscle energy technique versus static stretching exercises in the management of cervical dysfunction in upper cross syndrome: a randomized control trial. J Pak Med Assoc. 2020 Mar;70(3):394-398. doi: 10.5455/JPMA.300417.
- Background: PubMed 29950768Kang JI, Choi HH, Jeong DK, Choi H, Moon YJ, Park JS. Effect of scapular stabilization exercise on neck alignment and muscle activity in patients with forward head posture. J Phys Ther Sci. 2018 Jun;30(6):804-808. doi: 10.1589/jpts.30.804. Epub 2018 Jun 12.
- BackgroundAli S, Ahmad S, Jalal Y, Shah B. Effectiveness of Stretching Exercises Versus Muscle Energy Techniques in the Management of Upper Cross Syndrome: JRCRS. 2017; 5 (1): 12-16. Journal Riphah College of Rehabilitation Sciences. 2017;5(1):12-6.
- BackgroundSasidharan S. Comparing the effectiveness of muscle energy technique and static stretching in upper crossed syndrome on IT professionals: City University.
- BackgroundIBRAHIM ME, HANAN SE-S, ABDELSALAM S. Cervical Stabilization Exercises Versus Scapular Stabilization Exercises in Treatment of Chronic Mechanical Neck Pain. The Medical Journal of Cairo University. 2022;90(9):1729-35.
- BackgroundSakshi N, Suman M, Geetanjali S. Effect of muscle energy technique and deep neck flexors exercise on pain, disability and forward head posture in patients with chronic neck pain. National Editorial Advisory Board. 2014;8(4):43.
- Background: PubMed 29856244Young IA PT, DSc, Dunning J PT, DPT, Butts R PT, PhD, Mourad F PT, DPT, Cleland JA PT, PhD. Reliability, construct validity, and responsiveness of the neck disability index and numeric pain rating scale in patients with mechanical neck pain without upper extremity symptoms. Physiother Theory Pract. 2019 Dec;35(12):1328-1335. doi: 10.1080/09593985.2018.1471763. Epub 2018 Jun 1.
- Background: PubMed 22752592Jorritsma W, Dijkstra PU, de Vries GE, Geertzen JH, Reneman MF. Detecting relevant changes and responsiveness of Neck Pain and Disability Scale and Neck Disability Index. Eur Spine J. 2012 Dec;21(12):2550-7. doi: 10.1007/s00586-012-2407-8. Epub 2012 Jul 3.
- Background: PubMed 34151819Nitayarak H, Charntaraviroj P. Effects of scapular stabilization exercises on posture and muscle imbalances in women with upper crossed syndrome: A randomized controlled trial. J Back Musculoskelet Rehabil. 2021;34(6):1031-1040. doi: 10.3233/BMR-200088.
- 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.
Dr hajira Anwer, M.S 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 Protocol of Scapular Stabilization Exercises; and Protocol of Muscle Energy technique; in people with Upper Crossed Syndrome, 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 7 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: status not confirmed, as of the sponsor's last update on 19 Jul 2024. 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?
Results are not available in the source record.
How can a doctor refer a patient or contact the research team?
Contact Imran Amjad, PhD (03324390125, imran.amjad@riphah.edu.pk), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Numeric pain rating scale (NPRS) (time frame: 4 weeks). 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 NCT06509594, which also lists 10 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 19 Jul 2024.