Upper Cross SyndromeNCT06605456
Proprioceptive Neuromuscular Facilitation Combined With Postural Education in Upper Cross Syndrome
A study testing Proprioceptive neuromuscular facilitation with postural education and Active neck muscle stretching and strengthening exercises in people with Upper Cross Syndrome, run by Gulf Medical University at 1 site in United Arab Emirates.
Trial summary
The aim of this study was to investigate the effectiveness of PNF and conventional neck stretching, combined with a postural education program in improving forward head posture in students with clinical signs and symptoms of UCS. Read more about this study
- Who is it for?
- Ages 18 to 30 yearsHealthy volunteers can take part
- Conditions the study is for
- Upper Cross Syndrome
- What is being tested?
- Proprioceptive neuromuscular facilitation with postural education and Active neck muscle stretching and strengthening exercises
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 24 participants
- Where
- 1 siteUnited Arab Emirates
- Study dates
- 16 Feb 2023to 15 Jul 2023
- 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 30 years
- All sexes
- Healthy volunteers accepted
- Adult
Who may be able to join
- Students of Gulf Medical University.
- Both genders.
- Age between 18 - 30 years.
- Presence of clinical signs and symptoms of UCS.
- Presence of FHP with CVA of 49 degrees and below.
Who cannot join
- Musculoskeletal disorder such as strain, sprain, scoliosis.
- Students participating in any other interventions.
- Nutritional deficiencies.
- Unwilling participate.
- Degenerative joint disorder
- Neurologically unstable individuals
Trial locations and contacts
1 site in 1 country.
United Arab Emirates1 site
Gulf Medical University
Al Jurf, Ajman Emirate, 4184
About this study
Official title: The Effect of Proprioceptive Neuromuscular Facilitation Combined With Postural Education on Pressure Pain Threshold in Upper Back Among Students With Upper Cross Syndrome: an Experimental Study
The aim of this study was to investigate the effectiveness of PNF and conventional neck stretching, combined with a postural education program in improving forward head posture in students with clinical signs and symptoms of UCS. The study included a sample of undergraduate Gulf Medical University students with clinical signs and symptoms of UCS. A total of 24 samples were divided into two groups of 12. Group A received PNF pattern neck stretching and self-resisted neck PNF pattern, whereas Group B received Conventional neck stretches along with isometric strengthening of the neck muscles. Both groups were given a common postural education program. The intervention duration was 5 days per week for 4 weeks.
Read the detailed description
Collegiate students are prone to adopt slouched posture and develop muscular imbalance which is considered as a causative factor for the development of UCS. Studies have shown that students in medical universities have a higher risk of developing UCS. Even though PNF is considered to be simple and effective to improve inter and intramuscular coordination, its application to collegiate students with UCS is limited. Application of PNF combined with postural education programs may benefit the students to reduce UCS-associated clinical problems such as reduced forward head posture, pain intensity and improving muscle strength etc. Our current study might open the door of simple and effective management of UCS among collegiate students. Therefore, our study was conducted to find out the effect of PNF and active muscle stretching, both in combination with postural education programs, on forward head posture of the students with upper crossed syndrome.
Objectives:
● To compare the effect of PNF with active muscle stretching, both in combination with postural education programs on forward head posture of students with upper cross syndrome.
- Conditions
- Upper Cross Syndrome
- Being tested
- Proprioceptive neuromuscular facilitation with postural education, Active neck muscle stretching and strengthening exercises
- Keywords
- Upper cross syndrome, Postural correction, Neck pain, Upper back pain, Neuromuscular facilitation
- Medical subject headings
- Oculocerebral hypopigmentation syndrome type Preus, Neck Pain, Back Pain
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Proprioceptive neuromuscular facilitation with postural educationOther
Phase 1: Active Rhythmic Initiation The exercise was demonstrated to the students in a seated position, as sitting is considered the functional position for neck motion and stability. Then, the exercises was passively practiced on the students using tactile input. After passive demonstration, students were asked to perform the same exercise actively and verbal commands were used to guide and correct them.
Phase 2: Resisted Rhythmic Initiation "Modified" The investigators applied resistance by placing the palm of one hand on the right side of the chin to strengthen the muscles. Then, resisted scapular posterior depression PNF exercise also employed.
Also received a comprehensive postural education program to emphasize the importance of proper posture. The program was divided into three sections, which focused on the effects of good and bad posture, as well as practical demonstration.
Active neck muscle stretching and strengthening exercisesOther
Phase 1: Active Muscle Stretching In this phase, participants were instructed on performing active muscle stretching exercises for all cervical muscles, including neck flexors, extensors, lateral flexors and neck rotators. Each stretch was held for a period of 25-30 seconds and repeated three times.
Phase 2: Self-Isometric Strengthening Participants were provided with a demonstration of self-isometric strengthening exercise for the neck muscles. The exercises involved six movement patterns: cervical flexion, cervical extension, right/left lateral flexion and right/left rotation. For each exercise the participants were required to apply resistance against the direction of movement using their hand without allowing any motion in the neck.
Also received a comprehensive postural education program to emphasize the importance of proper posture. The program was divided into three sections, which focused on the effects of good and bad posture, as well as practical demonstration.
| Study group | Role | What they receive |
|---|---|---|
| Group A: PNF with postural education | Experimental | PNF neck pattern intervention with a rhythmic initiation technique implemented. This exercise intervention consisted of a two-phase exercise set: stretching the muscles and strengthening them Receives: Other: Proprioceptive neuromuscular facilitation with postural education |
| Group B: Active neck muscle stretching and strengthening exercises | Active comparator | Active neck muscle stretching and self-isometric strengthening exercises, targeting all cervical muscle groups. Receives: Other: Active neck muscle stretching and strengthening exercises |
What is being measured
The primary outcome is the main question the study is designed to answer.
Forward Head Posture
Measured by using a mobile phone app (physio master) and have taken craniovertebral angle, sagittal head tilt, and, head shoulder angle to identify a forward head posture.
Measured: Day one before the treatment, Four weeks post treatment.
Secondary outcomes (2)
Trigger point tenderness
The manual palpation method was applied to specific muscle groups associated with UCS, including the upper trapezius, rhomboids, levator scapulae, and sternomastoid (STM). The grading scale involved four grades: grade 1, where the patient complains of pain; grade 2, where the patient winces on palpation; grade 3, where the patient withdraws from palpation; and grade 4, where the patient is not allowed to be touched.
Measured: Day one before the treatment, Four weeks post treatment.
Cervical spine range of motion
To assess the range of motion (ROM) of the cervical muscle groups, an Acumar single \& Dual inclinometer (Lafayette instrument, models ACU001 \& ACU002) was utilized. For neck flexion, the inclinometer was placed on the top of the student\'s head, and the other end of the inclinometer was positioned on the T1 vertebra while the student was seated. The same method was applied for measuring neck extension and left/right lateral flexion. To measure left/right rotation, the participants were asked to be in a supine position, and the inclinometer was placed on the forehead as the main reference point. During each measurement, three trials were conducted, and the mean value of the three trials was calculated to determine the ROM for each specific movement.
Measured: Day one before the treatment, Four weeks post treatment.
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted20 Sep 2024
- Study start16 Feb 2023
- Primary completion15 Jun 2023
- Study completion15 Jul 2023
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Upper Cross 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
- Model description
- Group A, who were assigned the PNF neck pattern intervention, a rhythmic initiation technique was implemented. Group B were assigned active neck muscle stretching as well as self-isometric strengthening exercises, targeting all cervical muscle groups.
- Masking
- Single blind
- Who is masked
- Outcomes assessor
- Enrolment
- 24 participants (actual)
Sponsor and investigators
- Lead sponsor
- Gulf Medical University
- Sponsor type
- University, hospital or other
- Responsible party
- Sponsor
- Investigators
- Ramprasad Muthukrishnan, PhD, Study chair, Gulf Medical University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT06605456
- Sponsor's protocol ID
- IRB/COHS/STD/16/FEB-2023
- Status last verified
- Nov 2024
- First submitted
- 18 Sep 2024
- Last updated
- 27 Nov 2024
- Results posted
- No
- Data monitoring committee
- Yes
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No: Data might be shared based on the request
Study at a glance
From the registry record, last updated by the sponsor on 27 Nov 2024. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- The Effect of Proprioceptive Neuromuscular Facilitation Combined With Postural Education on Pressure Pain Threshold in Upper Back Among Students With Upper Cross Syndrome: an Experimental Study
- ClinicalTrials.gov ID
- NCT06605456
- Acronym / sponsor ID
- IRB/COHS/STD/16/FEB-2023
- Conditions
- Upper Cross Syndrome
- Keywords
- Upper cross syndrome, Postural correction, Neck pain, Upper back pain, Neuromuscular facilitation
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 24 participants (actual)
- Lead sponsor
- Gulf Medical UniversityUniversity, hospital or other
- Study start
- 16 Feb 2023 (actual)
- Primary completion
- 15 Jun 2023 (actual)
- Study completion
- 15 Jul 2023 (actual)
- First posted
- 20 Sep 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.
The aim of this study was to investigate the effectiveness of PNF and conventional neck stretching, combined with a postural education program in improving forward head posture in students with clinical signs and symptoms of UCS. The study included a sample of undergraduate Gulf Medical University students with clinical signs and symptoms of UCS. A total of 24 samples were divided into two groups of 12. Group A received PNF pattern neck stretching and self-resisted neck PNF pattern, whereas Group B received Conventional neck stretches along with isometric strengthening of the neck muscles. Both groups were given a common postural education program. The intervention duration was 5 days per week for 4 weeks.
Detailed description
Collegiate students are prone to adopt slouched posture and develop muscular imbalance which is considered as a causative factor for the development of UCS. Studies have shown that students in medical universities have a higher risk of developing UCS. Even though PNF is considered to be simple and effective to improve inter and intramuscular coordination, its application to collegiate students with UCS is limited. Application of PNF combined with postural education programs may benefit the students to reduce UCS-associated clinical problems such as reduced forward head posture, pain intensity and improving muscle strength etc. Our current study might open the door of simple and effective management of UCS among collegiate students. Therefore, our study was conducted to find out the effect of PNF and active muscle stretching, both in combination with postural education programs, on forward head posture of the students with upper crossed syndrome.
Objectives:
● To compare the effect of PNF with active muscle stretching, both in combination with postural education programs on forward head posture of students with upper cross syndrome.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind (outcomes assessor)
- Number of arms
- 2
- Model description
- Group A, who were assigned the PNF neck pattern intervention, a rhythmic initiation technique was implemented. Group B were assigned active neck muscle stretching as well as self-isometric strengthening exercises, targeting all cervical muscle groups.
| Arm | Type | Receives |
|---|---|---|
| Group A: PNF with postural education | Experimental | Other: Proprioceptive neuromuscular facilitation with postural educationPNF neck pattern intervention with a rhythmic initiation technique implemented. This exercise intervention consisted of a two-phase exercise set: stretching the muscles and strengthening them |
| Group B: Active neck muscle stretching and strengthening exercises | Active comparator | Other: Active neck muscle stretching and strengthening exercisesActive neck muscle stretching and self-isometric strengthening exercises, targeting all cervical muscle groups. |
Who may qualify
- Ages
- 18 to 30 years
- Sex
- All
- Healthy volunteers
- Accepted
- Age groups
- Adult
Key inclusion criteria (5 listed)
- Students of Gulf Medical University.
- Both genders.
- Age between 18 - 30 years.
- Presence of clinical signs and symptoms of UCS.
- Presence of FHP with CVA of 49 degrees and below.
Key exclusion criteria (6 listed)
- Musculoskeletal disorder such as strain, sprain, scoliosis.
- Students participating in any other interventions.
- Nutritional deficiencies.
- Unwilling participate.
- Degenerative joint disorder
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 |
|---|---|---|
| Proprioceptive neuromuscular facilitation with postural educationPhase 1: Active Rhythmic Initiation The exercise was demonstrated to the students in a seated position, as sitting is considered the functional position for neck motion and stability. Then, the exercises was passively practiced on the students using tactile input. After passive demonstration, students were asked to perform the same exercise actively and verbal commands were used to guide and correct them. Phase 2: Resisted Rhythmic Initiation "Modified" The investigators applied resistance by placing the palm of one hand on the right side of the chin to strengthen the muscles. Then, resisted scapular posterior depression PNF exercise also employed. Also received a comprehensive postural education program to emphasize the importance of proper posture. The program was divided into three sections, which focused on the effects of good and bad posture, as well as practical demonstration. | Other | Group A: PNF with postural education |
| Active neck muscle stretching and strengthening exercisesPhase 1: Active Muscle Stretching In this phase, participants were instructed on performing active muscle stretching exercises for all cervical muscles, including neck flexors, extensors, lateral flexors and neck rotators. Each stretch was held for a period of 25-30 seconds and repeated three times. Phase 2: Self-Isometric Strengthening Participants were provided with a demonstration of self-isometric strengthening exercise for the neck muscles. The exercises involved six movement patterns: cervical flexion, cervical extension, right/left lateral flexion and right/left rotation. For each exercise the participants were required to apply resistance against the direction of movement using their hand without allowing any motion in the neck. Also received a comprehensive postural education program to emphasize the importance of proper posture. The program was divided into three sections, which focused on the effects of good and bad posture, as well as practical demonstration. | Other | Group B: Active neck muscle stretching and strengthening exercises |
Primary outcome
Forward Head Posture
Time frame: Day one before the treatment, Four weeks post treatment.
Measured by using a mobile phone app (physio master) and have taken craniovertebral angle, sagittal head tilt, and, head shoulder angle to identify a forward head posture.
2 secondary outcomes
Trigger point tenderness
Time frame: Day one before the treatment, Four weeks post treatment.
Cervical spine range of motion
Time frame: Day one before the treatment, Four weeks post treatment.
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 27 Nov 2024.
- Individual participant dataSharing planned: No. Data might be shared based on the request
Related trials for Upper Cross Syndrome
Not yet recruitingObservational study
Functional Impact of Psychological Symptoms in Patients With Superior Semicircular Canal Dehiscence Syndrome (SSCD): a National Cross-sectional Study
Superior Semicircular Canal Dehiscence
Recruiting
Effect of Kendall Versus McKenzie Exercises in Patients With Upper Crossed Syndrome
Upper Crossed Syndrome
Not yet recruitingPhase 3
Effect of Botulinum Toxin on Resting Tremor of the Refractory Upper Limb in Parkinsonians
PARKINSON DISEASE (Disorder)
RecruitingObservational study
The Association Between Smartphone Overuse and Mechanical Neck Pain Among Galala University Students
Mechanical Neck Pain, Forward Head Posture (FHP)
Recruiting
Beyond Osteopathic Therapy: Functional Performance Following the Addition of Ujjayi Pranayama in College Students With Upper Cross Syndrome
Upper Cross Syndrome, Spinal Alignment
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.
Ramprasad Muthukrishnan, PhD study chair
Gulf Medical 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 Proprioceptive neuromuscular facilitation with postural education and Active neck muscle stretching and strengthening exercises in people with Upper Cross Syndrome, run by Gulf Medical University at 1 site in United Arab Emirates.
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 27 Nov 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 United Arab Emirates. 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?
Forward Head Posture (time frame: Day one before the treatment, Four weeks post treatment.). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
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 27 Nov 2024.