Upper Cross SyndromeNCT07017738
Effect of Neural Mobilization in Upper Cross Syndrome
A study testing Corrective exercises and Neural mobilization in people with Upper Cross Syndrome, run by Cairo University at 1 site in Egypt.
Trial summary
The purpose of this study is to investigate the effect of Neural Mobilization in patients with Upper Cross Syndrome. Read more about this study
- Who is it for?
- Ages 20 to 50 years
- Conditions the study is for
- Upper Cross Syndrome
- What is being tested?
- Corrective exercises and Neural mobilization
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 60 participants
- Where
- 1 siteEgypt
- Study dates
- 10 Jun 2025to 15 Dec 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 50 years
- All sexes
- No healthy volunteers
- Adult
Who may be able to join
- Age ranged from 20 to 50 years.
- Body Mass Index ≤30 kg/m².
- All participants have a forward head, craniovertebral angle < 50°.
- All participants have round back (kyphosis angle ≥ 42°).
- All participants have rounded shoulders of ≥ 52°.
- The subjects were chosen from both genders based on an assessment of upper cross syndrome by photogrammetric analysis.
- All participants have pain intensity level measured by visual analogue scale (4-8).
- All participants tested positive for upper limb tension test of median nerve.
Who cannot join
- History of trauma or surgery in the cervical region.
- Bone fractures or acute soft tissue injuries.
- Osteoporosis.
- Pregnant women.
- Cancer.
- Neurological conditions affecting cervical and thoracic spine.
- Connective tissue disease: This includes diseases such as osteomyelitis, lupus, and scleroderma.
Trial locations and contacts
1 site in 1 country.
About this study
The purpose of this study is to investigate the effect of Neural Mobilization in patients with Upper Cross Syndrome.
Read the detailed description
Upper cross syndrome (UCS) is the tightness of the levator scapulae, pectoralis major, and upper trapezius whereas inhibition of serratus anterior, deep neck flexors more specifically scalene, middle trapezius, lower trapezius, and rhomboids. This condition is given its name because a cross can be drawn across the upper body. One arm of the cross indicates the tight muscles and the other arm of the cross indicates the inhibited muscles.
People suffering from UCS present with a forward head posture (FHP), hunching of the thoracic spine (rounded upper back), elevated and protracted shoulders, scapular winging, and decreased mobility of the thoracic spine. Sometimes, manual work can cause musculoskeletal disorders, for example, the workers who do their work in awkward positions repeat the same action throughout their workday.
It was found that UCS causes pain among 24.3% of drivers. Also, 35.9% of office workers suffer from the upper cross syndrome and body posture was the leading cause. Housewives were also suffering from upper cross syndrome. The reason behind this is that during household tasks they don't keep a good posture which causes them pain and other difficulties.
Patients complaining of non-traumatic neck pain tend to keep the forward head posture, when compared to people without pain.
Rounded shoulder has been identified as a leading cause of upper quarter pain. Kyphosis, by both clinical and quantitative assessment, causes diminished function especially in tasks that require mobility.
The effect of neural mobilization in various diseases and conditions includes increasing nerve conduction and functional status, decreasing pain and subjective symptoms.
Accordingly, there are no available studies in the literature investigating the effect of neural mobilization on the upper cross syndrome, therefore this is the purpose of the study.
- Conditions
- Upper Cross Syndrome
- Being tested
- Corrective exercises, Neural mobilization
- Medical subject headings
- Oculocerebral hypopigmentation syndrome type Preus
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Corrective exercisesOther
The corrective exercise program will include various positions: in standing, scapular retraction and arms overhead; in sitting, chin tuck and thoracic extension; in supine, arms in a W shape and horizontal abduction with external rotation; in side-lying, forward flexion starting with arms parallel to the body; and in prone, scapular retraction and depression in a T shape, extension from 90° forward flexion, and horizontal abduction at 90° with external rotation. Exercises will start with three repetitions held for 10 seconds and progress to six repetitions held for 25 seconds, based on overload principles and individual needs. Participants experiencing pain may stop and rest until symptoms subside.
Neural mobilizationOther
Median nerve mobilization will be performed with the patient in a supine position, shoulder abducted to 90°, elbow flexed at 90°, and both wrist and head in a neutral position. The therapist will mobilize the nerve by extending the elbow to 45°, while the patient performs ipsilateral cervical lateral flexion to unload the nervous system.
| Study group | Role | What they receive |
|---|---|---|
| Neural mobilization + Corrective exercises | Experimental | They will receive neural mobilization in addition to corrective exercises for UCS, 3 times per week for 6 weeks. Receives: Other: Corrective exercises; Other: Neural mobilization |
| Corrective exercises | Active comparator | They will receive corrective exercise for UCS, 3 times per week for 6 weeks. Receives: Other: Corrective exercises |
What is being measured
The primary outcome is the main question the study is designed to answer.
Forward head angle
The forward head angle between the line connecting the tragus and C7 with the perpendicular line will be measured for all participants in both groups pre- and post-treatment, using the photogrammetric method.
Measured: 6 weeks
Rounded shoulder angle
The rounded shoulder angle between the line between the acromion process and C7 with the perpendicular line will be measured for all participants in both groups pre- and post-treatment, using the photogrammetric method.
Measured: 6 weeks
Kyphosis angle
For the kyphosis angle, the bone marker on the spinous process of C7 will be used as the starting point of the arch and the spinous process of T12 will be used as the endpoint of the arch. It will be measured for all participants in both groups pre- and post-treatment, using the photogrammetric method.
Measured: 6 weeks
Secondary outcomes (1)
Boston Questionnaire (Arabic version)
The Boston Questionnaire is a patient-reported outcome measure that has demonstrated reliability, validity, and responsiveness to both surgical and non-surgical treatments. The Arabic version has also been shown to be reliable and valid among Arabic-speaking patients. The questionnaire consists of two separate scales: the Symptom Severity Scale (SSS), which includes 11 questions, and the Functional Status Scale (FSS), which includes 8 items. Respondents rate the difficulty of each item using a five-point scale. Higher scores indicate greater symptom severity or functional impairment.
Measured: 6 weeks
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted12 Jun 2025
- Study start10 Jun 2025
- Primary completion10 Dec 2025
- Study completion15 Dec 2025
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.
- More trials run by Cairo 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
- 60 participants (actual)
Sponsor and investigators
- Lead sponsor
- Cairo University
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Essam Ahmed Abdelbaky Abdelbaky, Cairo University
- Investigators
- Abeer Abdelrahman, PhD, Study chair, Professor, Cairo university
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07017738
- Sponsor's protocol ID
- P.T.REC/012/005577
- Status last verified
- Jan 2026
- First submitted
- 4 Jun 2025
- Last updated
- 9 Jan 2026
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
Study at a glance
From the registry record, last updated by the sponsor on 9 Jan 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Effect of Neural Mobilization in Upper Cross Syndrome
- ClinicalTrials.gov ID
- NCT07017738
- Acronym / sponsor ID
- P.T.REC/012/005577
- Conditions
- Upper Cross Syndrome
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 60 participants (actual)
- Lead sponsor
- Cairo UniversityUniversity, hospital or other
- Study start
- 10 Jun 2025 (actual)
- Primary completion
- 10 Dec 2025 (actual)
- Study completion
- 15 Dec 2025 (actual)
- First posted
- 12 Jun 2025 (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 purpose of this study is to investigate the effect of Neural Mobilization in patients with Upper Cross Syndrome.
Detailed description
Upper cross syndrome (UCS) is the tightness of the levator scapulae, pectoralis major, and upper trapezius whereas inhibition of serratus anterior, deep neck flexors more specifically scalene, middle trapezius, lower trapezius, and rhomboids. This condition is given its name because a cross can be drawn across the upper body. One arm of the cross indicates the tight muscles and the other arm of the cross indicates the inhibited muscles.
People suffering from UCS present with a forward head posture (FHP), hunching of the thoracic spine (rounded upper back), elevated and protracted shoulders, scapular winging, and decreased mobility of the thoracic spine. Sometimes, manual work can cause musculoskeletal disorders, for example, the workers who do their work in awkward positions repeat the same action throughout their workday.
It was found that UCS causes pain among 24.3% of drivers. Also, 35.9% of office workers suffer from the upper cross syndrome and body posture was the leading cause. Housewives were also suffering from upper cross syndrome. The reason behind this is that during household tasks they don't keep a good posture which causes them pain and other difficulties.
Patients complaining of non-traumatic neck pain tend to keep the forward head posture, when compared to people without pain.
Rounded shoulder has been identified as a leading cause of upper quarter pain. Kyphosis, by both clinical and quantitative assessment, causes diminished function especially in tasks that require mobility.
The effect of neural mobilization in various diseases and conditions includes increasing nerve conduction and functional status, decreasing pain and subjective symptoms.
Accordingly, there are no available studies in the literature investigating the effect of neural mobilization on the upper cross syndrome, therefore this is the purpose of the study.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind (outcomes assessor)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Neural mobilization + Corrective exercises | Experimental | Other: Corrective exercises, Other: Neural mobilizationThey will receive neural mobilization in addition to corrective exercises for UCS, 3 times per week for 6 weeks. |
| Corrective exercises | Active comparator | Other: Corrective exercisesThey will receive corrective exercise for UCS, 3 times per week for 6 weeks. |
Who may qualify
- Ages
- 20 to 50 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult
Key inclusion criteria (8 listed)
- Age ranged from 20 to 50 years.
- Body Mass Index ≤30 kg/m².
- All participants have a forward head, craniovertebral angle < 50°.
- All participants have round back (kyphosis angle ≥ 42°).
- All participants have rounded shoulders of ≥ 52°.
Key exclusion criteria (7 listed)
- History of trauma or surgery in the cervical region.
- Bone fractures or acute soft tissue injuries.
- Osteoporosis.
- Pregnant women.
- Cancer.
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 |
|---|---|---|
| Corrective exercisesThe corrective exercise program will include various positions: in standing, scapular retraction and arms overhead; in sitting, chin tuck and thoracic extension; in supine, arms in a W shape and horizontal abduction with external rotation; in side-lying, forward flexion starting with arms parallel to the body; and in prone, scapular retraction and depression in a T shape, extension from 90° forward flexion, and horizontal abduction at 90° with external rotation. Exercises will start with three repetitions held for 10 seconds and progress to six repetitions held for 25 seconds, based on overload principles and individual needs. Participants experiencing pain may stop and rest until symptoms subside. | Other | Corrective exercises, Neural mobilization + Corrective exercises |
| Neural mobilizationMedian nerve mobilization will be performed with the patient in a supine position, shoulder abducted to 90°, elbow flexed at 90°, and both wrist and head in a neutral position. The therapist will mobilize the nerve by extending the elbow to 45°, while the patient performs ipsilateral cervical lateral flexion to unload the nervous system. | Other | Neural mobilization + Corrective exercises |
Primary outcome
Forward head angle
Time frame: 6 weeks
The forward head angle between the line connecting the tragus and C7 with the perpendicular line will be measured for all participants in both groups pre- and post-treatment, using the photogrammetric method.
Rounded shoulder angle
Time frame: 6 weeks
The rounded shoulder angle between the line between the acromion process and C7 with the perpendicular line will be measured for all participants in both groups pre- and post-treatment, using the photogrammetric method.
Kyphosis angle
Time frame: 6 weeks
For the kyphosis angle, the bone marker on the spinous process of C7 will be used as the starting point of the arch and the spinous process of T12 will be used as the endpoint of the arch. It will be measured for all participants in both groups pre- and post-treatment, using the photogrammetric method.
1 secondary outcome
Boston Questionnaire (Arabic version)
Time frame: 6 weeks
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 9 Jan 2026.
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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.
Abeer Abdelrahman, PhD study chair
Professor, Cairo 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 Corrective exercises and Neural mobilization in people with Upper Cross Syndrome, run by Cairo University at 1 site in Egypt.
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 8 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: finished, as of the sponsor's last update on 9 Jan 2026. 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 Egypt. 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 angle (time frame: 6 weeks). 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?
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 9 Jan 2026; AzTrials last refreshed its copy on 6 Nov 2026.