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Neck PainNCT07079319

Effects of MET and Biofeedback Strengthening With and Without Kinesiotaping in Upper Crossed Syndrome

A study testing MET + Biofeedback Strengthening + Kinesiotaping and MET + Biofeedback Strengthening in people with Neck Pain, run by Riphah International University at 1 site in Pakistan.

Not yet recruiting

Opening soon. The study is approved but enrolment has not started yet. Sites may already take enquiries.

Sites and contacts
Official record
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Trial summary

This randomised controlled trial will aim to evaluate the combined effects of Muscle Energy Technique (MET) and biofeedback strengthening, with and without Kinesiotaping (KT), on pain, posture, deep neck flexor strength, and functional status in individuals with Upper Crossed Syndrome (UCS). Read more about this study

Who is it for?
Ages 18 to 40 years
Conditions the study is for
Neck Pain
What is being tested?
MET + Biofeedback Strengthening + Kinesiotaping and MET + Biofeedback Strengthening
Could I receive a placebo?
No, everyone receives an active treatment
How many people
58 participants
Where
1 sitePakistan
Study dates
Jul 2025to 30 Nov 2025
Phase
Interventional
Are there results?
Not yet: the study is under way

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 40 years
  • All sexes
  • No healthy volunteers
  • Adult

Who may be able to join

  • Age group between 18-40 years
  • Both males and females
  • NPRS score <7 for more than 2 months
  • NDI score between 15-34
  • Forward neck posture (confirmed by craniovertebral angle <48-50° measured by goniometer)
  • Rounded shoulders posture (confirmed by supine lying test; if the distance between posterior aspect of acromion and plinth is >1 inch or 2.5 cm)
  • Reduced deep neck flexors strength (confirmed by cranio-cervical flexion test (CCFT))

Who cannot join

  • Age less than 18 or more than 40
  • Recent trauma and/or hyper-flexibility
  • History of cervical surgery in the last year
  • History of infection (local or systemic), any dermatological condition tumor, chemotherapy, radiotherapy
  • History of cervical fracture in the last year
  • Radiating pain
  • Positive upper limb tension tests

Trial locations and contacts

1 site in 1 country. Contact the study team or a site near you to ask about taking part.

Samrood Akram, Phd Scholar contact

03324806143

samood.akram@riphah.edu.pk

Amna Zia, Phd Scholar contact

03244686993

amna_zia_17@live.com

Pakistan1 site
  • Horizon Hospital

    Lahore, Punjab Province, 54000

    Irfan Ahmad, 03214722540

Other trials in Pakistan

About this study

Official title: Combined Effects of Muscle Energy Technique and Biofeedback Strengthening With and Without Kinesio Taping on Pain, Muscle Performance and Functional Status in Patients With Upper Crossed Syndrome

This randomised controlled trial will aim to evaluate the combined effects of Muscle Energy Technique (MET) and biofeedback strengthening, with and without Kinesiotaping (KT), on pain, posture, deep neck flexor strength, and functional status in individuals with Upper Crossed Syndrome (UCS). A total of 58 participants aged 18-40 years will be randomly allocated into two groups. Group A will receive MET and biofeedback strengthening, while Group B will receive the same intervention with the addition of KT. Treatments will be administered three times per week over a four-week period. Outcome measures will include the Numeric Pain Rating Scale (NPRS), Neck Disability Index (NDI), craniovertebral angle (CVA), rounded shoulder posture (RSP), and cranio-cervical flexion test (CCFT) using a pressure biofeedback unit. It is hypothesised that the addition of KT will result in greater improvements in pain reduction and postural correction compared to MET and biofeedback alone.

Read the detailed description

This study will be a single-blinded, two-arm randomized controlled trial designed to evaluate the effects of combining Muscle Energy Technique (MET) and biofeedback-based strengthening exercises, with and without Kinesiotaping (KT), on pain intensity, postural correction, muscle performance, and functional status in individuals diagnosed with Upper Crossed Syndrome (UCS). UCS is a common postural dysfunction resulting from muscle imbalances in the upper quadrant, often associated with forward head posture, rounded shoulders, and neck pain, particularly in individuals with sedentary lifestyles.

A total of 58 participants between the ages of 18 and 40 years will be recruited through non-probability consecutive sampling from Horizon Hospital, Lahore. Participants who meet the inclusion criteria will be randomly assigned into two groups using computer-generated randomisation. Group A will receive MET and biofeedback strengthening via cranio-cervical flexion exercises. Group B will receive the same interventions with the addition of Kinesiotaping applied to the shoulder girdle. Interventions will be administered three times per week for a duration of four weeks, for a total of 12 sessions. Both groups will receive standard physiotherapy care, including heat application, therapeutic ultrasound, neck isometric exercises, and stretches for superficial neck muscles.

The primary outcomes will include pain measured by the Numeric Pain Rating Scale (NPRS), disability assessed using the Neck Disability Index (NDI), and postural parameters including craniovertebral angle (CVA) and rounded shoulder posture (RSP) assessed with a goniometer and measuring tape respectively. Deep neck flexor strength will be measured using the cranio-cervical flexion test (CCFT) with a pressure biofeedback unit (PBU).

Statistical analysis will be conducted using SPSS v25.0. The normality of the data will be assessed via the Kolmogorov-Smirnov test. Non-parametric tests (Wilcoxon signed-rank test and Mann-Whitney U test) will be used to evaluate within-group and between-group differences, respectively. The level of significance will be set at p < 0.05.

It is hypothesised that the group receiving MET and biofeedback strengthening with Kinesiotaping will demonstrate greater improvements in pain relief, postural alignment, deep neck flexor strength, and functional status compared to the group receiving MET and biofeedback strengthening alone.

This study aims to contribute to the growing evidence for multimodal physiotherapy interventions in the management of UCS and provide clinical guidance for the use of kinesiotaping as an adjunctive treatment in postural correction.

Conditions
Neck Pain
Being tested
MET + Biofeedback Strengthening + Kinesiotaping, MET + Biofeedback Strengthening
Keywords
Upper Crossed Syndrome, Biofeedback Strengthening, Kinesiotaping, Muscle Energy Technique, Muscle Performance
Medical subject headings
Neck Pain, Oculocerebral hypopigmentation syndrome type Preus

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • MET + Biofeedback Strengthening + KinesiotapingOther

    Participants in this group will receive the same treatment protocol as Arm 1 (MET and biofeedback strengthening), with the addition of Kinesiotaping (KT) applied across the shoulder girdle. KT will be applied with 50-70% stretch from the anterior acromion to the opposite scapula, 3 times per week for 4 weeks. The tape will be worn for 14-16 hours per application. Standard physiotherapy (heat, ultrasound, neck isometrics, and stretching) will also be administered as part of the protocol.

  • MET + Biofeedback StrengtheningOther

    Participants in this group will receive Muscle Energy Technique (MET) for the upper trapezius, levator scapulae, pectoralis major, and pectoralis minor using post-isometric relaxation technique. Additionally, they will perform biofeedback-based cranio-cervical flexion exercises using a pressure biofeedback unit (PBU). The intervention will be administered 3 times per week for 4 weeks, with a total of 12 sessions. Standard physiotherapy (heat application, ultrasound, neck isometrics, and stretching exercises) will also be provided.

Study groups in NCT07079319
Study groupRoleWhat they receive
MET + Biofeedback Strengthening + KinesiotapingExperimentalParticipants in this group will receive the same treatment protocol as Arm 1 (MET and biofeedback strengthening), with the addition of Kinesiotaping (KT) applied across the shoulder girdle. KT will be applied with 50-70% stretch from the anterior acromion to the opposite scapula, 3 times per week for 4 weeks. The tape will be worn for 14-16 hours per application. Standard physiotherapy (heat, ultrasound, neck isometrics, and stretching) will also be administered as part of the protocol.
Receives: Other: MET + Biofeedback Strengthening + Kinesiotaping
MET + Biofeedback StrengtheningActive comparatorParticipants in this group will receive Muscle Energy Technique (MET) for the upper trapezius, levator scapulae, pectoralis major, and pectoralis minor using post-isometric relaxation technique. Additionally, they will perform biofeedback-based cranio-cervical flexion exercises using a pressure biofeedback unit (PBU). The intervention will be administered 3 times per week for 4 weeks, with a total of 12 sessions. Standard physiotherapy (heat application, ultrasound, neck isometrics, and stretching exercises) will also be provided.
Receives: Other: MET + Biofeedback Strengthening

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Numeric Pain Rating Scale - NPRS

    Pain intensity will be measured using the Numeric Pain Rating Scale (NPRS), a validated 11-point scale ranging from 0 (no pain) to 10 (worst imaginable pain). Participants will self-report their pain levels at baseline and after 4 weeks of intervention.

    Measured: Baseline and 4 weeks post-intervention

  2. Craniovertebral Angle (CVA)

    Cervical posture will be assessed using the craniovertebral angle (CVA), measured with a universal goniometer. A greater angle indicates improved head posture. Measurements will be taken at baseline and after 4 weeks of intervention.

    Measured: Baseline and 4 weeks post-intervention

  3. Rounded Shoulder Posture (RSP) Rounded Shoulder Posture (RSP) Rounded Shoulder Posture (RSP)

    Rounded shoulder posture will be evaluated by measuring the distance from the posterior acromion to the plinth in a supine position using a measuring tape. A decrease in distance reflects improved shoulder alignment.

    Measured: Baseline and 4 weeks post-intervention

  4. Deep Neck Flexor Strength (CCFT Score)

    Deep neck flexor strength will be measured using the Craniocervical Flexion Test (CCFT) with a pressure biofeedback unit (PBU). Pressure will be increased in 2 mmHg increments from 20 mmHg to 30 mmHg. The maximum pressure level held for 10 seconds without superficial muscle compensation will be recorded.

    Measured: Baseline and 4 weeks post-intervention

  5. Neck Disability Index - NDI

    The Neck Disability Index (NDI) will be used to evaluate functional disability related to neck pain. It includes 10 sections rated 0-5, with higher scores indicating greater disability. Scores will be recorded at baseline and 4 weeks.

    Measured: Baseline and 4 weeks post-intervention

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted23 Jul 2025
  2. Study startJul 2025 (estimated)
  3. Primary completion15 Nov 2025 (estimated)
  4. Study completion30 Nov 2025 (estimated)

Resources

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, Outcomes assessor
Enrolment
58 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07079319
Sponsor's protocol ID
REC/RCR & AHS/24/0165- Rabia
Status last verified
Jul 2025
First submitted
14 Jul 2025
Last updated
23 Jul 2025
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Dr. Samarjeet Kittad DPC. Prevalence Of Upper Cross Syndrome In Students Studying For Competitive Exams Using Pressure Biofeedback. International Journal of Creative Research Thoughts (IJCRT). June 2023;11(6):g668-g78.

  • Thacker D, Jameson J, Baker J, Divine J, Unfried A. Management of upper cross syndrome through the use of active release technique and prescribed exercises. Logan College of Chiropractic. 2011.

  • Ashfaq R, Riaz H. Effect of Pressure biofeedback training on deep cervical flexors endurance in patients with mechanical neck pain: A randomized controlled trial. Pak J Med Sci. 2021 Mar-Apr;37(2):550-555. doi: 10.12669/pjms.37.2.2343.

    PubMed 33679948
  • Lwin NN, Myint T, Oo WM, San HH, Tun MT. EFFICACY ON PRESSURE-BIOFEEDBACK GUIDED CRANIOCERVICAL FLEXION EXERCISE IN NECK PAIN: A RANDOMIZED CONTROLLED TRIAL. Journal of Musculoskeletal Research.0(0):2150013.

  • A Rayjade TY, R Chintamani, N Joshi. Comparative effectiveness of Kinesio taping and Ift in upper cross syndrome-A randomized clinical trial. Indian Journal of Forensic Medicine & Toxicology. 2020;14(3):127-32.

Questions about this trial

What is this clinical trial studying?

A study testing MET + Biofeedback Strengthening + Kinesiotaping and MET + Biofeedback Strengthening 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 7 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: opening soon, as of the sponsor's last update on 23 Jul 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?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Samrood Akram, Phd Scholar (03324806143, samood.akram@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: Baseline and 4 weeks post-intervention). The study lists 5 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 NCT07079319, 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 23 Jul 2025.

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