Upper Crossed SyndromeDNS/NASMNCT07698392
Dynamic Neuromuscular Stabilization Versus Corrective Exercises in Upper Cross Syndrome
A study testing Dynamic neuromuscular stabilization and NASM corrective exercises in people with Upper Crossed Syndrome and Upper Cross Syndrome, run by Cairo University at 1 site in Egypt.
Trial summary
The purpose of the study will be to investigate dynamic neuromuscular stabilization versus National American Academy of Sports Medicine (NASM) corrective exercises on pain, functional disability, cranio-vertebral angle, forward shoulder angle, and thoracic kyphosis in upper cross syndrome. Read more about this study
- Who is it for?
- Ages 20 to 40 years
- Conditions the study is for
- Upper Crossed Syndrome, Upper Cross Syndrome, Upper Crossed Syndorme
- What is being tested?
- Dynamic neuromuscular stabilization and NASM corrective exercises
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 45 participants
- Where
- 1 siteEgypt
- Study dates
- 1 Nov 2026to 30 Sep 2028
- 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 20 to 40 years
- All sexes
- No healthy volunteers
- Adult
Who may be able to join
- Having non-specfic neck Pain.
- Patients having a CVA of < 52 .
- Forward shoulder angle > 52 degrees.
Who cannot join
- Participants having conditions such as osteoporosis, blood disease, congestive heart disease, cancer, severe skin sensitization, major mental disease, and frozen shoulder, will be excluded from the study. Neck pain has a specific underlying pathology such as fractures, rheumatoid arthritis, osteoporosis, or whiplash injuries as well as neck pain associated with radiculopathy.
Trial locations and contacts
1 site in 1 country. Contact the study team or a site near you to ask about taking part.
Egypt1 site
Outpatient clinic at faculty of physical therapy - Cairo University
Cairo, Cairo Governorate, 11432
Passant M Assistant lecturer, MSc, 01004139949, passant.moustafa@cu.edu.eg
Nesreen F Lecturer, PhD, 01127283925, dr_nesreenfawzy@cu.edu.eg
About this study
Official title: Effect of Dynamic Neuromuscular Stabilization Versus Corrective Exercises on Pain, Functional Disability, and Postural Alignment in Upper Crossed Syndrome.
The purpose of the study will be to investigate dynamic neuromuscular stabilization versus National American Academy of Sports Medicine (NASM) corrective exercises on pain, functional disability, cranio-vertebral angle, forward shoulder angle, and thoracic kyphosis in upper cross syndrome.
Read the detailed description
Upper Cross Syndrome (UCS) is a frequent condition that is most commonly encountered in musculoskeletal disorders, showing a typical pattern of imbalance in muscles and neck and shoulder region joint dysfunction. It causes pain in shoulders, upper back, thoracic and cervical spine. It is frequently associated with inadequate posture or forward head position, muscular weakness, and alterations in movement patterns, leading to pain, restricted mobility, and dysfunction in the affected areas of patients suffering from UCS.
Dynamic Neuromuscular Stabilization (DNS) is a developing rehabilitation approach based on reflex locomotion. The idea of reflex locomotion describes particular involuntary motor reactions/movement patterns that occur when firm pressure is applied to specific muscle zones. These movement patterns are standard and referred to as "global patterns". The global pattern generated from the prone position is known as "reflex creeping," whereas the one from the supine or side lying posture is known as "reflex rolling". Furthermore, some motor motions such as gripping, turning, crawling, and eventually walking occur automatically without the need for specific training in normal babies.
The National American Academy of Sports Medicine (NASM) provided a corrective exercise protocol for postural malalignment. It includes 4 steps: inhibition (self-mobilization release technique targeting trigger points), lengthening (stretching techniques for tight muscles), third: activation (strengthening techniques for weak muscles), and integration (retraining all muscles through functionally progressive movements). It was successful in treating UCS.
- Being tested
- Dynamic neuromuscular stabilization, NASM corrective exercises
- 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.
Dynamic neuromuscular stabilizationOther
Dynamic neuromuscular stabilization involves precise co-activation of the intrinsic muscles of the spine which forms the Integrated spinal stabilization system (ISSS) and includes cervical flexors and extensors, diaphragm, transverses abdominis, multifidus and pelvic floor.
NASM corrective exercisesOther
It is corrective exercise protocol, which includes four phases, i.e. inhibit, lengthen, activate, and integrate stage
| Study group | Role | What they receive |
|---|---|---|
| Dynamic neuromuscular stabilization | Experimental | Dynamic neuromuscular stabilization involves precise co-activation of the intrinsic muscles of the spine which forms the Integrated spinal stabilization system (ISSS) and includes cervical flexors and extensors, diaphragm, transversus abdominis, multifidus and pelvic floor.
Participants will receive DNS for 6 weeks. Receives: Other: Dynamic neuromuscular stabilization |
| Corrective exercises | Experimental | National Academy of sports medicine corrective exercises that involve 4 steps : First: Inhibition for tight muscles Second: Lengthening for tight muscles Third: Activation for weak muscles fourth: Intergration to retrain all muscles through functionally progressive movements using integrated dynamic movements.
Participants will receive NASM corrective exercises for 6 weeks. Receives: Other: NASM corrective exercises |
| Combined Dynamic neuromuscular stabilization and corrective exercises group | Experimental | Participants will receive both DNS and NASM for 6 weeks. Receives: Other: Dynamic neuromuscular stabilization; Other: NASM corrective exercises |
What is being measured
The primary outcome is the main question the study is designed to answer.
Neck pain intensity
Neck pain intensity will be measured through Numerical pain rating scale. A scale from 0 to 10, with 0 indicating no pain and 10 signifying excruciating pain.
Measured: At baseline at the first session and reassessed at the end of six weeks of intervention.
Secondary outcomes (4)
Neck disability
The patient will be asked to fill the 10- section of the questionnaire. Higher score indicate higher disability.
Measured: At baseline at the first session and after 6 weeks of intervention.
Craniovertebral angle
craniovertebral angle will be measured using Kinovea software to assess forward head posture
Measured: At baseline and after 6 weeks of intervention
Forward shoulder angle
Forward shoulder angle will be measured using Kinovea software to assess rounded shoulder posture
Measured: At baseline and after 6 weeks of intervention
Thoracic kyphosis angle
Thoracic kyphosis angle will be measured using a bubble inclinometer
Measured: At baseline and after 6 weeks of intervention
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted13 Jul 2026
- Study start1 Nov 2026 (estimated)
- Primary completion1 Feb 2027 (estimated)
- Study completion30 Sep 2028 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Upper Crossed 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
- None (open label)
- Enrolment
- 45 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Cairo University
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Passant Moustafa Kamal Mahmoud Mohamed Zaid, Cairo University
- Investigators
- Karima A Hassan, PhD, Principal investigator, Cairo University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07698392
- Sponsor's protocol ID
- P.T.REC/012/006422
- Acronym
- DNS/NASM
- Status last verified
- Jul 2026
- First submitted
- 8 Jul 2026
- Last updated
- 13 Jul 2026
- Results posted
- No
- Data monitoring committee
- Yes
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Study at a glance
From the registry record, last updated by the sponsor on 13 Jul 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Effect of Dynamic Neuromuscular Stabilization Versus Corrective Exercises on Pain, Functional Disability, and Postural Alignment in Upper Crossed Syndrome.
- ClinicalTrials.gov ID
- NCT07698392
- Acronym / sponsor ID
- DNS/NASM / P.T.REC/012/006422
- Study type
- Interventional
- Recruitment status
- Not yet recruiting
- Enrolment
- 45 participants (estimated)
- Lead sponsor
- Cairo UniversityUniversity, hospital or other
- Study start
- 1 Nov 2026 (estimated)
- Primary completion
- 1 Feb 2027 (estimated)
- Study completion
- 30 Sep 2028 (estimated)
- First posted
- 13 Jul 2026 (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 the study will be to investigate dynamic neuromuscular stabilization versus National American Academy of Sports Medicine (NASM) corrective exercises on pain, functional disability, cranio-vertebral angle, forward shoulder angle, and thoracic kyphosis in upper cross syndrome.
Detailed description
Upper Cross Syndrome (UCS) is a frequent condition that is most commonly encountered in musculoskeletal disorders, showing a typical pattern of imbalance in muscles and neck and shoulder region joint dysfunction. It causes pain in shoulders, upper back, thoracic and cervical spine. It is frequently associated with inadequate posture or forward head position, muscular weakness, and alterations in movement patterns, leading to pain, restricted mobility, and dysfunction in the affected areas of patients suffering from UCS.
Dynamic Neuromuscular Stabilization (DNS) is a developing rehabilitation approach based on reflex locomotion. The idea of reflex locomotion describes particular involuntary motor reactions/movement patterns that occur when firm pressure is applied to specific muscle zones. These movement patterns are standard and referred to as "global patterns". The global pattern generated from the prone position is known as "reflex creeping," whereas the one from the supine or side lying posture is known as "reflex rolling". Furthermore, some motor motions such as gripping, turning, crawling, and eventually walking occur automatically without the need for specific training in normal babies.
The National American Academy of Sports Medicine (NASM) provided a corrective exercise protocol for postural malalignment. It includes 4 steps: inhibition (self-mobilization release technique targeting trigger points), lengthening (stretching techniques for tight muscles), third: activation (strengthening techniques for weak muscles), and integration (retraining all muscles through functionally progressive movements). It was successful in treating UCS.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Number of arms
- 3
| Arm | Type | Receives |
|---|---|---|
| Dynamic neuromuscular stabilization | Experimental | Other: Dynamic neuromuscular stabilizationDynamic neuromuscular stabilization involves precise co-activation of the intrinsic muscles of the spine which forms the Integrated spinal stabilization system (ISSS) and includes cervical flexors and extensors, diaphragm, transversus abdominis, multifidus and pelvic floor. Participants will receive DNS for 6 weeks. |
| Corrective exercises | Experimental | Other: NASM corrective exercisesNational Academy of sports medicine corrective exercises that involve 4 steps : First: Inhibition for tight muscles Second: Lengthening for tight muscles Third: Activation for weak muscles fourth: Intergration to retrain all muscles through functionally progressive movements using integrated dynamic movements. Participants will receive NASM corrective exercises for 6 weeks. |
| Combined Dynamic neuromuscular stabilization and corrective exercises group | Experimental | Other: Dynamic neuromuscular stabilization, Other: NASM corrective exercisesParticipants will receive both DNS and NASM for 6 weeks. |
Who may qualify
- Ages
- 20 to 40 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult
Key inclusion criteria (3 listed)
- Having non-specfic neck Pain.
- Patients having a CVA of < 52 .
- Forward shoulder angle > 52 degrees.
Key exclusion criteria (1 listed)
- Participants having conditions such as osteoporosis, blood disease, congestive heart disease, cancer, severe skin sensitization, major mental disease, and frozen shoulder, will be excluded from the study. Neck pain has a specific underlying pathology such as fractures, rheumatoid arthritis, osteoporosis, or whiplash injuries as well as neck pain associated with radiculopathy.
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 |
|---|---|---|
| Dynamic neuromuscular stabilizationDynamic neuromuscular stabilization involves precise co-activation of the intrinsic muscles of the spine which forms the Integrated spinal stabilization system (ISSS) and includes cervical flexors and extensors, diaphragm, transverses abdominis, multifidus and pelvic floor. | Other | Combined Dynamic neuromuscular stabilization and corrective exercises group, Dynamic neuromuscular stabilization |
| NASM corrective exercisesIt is corrective exercise protocol, which includes four phases, i.e. inhibit, lengthen, activate, and integrate stage | Other | Combined Dynamic neuromuscular stabilization and corrective exercises group, Corrective exercises |
Primary outcome
Neck pain intensity
Time frame: At baseline at the first session and reassessed at the end of six weeks of intervention.
Neck pain intensity will be measured through Numerical pain rating scale. A scale from 0 to 10, with 0 indicating no pain and 10 signifying excruciating pain.
4 secondary outcomes
Neck disability
Time frame: At baseline at the first session and after 6 weeks of intervention.
Craniovertebral angle
Time frame: At baseline and after 6 weeks of intervention
Forward shoulder angle
Time frame: At baseline and after 6 weeks of intervention
Thoracic kyphosis angle
Time frame: At baseline and after 6 weeks of intervention
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 13 Jul 2026.
- Individual participant dataSharing planned: No
Related trials for Upper Crossed Syndrome
Not yet recruiting
Effect of a Comprehensive Corrective Exercise Program With and Without Instrument-Assisted Soft Tissue Mobilization on Cervical Range of Motion, Muscle Strength, Disability, and Postural Alignment in Individuals With Upper-Crossed Syndrome
Upper Crossed Syndrome, Postural Dysfunction
RecruitingObservational study
Cervical Position Sense, Core Stability, and Postural Balance in University Students With Upper Crossed Syndrome
Upper Crossed Syndrome
Active, not recruiting
Dry Cupping Therapy and Muscle Energy Technique on Upper Crossed Syndrome
Upper Crossed Syndrome, Muscle Energy Techniques
Recruiting
Comparative Effects of Kendall and Feldenkrais Exercise in Upper Crossed Syndrome
Upper Crossed Syndrome
Recruiting
Effect of Mat Pilates on Pain and Postural Alignment in School Going Children With Upper Crossed Syndrome.
Children, Only, Upper Crossed Syndrome
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.
Karima A Hassan, PhD principal investigator
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 Dynamic neuromuscular stabilization and NASM corrective exercises in people with Upper Crossed Syndrome and 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 3 inclusion and 1 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 13 Jul 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?
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 Passant M Assistant lecturer, MSc (01004139949, passant.moustafa@cu.edu.eg), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Neck pain intensity (time frame: At baseline at the first session and reassessed at the end of six weeks of intervention.). 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 13 Jul 2026; AzTrials last refreshed its copy on 30 Oct 2026.