Comparison Of The Neck And Scapular Proprioceptive Neuromuscular Facilitation Exercises On Postural Disorders, Scapular Dyskinesia And Round Shoulders in Individuals With Cervical Sagittal Alignment Disorder.

NCT ID: NCT04865926

Last Updated: 2022-04-29

Basic Information

• Recruitment Status: COMPLETED
• Clinical Phase: NA
• Total Enrollment: 29 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2021-03-22
• Study Completion Date: 2022-01-30

Brief Summary

In modern society, repetitive and monotonous activities are increasing due to the decrease in general physical activity, the development of the information technology industry, and time culture flow. Therefore, prolonged exposure to unstable or abnormal posture can trigger a chain reaction of poor alignment and imbalance, leading to musculoskeletal diseases such as muscle stiffness or repetitive traumatic injury.

Sagittal cervical malalignment (SCM), and also known as Forward head posture (FHP), is one of the poor posture types of the head commonly seen in the sagittal plane. İt is defined as the forward shift of the head. As the head moves forward, the center of gravity changes. To compensate for this shift in the center of gravity, the upper body slides back and the shoulders move forward, the rounded shoulder develops so that the head is placed in front of the body.

SCM can cause many harmful symptoms such as neck pain, shoulder pain, back pain, chronic headaches, increased curvature of the spine and scapular dyskinesis, and rounded shoulder.

Detailed Description

Proper posture is defined as musculoskeletal balance with minimal stress or strain on the body. The human body is a multi-joint system with kinetic chains controlled by the central nervous system, with a series of joints that interact with muscle activity.

Prolonged exposure to unstable or abnormal posture can trigger a chain reaction of weak alignment and imbalance, leading to musculoskeletal diseases such as muscle stiffness or repeated traumatic injury. Sagittal cervical malalignment (SCM), in other words forward head posture (FHP), is one of the poor posture types of the head commonly seen in the sagittal plane. It is defined as the shift of the center of the head towards the front. As the head moves forward, the center of gravity changes. To compensate for this shift in the center of gravity, the upper body slides back and the shoulders move forward, the rounded shoulder develops so that the head is placed in front of the body.

SCM of the head is defined as the anterior extension of the head with hyperextension of the upper cervical vertebrae (C1-C3) and flexion of the lower cervical vertebrae (C4-C7) and hyperlordosis of the cervical curve. It can be caused by a variety of factors, including Sleeping in positions with an excessive elevation of the head, prolonged use of the computer, and developed back muscle weakness.

SCM can cause many harmful symptoms such as neck pain, shoulder pain, back pain, chronic headaches, increased curvature of the spine and scapular dyskinesia, and rounded shoulder.

The rounded shoulder is a bent posture in which the scapulae are elevated and the acromion protrudes forward compared to the center of gravity of the body. These changes can cause an imbalance of the surrounding muscles and eventually pain in the head, temporomandibular joints, neck, back, shoulders and arms.

Scapular dyskinesia is referred to as visible changes in scapular position and movement patterns. It produces changes in the kinematics of the glenohumeral and acromioclavicular joints and can interfere with the activity of the periscapular muscles and rotator cuffs.7 Proprioceptive neuromuscular facilitation (PNF) methods focus on functional diagonal movement patterns and use cutaneous, visual, and auditory stimulation to improve neuromuscular control and function as well as muscle strength, balance, and flexibility. It is used as a progressive resistance for functional training in therapeutic exercises, improves joint limitations, and strengthens muscles. Scapular and neck PNF patterns are known to increase the stability of the head, neck, and scapular muscles.

Conditions

Forward Head Posture; Sagittal Cervical Malalignment; Rounded Shouler; Scapular Dyskinesis

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: TREATMENT
• Blinding Strategy: SINGLE

Study Groups

Scapular and Neck Proprioceptive Neuromuscular Facilitation Group

Participants in the intervention group will be applied neck and scapular Proprioceptive Neuromuscular Facilitation exercises lasting 40 minutes for 3 sessions a week for 4 weeks.

Group Type: EXPERIMENTAL

Scapular and Neck Proprioceptive Neuromuscular Facilitation exercises

Intervention Type: OTHER

The researcher will perform a total of 12 sessions of scapular and neck pnf exercises for 4 weeks. The participants will apply PNF exercises using rhythmic initiation, rhythmic stabilization and cobination techniques of isotonics. Patterns of anterior elevation, posterior depression, anterior depression, posterior elevation will be used in scapular exercises. Upper cervical flexion, lower cervical flexion, rotation and lateral flexion patterns will be used in neck pnf exercises.

Control Group

McKenzie and Kendall exercises will be given to the participants in the control group. Exercises will be done 3 sessions a week over a 4-week period.

Group Type: EXPERIMENTAL

McKenzie and Kendall exercises

Intervention Type: OTHER

Kendall and Mckenzie exercises will be given to the participants as a home workout. The self-stretch exercise methods are as followed: Placing both hands on the shoulders and pushing out the chest, placing one hand over the shoulder and grasp the elbow of the turned hand, with the other hand over the head and slowly pull it inward, throwback the head until it has reached the fully stretched point, look straight ahead and slowly turn the head horizontally until the maximum value is reached, throwback the head, and turn it until it has reached the fully stretched point, lower the head turn it until it has reached the maximal point. Stretching pectoralis muscle, strengthening shoulder retraction, strengthening the deep cervical flexors, strengthening the deep cervical flexors.

Interventions

Scapular and Neck Proprioceptive Neuromuscular Facilitation exercises

The researcher will perform a total of 12 sessions of scapular and neck pnf exercises for 4 weeks. The participants will apply PNF exercises using rhythmic initiation, rhythmic stabilization and cobination techniques of isotonics. Patterns of anterior elevation, posterior depression, anterior depression, posterior elevation will be used in scapular exercises. Upper cervical flexion, lower cervical flexion, rotation and lateral flexion patterns will be used in neck pnf exercises.

Intervention Type: OTHER

McKenzie and Kendall exercises

Kendall and Mckenzie exercises will be given to the participants as a home workout. The self-stretch exercise methods are as followed: Placing both hands on the shoulders and pushing out the chest, placing one hand over the shoulder and grasp the elbow of the turned hand, with the other hand over the head and slowly pull it inward, throwback the head until it has reached the fully stretched point, look straight ahead and slowly turn the head horizontally until the maximum value is reached, throwback the head, and turn it until it has reached the fully stretched point, lower the head turn it until it has reached the maximal point. Stretching pectoralis muscle, strengthening shoulder retraction, strengthening the deep cervical flexors, strengthening the deep cervical flexors.

Intervention Type: OTHER

Eligibility Criteria

Inclusion Criteria

• Those with a Kraviovertebral angle below 50o.
• Healthy individuals who have not had an upper extremity injury in the last 6 months.
• Has 3 or more pain in VAS for at least 3 months

Exclusion Criteria

• Have received any physiotherapy program in the last 6 months due to neck pain or back pain.
• With structural scoliosis
• Have a history of fracture in the cervical vertebrae
• Have any rheumatic disease affecting the neck
• Having had a cervical spine surgery
• Spinal cord compression from a tumor or other cause
• Those with neurological deficits

• Minimum Eligible Age: 18 Years
• Maximum Eligible Age: 65 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: Yes

Sponsors

Eastern Mediterranean University

OTHER

Sponsor Role: lead

Responsible Party

Responsibility Role: SPONSOR

Locations

Eastern Mediterranean University

Famagusta, , Cyprus

Countries

Cyprus

Other Identifiers

2020-0287

Identifier Type: -

Identifier Source: org_study_id