Effect of Cervicothoracic Mobilization on Upper Crossed Syndrome

NCT ID: NCT05665296

Last Updated: 2023-04-11

Basic Information

• Recruitment Status: UNKNOWN
• Clinical Phase: NA
• Total Enrollment: 60 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2023-04-30
• Study Completion Date: 2023-09-30

Brief Summary

PURPOSE: To investigate the effect of cervicothoracic mobilization on Craniovertebral angle (CVA), sagittal shoulder angle (SSA), kyphotic angle and pain intensity level in upper crossed syndrome.

Detailed Description

Upper crossed syndrome and its associated neck pain is considered to be the fourth most frequent cause of disability with an annual 30% increase in the rate of prevalence. According to the report on Global burden of diseases (GBD) 2010, neck pain is ranked 21st in terms overall burden of diseases. Musculoskeletal pain in the neck and upper limbs is common; population studies suggest that 6-48% of adults have pain in one of these areas .

Recently, joint mobilization has proven to be effective, and it is now frequently used in clinics .Cervical mobilization combined with thoracic mobilization is recommended as a clinical intervention for neck pain patients with forward head posture ( FHP) rather than cervical mobilization alone. This study has two groups; one will receive cervicothoracic Mobilization + conventional treatment and the second will receive conventional treatment for eight weeks.

Conditions

Upper Crossed Syndrome

Study Design

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

Study Groups

cervicothoracic mobilization

This group will receive cervicothoracic mobilization with comprehensive corrective exercise

Group Type: EXPERIMENTAL

cervicothoracic mobilization

Intervention Type: OTHER

Each participant in study group will receive cervicothoracic mobilization (central PA and transverse Grade III or grade IV) with comprehensive corrective exercise. The duration will eight weeks three sessions per week.

CCE

Intervention Type: OTHER

Each participant will receive comprehensive corrective exercise include three phases: Initial phase -Improvement phase and Maintenance phase.

The initial phase exercises progress in frequency and intensity during this phase, as long as participants are able to demonstrate good quality movement. The initial phase duration is 2 weeks and the exercises will be performed for seven sets of 10-s hold .

Improvement phase exercises are progressed by considering individual characteristics of each participant and by observing the overload principle and the progression in the number of repetitions of each set during the 4 weeks of the improvement phase. The exercises will be performed from five sets of ten repetitions to six sets of 15 repetitions .

Maintenance phase exercises:The exercises are the same as in the improvement phase without any progression in intensity and frequency. The maintenance phase duration is 2 weeks

control group: comprehensive corrective exercise (CCE).

This group will receive traditional treatment comprehensive corrective exercise (CCE).

Group Type: ACTIVE_COMPARATOR

CCE

Intervention Type: OTHER

Each participant will receive comprehensive corrective exercise include three phases: Initial phase -Improvement phase and Maintenance phase.

The initial phase exercises progress in frequency and intensity during this phase, as long as participants are able to demonstrate good quality movement. The initial phase duration is 2 weeks and the exercises will be performed for seven sets of 10-s hold .

Improvement phase exercises are progressed by considering individual characteristics of each participant and by observing the overload principle and the progression in the number of repetitions of each set during the 4 weeks of the improvement phase. The exercises will be performed from five sets of ten repetitions to six sets of 15 repetitions .

Maintenance phase exercises:The exercises are the same as in the improvement phase without any progression in intensity and frequency. The maintenance phase duration is 2 weeks

Interventions

cervicothoracic mobilization

Each participant in study group will receive cervicothoracic mobilization (central PA and transverse Grade III or grade IV) with comprehensive corrective exercise. The duration will eight weeks three sessions per week.

Intervention Type: OTHER

CCE

Each participant will receive comprehensive corrective exercise include three phases: Initial phase -Improvement phase and Maintenance phase.

The initial phase exercises progress in frequency and intensity during this phase, as long as participants are able to demonstrate good quality movement. The initial phase duration is 2 weeks and the exercises will be performed for seven sets of 10-s hold .

Improvement phase exercises are progressed by considering individual characteristics of each participant and by observing the overload principle and the progression in the number of repetitions of each set during the 4 weeks of the improvement phase. The exercises will be performed from five sets of ten repetitions to six sets of 15 repetitions .

Maintenance phase exercises:The exercises are the same as in the improvement phase without any progression in intensity and frequency. The maintenance phase duration is 2 weeks

Intervention Type: OTHER

Eligibility Criteria

Inclusion Criteria

1. Age between 20-50 years .

2. Participants will included if their CVA less than 48° ( SSA less than 52°) , as above these values are considered normal and thoracic kyphosis (with flexicurve angle more than 45 degrees) .

3. Subjects who have weakness in deep neck flexors, serratus anterior, middle and lower trapezius and rhomboid muscles and tightness in upper trapezius, levator scapulae, scalene, posterior neck and suboccipital muscles, pectoralis major and minor and sternocleidomastoid muscles.

4. Subject complaining of this symptom for more than 3mothes.

5. Marking pain intensity score visual analog scale (VAS) ≥3 in neck and shoulder

Exclusion Criteria

1. History of surgery or joint diseases of the spine or shoulder.

2. Osteoporosis, or fracture ,cervical instability or any sign those with other contraindications against joint mobilization.

3. Individuals with any cervical condition e.g. radiculopathy, cervical rib, whiplash injury and individuals with any neurological/ condition .

4. History of congenital spinal deformity (congenital scoliosis) .

5. Any malignancy related to soft tissue and joints .

6. Subjects taking analgesics and/or muscle relaxants.

7. pregnancy.

8. Being in weight out of the normal range (18 ≥ BMI ≥ 25).

9. Cognitive impairment and inability to understand the scale.

• Minimum Eligible Age: 20 Years
• Maximum Eligible Age: 50 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Cairo University

OTHER

Sponsor Role: lead

Responsible Party

Reem Mohamed Atta El-Kaffas

assistant lecturer of physical therapy-Benha University

Responsibility Role: PRINCIPAL_INVESTIGATOR

Principal Investigators

Abeer Yamany, professor

Role: STUDY_CHAIR

Professor of physical therapy, Cairo University

Central Contacts

Reem M El-kaffas, ass lecturer

Role: CONTACT

reem_elqaffas@yahoo.com

01124434473

Abeer Yamany, professor

Role: CONTACT

abeer.yamany@pt.cu.edu.eg

01006899872

References

Seidi F, Bayattork M, Minoonejad H, Andersen LL, Page P. Comprehensive corrective exercise program improves alignment, muscle activation and movement pattern of men with upper crossed syndrome: randomized controlled trial. Sci Rep. 2020 Nov 26;10(1):20688. doi: 10.1038/s41598-020-77571-4.

Reference Type: BACKGROUND

PMID: 33244045 (View on PubMed)

Other Identifiers

P.T.REC/012/003840

Identifier Type: -

Identifier Source: org_study_id