The Effectiveness of Muscle Energy Technique Combined With Strengthening of Deep Neck Flexors With and Without Core Stability Exercise in Upper Cross Syndrome Patients.

NCT ID: NCT06139146

Last Updated: 2024-03-21

Basic Information

• Recruitment Status: COMPLETED
• Clinical Phase: NA
• Total Enrollment: 70 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2023-01-20
• Study Completion Date: 2024-01-27

Brief Summary

Upper cross syndrome (UCS) is a common muscles related postural disorder which is increasing every new day that is affecting the health related quality of life. It is most prevalent amongst the individuals who work at computers or laptops, or on desks.

The UCS is caused by poor posture. Weak core musculature leads to poor body posture causing chronic degenerative changes and disturbing body alignment and body equilibrium. Core stability exercises (CSE) are a good strategy to improve body posture. The purpose of this study is to determine the effects of muscle energy technique (MET) combined with the strengthening of deep neck flexors with and without core stability exercise to manage Upper Cross Syndrome (UCS) patients.

Detailed Description

This randomized controlled trial will be conducted at the Dow University of Health Sciences Ojha campus in Karachi, Pakistan. Those patients who fulfill the criteria will be enrolled in physiotherapy OPD and general OPD. Then they will be randomized into two groups as per the random allocation sheet for treatment. Pre- and post-intervention assessment for pain, functional disability, and range of motions will be done by visual analog scale (VAS), neck disability index (NDI), and goniometer.

Analysis of pre- and post-intervention measure analysis will be performed using SPSS version 21.The Sampling technique will be Nonprobability purposive sampling with Sample size of 70 participants (35 in each group).

Intervention: The Participant will be divided into two groups as per the random allocation sheet for treatment. In Group A, the control group will receive a moist heat pack for 20 minutes then muscle energy technique (MET) of the upper trapezius, levator scapula, and pectoralis muscles (major and minor) and strengthening exercise of deep neck flexors. In Group B, the experimental group will receive the same treatment session as the control group along with the Core stability exercise. There will be 12 sessions for each patient, 6 sessions regularly in the 1st week and then 3 sessions per week for the next 2 weeks.

Conditions

Upper Cross Syndrome; Forward Head Posture

Study Design

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

Study Groups

Group A Control

A moist heat pack for 15-20 minutes MET of the upper trapezius, levator scapula and pectoral Major muscles Strengthening exercise of deep neck flexors

Group Type: EXPERIMENTAL

Muscle energy technique (MET)

Intervention Type: OTHER

MET treatment protocol of pectoral major:

The patient's position was supine lying. Starting with the position which took the affected fibres to just short of their restriction barrier, the patient introduced a light contraction involving adduction of the arm against resistance from the therapist for 7-10 seconds. As the patient exhaled the therapist stretched across the new barrier.

MET treatment protocol of upper trapezius:

The patient moved the stabilized shoulder in a shrug motion toward the ear, and the ear toward the shoulder, with a light resistance (20% of possible strength). The contraction was sustained for 7-1 0 seconds MET treatment protocol of levator scapula The patient was in a supine position, with the hand supinated and the arm of the side to be tested extended alongside the trunk.

Strengthening of deep neck flexors: Patient was instructed to his nod head to flatten the neck's curve. 10 reps for 10 sec.

Group B Experimental

A moist heat pack for 15-20 minutes Core stability exercises MET of the upper trapezius, levator scapula and pectoral Major muscles Strengthening exercise of deep neck flexors

Group Type: EXPERIMENTAL

Core stability exercises:

Intervention Type: OTHER

Warm up: The cat and camel stretches

Exercises:

• It included Crook lying, abdominal bracing, and 10 second - 20 repetitions (reps).
• Crook lying, abdominal Bracing with leg lifts holding the position for 3 second for 10 reps.
• Crook lying, abdominal Bracing with bridging with 10 reps with a 10 second hold.
• It included a Quadruped position with abdominal bracing for 10 s - 10 reps
• Quadruped position arm lifts with abdominal bracing 10 reps on each side.
• Quadruped position leg lifts with abdominal bracing 10 reps on each side.
• Quadruped position alternate arm and leg lifts with abdominal bracing holding position for 3 s - 10 reps on each side.
• The curl-up in hook lying, Fold arms across the torso. Lift shoulder blades off the ground. 1 to 2 seconds holds - 10 reps.
• Side plank on knees; holding position for 10 s - 5 reps .

Interventions

Muscle energy technique (MET)

MET treatment protocol of pectoral major:

The patient's position was supine lying. Starting with the position which took the affected fibres to just short of their restriction barrier, the patient introduced a light contraction involving adduction of the arm against resistance from the therapist for 7-10 seconds. As the patient exhaled the therapist stretched across the new barrier.

MET treatment protocol of upper trapezius:

The patient moved the stabilized shoulder in a shrug motion toward the ear, and the ear toward the shoulder, with a light resistance (20% of possible strength). The contraction was sustained for 7-1 0 seconds MET treatment protocol of levator scapula The patient was in a supine position, with the hand supinated and the arm of the side to be tested extended alongside the trunk.

Strengthening of deep neck flexors: Patient was instructed to his nod head to flatten the neck's curve. 10 reps for 10 sec.

Intervention Type: OTHER

Core stability exercises:

Warm up: The cat and camel stretches

Exercises:

• It included Crook lying, abdominal bracing, and 10 second - 20 repetitions (reps).
• Crook lying, abdominal Bracing with leg lifts holding the position for 3 second for 10 reps.
• Crook lying, abdominal Bracing with bridging with 10 reps with a 10 second hold.
• It included a Quadruped position with abdominal bracing for 10 s - 10 reps
• Quadruped position arm lifts with abdominal bracing 10 reps on each side.
• Quadruped position leg lifts with abdominal bracing 10 reps on each side.
• Quadruped position alternate arm and leg lifts with abdominal bracing holding position for 3 s - 10 reps on each side.
• The curl-up in hook lying, Fold arms across the torso. Lift shoulder blades off the ground. 1 to 2 seconds holds - 10 reps.
• Side plank on knees; holding position for 10 s - 5 reps .

Intervention Type: OTHER

Other Intervention Names

Strengthening of deep neck flexors; Moist heat pack

Eligibility Criteria

Inclusion Criteria

• Participants who were diagnosed or referred with UCS
• The participant with the age of 18 - 45 years old.
• Both male and female.
• Craniovertebral angle less than 48.
• Restricted cervical range of motion.

Exclusion Criteria

• • Participants who were diagnosed with: Inflammatory/Rheumatoid Arthritis , neurological disorders, History of trauma or fracture with cervical spine, Cervical spine surgery or trauma or any spinal Congenital deformities.

• Minimum Eligible Age: 18 Years
• Maximum Eligible Age: 45 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Dow University of Health Sciences

OTHER

Sponsor Role: lead

Responsible Party

DR. SUNDUS NAZ

Principal Investigator

Responsibility Role: PRINCIPAL_INVESTIGATOR

Locations

Dr. SUNDUS NAZ

Karachi, Sindh, Pakistan

Countries

Pakistan

Other Identifiers

2695

Identifier Type: -

Identifier Source: org_study_id