Effects of IASTM Along With Comprehensive Corrective Exercise Program in Upper Cross Syndrome.

NCT ID: NCT06302972

Last Updated: 2024-04-19

Basic Information

• Recruitment Status: RECRUITING
• Clinical Phase: NA
• Total Enrollment: 44 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2023-10-30
• Study Completion Date: 2024-06-30

Brief Summary

This study will see the effects of IASTM along with comprehensive corrective exercise program in upper cross syndrome through their effects on pain and cervical ranges as well as postural improvement. Our study targets both male and female population. In the reference study only male population was targeted which did not show effects of both techniques on the female population though females have high stress levels which may alter results.

Detailed Description

The upper cross syndrome involves stiffness of levator scapulae, pectoralis major and upper trapezius muscles and serratus anterior, deep neck flexors, rhomboids, middle and lower trapezius and scalene muscles weakness. Numerous bodily abnormalities such as headache, early deterioration of cervical spine and loss of cervical spine curve can be brought on by this syndrome. This syndrome can also result in thoracic spine abnormality and impaired glenohumeral joint biomechanics. Upper cross syndrome develops abnormality in head, neck and shoulder and develops in upper 1⁄4 of the trunk. The underlying causative agents of Upper cross syndrome are long surgeries, weakness, female gender, disability and poor posture. It was a randomized, controlled trial, conducted among patient with upper cross syndrome with Sample size was 44 by using G- Power software. Group A will be given IASTM with Graston's tool and comprehensive corrective exercise program and Group B will receive only comprehensive corrective exercise program. The protocol will consist of 12 sessions in total with 3 sessions a week 45 minutes / session for both groups. Assessment will be at baseline then after 2 weeks after that 2 weeks home plan for exercises and then after 4 weeks assessment will be done. Only pain will be assessed on alternative days

Conditions

Upper Cross Syndrome

Study Design

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

Study Groups

IASTM and CCEP

Instrument Assisted Soft Mobilization Technique; For pectoralis major:

Subjects will be asked to lay supine with their thorax front side exposed. In abduction, restriction or adhesions will be located using scanning and gel will be applied. IASTM also address soft tissue restrictions and pain in levator scapulae, suboccipital muscles and sternocleidomastoid muscle.

The CCEP will be designed in three phases, including initial, improvement, and maintenance.. The exercises in appropriate muscles in correct alignment during the movement pattern, the protocol focused on improving sustained postures.

Exercises in initial phase protocol from 10 s hold x7 to 15 s hold x 10 from roller Exercises in improvement phase protocol from 10 repetition x 5 to 15 repetition x 6 from dumbbell , thera band, swiss ball and balance board

Group Type: EXPERIMENTAL

IASTM and CCEP

Intervention Type: OTHER

Instrument Assisted Soft Mobilization Technique (IASTM); For pectoralis major:

Subjects will be asked to lay supine with their thorax front side exposed. In abduction, restriction or adhesions will be located using scanning and gel will be applied. IASTM also address soft tissue restrictions and pain in levator scapulae, suboccipital muscles and sternocleidomastoid muscle.

The Comprehensive Corrective Exercise Program (CCEP) will be designed in three phases, including initial, improvement, and maintenance.. The exercises in appropriate muscles in correct alignment during the movement pattern, the protocol focused on improving sustained postures.

Exercises in initial phase protocol from 10 s hold x7 to 15 s hold x 10 from roller Exercises in improvement phase protocol from 10 repetition x 5 to 15 repetition x 6 from dumbbell , thera band, swiss ball and balance board

Comprehensive Corrective Exercise Program.Type

The CCEP will be designed in three phases, including initial, improvement, and maintenance. Exercises are progressed in frequency and intensity during these phases, as long as the movements are performed in a good quality. The exercises in appropriate muscles in correct alignment during the movement pattern, the protocol focused on improving sustained postures. This goal was addressed in the improvement phase when necessary tissue adaptations occurred by increasing the load of exercises. In the maintenance phase, the participant continued to do the exercises and maintain the training adaptations for two weeks. The exercises will be the same as the improvement phase without any progression in intensity and frequency.

Exercises in initial phase protocol from 10 s hold x7 to 15 s hold x 10 from roller Exercises in improvement phase protocol from 10 repetition x 5 to 15 repetition x 6 from dumbbell , thera band, swiss ball and balance board

Group Type: ACTIVE_COMPARATOR

Traditional treatment

Intervention Type: OTHER

Hot Pack will be applied at the beginning of the session for 10 minutes. Wall corner stretching exercises, neck isometric exercises and neck stretching exercises will be performed Cold pack will be applied at the end of the session for a few minutes.

Interventions

Traditional treatment

Hot Pack will be applied at the beginning of the session for 10 minutes. Wall corner stretching exercises, neck isometric exercises and neck stretching exercises will be performed Cold pack will be applied at the end of the session for a few minutes.

Intervention Type: OTHER

IASTM and CCEP

Instrument Assisted Soft Mobilization Technique (IASTM); For pectoralis major:

Subjects will be asked to lay supine with their thorax front side exposed. In abduction, restriction or adhesions will be located using scanning and gel will be applied. IASTM also address soft tissue restrictions and pain in levator scapulae, suboccipital muscles and sternocleidomastoid muscle.

The Comprehensive Corrective Exercise Program (CCEP) will be designed in three phases, including initial, improvement, and maintenance.. The exercises in appropriate muscles in correct alignment during the movement pattern, the protocol focused on improving sustained postures.

Exercises in initial phase protocol from 10 s hold x7 to 15 s hold x 10 from roller Exercises in improvement phase protocol from 10 repetition x 5 to 15 repetition x 6 from dumbbell , thera band, swiss ball and balance board

Intervention Type: OTHER

Eligibility Criteria

Inclusion Criteria

Age 18-40 years.

• Diagnosed patients with the upper crossed syndrome who have chronic neck
• pain for more than 3 months.
• Having neck pain scoring more than 3 on the Numeric Pain Scale were included
• in this study.
• Any abnormality in the position and rhythm of the scapula, as measured by the Scapular dyskinesis test, having postural changes such as excessive thoracic kyphosis (≥42°), forward head (≥44°) or round shoulder (≥49°) as measured by Flexicurve and photogrammetry.
• Both male and female population will be included

Exclusion Criteria

The subjects with any previous surgery, any type of Infection Hypersensitive skin Diabetes Mellitus type II Having Traumatic Injury Psychological disorder Manual Therapy contraindication like osteoporosis, infection, Disc- Herniation acute Inflammation, burn scars, closed /non-complicated fractures and open wound.

• Minimum Eligible Age: 18 Years
• Maximum Eligible Age: 40 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Riphah International University

OTHER

Sponsor Role: lead

Responsible Party

Responsibility Role: SPONSOR

Principal Investigators

Nadia Ishtiaq, MSOMPT

Role: PRINCIPAL_INVESTIGATOR

Riphah International university Islamabad

Locations

Maroof international Hospital and Railway Hospital

Islamabad, Federal, Pakistan

Site Status: RECRUITING

Countries

Pakistan

Central Contacts

Rida Alam, MSOMPT

Role: CONTACT

nadia.ishtiaq@riphah.edu.pk

03359635579

References

Dehdilani M, Gol MK, Hashemzadeh K. Effects of Stretching Exercises on Upper Crossed Syndrome in Women after a Coronary Artery Bypass Graft. Crescent Journal of Medical & Biological Sciences. 2019 Jul 1;6(3).

Reference Type: BACKGROUND

Mahmood T, Afzal MW, Waseem I, Arif MA, Mahmood W. Comparative Effectiveness of Routine Physical Therapy with and without Instrument Assisted Soft Tissue Mobilization for Improving Pain and Disability in Patients with Neck Pain Due to Upper Crossed Syndrome. Annals of Punjab Medical College (APMC). 2022 Mar 31;16(1):45-50.

Reference Type: BACKGROUND

Page P. Cervicogenic headaches: an evidence-led approach to clinical management. Int J Sports Phys Ther. 2011 Sep;6(3):254-66.

Reference Type: BACKGROUND

PMID: 22034615 (View on PubMed)

Gull M, Akbar UU, Asim HM. FREQUENCY OF CHRONIC NECK PAIN IN UPPER CROSS SYNDROME IN FEMALE SCHOOL TEACHERS. Independent Journal of Allied Health Sciences. 2018;1(01):33-8.

Reference Type: BACKGROUND

Ali S, Ahmad S, Jalal Y, Shah B. Effectiveness of Stretching Exercises Versus Muscle Energy Techniques in the Management of Upper Cross Syndrome: JRCRS. 2017; 5 (1): 12-16. Journal Riphah College of Rehabilitation Sciences. 2017 Mar 10;5(1):12-6.

Reference Type: BACKGROUND

El-Hafez HM, Hamdy HA, Takla MK, Ahmed SEB, Genedy AF, Abd El-Azeim ASS. Instrument-assisted soft tissue mobilisation versus stripping massage for upper trapezius myofascial trigger points. J Taibah Univ Med Sci. 2020 Mar 6;15(2):87-93. doi: 10.1016/j.jtumed.2020.01.006. eCollection 2020 Apr.

Reference Type: BACKGROUND

PMID: 32368203 (View on PubMed)

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

RCRAHS-ISB/REC/MS-PT/01771

Identifier Type: -

Identifier Source: org_study_id