Effects of Bruegger's Versus Kendall Exercises in Cervical Postural Syndrome

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

26 participants

Study Classification

INTERVENTIONAL

Study Start Date

2024-12-15

Study Completion Date

2025-05-07

Brief Summary

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Cervical Postural Syndrome is an uncomfortable and painful condition characterized by a protruding chin and rounded shoulders, commonly resulting from poor posture in the neck, middle back, and shoulders. This syndrome often leads to an excessive forward curvature of the upper back, causing the chin to jut forward and the shoulders to hunch forward. A prevalent cervical abnormality associated with this condition is the forward head position, which increases the risk of neck pain. The entire clinical condition is referred to as "sterno-symphyseal syndrome" by Bruegger. He describes the muscles involved as "painfully tense and painfully weak." Bruegger's exercises are designed to align the spine correctly by strengthening the scapular and neck muscles. Similarly, Kendall's exercises focus on restoring cervical spine alignment, particularly for individuals with forward head posture, by targeting the shoulder extensors and deep neck flexors. While numerous studies have examined the direct effects of forward head posture on the cervical spine, there is limited research comparing the effectiveness of Bruegger's exercises and Kendall's exercises, particularly regarding exercises that do not directly target the neck.

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Detailed Description

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Cervical Postural Syndrome is a common and painful condition characterized by a projecting chin and rounded shoulders, resulting from poor posture in the neck, middle back, and shoulders. This syndrome often causes an exaggerated forward curvature of the upper back, leading to a forward-protruding chin and forward-sitting shoulders. The forward head position is a prevalent cervical issue that increases the risk of neck pain. Bruegger refers to this condition as "sterno-symphyseal syndrome," describing the involved muscles as "painfully tense and painfully weak." Bruegger's exercises aim to correct spinal alignment by strengthening the scapular and neck muscles. Kendall's exercises focus on restoring cervical spine alignment, especially for those with forward head posture, by strengthening the shoulder extensors and deep neck flexors. While many studies have examined the direct impact of forward head posture on the cervical spine, there is limited research comparing the effectiveness of Bruegger's exercises and Kendall's exercises, particularly for exercises that do not directly target the neck.

The objective of this study will be to compare the effects of Bruegger's exercises and Kendall's exercises on pain, range of motion, craniovertebral angle, and functional disability in patients with Cervical Postural Syndrome.

A randomized clinical trial will be conducted at Rasheed Hospital, using a non-probability convenient sampling technique on 36 patients who will be divided into two groups. One group will follow the Bruegger's exercises protocol, while the other group will follow Kendall's exercises. The protocol duration will be six weeks, with sessions three times a week. Each session will consist of one set of 10 repetitions for each movement, repeated for three sets, with a 10-second rest per repetition, a one-minute rest after each set, and a three-minute rest between each movement. Outcome measures will include pain, range of motion, craniovertebral angle, and functional disability. Data will be collected before and after the training sessions. The data will be entered and analyzed using SPSS version 25, and the Shapiro-Wilk test will be applied to determine the normality of the data.

Conditions

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Neck Pain

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Outcome Assessors

Study Groups

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Brugger's Exercises

Participants will receive Burger Exercise

Group Type EXPERIMENTAL

Brugger's Exercises

Intervention Type OTHER

1. The participant will sit upright and wrap an elastic resistance band around each hand, leaving the palms open. They will perform thumb and finger abduction and extension, wrist extension, and forearm supination. This will be followed by scapular retraction with shoulder external rotation, elbow extension, shoulder abduction, and extension, holding this position for 10 seconds.
2. In both sitting and standing positions, the participant will sit at the edge of a seat, naturally lifting the sternum, with legs spread at a 45-degree angle and feet slightly turned out. Shoulders should be relaxed, chin tucked, and elbows fully extended. The participant will keep their shoulders down, imagining the scapulae pressing together and downward into a V shape, with thumbs turned out, palms up, and fingers spread. This position is held for 10 seconds.

KENDALL EXERCISE

Participants will receive Kendal Exercise

Group Type ACTIVE_COMPARATOR

Kendal Exercise

Intervention Type OTHER

1. In a supine position, the participant will place a towel around their neck. With their head on the floor, they will tuck their chin and use the towel to apply gentle resistance, holding for 10 seconds to strengthen the deep flexor muscles of the cervical spine.
2. In a prone position, the participant will point their thumbs toward the ceiling and extend their arms fully while leaning forward, then return to the starting position. They will then extend their arms horizontally and hold for 10 seconds.
3. The participant will place both hands on the back of their head, lift their elbows upward, pull them back, and simultaneously spread their arms out to the side. This position will be held for 10 seconds before returning to the starting position.

Interventions

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Brugger's Exercises

1. The participant will sit upright and wrap an elastic resistance band around each hand, leaving the palms open. They will perform thumb and finger abduction and extension, wrist extension, and forearm supination. This will be followed by scapular retraction with shoulder external rotation, elbow extension, shoulder abduction, and extension, holding this position for 10 seconds.
2. In both sitting and standing positions, the participant will sit at the edge of a seat, naturally lifting the sternum, with legs spread at a 45-degree angle and feet slightly turned out. Shoulders should be relaxed, chin tucked, and elbows fully extended. The participant will keep their shoulders down, imagining the scapulae pressing together and downward into a V shape, with thumbs turned out, palms up, and fingers spread. This position is held for 10 seconds.

Intervention Type OTHER

Kendal Exercise

1. In a supine position, the participant will place a towel around their neck. With their head on the floor, they will tuck their chin and use the towel to apply gentle resistance, holding for 10 seconds to strengthen the deep flexor muscles of the cervical spine.
2. In a prone position, the participant will point their thumbs toward the ceiling and extend their arms fully while leaning forward, then return to the starting position. They will then extend their arms horizontally and hold for 10 seconds.
3. The participant will place both hands on the back of their head, lift their elbows upward, pull them back, and simultaneously spread their arms out to the side. This position will be held for 10 seconds before returning to the starting position.

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Age range: 20-40
* A patient who has neither "specific pain" nor "poor posture."
* A cranio-vertebral angle (CVA) of less than 52 degrees
* A Numeric Pain Rating Scale (NPRS) score of fewer than 7
* A Neck Disability Index score of greater than 10 (NDI)

Exclusion Criteria

* Surgery on the neck or back
* Recent trauma history
* Malignancy
* Cervical dysfunction-related neurological symptoms
* Temporomandibular joint surgery
* Recent fractures or injuries

Minimum Eligible Age

20 Years

Maximum Eligible Age

40 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No