Effect Of PNF Techniques Versus CCEP On Pain, Function and Quality of Life In Patients With Upper Cross Syndrome

NCT ID: NCT07058272

Last Updated: 2025-07-10

Basic Information

• Recruitment Status: COMPLETED
• Clinical Phase: NA
• Total Enrollment: 38 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2025-05-08
• Study Completion Date: 2025-07-01

Brief Summary

The study aims to determine which approach either PNF Techniques or Comprehensive Corrective Exercise Protocol provides better outcomes for pain relief, functional improvement, and quality of life in patients with upper cross syndrome.

Detailed Description

Upper crossed syndrome is caused due to altered muscle activation and movement patterns of the neck, shoulders, head and back muscles. In addition to postural deviations (forward head and rounded shoulders, and an excessive curve of the thoracic spine), upper cross syndrome is characterized by abnormal posture brought on by changed muscle activation patterns and varied movement patterns. Most cases of this condition occurred in people over 20. The symptoms of upper cross syndrome managed by correcting posture, stretching and strengthening the affected muscles, and making ergonomic adjustments.

It will be a Randomized Clinical Trial with sample size of 38. They will be randomly allocated into two groups by using chit and draw method. 19 participants in Group 1 will get PNF protocol while 19 participants in Group 2 get CCEP .For eight weeks, each patient will receive four sessions per week through which their neck disability index, visual analogue scale, and quality of life would measure .Data will be collected at the start of the trial, after four weeks of treatment, and again at the end of treatment. In participants with upper cross syndrome, the goal for applying a comprehensive corrective exercise program and a proprioceptive neuromuscular facilitation technique is to alleviate pain and improve functioning, posture, and quality of life.

Conditions

Upper Cross Syndrome

Study Design

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

Study Groups

Group 1

CCEP and TENS

Group Type: ACTIVE_COMPARATOR

Comprehensive corrective exercise protocol

Intervention Type: OTHER

Initial phase exercises include lying supine on a foam roll with the arms in 3 different abduction angles, side-lying external rotation, side-lying forward flexion, standing diagonal flexion , and military press .Initial phase lasts for 2 weeks, with exercises progressing from 7 Reps of 10-second holds to 10 Reps of 15-second hold.

Improvement phase consist of exercises including side-lying external rotation with a dumbbell , side-lying forward flexion with a dumbbell , standing diagonal flexion with a dumbbell, standing external rotation with Thera-Band, standing diagonal flexion with Thera-Band, abduction while sitting on a training ball, prone lying V, T, and W exercises, and standing abduction on a balance board. The improvement phase lasts for 2 weeks, with exercises progressing from seven sets of 10-seconds hold to 10 sets of 15 secs hold.

The exercises in the maintenance phase are the same as those in the improvement phase, with no increase in intensity and frequency

Group 2

PNF and TENS

Group Type: EXPERIMENTAL

Proprioceptive Neuromuscular Facilitation (PNF) Techniques

Intervention Type: OTHER

In this study following PNF Stretching techniques are used

• Hold-relax or Contract-relax
• Hold-relax with agonist contraction In the Hold-Relax or Contract-Relax technique, stretching is performed 4sessions per week for each muscle group, with each session lasting 40 min. The protocol includes a 10-sec hold phase followed by a 10-sec contraction phase, repeated for 7 reps . The total duration of this program is 8weeks including 6 weeks of treatment phase and last 2 weeks of detraining.

In Hold-Relax with Agonist contract, the same procedure is followed as in Hold-Relax method, with 4sessions per week for each muscle group. The patient is asked to hold the initial stretch for 10 sec, followed by a relaxation phase. Afterward, the agonist muscle is contracted to actively move further into the stretch, which is then held for 10 sec. This protocol is performed for 7 reps per session, and the total duration of study is 8 weeks including 6 weeks of treatment program with last 2 weeks

Interventions

Comprehensive corrective exercise protocol

Initial phase exercises include lying supine on a foam roll with the arms in 3 different abduction angles, side-lying external rotation, side-lying forward flexion, standing diagonal flexion , and military press .Initial phase lasts for 2 weeks, with exercises progressing from 7 Reps of 10-second holds to 10 Reps of 15-second hold.

Improvement phase consist of exercises including side-lying external rotation with a dumbbell , side-lying forward flexion with a dumbbell , standing diagonal flexion with a dumbbell, standing external rotation with Thera-Band, standing diagonal flexion with Thera-Band, abduction while sitting on a training ball, prone lying V, T, and W exercises, and standing abduction on a balance board. The improvement phase lasts for 2 weeks, with exercises progressing from seven sets of 10-seconds hold to 10 sets of 15 secs hold.

The exercises in the maintenance phase are the same as those in the improvement phase, with no increase in intensity and frequency

Intervention Type: OTHER

Proprioceptive Neuromuscular Facilitation (PNF) Techniques

In this study following PNF Stretching techniques are used

• Hold-relax or Contract-relax
• Hold-relax with agonist contraction In the Hold-Relax or Contract-Relax technique, stretching is performed 4sessions per week for each muscle group, with each session lasting 40 min. The protocol includes a 10-sec hold phase followed by a 10-sec contraction phase, repeated for 7 reps . The total duration of this program is 8weeks including 6 weeks of treatment phase and last 2 weeks of detraining.

In Hold-Relax with Agonist contract, the same procedure is followed as in Hold-Relax method, with 4sessions per week for each muscle group. The patient is asked to hold the initial stretch for 10 sec, followed by a relaxation phase. Afterward, the agonist muscle is contracted to actively move further into the stretch, which is then held for 10 sec. This protocol is performed for 7 reps per session, and the total duration of study is 8 weeks including 6 weeks of treatment program with last 2 weeks

Intervention Type: OTHER

Eligibility Criteria

Inclusion Criteria

• Age : 25-65
• Symptoms of upper cross syndrome appeared from maximum 6 months
• Occiput to wall test positive
• Patients presenting postural changes e.g: severe kyphosis

Exclusion Criteria

• Any apparent misalignment in the pelvis or lower limbs.
• Rotation exceeding 5 degrees during forward bending as a result of scoliosis.
• Prior history of joint disorders in the spine, shoulders, and pelvis.
• Body weight that falls outside the normal range (BMI between 18 and 25)

• Minimum Eligible Age: 25 Years
• Maximum Eligible Age: 65 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: Yes

Sponsors

Elite College of Management Sciences, Gujranwala, Pakistan

OTHER

Sponsor Role: lead

Responsible Party

Responsibility Role: SPONSOR

Principal Investigators

Usman Iqbal Janjua

Role: PRINCIPAL_INVESTIGATOR

Ellite College of Managment Sciences, Gujranwala

Locations

Al-Raee Hospital

Gujranwala, Punjab Province, Pakistan

Countries

Pakistan

References

(3)Asad, A., Farooq, N., Kafeel, S., Hassan, T., & Zubair, M. (2021). Association of upper crossed syndrome and posture among general population having neck pain in Islamabad. Journal of Rehman Medical Institute, 7(2), 07-11.

Reference Type: BACKGROUND

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)

Chang MC, Choo YJ, Hong K, Boudier-Reveret M, Yang S. Treatment of Upper Crossed Syndrome: A Narrative Systematic Review. Healthcare (Basel). 2023 Aug 17;11(16):2328. doi: 10.3390/healthcare11162328.

Reference Type: BACKGROUND

PMID: 37628525 (View on PubMed)

Other Identifiers

2020-GCUF-079297

Identifier Type: -

Identifier Source: org_study_id