Effects of Post Isometric Relaxation and Janda's Approach in Patient With Shoudler Girdle Crossed Syndrome

NCT ID: NCT07064031

Last Updated: 2025-07-14

Basic Information

• Recruitment Status: NOT_YET_RECRUITING
• Clinical Phase: NA
• Total Enrollment: 54 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2025-07-31
• Study Completion Date: 2025-10-31

Brief Summary

Shoulder girdle crossed syndrome referred as upper crossed syndrome. In this syndrome, tightness of the upper trapezius and levator scapula on the dorsal side crosses with tightness of the pectoralis major and minor. Weakness of the deep cervical flexors, ventrally, crosses with weakness of the middle, lower trapezius and Rhomboids. Janda Approach treatment involves steps i.e Normalize the Periphery, Restore Muscle Balance, Increase afferent input to facilitate reflexive stabilization and increase endurance in muscles.

Detailed Description

This study will be a randomized controlled trial and will be conducted in Riphah Rehabilitation Clinic Lahore. Non-probability convenient sampling will be used to collect the data. Sample size of 54 subjects with age group between 18-50 years will be taken. Data will be collected from the patients having present complaint of neck pain. Outcome measures will be taken using Numeric pain rating scale (NPRS) for pain, Neck disability index (NDI) for disability and Muscle Endurance tests for neck flexors, extensors and lateral flexors, an informed consent will be taken. Subjects will be selected on the basis of inclusion and exclusion criteria and will be equally divided into two groups by random number generator table. Both the Groups will receive Janda treatment as standard physical therapy, while Group A will receive janda's Technique and Muscle Energy Technique. In Janda technique weak muscles will be Strengthened and Tight muscles will be stretched. While group B is control group and receive only Janda Technique. Outcome measures will be measured at baseline and after 4 weeks. Data analysis will be done by SPSS version 25.

Conditions

Upper Crossed Syndrome

Study Design

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

Study Groups

Post isometric relaxation

This Group Will Receive Post isometric relaxation and Janda . PIR will be perform on upper trapezius and pectorals major muscle. In Janda technique weak muscles will be Strengthened and Tight muscles will be stretched.

Group Type: EXPERIMENTAL

Neck Isometrics , TENS and Hot pack

Intervention Type: OTHER

Hot apck and TENS applied for 10min each. Using the same amount of light pressure, gently push your head into your hand as you did before. This time, allow the head to move slowly toward the shoulder against the pressure of the hand. This too can be repeated on the opposite side, forwards, backward, and into left and right rotation

Janda Technique

This group is control group and receive only Janda Technique as mentioned weak muscles i.e. serratus Anterior and Rhomboids are strengthened by isometric contraction of these muscles. Stretching of tight muscles i.e. upper trapezius and Pectoralis major muscle.

Group Type: ACTIVE_COMPARATOR

Neck Isometrics , TENS and Hot pack

Intervention Type: OTHER

Hot apck and TENS applied for 10min each. Using the same amount of light pressure, gently push your head into your hand as you did before. This time, allow the head to move slowly toward the shoulder against the pressure of the hand. This too can be repeated on the opposite side, forwards, backward, and into left and right rotation

Interventions

Neck Isometrics , TENS and Hot pack

Hot apck and TENS applied for 10min each. Using the same amount of light pressure, gently push your head into your hand as you did before. This time, allow the head to move slowly toward the shoulder against the pressure of the hand. This too can be repeated on the opposite side, forwards, backward, and into left and right rotation

Intervention Type: OTHER

Eligibility Criteria

Inclusion Criteria

• Age group between 18 and 50 years (defined as pain in the area of the neck could be provoked by mechanical characteristics, including sustained neck postures, cervical movement, or manual palpation of the cervical musculature)

Exclusion Criteria

• Cervical radiculopathy
• History of whiplash injury
• History of cervical and thoracic spine surgery
• Neck pain associated with vertigo

• Minimum Eligible Age: 18 Years
• Maximum Eligible Age: 50 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Riphah International University

OTHER

Sponsor Role: lead

Responsible Party

Responsibility Role: SPONSOR

Principal Investigators

Samrood Akram, PhD*

Role: PRINCIPAL_INVESTIGATOR

Riphah International University

Locations

Ittefaq Hospital

Lahore, Punjab Province, Pakistan

Countries

Pakistan

Central Contacts

Samrood Akram, PhD Scholar

Role: CONTACT

samrood.akram@riphah.edu.pk.com

03324806143

References

Mubeen I, Malik S, Akhtar W, Iqbal M, Asif M, Arshad A, et al. Prevalence of upper cross syndrome among the medical students of University of Lahore. International journal of Physiotherapy. 2016;3(3):381-4.

Reference Type: BACKGROUND

Dhage P, Anap D. Prevalence of an "Upper Crossed Syndrome in Physiotherapy College Students"-A Cross-Sectional Study. VIMS Health Science Journal. 2019;6(1):10-3.

Reference Type: BACKGROUND

Kage V, Putti B. Effectiveness of stretching and strengthening exercises (Janda's approach) in subjects with postural backache: A randomized controlled trial. Int J Physiother Res. 2015;3(6):1301-6.

Reference Type: BACKGROUND

Bae WS, Lee HO, Shin JW, Lee KC. The effect of middle and lower trapezius strength exercises and levator scapulae and upper trapezius stretching exercises in upper crossed syndrome. J Phys Ther Sci. 2016 May;28(5):1636-9. doi: 10.1589/jpts.28.1636. Epub 2016 May 31.

Reference Type: BACKGROUND

PMID: 27313388 (View on PubMed)

Guanche C, Knatt T, Solomonow M, Lu Y, Baratta R. The synergistic action of the capsule and the shoulder muscles. Am J Sports Med. 1995 May-Jun;23(3):301-6. doi: 10.1177/036354659502300308.

Reference Type: BACKGROUND

PMID: 7661256 (View on PubMed)

Umphred D, Byl N, Lazaro R, Roller M. Interventions for neurological disabilities. Neurological rehabilitation. 2001;4:56-134.

Reference Type: BACKGROUND

Sherrington C. On reciprocal innervation of antagonistic muscles. Proc R Soc London B. 1905;76:161-269.

Reference Type: BACKGROUND

El Laithy MH, Fouda KZ. Effect of post isometric relaxation technique in the treatment of mechanical neck pain. Physical Therapy and Rehabilitation. 2018;5(1):20.

Reference Type: BACKGROUND

Other Identifiers

REC/RCR &AHS/24/0144 Muqaddas

Identifier Type: -

Identifier Source: org_study_id