Effects of MET and Biofeedback Strengthening With and Without Kinesiotaping in Upper Crossed Syndrome

NCT ID: NCT07079319

Last Updated: 2025-07-23

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

NOT_YET_RECRUITING

Clinical Phase

NA

Total Enrollment

58 participants

Study Classification

INTERVENTIONAL

Study Start Date

2025-07-31

Study Completion Date

2025-11-30

Brief Summary

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This randomised controlled trial will aim to evaluate the combined effects of Muscle Energy Technique (MET) and biofeedback strengthening, with and without Kinesiotaping (KT), on pain, posture, deep neck flexor strength, and functional status in individuals with Upper Crossed Syndrome (UCS). A total of 58 participants aged 18-40 years will be randomly allocated into two groups. Group A will receive MET and biofeedback strengthening, while Group B will receive the same intervention with the addition of KT. Treatments will be administered three times per week over a four-week period. Outcome measures will include the Numeric Pain Rating Scale (NPRS), Neck Disability Index (NDI), craniovertebral angle (CVA), rounded shoulder posture (RSP), and cranio-cervical flexion test (CCFT) using a pressure biofeedback unit. It is hypothesised that the addition of KT will result in greater improvements in pain reduction and postural correction compared to MET and biofeedback alone.

Detailed Description

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This study will be a single-blinded, two-arm randomized controlled trial designed to evaluate the effects of combining Muscle Energy Technique (MET) and biofeedback-based strengthening exercises, with and without Kinesiotaping (KT), on pain intensity, postural correction, muscle performance, and functional status in individuals diagnosed with Upper Crossed Syndrome (UCS). UCS is a common postural dysfunction resulting from muscle imbalances in the upper quadrant, often associated with forward head posture, rounded shoulders, and neck pain, particularly in individuals with sedentary lifestyles.

A total of 58 participants between the ages of 18 and 40 years will be recruited through non-probability consecutive sampling from Horizon Hospital, Lahore. Participants who meet the inclusion criteria will be randomly assigned into two groups using computer-generated randomisation. Group A will receive MET and biofeedback strengthening via cranio-cervical flexion exercises. Group B will receive the same interventions with the addition of Kinesiotaping applied to the shoulder girdle. Interventions will be administered three times per week for a duration of four weeks, for a total of 12 sessions. Both groups will receive standard physiotherapy care, including heat application, therapeutic ultrasound, neck isometric exercises, and stretches for superficial neck muscles.

The primary outcomes will include pain measured by the Numeric Pain Rating Scale (NPRS), disability assessed using the Neck Disability Index (NDI), and postural parameters including craniovertebral angle (CVA) and rounded shoulder posture (RSP) assessed with a goniometer and measuring tape respectively. Deep neck flexor strength will be measured using the cranio-cervical flexion test (CCFT) with a pressure biofeedback unit (PBU).

Statistical analysis will be conducted using SPSS v25.0. The normality of the data will be assessed via the Kolmogorov-Smirnov test. Non-parametric tests (Wilcoxon signed-rank test and Mann-Whitney U test) will be used to evaluate within-group and between-group differences, respectively. The level of significance will be set at p \< 0.05.

It is hypothesised that the group receiving MET and biofeedback strengthening with Kinesiotaping will demonstrate greater improvements in pain relief, postural alignment, deep neck flexor strength, and functional status compared to the group receiving MET and biofeedback strengthening alone.

This study aims to contribute to the growing evidence for multimodal physiotherapy interventions in the management of UCS and provide clinical guidance for the use of kinesiotaping as an adjunctive treatment in postural correction.

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

DOUBLE

Participants Outcome Assessors

Study Groups

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MET + Biofeedback Strengthening + Kinesiotaping

Participants in this group will receive the same treatment protocol as Arm 1 (MET and biofeedback strengthening), with the addition of Kinesiotaping (KT) applied across the shoulder girdle. KT will be applied with 50-70% stretch from the anterior acromion to the opposite scapula, 3 times per week for 4 weeks. The tape will be worn for 14-16 hours per application. Standard physiotherapy (heat, ultrasound, neck isometrics, and stretching) will also be administered as part of the protocol.

Group Type EXPERIMENTAL

MET + Biofeedback Strengthening + Kinesiotaping

Intervention Type OTHER

Participants in this group will receive the same treatment protocol as Arm 1 (MET and biofeedback strengthening), with the addition of Kinesiotaping (KT) applied across the shoulder girdle. KT will be applied with 50-70% stretch from the anterior acromion to the opposite scapula, 3 times per week for 4 weeks. The tape will be worn for 14-16 hours per application. Standard physiotherapy (heat, ultrasound, neck isometrics, and stretching) will also be administered as part of the protocol.

MET + Biofeedback Strengthening

Participants in this group will receive Muscle Energy Technique (MET) for the upper trapezius, levator scapulae, pectoralis major, and pectoralis minor using post-isometric relaxation technique. Additionally, they will perform biofeedback-based cranio-cervical flexion exercises using a pressure biofeedback unit (PBU). The intervention will be administered 3 times per week for 4 weeks, with a total of 12 sessions. Standard physiotherapy (heat application, ultrasound, neck isometrics, and stretching exercises) will also be provided.

Group Type ACTIVE_COMPARATOR

MET + Biofeedback Strengthening

Intervention Type OTHER

Participants in this group will receive Muscle Energy Technique (MET) for the upper trapezius, levator scapulae, pectoralis major, and pectoralis minor using post-isometric relaxation technique. Additionally, they will perform biofeedback-based cranio-cervical flexion exercises using a pressure biofeedback unit (PBU). The intervention will be administered 3 times per week for 4 weeks, with a total of 12 sessions. Standard physiotherapy (heat application, ultrasound, neck isometrics, and stretching exercises) will also be provided.

Interventions

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MET + Biofeedback Strengthening + Kinesiotaping

Participants in this group will receive the same treatment protocol as Arm 1 (MET and biofeedback strengthening), with the addition of Kinesiotaping (KT) applied across the shoulder girdle. KT will be applied with 50-70% stretch from the anterior acromion to the opposite scapula, 3 times per week for 4 weeks. The tape will be worn for 14-16 hours per application. Standard physiotherapy (heat, ultrasound, neck isometrics, and stretching) will also be administered as part of the protocol.

Intervention Type OTHER

MET + Biofeedback Strengthening

Participants in this group will receive Muscle Energy Technique (MET) for the upper trapezius, levator scapulae, pectoralis major, and pectoralis minor using post-isometric relaxation technique. Additionally, they will perform biofeedback-based cranio-cervical flexion exercises using a pressure biofeedback unit (PBU). The intervention will be administered 3 times per week for 4 weeks, with a total of 12 sessions. Standard physiotherapy (heat application, ultrasound, neck isometrics, and stretching exercises) will also be provided.

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Age group between 18-40 years
* Both males and females
* NPRS score \<7 for more than 2 months
* NDI score between 15-34
* Forward neck posture (confirmed by craniovertebral angle \<48-50° measured by goniometer)
* Rounded shoulders posture (confirmed by supine lying test; if the distance between posterior aspect of acromion and plinth is \>1 inch or 2.5 cm)
* Reduced deep neck flexors strength (confirmed by cranio-cervical flexion test (CCFT))

Exclusion Criteria

* Age less than 18 or more than 40
* Recent trauma and/or hyper-flexibility
* History of cervical surgery in the last year
* History of infection (local or systemic), any dermatological condition tumor, chemotherapy, radiotherapy
* History of cervical fracture in the last year
* Radiating pain
* Positive upper limb tension tests
Minimum Eligible Age

18 Years

Maximum Eligible Age

40 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Riphah International University

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Amna Zia, Phd Scholar

Role: PRINCIPAL_INVESTIGATOR

Riphah International University/ Mayo Hospital, Lahore

Rabia Afzal, MSc Student

Role: PRINCIPAL_INVESTIGATOR

Riphah International University

Locations

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Horizon Hospital

Lahore, Punjab Province, Pakistan

Site Status

Countries

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Pakistan

Central Contacts

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Samrood Akram, Phd Scholar

Role: CONTACT

03324806143

Amna Zia, Phd Scholar

Role: CONTACT

03244686993

Facility Contacts

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Irfan Ahmad

Role: primary

03214722540

References

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Dr. Samarjeet Kittad DPC. Prevalence Of Upper Cross Syndrome In Students Studying For Competitive Exams Using Pressure Biofeedback. International Journal of Creative Research Thoughts (IJCRT). June 2023;11(6):g668-g78.

Reference Type BACKGROUND

Thacker D, Jameson J, Baker J, Divine J, Unfried A. Management of upper cross syndrome through the use of active release technique and prescribed exercises. Logan College of Chiropractic. 2011.

Reference Type BACKGROUND

Ashfaq R, Riaz H. Effect of Pressure biofeedback training on deep cervical flexors endurance in patients with mechanical neck pain: A randomized controlled trial. Pak J Med Sci. 2021 Mar-Apr;37(2):550-555. doi: 10.12669/pjms.37.2.2343.

Reference Type BACKGROUND
PMID: 33679948 (View on PubMed)

Lwin NN, Myint T, Oo WM, San HH, Tun MT. EFFICACY ON PRESSURE-BIOFEEDBACK GUIDED CRANIOCERVICAL FLEXION EXERCISE IN NECK PAIN: A RANDOMIZED CONTROLLED TRIAL. Journal of Musculoskeletal Research.0(0):2150013.

Reference Type BACKGROUND

A Rayjade TY, R Chintamani, N Joshi. Comparative effectiveness of Kinesio taping and Ift in upper cross syndrome-A randomized clinical trial. Indian Journal of Forensic Medicine & Toxicology. 2020;14(3):127-32.

Reference Type BACKGROUND

Other Identifiers

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REC/RCR & AHS/24/0165- Rabia

Identifier Type: -

Identifier Source: org_study_id

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