Effectiveness Of Combination Of Isotonic Technique And Stretching On Craniovertebral Angle, Shoulder Range Of Motion And Functional Disability In Upper Crossed Syndrome Associated With Adhesive Capsulitis: A Randomized Controlled Trail

Upper Crossed Syndrome involves a common pattern of muscle imbalance that is tightness in the chest and neck muscles, and weakness in the upper back and deep neck flexors. This imbalance often leads to poor posture and abnormal shoulder movements, such as limited flexion and abduction. Research by Jaideep et al. found that Upper Crossed Syndrome can worsen existing shoulder problems in people with Adhesive Capsulitis. However, current physiotherapy treatments for Adhesive Capsulitis rarely address UCS, and there’s limited evidence on combining interventions for both conditions. Ignoring UCS in these patients may slow down recovery or reduce the effectiveness of treatment.  This study addresses gap by exploring a combined rehabilitation approach. By treating both UCS and Adhesive Capsulitis together, we may offer patients faster recovery, better shoulder function, and improved overall outcomes. The study hypothesises that the Combination of Isotonic Technique and stretching is significantly effective in improving Craniovertebral Angle, Shoulder Range of Motion and Disability in Upper Crossed Syndrome associated with Adhesive Capsulitis.

Subjects will be screened as per the inclusion & the exclusion criteria. Subjects will be randomly divided into Control group and Intervention group with 26 participants in each group. The Pre-assessment will be done on basis of Range of motion, Craniovertebral angle, Shoulder pain and disability index. Control group participants receive conventional Adhesive Capsulitis Physiotherapy protocol including Moist heat- 10 minutes, Ultrasound: 1MHz, 0.8 intensity, duration of  8 minutes, Passive ROM exercises ,Active ROM exercises, Shoulder isometric exercises, Progressive resistance exercises, Mobilization with Anteroposterior glide, Inferior glide 120 glides/ minute, Pulley exercises, Scapular retraction, External rotation stretch, Posterior capsule stretch, Treatment Duration of 2 weeks. Intervention Group participants will be given Combination of Isotonic technique, Stretching exercises and conventional Adhesive Capsulitis physiotherapy intervention. Stretching exercises for Upper trapezius, Levator Scapulae, Pectoralis major, Dosage: Hold stretch for 15-30 seconds, 2-3 repetitions on each side. 2,3 times per session, 5 times/ week.  Combination of Isotonic PNF technique for Deep cervical flexor, Middle trapezius, Lower trapezius, Rhomboids and Serratus Anterior, Dosage: 10 second hold, 10 repetitions, 5 times/ week.  Treatment Duration: 2 weeks. Post intervention assessment will be done using the same outcome measures as that of pre-assessment. Upon complete data recording, the data will be statistically analysed by using the unpaired T – test for comparative analysis for between the two groups, while paired t test will be used to analyse the within group parameters.