Effects of IASTM Along With Comprehensive Corrective Exercise Program in Upper Cross Syndrome.

Not Applicable

Recruiting

• Conditions: Upper Cross Syndrome
• Interventions: Other: IASTM and CCEP; Other: Traditional treatment

• Registration Number: NCT06302972
• Lead Sponsor: Riphah International University

Brief Summary

This study will see the effects of IASTM along with comprehensive corrective exercise program in upper cross syndrome through their effects on pain and cervical ranges as well as postural improvement. Our study targets both male and female population. In the reference study only male population was targeted which did not show effects of both techniques on the female population though females have high stress levels which may alter results.

Detailed Description

The upper cross syndrome involves stiffness of levator scapulae, pectoralis major and upper trapezius muscles and serratus anterior, deep neck flexors, rhomboids, middle and lower trapezius and scalene muscles weakness. Numerous bodily abnormalities such as headache, early deterioration of cervical spine and loss of cervical spine curve can be brought on by this syndrome. This syndrome can also result in thoracic spine abnormality and impaired glenohumeral joint biomechanics. Upper cross syndrome develops abnormality in head, neck and shoulder and develops in upper 1⁄4 of the trunk. The underlying causative agents of Upper cross syndrome are long surgeries, weakness, female gender, disability and poor posture. It was a randomized, controlled trial, conducted among patient with upper cross syndrome with Sample size was 44 by using G- Power software. Group A will be given IASTM with Graston's tool and comprehensive corrective exercise program and Group B will receive only comprehensive corrective exercise program. The protocol will consist of 12 sessions in total with 3 sessions a week 45 minutes / session for both groups. Assessment will be at baseline then after 2 weeks after that 2 weeks home plan for exercises and then after 4 weeks assessment will be done. Only pain will be assessed on alternative days

Study Timeline

• Study Start: 2023-10-30
• Study First Submitted: 2024-03-04
• Study First Submitted QC: 2024-03-04
• Study First Posted: 2024-03-12
• Status Verified: 2024-04
• Last Update Submitted: 2024-04-18
• Last Update Posted: 2024-04-19
• Primary Completion: 2024-06-30
• Study Completion: 2024-06-30

Recruitment & Eligibility

• Status: RECRUITING
• Sex: All
• Target Recruitment: 44

Inclusion Criteria

Age 18-40 years.

• Diagnosed patients with the upper crossed syndrome who have chronic neck
• pain for more than 3 months.
• Having neck pain scoring more than 3 on the Numeric Pain Scale were included
• in this study.
• Any abnormality in the position and rhythm of the scapula, as measured by the Scapular dyskinesis test, having postural changes such as excessive thoracic kyphosis (≥42°), forward head (≥44°) or round shoulder (≥49°) as measured by Flexicurve and photogrammetry.
• Both male and female population will be included

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Exclusion Criteria

The subjects with any previous surgery, any type of Infection Hypersensitive skin Diabetes Mellitus type II Having Traumatic Injury Psychological disorder Manual Therapy contraindication like osteoporosis, infection, Disc- Herniation acute Inflammation, burn scars, closed /non-complicated fractures and open wound.

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Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
IASTM and CCEP	IASTM and CCEP	Instrument Assisted Soft Mobilization Technique; For pectoralis major: Subjects will be asked to lay supine with their thorax front side exposed. In abduction, restriction or adhesions will be located using scanning and gel will be applied. IASTM also address soft tissue restrictions and pain in levator scapulae, suboccipital muscles and sternocleidomastoid muscle. The CCEP will be designed in three phases, including initial, improvement, and maintenance.. The exercises in appropriate muscles in correct alignment during the movement pattern, the protocol focused on improving sustained postures. Exercises in initial phase protocol from 10 s hold x7 to 15 s hold x 10 from roller Exercises in improvement phase protocol from 10 repetition x 5 to 15 repetition x 6 from dumbbell , thera band, swiss ball and balance board
Comprehensive Corrective Exercise Program.Type	Traditional treatment	The CCEP will be designed in three phases, including initial, improvement, and maintenance. Exercises are progressed in frequency and intensity during these phases, as long as the movements are performed in a good quality. The exercises in appropriate muscles in correct alignment during the movement pattern, the protocol focused on improving sustained postures. This goal was addressed in the improvement phase when necessary tissue adaptations occurred by increasing the load of exercises. In the maintenance phase, the participant continued to do the exercises and maintain the training adaptations for two weeks. The exercises will be the same as the improvement phase without any progression in intensity and frequency. Exercises in initial phase protocol from 10 s hold x7 to 15 s hold x 10 from roller Exercises in improvement phase protocol from 10 repetition x 5 to 15 repetition x 6 from dumbbell , thera band, swiss ball and balance board

Primary Outcome Measures

Name	Time	Method
Range of motion Cervical (Flexion)	4 week	Changes from baseline,2nd week, 4th week ROM range of motion of cervical flexion was taken
ROM Cervical (Extension)	4 Week	Changes from baseline,2nd week, 4th week ROM range of motion of cervical extension was taken
ROM Cervical ( Left Rotation)	4 week	Changes from baseline,2nd week, 4th week ROM range of motion of Cervical Left Rotation was taken.
ROM Cervical ( Right Rotation)	4 week	Changes from baseline,2nd week, 4th week ROM range of motion of Cervical Right Rotation was taken
ROM Cervical( Right Lateral Flexion)	4 week	Changes from baseline,2nd week, 4th week ROM range of motion of Cervical Right Lateral flexion was taken with the help of bubble Inclinometer
ROM Cervical (Left Lateral Flexion)	4 week	Changes from baseline,2nd week, 4th week ROM range of motion of Cervical Left Lateral Flexion was taken

Secondary Outcome Measures

Name	Time	Method
Flexicurve Ruler and Photogrammetry for posture	4 week	Excessive thoracic kyphosis, forward head or round shoulder as measured by Flexicurve and photogrammetry. For posture correction assessment will be at baseline and then after 2 weeks and then after 4 weeks.
Numeric Pain Rating Scale (NPRS)	4 week	NPRS is used for pain assessment. Pain assessment will be at baseline and in week one on alternative days and then after 2nd, 3rd and 4th weeks pain will be assessed on alternative days.

Trial Locations

Locations (1)

Maroof international Hospital and Railway Hospital; 🇵🇰 Islamabad, Federal, Pakistan