The effect of scapular PNF on Forward head posture and rounded shoulder posture in students: A Randomized Controlled Trial

Participants will be selected from students of Pravara Institute of Medical Sciences having Forward Head and Rounded Shoulder posture

The participants will be selected based on the inclusion and exclusion criteria mentioned above The consent of the participants will be taken and the ones willing to participate in the project will be selected All information the procedure of the study and how it will be beneficial to the participants will be explained Patients who are students experiencing FHP and RSP between age of 18 to 25

The participants will be randomly assigned to two exercise groups ensuring both participants and researchers are aware of the group allocation

Group  A of 25 participants Conventional physiotherapy

Conventional group

Conventional physiotherapy Warm up phase Neck rotations and tilts Arm circles Cat-Cow stretch Threading the needle Duration 5 to 10 minutes Frequency 3 times per week Exercise protocol Pectoralis corner stretch Chin tucks Scapular retraction Wall push ups I V and W arm exercises in prone Middle and lower trapezius strengthening exercises using theraband Core muscle dead bug thoracic spine extension using foam roller Duration 20 to 30 minutes Frequency 3 times per week Cool down phase Stretching exercises for upper trapezius levator scapulae and sternocleidomastoid Duration 5 to 10 minutes Frequency 3 times per week

Group B of 25 participants Scapular PNF plus conventional physiotherapy

A Scapular anterior elevation Involved muscles levator scapulae rhomboids serratus anterior Positioning lying on the side with knees and hips flexed appropriately Grip fingers overlapped on the front of the GH joint and acromion Sequence pull the scapula downward and backward into posterior depression to tension the anterior lateral neck muscles avoid pulling too much to prevent lifting the patient s head no rotation of the trunk is allowed Command Up Movement the scapula elevates and moves slightly forward Body Mechanics arms should remain relaxed use weight shifting from the back leg to the front leg for resistance Resistance follow the curve of the patient s body during the arc of resistance B Scapular posterior depression Muscles involved lower serratus anterior rhomboids latissimus dorsi Position lying on the side with hips and knees flexed as needed Grip place the heels of your hands along the vertebral border of the scapula with one hand positioned slightly above the other and fingers pointing towards the acromion Sequence elevate the scapula forward and up into anterior elevation until the posterior muscles located beneath the spine of the scapula become taut avoid rotating the trunk Command Down Movement the scapula descends and moves slightly posteriorly Body Mechanics keep arms relaxed provide resistance by shifting your weight from the front leg to the back leg Resistance follow the arc that aligns with the curve of the patient s body C Scapular posterior elevation Muscles involved trapezius levator scapulae Position sidelying with hips and knees flexed appropriately Grip overlap hands at the back on the upper trapezius muscle above the scapular spine Sequence apply pressure to push the scapula down and slightly forward into anterior depression ensuring posterior lateral neck muscles are taut avoid pushing too far to prevent lifting the patient s head maintain a neutral trunk position Command Up Movement the scapula elevates upward and slightly backward Body Mechanics keep arms relaxed apply resistance by shifting weight from the front leg to the back leg Resistance follow the curve of the patient s body during the movement D Scapular Anterior Depression Muscles involved rhomboids serratus anterior pectoralis minor major Positioning lying on the side with hips and knees flexed appropriately Grip hands placed on the anterior and posterior axilla with fingers directed toward the opposite hip Sequence elevate the scapula upwards and backward into posterior elevation avoid lifting the patient s head too far ensure no trunk rotation occurs Command Down Movement the scapula descends and moves slightly forward Body Mechanics keep arms relaxed apply resistance by shifting weight from the back leg to the front leg Resistance follow the arc that contours to the patient s body