Effect of a Comprehensive Corrective Exercise Program With and Without Instrument-Assisted Soft Tissue Mobilization on Cervical Range of Motion, Muscle Strength, Disability, and Postural Alignment in Individuals With Upper-Crossed Syndrome
试验速览
- 阶段
- 不适用
- 状态
- 尚未招募
- 发起方
- 入组人数
- 48
- 试验地点
- 1
- 主要终点
- Cervical Range of Motion (CROM)
研究概览
简要总结
This study is a double-blind, parallel-group randomized controlled trial designed to evaluate the effectiveness of a Comprehensive Corrective Exercise Program (CCEP) with and without Instrument-Assisted Soft Tissue Mobilization (IASTM) in individuals with Upper-Crossed Syndrome (UCS). UCS is a common postural dysfunction characterized by muscular imbalance, including tightness of the upper trapezius, levator scapulae, and pectoral muscles, along with weakness of the deep cervical flexors and scapular stabilizers. This imbalance leads to forward head posture, rounded shoulders, neck pain, reduced cervical mobility, and functional limitations, particularly in individuals exposed to prolonged sedentary activities and poor ergonomic conditions.
A total of 60 participants aged 18-40 years diagnosed with Upper-Crossed Syndrome will be recruited and randomly allocated into two groups. The control group will receive a structured Comprehensive Corrective Exercise Program (CCEP), while the experimental group will receive the same exercise program combined with Instrument-Assisted Soft Tissue Mobilization (IASTM).
Both interventions will be administered three times per week for six weeks under the supervision of a trained physiotherapist. Outcome measures will be assessed at baseline and after completion of the intervention period. Primary outcomes include cervical range of motion, muscle strength assessed by the Deep Neck Flexor endurance test, functional disability measured using the Neck Disability Index, and postural alignment assessed using a plumb line method.
The aim of this study is to determine whether the addition of IASTM to a corrective exercise program results in superior improvements in cervical mobility, muscle strength, functional disability, and postural alignment compared to corrective exercise alone. It is hypothesized that the combined intervention will produce greater clinical improvements in individuals with Upper-Crossed Syndrome.
详细描述
Upper-Crossed Syndrome (UCS) is a commonly observed postural dysfunction characterized by a predictable pattern of muscular imbalance involving tightness of the upper trapezius, levator scapulae, and pectoral muscles, along with weakness of the deep cervical flexors, lower trapezius, and serratus anterior. This imbalance alters normal cervical-thoracic alignment, resulting in forward head posture, rounded shoulders, and increased thoracic kyphosis. These postural deviations are frequently associated with neck pain, reduced cervical range of motion, impaired neuromuscular control, and decreased functional performance.
The prevalence of UCS has increased significantly due to modern lifestyle factors such as prolonged screen exposure, sedentary work environments, and poor ergonomic habits. Individuals including students, office workers, and healthcare professionals are particularly vulnerable. UCS is now recognized as a multidimensional condition involving biomechanical, neuromuscular, and sensorimotor dysfunction rather than a purely structural disorder.
Corrective exercise programs are widely regarded as the cornerstone of UCS management. These programs aim to restore muscular balance by stretching shortened muscles and strengthening inhibited muscles, thereby improving posture, alignment, and functional outcomes. Evidence from randomized controlled trials demonstrates that structured corrective exercise programs can significantly improve forward head posture, scapular alignment, muscle activation, and functional performance.
Instrument-Assisted Soft Tissue Mobilization (IASTM) has emerged as an effective adjunctive intervention in musculoskeletal rehabilitation. IASTM is believed to improve soft tissue mobility, reduce fascial adhesions, enhance local circulation, and facilitate neuromuscular activation. Previous studies have shown that IASTM can lead to reductions in pain, improvements in cervical range of motion, and enhanced functional outcomes in individuals with chronic neck pain and related conditions.
Despite evidence supporting both corrective exercise programs and IASTM independently, limited research has evaluated their combined effects specifically in individuals with Upper-Crossed Syndrome. Existing studies have often used general physiotherapy protocols without incorporating structured Comprehensive Corrective Exercise Programs tailored to UCS. Therefore, it remains unclear whether the integration of IASTM with a targeted corrective exercise program provides superior outcomes compared to exercise alone.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- Double (Participant, Outcomes Assessor)
入排标准
- 年龄范围
- 18 Years 至 40 Years（Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Age between 18-40 years
- •Both males and females
- •Diagnosed with Upper-Crossed Syndrome
- •Presence of forward head posture and rounded shoulders
- •Chronic neck pain related to postural dysfunction
排除标准
- •History of cervical spine surgery or fracture
- •Neurological conditions (e.g., radiculopathy, myelopathy)
- •Systemic musculoskeletal disorders (e.g., rheumatoid arthritis)
- •Current physiotherapy treatment for neck pain
- •Skin conditions preventing IASTM application
研究组 & 干预措施
CCEP with Instrument-Assisted Soft Tissue Mobilization (IASTM)
Participants in this arm will receive the same Comprehensive Corrective Exercise Program (CCEP) as the control group, combined with Instrument-Assisted Soft Tissue Mobilization (IASTM). IASTM will be applied to overactive muscles including upper trapezius, levator scapulae, sternocleidomastoid, and pectoral muscles using standardized techniques (scanning, sweeping, and fanning). Each session will last approximately 20 minutes and will be performed three times per week for six weeks under physiotherapist supervision.
干预措施: Instrument-Assisted Soft Tissue Mobilization (IASTM) + Comprehensive Corrective Exercise Program (CCEP) (Other)
Comprehensive Corrective Exercise Program (CCEP)
Participants in this arm will receive a Comprehensive Corrective Exercise Program (CCEP) only. The program includes stretching of overactive muscles (pectoralis major/minor, upper trapezius, levator scapulae, sternocleidomastoid), strengthening of weak muscles (deep cervical flexors, lower trapezius, rhomboids, serratus anterior), and postural re-education and motor control exercises. Sessions will be supervised by a physiotherapist, conducted three times per week for six weeks.
干预措施: Comprehensive Corrective Exercise Program (CCEP) (Other)
结局指标
主要结局
Cervical Range of Motion (CROM)
时间窗: Baseline and 6 weeks
Cervical range of motion will be measured using a goniometer. Measurements will include flexion, extension, lateral flexion, and rotation.
Neck Disability (NDI)
时间窗: Baseline and 6 weeks
The Neck Disability Index is a patient-reported outcome measure used to assess functional disability related to neck pain. It consists of 10 items evaluating daily activities and functional limitation
Postural Alignment
时间窗: Baseline and 6 weeks
Postural alignment will be assessed using a plumb line method to evaluate forward head posture and rounded shoulder posture.
Muscle Strength (Deep Neck Flexor Endurance Test)
时间窗: Baseline and 6 weeks
The Deep Neck Flexor Endurance Test (also known as the craniocervical flexion endurance test) measures the duration a participant can hold a chin-tuck position with correct form. Scores range from 0 to 60 seconds, with the test terminated at 60 seconds if the position is maintained that long. Higher scores indicate better deep neck flexor muscle endurance.
Neck Disability (Neck Disability Index)
时间窗: Baseline and 6 weeks
The Neck Disability Index is a 10-item patient-reported outcome measure assessing functional disability related to neck pain, covering activities such as personal care, lifting, reading, and concentration. Each item is scored 0-5, for a total score range of 0 to 50. Higher scores indicate greater disability.
次要结局
未报告次要终点