Effects of Bruegger's Versus Kendall Exercises in Cervical Postural Syndrome

NCT06460129 | Completed

• 1 other identifier: REC/RCR&AHS/23/01105
• Study Type: interventional
• Target: 26
• Locations: 1 country
• Sites: 1

Brief Summary

Cervical Postural Syndrome is an uncomfortable and painful condition characterized by a protruding chin and rounded shoulders, commonly resulting from poor posture in the neck, middle back, and shoulders. This syndrome often leads to an excessive forward curvature of the upper back, causing the chin to jut forward and the shoulders to hunch forward. A prevalent cervical abnormality associated with this condition is the forward head position, which increases the risk of neck pain. The entire clinical condition is referred to as "sterno-symphyseal syndrome" by Bruegger. He describes the muscles involved as "painfully tense and painfully weak." Bruegger's exercises are designed to align the spine correctly by strengthening the scapular and neck muscles. Similarly, Kendall's exercises focus on restoring cervical spine alignment, particularly for individuals with forward head posture, by targeting the shoulder extensors and deep neck flexors. While numerous studies have examined the direct effects of forward head posture on the cervical spine, there is limited research comparing the effectiveness of Bruegger's exercises and Kendall's exercises, particularly regarding exercises that do not directly target the neck.

Conditions

Neck Pain

Keywords

Bruegger's exercises; Kendal exercises; Forward Neck Posture; Mobile Posture

Outcome Measures

Primary Outcomes (3)

• Pain level

  A numerical pain rating scale is a quantitative tool for determining how much pain is experienced. This scale is trustworthy and valid for measuring pain. Its measurement ranges from 0 to 10. I mean that when the numbers go from 0 to 10, the pain is more intense. O denotes "no pain," 1-3 indicate "mild pain," 4-6 indicate "moderate pain," 7-9 indicate "severe pain," and 10 indicate the worst pain. Dependability

  6th week

• Range of Motion

  Range of movement refers to the area that a joint can cover while moving. We utilize a universal goniometer to measure the range of motion (ROM). A scale called a universal goniometer is used to measure the range of quantitative values. The universal goniometer is also a useful and trustworthy instrument for ROM measurement. For cervical range of motion and cranio-vertebral angle, therefore, we use it.

  6th week

• limited function

  Disability is the inability of an individual to accomplish a goal or to carry out a daily activity. The Neck Disability Index (NDI) is the main tool used in neck assessments. The NDI is a scale used to assess a joint's limited range of motion or to measure the useful action. This scale has ten items that are linked to carrying out an activity. The neck impairment can be measured using this accurate and trustworthy scale. Dependability

  6th week

Study Arms (2)

Brugger's Exercises

EXPERIMENTAL

Participants will receive Burger Exercise

Other: Brugger's Exercises

KENDALL EXERCISE

ACTIVE COMPARATOR

Participants will receive Kendal Exercise

Other: Kendal Exercise

Interventions

Brugger's Exercises OTHER

1. The participant will sit upright and wrap an elastic resistance band around each hand, leaving the palms open. They will perform thumb and finger abduction and extension, wrist extension, and forearm supination. This will be followed by scapular retraction with shoulder external rotation, elbow extension, shoulder abduction, and extension, holding this position for 10 seconds. 2. In both sitting and standing positions, the participant will sit at the edge of a seat, naturally lifting the sternum, with legs spread at a 45-degree angle and feet slightly turned out. Shoulders should be relaxed, chin tucked, and elbows fully extended. The participant will keep their shoulders down, imagining the scapulae pressing together and downward into a V shape, with thumbs turned out, palms up, and fingers spread. This position is held for 10 seconds.

Brugger's Exercises

Kendal Exercise OTHER

1. In a supine position, the participant will place a towel around their neck. With their head on the floor, they will tuck their chin and use the towel to apply gentle resistance, holding for 10 seconds to strengthen the deep flexor muscles of the cervical spine. 2. In a prone position, the participant will point their thumbs toward the ceiling and extend their arms fully while leaning forward, then return to the starting position. They will then extend their arms horizontally and hold for 10 seconds. 3. The participant will place both hands on the back of their head, lift their elbows upward, pull them back, and simultaneously spread their arms out to the side. This position will be held for 10 seconds before returning to the starting position.

KENDALL EXERCISE

Eligibility Criteria

• Age: 20 Years - 40 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64)

You may qualify if:

• Age range: 20-40
• A patient who has neither "specific pain" nor "poor posture."
• A cranio-vertebral angle (CVA) of less than 52 degrees
• A Numeric Pain Rating Scale (NPRS) score of fewer than 7
• A Neck Disability Index score of greater than 10 (NDI)

You may not qualify if:

• Surgery on the neck or back
• Recent trauma history
• Malignancy
• Cervical dysfunction-related neurological symptoms
• Temporomandibular joint surgery
• Recent fractures or injuries

Sponsors & Collaborators

• Riphah International University: lead

Study Sites (1)

Rasheed Hospital

Lahore, Punjab Province, 05450, Pakistan

Location

Related Publications (5)

• Avaghade RR, Shinde SB, Dhane SB. Effectiveness of McKenzie approach and segmental spinal stabilization exercises on neck pain in individuals with cervical postural syndrome: An experimental study. J Educ Health Promot. 2023 Jul 29;12:225. doi: 10.4103/jehp.jehp_239_23. eCollection 2023.

  PMID: 37727425 BACKGROUND

• Abdel-Aziem AA, Abdel-Ghafar MA, Ali OI, Abdelraouf OR. Effects of smartphone screen viewing duration and body position on head and neck posture in elementary school children. J Back Musculoskelet Rehabil. 2022;35(1):185-193. doi: 10.3233/BMR-200334.

  PMID: 34092602 BACKGROUND

• Kazeminasab S, Nejadghaderi SA, Amiri P, Pourfathi H, Araj-Khodaei M, Sullman MJM, Kolahi AA, Safiri S. Neck pain: global epidemiology, trends and risk factors. BMC Musculoskelet Disord. 2022 Jan 3;23(1):26. doi: 10.1186/s12891-021-04957-4.

  PMID: 34980079 BACKGROUND

• Al-Khazali HM, Younis S, Al-Sayegh Z, Ashina S, Ashina M, Schytz HW. Prevalence of neck pain in migraine: A systematic review and meta-analysis. Cephalalgia. 2022 Jun;42(7):663-673. doi: 10.1177/03331024211068073. Epub 2022 Feb 15.

  PMID: 35166137 BACKGROUND

• Richards KV, Beales DJ, Smith AL, O'Sullivan PB, Straker LM. Is Neck Posture Subgroup in Late Adolescence a Risk Factor for Persistent Neck Pain in Young Adults? A Prospective Study. Phys Ther. 2021 Mar 3;101(3):pzab007. doi: 10.1093/ptj/pzab007.

  PMID: 33444448 BACKGROUND

MeSH Terms

Conditions

Neck Pain

Condition Hierarchy (Ancestors)

Pain; Neurologic Manifestations; Signs and Symptoms; Pathological Conditions, Signs and Symptoms

Study Officials

• Arslan Qaramat, DPT

  Riphah International University

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: June 11, 2024
• First Posted: June 14, 2024
• Study Start: December 15, 2024
• Primary Completion: April 15, 2025
• Study Completion: May 7, 2025
• Last Updated: May 22, 2025

Record last verified: 2025-05

Data Sharing

• IPD Sharing: Will not share

Locations

PA (1)