Kendall Exercises Versus Proprioceptive Neuromuscular Facilitation Technique in Patients With Upper Cross Syndrome

NCT06770205 | Active Not Recruiting

• 1 other identifier: REC/RCR&AHS/24/0108
• Study Type: interventional
• Target: 58
• Locations: 1 country
• Sites: 1

Brief Summary

Upper Crossed Syndrome (UCS) is a postural disorder characterized by a distinct pattern of muscle imbalances within the musculature of the shoulder girdle and cervico-thoracic region. The use of different corrective exercise approaches enhances and improves muscle balance and motor control thereby reducing postural abnormalities. Therefore, the aim of study will be to compare the effects of Kendall exercises versus proprioceptive neuromuscular facilitation technique on pain, range of motion, disability craniovertebral and thoracic angle in patients with upper cross syndrome. A Randomized Clinical Trial will be conducted at Riphah Clinic Lahore, Sehat medical complex hospital Lahore through consecutive sampling technique on 52 patients which will be allocated using computer generated sampling (random number table) into Group A and Group B. Group A will be treated with kendall exercises and Group B will be treated with Proprioceptive Neuromuscular Facilitation techniques with the frequency that Stretching exercises will be performed actively for 30 second hold and 3 repetitions. Strengthening exercise will be performed for 10 second hold and 10 repetitions. All Exercises will be performed 3 times per week for total of 4 weeks. Outcome measures will be conducted through pain, range of motion, disability craniovertebral and thoracic angle after 4 weeks. Data will be analyzed during SPSS software version 25.

Conditions

Upper Extremity Dysfunction

Keywords

Pain; Disability; Range of Motion; Craniovertebral angle; Thoracic angle.

Outcome Measures

Primary Outcomes (2)

• Numeric pain rate scale

  Numeric pain rate scale, Patient level of pain will be assessed using this scale. This scale ranges from 0 to 10. 0 indicates "no pain" and 10 indicate worst pain. The NPRS has a validity of (r=0.79-0.96) and a reliability of 0.86-0.89. (16) It takes less than one minute to complete, and can be understood in any language; i.e. there is no language barrier. It is a valid and reliable scale that measures pain intensity and experience.

  4th day

• Neck Disability index

  Neck Disability index (NDI), this questionnaire will be used to assess disability. It comprises of 10 items; 7 related to daily living activities, 2 related to pain and 1 related to concentration. Each item is scored from 0 to 5. Total score is expressed as a percentage, with higher scores related to greater disability.

  4th day

Secondary Outcomes (3)

• Range of motion

  4th day

• Craniovertebral angle

  4th day

• Thoracic angle

  4th day

Study Arms (2)

traditional physical therapy

ACTIVE COMPARATOR

Hot pack and TENS for 10 minutes and massage that will as 3 sessions per week for 4 weeks.

Other: traditional physical therapy

kendall Exercise Group A

EXPERIMENTAL

The Kendall exercise group participated in 5 sets of consisting of 12 repetitions of postures, each taking 30 seconds, based on Kendall exercise. The Kendall exercise methods were as follows: 1. Strengthening the deep cervical flexors, lying flat on the back with the chin down and then lifting the head and holding this position for 2-8 seconds to strengthen deep cervical flexors 2. Stretching the cervical extensors, placing both hands on the occipital area in a sitting position followed by a flexed neck posture with the head down to stretch the cervical extensors 3. strengthening shoulder retraction, putting a Thera Band around a secure object and pulling the band back with both hands as far as possible to move the shoulder blades toward each other in a standing position 4. stretching the pectoralis muscle, placing both hands on the occipital area and pulling the elbows back up

Other: kendall Exercise Group A

Interventions

traditional physical therapy OTHER

hot pack and TENS for 10 minutes and massage that will as 3 sessions per week for 4 weeks.

traditional physical therapy

kendall Exercise Group A OTHER

The group B will receive Proprioceptive Neuromuscular Facilitation technique for stretching and rhythmic stabilization technique for strengthening. Proprioceptive Neuromuscular Facilitation (PNF) is a stretching technique utilized to improve muscle elasticity and has been shown to have a positive effect on active and passive range of motions. The PNF group performed the intervention for 30 minutes a day, six times a week, a total of 24 times. (13) In this group, two types of PNF techniques were given: 1. first is strengthening technique included rhythmic stabilization that is characterized by alternating isometric contractions against resistance, no motion intended to apply for the weak muscles of upper cross syndrome included deep neck flexors specifically lower trapezius and serratus anterior. 2. Second is stretching technique included contract relax that is resisted isotonic contractions of the restricting muscles (antagonists) followed by relaxation and movement

kendall Exercise Group A

Eligibility Criteria

• Age: 25 Years - 50 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64)

You may qualify if:

• Patients diagnose with upper crossed syndrome.
• To diagnose upper cross syndrome, janda classification or approach will be use. Janda believed that muscle tightness or spasticity is predominant. Often weakness from muscle imbalance results from reciprocal inhibition of the tight antagonist. These patterns lead to postural changes and joint dysfunction and degeneration (23)
• Both genders male and female.
• Participants with constantly or frequently occurring neck-shoulder pain more than 1 month.
• Age between 25 and 50 years (3)
• Pain and restricted range of motion
• NPRS score greater than 3
• Craniovertebral angle \< 51 degree. (20)

You may not qualify if:

• Tumors
• Pregnancy
• Diagnosed psychological disorders
• Surgery
• Cancer and neuropathies past one year
• Rheumatoid arthritis and cervical instability.

Sponsors & Collaborators

• Riphah International University: lead

Study Sites (1)

Riphah Rehab Training and Research Center

Lahore, Punjab Province, 54000, Pakistan

Location

MeSH Terms

Conditions

Pain

Condition Hierarchy (Ancestors)

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

Study Officials

• Amna Shahid, t-DPT

  Riphah International University

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: DOUBLE
• Who Masked: PARTICIPANT, INVESTIGATOR
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Model Details: A Randomized Clinical Trial will be conducted at Riphah Clinic Lahore, Sehat medical complex hospital Lahore through consecutive sampling technique on 52 patients which will be allocated using computer generated sampling (random number table) into Group A and Group B. Group A will be treated with kendall exercises and Group B will be treated with Proprioceptive Neuromuscular Facilitation techniques with the frequency that Stretching exercises will be performed actively for 30 second hold and 3 repetitions. Strengthening exercise will be performed for 10 second hold and 10 repetitions. All Exercises will be performed 3 times per week for total of 4 weeks. Outcome measures will be conducted through pain, range of motion, disability craniovertebral and thoracic angle after 4 weeks. Data will be analyzed during SPSS software version 25. The normality of data will be assessed by Shapiro-Wilk test after which it will be decided either parametric or non-parametric test will be used within a g

Study Record Dates

• First Submitted: December 12, 2024
• First Posted: January 13, 2025
• Study Start: July 1, 2024
• Primary Completion: January 1, 2025
• Study Completion: January 1, 2025
• Last Updated: January 13, 2025

Record last verified: 2025-01

Data Sharing

• IPD Sharing: Will not share

Locations

PA (1)