Effects of Rhomboids Strength Training Regime Among Patients With Upper Crossed Syndrome

NCT06996002 | Not Yet Recruiting

• 1 other identifier: REC/RCR &AHS/24/0145 Bisma
• Study Type: interventional
• Target: 38
• Locations: 1 country
• Sites: 1

Brief Summary

Upper Cross Syndrome (UCS) is characterized by weakening of the neck flexors and rhomboids and stiffness in the pectoralis major, upper trapezius, and levator scapulae. Rhomboids major and minor need to be strengthened in order to enhance scapular stability and regain proper posture. The aim of this study is to determine effect of rhomboids strength training regime on pain, craniovertebral angle and disability among patients with upper crossed syndrome.

Conditions

Upper Crossed Syndrome

Keywords

Craniovertebral Angle; Pain; Disability

Outcome Measures

Primary Outcomes (3)

• Numerical Pain Rating Scale (NPRS)

  Patient level of pain will be assessed using this scale. This scale ranges from 0 to 10. 0 indicates "no pain" 1-3 indicate "Mild pain" 4-6 indicate "Moderate pain" 7-10 indicate "worst pain". NPRS have shown high test-retest reliability (r = 0.96 and 0.95, respectively)

  upto 4 weeks

• Neck Disability Index (NDI_

  The NDI is a 10-item, 50-point index that evaluates many facets of day-to-day functioning in individuals with neck pain. The NDI evaluates two items pertaining to discretionary daily living activities (personal care, reading), four items pertaining to activities of daily living (lifting, work, driving, and recreation), and four items related subjective symptoms (pain intensity, headache, concentration, and sleeping). The scores are interpreted as follows: 0-4: No disability 5-14: Mild disability 15-24: Moderate disability 25-34: Severe disability 35-50: Complete disability. For the NDI, test-retest reliability was good

  upto 4 weeks

• Craniovertebral Angle

  Anatomically speaking, the degree of forward head posture is measured using the craniovertebral angle (CVA), which is a measurement of the head and neck posture. It is the angle created by a horizontal line running from the C7 vertebra and the line joining the tragus of the ear to the vertebra (the seventh cervical vertebra). In order to calculate the craniovertebral angle: 1. Indicate the C7 vertebra and the tragus of the ear. 2. Draw an imaginary line that connects the C7 vertebra to the tragus. 3. Sketch a line that extends horizontally from the vertebra C7. 4. Calculate the angle that these two lines form. More than 50 degrees is the normal CVA. Head tilt slightly forward, between 40 and 50 degrees. A somewhat forward head posture, between 30 and 40 degrees. Head Posture Severe Forward when it is less than 30 degrees. CVA is a trustworthy measure of head and neck posture

  upto 4 weeks

Study Arms (2)

Rhomboids strengthening exercises along with conventional Exercises

EXPERIMENTAL

Rhomboids strengthening exercises: 1. Seated Bent Row 2. Bent Over Row 3. Lat Pull Down 4. Shoulder Horizontal Abduction 5. Band pull apart 6. Prone lateral raise hot pack for 10 min. Trans-cutaneous Electric Nerve Stimulation (TENS). Stretching chest muscles, pectoralis muscles, levator scapulae muscle, cervical extensor muscles, upper trapezius Posture correction exercises

Other: Rhomboids Strengthening Exercise; Other: Conventional Exercises

Conventional Exercises

ACTIVE COMPARATOR

* Both groups will receive hot pack for 10 min. * Trans-cutaneous Electric Nerve Stimulation (TENS). Stretching chest muscles, pectoralis muscles, levator scapulae muscle, cervical extensor muscles, upper trapezius * Posture correction exercises

Other: Conventional Exercises

Interventions

Rhomboids Strengthening Exercise OTHER

1. Seated Bent Row in Sitting position,3 sets of the exercise program with 12 repetitions per set, 3 times per week. 2. Bent Over Row in standing position, 3 sets, 12 repetitions, 3 times per week. 3. Lat Pull Down in sitting position with 12 repetitions per set, 3 times per week. 4. Shoulder Horizontal Abduction in lying position with 3 sets of the exercise program with 12 repetitions per set, 3 times per week. 5. Band pull apart performed 4sets, 12 repetitions, and 10 seconds rest for 2 mints, 3 times per week. 6. Prone lateral raise with 3 sets of the exercise program with 12 repetitions per set, 3 times per week. Conventional treatment Modalities: Trans-cutaneous Electric Nerve Stimulation (TENS) and Hot pack, postural exercises and stretching exercises

Rhomboids strengthening exercises along with conventional Exercises

Conventional Exercises OTHER

Conventional Treatment 1. hot pack for 10 min, 2. Trans-cutaneous Electric Nerve Stimulation (TENS) will be applied, with pulse duration of 250 microseconds at a frequency of 80 Hz for 15 min in the sub occipital region and the trapezius bilaterally. 3. Stretching exercises of tight muscles 2 sets of 15 min. 4. Posture correction exercises: releasing muscles of anterior part of the trunk, neck, shoulder.

Conventional Exercises; Rhomboids strengthening exercises along with conventional Exercises

Eligibility Criteria

• Age: 20 Years - 45 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64)

You may qualify if:

• Age group between 20 and 45 years
• Both gender male and female
• Subject with head neck angle less than 50 degrees(for forward head posture).
• Subject with positive JANDAS upper crossed syndrome tests .
• Population with occupation tailor, computer users and students.

You may not qualify if:

• Tuberculosis, carcinoma, heart disease, and osteoporosis
• Neural disorders due to prolapsed intervertebral disc
• Any trauma or localized infection in upper back region

Sponsors & Collaborators

• Riphah International University: lead

Study Sites (1)

Haleema Surgical Hospital

Jhang, Punjab Province, 54000, Pakistan

Location

Related Publications (8)

• Mujawar JC, Sagar JH. Prevalence of Upper Cross Syndrome in Laundry Workers. Indian J Occup Environ Med. 2019 Jan-Apr;23(1):54-56. doi: 10.4103/ijoem.IJOEM_169_18.

  PMID: 31040591 BACKGROUND

• Jeong GH, Lee BH. Effects of Telerehabilitation Combining Diaphragmatic Breathing Re-Education and Shoulder Stabilization Exercises on Neck Pain, Posture, and Function in Young Adult Men with Upper Crossed Syndrome: A Randomized Controlled Trial. J Clin Med. 2024 Mar 11;13(6):1612. doi: 10.3390/jcm13061612.

  PMID: 38541838 BACKGROUND

• Naseer R, Tauqeer S. Prevalence of upper cross syndrome in different occupations. Pakistan Journal of Physical Therapy (PJPT). 2021:03-7.

  BACKGROUND

• Huang JF, Meng Z, Zheng XQ, Qin Z, Sun XL, Zhang K, Tian HJ, Wang XB, Gao Z, Li YM, Wu AM. Real-World Evidence in Prescription Medication Use Among U.S. Adults with Neck Pain. Pain Ther. 2020 Dec;9(2):637-655. doi: 10.1007/s40122-020-00193-1. Epub 2020 Sep 17.

  PMID: 32940899 BACKGROUND

• Chu EC, Butler KR. Resolution of Gastroesophageal Reflux Disease Following Correction for Upper Cross Syndrome-A Case Study and Brief Review. Clin Pract. 2021 May 21;11(2):322-326. doi: 10.3390/clinpract11020045.

  PMID: 34063944 BACKGROUND

• Kirthika SV, Sudhakar S, Padmanabhan K, Ramanathan K. Impact of upper crossed syndrome on pulmonary function among the recreational male players: A preliminary report. Saudi Journal of Sports Medicine. 2018;18(2):71-4.

  BACKGROUND

• Gull M, Akbar UU, Asim HM. FREQUENCY OF CHRONIC NECK PAIN IN UPPER CROSS SYNDROME IN FEMALE SCHOOL TEACHERS. Independent Journal of Allied Health Sciences. 2018;1(01):33-8.

  BACKGROUND

• Firouzjah MH, Firouzjah EMAN, Ebrahimi Z. The effect of a course of selected corrective exercises on posture, scapula-humeral rhythm and performance of adolescent volleyball players with upper cross syndrome. BMC Musculoskelet Disord. 2023 Jun 14;24(1):489. doi: 10.1186/s12891-023-06592-7.

  PMID: 37316911 BACKGROUND

MeSH Terms

Conditions

Oculocerebral hypopigmentation syndrome type Preus; Pain

Condition Hierarchy (Ancestors)

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

Study Officials

• Samrood Akram, PhD Scholar

  Riphah International University

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Samrood Akram, PhD Scholar

CONTACT

03324806143; Samrood.akram@riphah.edu.pk

Bisma Batool, MSPT

CONTACT

03347191694; bismaiftikhar177@gmail.com

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: May 21, 2025
• First Posted: May 30, 2025
• Study Start: July 1, 2025
• Primary Completion: August 20, 2025
• Study Completion: September 20, 2025
• Last Updated: July 4, 2025

Record last verified: 2025-07

Data Sharing

• IPD Sharing: Will not share

Locations

PA (1)