Effects of Post Isometric Relaxation and Janda's Approach in Patient With Shoudler Girdle Crossed Syndrome

NCT07064031 | Not Yet Recruiting

• 1 other identifier: REC/RCR &AHS/24/0144 Muqaddas
• Study Type: interventional
• Target: 54
• Locations: 1 country
• Sites: 1

Brief Summary

Shoulder girdle crossed syndrome referred as upper crossed syndrome. In this syndrome, tightness of the upper trapezius and levator scapula on the dorsal side crosses with tightness of the pectoralis major and minor. Weakness of the deep cervical flexors, ventrally, crosses with weakness of the middle, lower trapezius and Rhomboids. Janda Approach treatment involves steps i.e Normalize the Periphery, Restore Muscle Balance, Increase afferent input to facilitate reflexive stabilization and increase endurance in muscles.

Conditions

Upper Crossed Syndrome

Keywords

Muscle strength; Muscle Endurance; pain; posture

Outcome Measures

Primary Outcomes (3)

• Numerical Pain Rating Scale (NPRS)

  The Numeric Pain Rating Scale (NPRS) is perhaps the most frequently applied scale used to quantify pain intensity in the clinical setting. It is an 11-point numeric scale, ranging from 0 indicating no pain to 10 indicating worst pain imaginable

  upto 4 weeks

• Neck Disability Index (NDI)

  The Neck Disability Index (NDI) is a validated 10-item-questionnaire for the assessment of neck pain. The items of the questionnaire assess deficits in physical and social functioning as well as pain and everyday activities.

  upto 4 weeks

• Endurance Tests

  Endurance Tests: Research by Parazza et al 2014 found the following results when looking at neck endurance strength in flexion and extension: Neck flexion: 44 seconds and Neck extension: 261 seconds

  upto 4 weeks

Study Arms (2)

Post isometric relaxation

EXPERIMENTAL

This Group Will Receive Post isometric relaxation and Janda . PIR will be perform on upper trapezius and pectorals major muscle. In Janda technique weak muscles will be Strengthened and Tight muscles will be stretched.

Other: Neck Isometrics , TENS and Hot pack

Janda Technique

ACTIVE COMPARATOR

This group is control group and receive only Janda Technique as mentioned weak muscles i.e. serratus Anterior and Rhomboids are strengthened by isometric contraction of these muscles. Stretching of tight muscles i.e. upper trapezius and Pectoralis major muscle.

Other: Neck Isometrics , TENS and Hot pack

Interventions

Neck Isometrics , TENS and Hot pack OTHER

Hot apck and TENS applied for 10min each. Using the same amount of light pressure, gently push your head into your hand as you did before. This time, allow the head to move slowly toward the shoulder against the pressure of the hand. This too can be repeated on the opposite side, forwards, backward, and into left and right rotation

Janda Technique; Post isometric relaxation

Eligibility Criteria

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

You may qualify if:

• Age group between 18 and 50 years (defined as pain in the area of the neck could be provoked by mechanical characteristics, including sustained neck postures, cervical movement, or manual palpation of the cervical musculature)

You may not qualify if:

• Cervical radiculopathy
• History of whiplash injury
• History of cervical and thoracic spine surgery
• Neck pain associated with vertigo

Sponsors & Collaborators

• Riphah International University: lead

Study Sites (1)

Ittefaq Hospital

Lahore, Punjab Province, 54000, Pakistan

Location

Related Publications (8)

• Mubeen I, Malik S, Akhtar W, Iqbal M, Asif M, Arshad A, et al. Prevalence of upper cross syndrome among the medical students of University of Lahore. International journal of Physiotherapy. 2016;3(3):381-4.

  BACKGROUND

• Dhage P, Anap D. Prevalence of an "Upper Crossed Syndrome in Physiotherapy College Students"-A Cross-Sectional Study. VIMS Health Science Journal. 2019;6(1):10-3.

  BACKGROUND

• Kage V, Putti B. Effectiveness of stretching and strengthening exercises (Janda's approach) in subjects with postural backache: A randomized controlled trial. Int J Physiother Res. 2015;3(6):1301-6.

  BACKGROUND

• Bae WS, Lee HO, Shin JW, Lee KC. The effect of middle and lower trapezius strength exercises and levator scapulae and upper trapezius stretching exercises in upper crossed syndrome. J Phys Ther Sci. 2016 May;28(5):1636-9. doi: 10.1589/jpts.28.1636. Epub 2016 May 31.

  PMID: 27313388 BACKGROUND

• Guanche C, Knatt T, Solomonow M, Lu Y, Baratta R. The synergistic action of the capsule and the shoulder muscles. Am J Sports Med. 1995 May-Jun;23(3):301-6. doi: 10.1177/036354659502300308.

  PMID: 7661256 BACKGROUND

• Umphred D, Byl N, Lazaro R, Roller M. Interventions for neurological disabilities. Neurological rehabilitation. 2001;4:56-134.

  BACKGROUND

• Sherrington C. On reciprocal innervation of antagonistic muscles. Proc R Soc London B. 1905;76:161-269.

  BACKGROUND

• El Laithy MH, Fouda KZ. Effect of post isometric relaxation technique in the treatment of mechanical neck pain. Physical Therapy and Rehabilitation. 2018;5(1):20.

  BACKGROUND

MeSH Terms

Conditions

Oculocerebral hypopigmentation syndrome type Preus; Pain

Interventions

Transcutaneous Electric Nerve Stimulation

Condition Hierarchy (Ancestors)

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

Intervention Hierarchy (Ancestors)

Electric Stimulation Therapy; Therapeutics; Physical Therapy Modalities; Rehabilitation; Analgesia; Anesthesia and Analgesia

Study Officials

• Samrood Akram, PhD*

  Riphah International University

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Samrood Akram, PhD Scholar

CONTACT

03324806143; samrood.akram@riphah.edu.pk.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: July 3, 2025
• First Posted: July 14, 2025
• Study Start: July 1, 2025
• Primary Completion: September 1, 2025
• Study Completion: October 1, 2025
• Last Updated: July 14, 2025

Record last verified: 2025-07

Data Sharing

• IPD Sharing: Will not share

Locations

PA (1)