Comparative Effects of Global Postural Re-education and NASM-based Corrective Exercises in Patients With Upper Cross Syndrome (UCS)

NCT07528248 | Recruiting

• 1 other identifier: IRB/FAHS/REHAB/10/25/MS/RS3458
• Study Type: interventional
• Target: 46
• Locations: 1 country
• Sites: 1

Brief Summary

The goal of this clinical trial is to learn the comparative effects of Global postural re-education (GPR) and National Academy of Sports Medicine (NASM) based corrective exercises in participants with upper cross syndrome (UCS). The main questions it aims to answer:

• Is there any difference between the effects of GPR and NASM-based corrective exercises in decreasing pain and disability and improving endurance in participants with upper cross syndrome?
• Is there any difference between the effects of GPR and NASM-based corrective exercises in improving cranio-vertebral angle of participants with upper cross syndrome? Researchers will compare GPR and NASM-based corrective exercises to see if there is difference between the two treatments in decreasing pain, disability and improving endurance and cranio-vertebral angle. Participants will be:
• Given treatment 3 times a week for 8 weeks.
• Assessed before first treatment session (baseline), at 4th week of intervention and at the end of last treatment session (8th week).

Conditions

Upper Cross Syndrome

Outcome Measures

Primary Outcomes (3)

• Mean change in endurance from baseline on Progressive iso-inertial lifting evaluation (PILE) test at 4 weeks and 8 weeks

  Progressive iso-inertial lifting evaluation (PILE) test has been recommended as a functional test to measure muscle endurance and involves lifting weights from waist to shoulder height (30-54 in.). Participants will begin with an 8- pound load and a 13-pound load for females and males respectively. Weight will be subsequently increased at a rate equal to the initial free weight every 20 s. Four lifting movements will actually performed at 20-s intervals. The test end-point will be established when aerobic capacity or neuromuscular fatigue being felt.

  From enrollment (before first treatment session) to the end of treatment at 8 weeks.

• Mean change in pain score from baseline on Numeric Pain Rating Scale (NPRS) at 4 weeks and 8 weeks

  The NPRS is an 11-point scale (0, no pain; 10, worst imaginable pain) used to assess the intensity of pain. Participants will be asked to rate their pain from 0 to 10.

  From enrollment (before first treatment session) to the end of treatment at 8 weeks.

• Mean change in disability score from baseline on Neck Disability Index (NDI) at 4 weeks and 8 weeks

  The NDI is 10 questions and each question has a possible total score of zero to 5. The total score from all 10 questions is divided by 50, the maximum score possible, with total scores expressed in percentage. Higher percentage scores indicate a worst disability.

  From enrollment (before first treatment session) to the end of treatment at 8 weeks.

Secondary Outcomes (1)

• Mean change in the Craniovertebral angle from baseline at 4 weeks and 8 weeks

  From enrollment (before first treatment session) to the end of treatment at 8 weeks.

Study Arms (2)

GPR+ Conventional Treatment

ACTIVE COMPARATOR

Participants in this arm will receive Global Postural re-education treatment in addition to the routine/conventional evidence based physiotherapy treatment. Participants will be asked to repeat each exercise three times a week for 8 weeks.

Other: Global Postural Re-education

NASM-based corrective exercises + Conventional Treatment

ACTIVE COMPARATOR

Participants in this arm will receive NASM-based corrective exercises in addition to the conventional treatment. Participants will be asked to repeat each exercise 10 to 15 times, for 1-2 sets, three times a week for 8 weeks.

Other: NASM-based Corrective exercises

Interventions

Global Postural Re-education OTHER

Global Postural Re-education 1st position: Patient will lie in supine, shoulders abducted to 30°, forearms supinated and the pelvis will be kept in a neutral position, while the lumbar spine remain supported. This position is characterized by a progression from flexion to extension of both hips and knees. 2nd position: Patient will remain in supine with their hips at 90° of flexion and perform gradual knee extensions. The participants will remain between 15 \& 20 min in each of these two positions. Under the supervision and verbal and/or manual guidance of the physiotherapist performing the intervention, they will perform 5-10s isomet contractions of the antagonist muscles of the muscle chain targeted by each posture. Subjects can also make active adjustments to their position, the physiotherapist can favor with some manual contact, sustained stretching and some joint traction to complete the session, the participants will be requested to maintain an upright posture in standing for 5min

Also known as: GPR

GPR+ Conventional Treatment

NASM-based Corrective exercises OTHER

NASM-based Corrective Exercises The four-stage exercise for UCS begins with preventing or reducing excessive muscle contraction (frequent foam wrapping), relaxing these same muscles, which fully eliminates dysfunctional muscles, and finally restores functional mobility. Step 1: inhibit or self-myofascial release overactive muscles: It includes the levator scapulae, trapezius (upper fibre), and sternocleidomastoid muscles. Hold pressure will be applied for 30 s on the tender spots. Step 2: Lengthen/ Static stretch. Upper trapezius Levator scapulae Sternocleidomastoid (SCM) Step 3: Activate/Strengthen. Chin tucks Floor Cobra Step 4: Integrate. Ball combination A routine/conventional evidence based physiotherapy treatment will also be given to both arms.

Also known as: National Academy of Sports Medicine Corrective exercises

NASM-based corrective exercises + Conventional Treatment

Eligibility Criteria

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

You may qualify if:

• Age between 20-45 years
• Pain in the upper back and neck region.
• Both male and female patients
• Rounded shoulders
• Craniovertebral angle less than 47 degrees
• Willingness to participate

You may not qualify if:

• History of spinal surgery
• Neurological deficits (radiculopathy, myelopathy, disc herniation)
• Severe scoliosis or structural deformity
• Active cervical spine pathology (spondylosis, stenosis and fracture)

Sponsors & Collaborators

• Rehana Hayat: lead

Study Sites (1)

District Headquarter Hospital (DHQ) Okara

Okāra, Punjab Province, 56300, Pakistan

RECRUITING

Related Publications (8)

• Azam H, Fatima N, Asjad A, Ashraf I, Asif T, Rehman F. Comparative effects of comprehensive corrective exercises versus muscle energy techniques in patients with upper cross syndrome: A randomized controlled trial: corrective exercises vs muscle energy techniques in patients with upper cross syndrome. Pakistan BioMedical Journal. 2022 Jul 31:173-7.

  BACKGROUND

• Almasoodi MC, Mahdavinejad R, Ghasmi G. The effect of 8 weeks national academy of sports medicine exercises training on posture, shoulder pain, and functional disability in male with upper cross syndrome. spine (cervicothoracic angle). 2020;21:22.

  BACKGROUND

• Abadiyan F, Hadadnezhad M, Khosrokiani Z, Letafatkar A, Akhshik H. Adding a smartphone app to global postural re-education to improve neck pain, posture, quality of life, and endurance in people with nonspecific neck pain: a randomized controlled trial. Trials. 2021 Apr 12;22(1):274. doi: 10.1186/s13063-021-05214-8.

  PMID: 33845880 BACKGROUND

• Chaudhuri S, Chawla JK, Phadke V. Physiotherapeutic Interventions for Upper Cross Syndrome: A Systematic Review and Meta-Analysis. Cureus. 2023 Sep 18;15(9):e45471. doi: 10.7759/cureus.45471. eCollection 2023 Sep.

  PMID: 37859911 BACKGROUND

• Chang MC, Choo YJ, Hong K, Boudier-Reveret M, Yang S. Treatment of Upper Crossed Syndrome: A Narrative Systematic Review. Healthcare (Basel). 2023 Aug 17;11(16):2328. doi: 10.3390/healthcare11162328.

  PMID: 37628525 BACKGROUND

• Gillani SN, Ain Q-, Rehman SU, Masood T. Effects of eccentric muscle energy technique versus static stretching exercises in the management of cervical dysfunction in upper cross syndrome: a randomized control trial. J Pak Med Assoc. 2020 Mar;70(3):394-398. doi: 10.5455/JPMA.300417.

  PMID: 32207413 BACKGROUND

• Mendes Fernandes T, Mendez-Sanchez R, Puente-Gonzalez AS, Martin-Vallejo FJ, Falla D, Vila-Cha C. A randomized controlled trial on the effects of "Global Postural Re-education" versus neck specific exercise on pain, disability, postural control, and neuromuscular features in women with chronic non-specific neck pain. Eur J Phys Rehabil Med. 2023 Feb;59(1):42-53. doi: 10.23736/S1973-9087.22.07554-2. Epub 2023 Jan 4.

  PMID: 36598342 BACKGROUND

• Karimian R, Rahnama N, Ghasemi G, Lenjannejadian S. Photogrammetric Analysis of Upper Cross Syndrome among Teachers and the Effects of National Academy of Sports Medicine Exercises with Ergonomic Intervention on the Syndrome. J Res Health Sci. 2019 Jul 3;19(3):e00450.

  PMID: 31586371 BACKGROUND

Related Links

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MeSH Terms

Conditions

Oculocerebral hypopigmentation syndrome type Preus

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: TRIPLE
• Who Masked: PARTICIPANT, CARE PROVIDER, INVESTIGATOR
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR INVESTIGATOR
• PI Title: Principal Investigator

Study Record Dates

• First Submitted: March 24, 2026
• First Posted: April 14, 2026
• Study Start: March 5, 2026
• Primary Completion (Estimated): May 10, 2026
• Study Completion (Estimated): May 10, 2026
• Last Updated: April 14, 2026

Record last verified: 2026-04

Data Sharing

• IPD Sharing: Will share
• Shared Documents: STUDY PROTOCOL, SAP, ICF
• Time Frame: 01-08-2026 to 30-08-2028
• Access Criteria: Data will be available to research journals, editors and reviewers on request through official email.

Locations

PA (1)