Effectiveness of Rib Mobilization Combined With Postural Correction Exercises in Individuals With Upper Crossed Syndrome

NCT07573553 | Recruiting DMC

• 1 other identifier: REC/02285 Altamash
• Study Type: interventional
• Target: 64
• Locations: 1 country
• Sites: 1

Brief Summary

This randomized controlled trial aims to evaluate the effectiveness of rib mobilization combined with postural correction exercises in reducing pain, improving cervical posture, and enhancing rib and thoracic mobility among individuals with Upper Crossed Syndrome (UCS). A total of 64 participants aged 20-45 years will be recruited and randomly assigned to two groups: Group A (rib mobilization + postural correction) and Group B (postural correction only). Intervention will be provided for 4-6 weeks, three sessions per week. Outcomes will include pain (VAS), cervical posture (inclinometer), and rib/thoracic mobility (tape measure). Data will be analyzed using SPSS version 26.

Conditions

Upper Cross Syndrome

Outcome Measures

Primary Outcomes (3)

• Pain Intensity

  1\. Pain Intensity - Measured using the Visual Analog Scale (VAS) ranging from 0 (no pain) to 10 (worst pain).

  1 year

• Cervical Posture

  Cervical Posture - Measured using an inclinometer to determine the craniovertebral angle.

  1 year

• Rib/Thoracic Mobility

  Rib/Thoracic Mobility - Measured using a tape measure and inclinometer to assess rib cage expansion and thoracic extension.

  1 year

Study Arms (2)

Intervention group

EXPERIMENTAL

Group receiving Rib Mobilization + Postural Correction Exercises

Behavioral: Rib Mobilization and Postural Correction Exercises

Control group

ACTIVE COMPARATOR

Group receiving Postural Correction Exercises Only

Other: Postural Correction Exercises Only

Interventions

Rib Mobilization and Postural Correction Exercises BEHAVIORAL

Participants will receive Grade I-III rib mobilizations at the costovertebral and costotransverse joints (ribs 2-6) along with thoracic central posterior-anterior mobilizations. In addition, postural correction exercises including scapular retraction, deep neck flexor training, pectoralis stretching, and thoracic extension exercises will be performed. Each session will last 30-40 minutes, three times per week for 4-6 weeks.

Intervention group

Postural Correction Exercises Only OTHER

Participants will perform only postural correction exercises, including scapular retraction, deep neck flexor training, pectoralis stretching, and thoracic extension exercises. Sessions will last 30-40 minutes, three times per week for 4-6 weeks.

Control group

Eligibility Criteria

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

You may qualify if:

• Age between 20 to 45 years
• Forward head posture (craniovertebral angle \< 50°)
• Cervical pain or discomfort for ≥4 weeks
• Moderate pain intensity (VAS 3-6)
• Willingness to participate and provide informed consent
• Clinically diagnosed Upper Crossed Syndrome (UCS)
• Meets Asian Fitness Society diagnostic criteria for UCS

You may not qualify if:

• History of trauma or surgery to cervical/thoracic spine
• Cervical disc herniation, radiculopathy, or neurological deficits
• Structural deformities (scoliosis, Scheuermann's disease)
• Systemic musculoskeletal disorders (e.g., rheumatoid arthritis)
• Vestibular, balance, or visual disorders
• Recent similar therapy within 3 months
• Pregnancy or contraindication to manual therapy
• Ongoing use of pain medications or muscle relaxants

Sponsors & Collaborators

• Riphah International University: lead

Study Sites (1)

District Headquater Haripur

Chak Six Hundred Twenty-four, Khyber Pakhtunkhwat, 22620, Pakistan

RECRUITING

Related Publications (4)

• Sepehri S, Sheikhhoseini R, Piri H, Sayyadi P. The effect of various therapeutic exercises on forward head posture, rounded shoulder, and hyperkyphosis among people with upper crossed syndrome: a systematic review and meta-analysis. BMC Musculoskelet Disord. 2024 Feb 1;25(1):105. doi: 10.1186/s12891-024-07224-4.

  PMID: 38302926 BACKGROUND

• Bayattork M, Skold MB, Sundstrup E, Andersen LL. Exercise interventions to improve postural malalignments in head, neck, and trunk among adolescents, adults, and older people: systematic review of randomized controlled trials. J Exerc Rehabil. 2020 Feb 26;16(1):36-48. doi: 10.12965/jer.2040034.017. eCollection 2020 Feb.

  PMID: 32161733 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

• Arshadi R, Ghasemi GA, Samadi H. Effects of an 8-week selective corrective exercises program on electromyography activity of scapular and neck muscles in persons with upper crossed syndrome: Randomized controlled trial. Phys Ther Sport. 2019 May;37:113-119. doi: 10.1016/j.ptsp.2019.03.008. Epub 2019 Mar 21.

  PMID: 30928841 BACKGROUND

MeSH Terms

Conditions

Oculocerebral hypopigmentation syndrome type Preus

Study Officials

• Attiq Ur Rehman, MS

  Riphah International University

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Altamash Hussain Khan, DPT

CONTACT

+92 3088805119; altamash.hussain1@icloud.com

Study Design

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

Study Record Dates

• First Submitted: April 30, 2026
• First Posted: May 7, 2026
• Study Start: October 16, 2025
• Primary Completion (Estimated): June 28, 2026
• Study Completion (Estimated): June 28, 2026
• Last Updated: May 7, 2026

Record last verified: 2026-04

Data Sharing

• IPD Sharing: Will not share

Locations

PA (1)