Dry Cupping Therapy and Muscle Energy Technique on Upper Crossed Syndrome

NCT07654543 | Active Not Recruiting

• 1 other identifier: 012/006489
• Study Type: interventional
• Target: 76
• Locations: 1 country
• Sites: 1

Brief Summary

This study evaluated and compared the therapeutic efficacy of combining Dry Cupping therapy with the Muscle Energy Technique (MET) against each intervention applied independently, focusing on three core parameters: Neck Disability Index (NDI), Craniovertebral Angle (CVA), and Sagittal Shoulder-C7 Angle (SSA).

Conditions

Upper Crossed Syndrome; Muscle Energy Techniques

Outcome Measures

Primary Outcomes (3)

• Neck Disability Index (NDI)

  Perceived functional limitations resulting from regional impairment were measured using the validated Arabic version of the NDI questionnaire. This instrument evaluates 10 clinical sections (including activities of daily living, concentration, and pain profiles) scored from 0 to 5 per item, yielding a cumulative score out of 50. Higher aggregate indices represent greater functional disability.

  At baseline and re assessed following 8 weeks

• craniovertebral angle (CVA)

  This biomechanical index reflects the architectural severity of forward head posture. It is defined as the angle formed between a horizontal line drawn through the spinous process of C7 and an intersecting line extending from the tragus of the ear to the C7 landmark. CVA was measured using precision digital photogrammetry via the Kinovea software application.

  At baseline and re assessed following 8 weeks

• Sagittal Shoulder-C7 Angle (SSA)

  This geometric marker quantifies shoulder roundedness and anterior protraction. It is formed by the intersection of a horizontal reference line passing through the lateral aspect of the acromion with a line drawn from the C7 spinous process to the lateral acromion. SSA was measured using precision digital photogrammetry via the Kinovea software application.

  At baseline and re assessed following 8 weeks

Study Arms (4)

Group A (Combined group)

EXPERIMENTAL

Group A (Combined group): This group of nineteen subjects received combined dry cupping therapy, Muscle energy techniques, and conventional physical therapy.

Procedure: combined therapy teatment

Group B (Cupping group)

EXPERIMENTAL

Group B (Cupping group): This group of nineteen subjects received dry cupping therapy and conventional physical therapy.

Procedure: cupping therapy group

Group C (MET group)

EXPERIMENTAL

Group C (MET group): This group of nineteen subjects received Muscle energy techniques and conventional physical therapy.

Procedure: muscle energy techniques group

Group D (Control group)

ACTIVE COMPARATOR

Group D (Control group): This group of nineteen subjects received conventional physical therapy alone

Procedure: control group

Interventions

combined therapy teatment PROCEDURE

19 subjects received combined dry cupping therapy, Muscle energy technique, and conventional physical therapy for eight weeks. 1. Dry cupping was applied to the regional hypertonic target sites. Standard plastic cups ranging from 25 to 50 mm were placed directly over each subject's levator scapulae trigger point (SI-14) and upper trapezius trigger point (GB-21) bilaterally. The treatment duration was set at exactly 8 minutes per session. 2. Muscle Energy Technique The Post-Isometric Relaxation (PIR) manual protocol targeted the hypertonic muscles of the upper crossed syndrome quadrant, including the upper trapezius, levator scapulae, sternocleidomastoid, scalenes, and suboccipital groups. Participants were placed in a supine position on the treatment table with their head free from the edge of the plinth, supported by the physical therapist. 3. conventional physical therapy treatment

Group A (Combined group)

cupping therapy group PROCEDURE

19 subjects received combined dry cupping therapy and conventional physical therapy for eight weeks. 1. Dry cupping was applied to the regional hypertonic target sites. Standard plastic cups ranging from 25 to 50 mm were placed directly over each subject's levator scapulae trigger point (SI-14) and upper trapezius trigger point (GB-21) bilaterally. The treatment duration was set at exactly 8 minutes per session. 2. conventional physical therapy treatment

Group B (Cupping group)

muscle energy techniques group PROCEDURE

19 subjects received combined Muscle energy technique, and conventional physical therapy for eight weeks. 1. Muscle Energy Technique The Post-Isometric Relaxation (PIR) manual protocol targeted the hypertonic muscles of the upper crossed syndrome quadrant, including the upper trapezius, levator scapulae, sternocleidomastoid, scalenes, and suboccipital groups. Participants were placed in a supine position on the treatment table with their head free from the edge of the plinth, supported by the physical therapist. 2. conventional physical therapy treatment

Group C (MET group)

control group PROCEDURE

19 subjects received only conventional physical therapy for eight weeks.

Group D (Control group)

Eligibility Criteria

• Age: 20 Years - 40 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64)

You may qualify if:

• The exact diagnostic criteria required a baseline craniovertebral angle (CVA) of less than 48 degrees.
• a sagittal shoulder-C7 angle (SSA) of less than 52 degrees.

You may not qualify if:

• acute post-surgical conditions
• structural spinal deformities (e.g., severe fixed structural scoliosis)
• cervical radiculopathy, or localized dermal infections contradicting cupping application.

Sponsors & Collaborators

• Amira saad mohamed: lead

Study Sites (1)

Cairo University

Giza, Egypt

Location

MeSH Terms

Conditions

Oculocerebral hypopigmentation syndrome type Preus

Interventions

Control Groups

Intervention Hierarchy (Ancestors)

Epidemiologic Research Design; Epidemiologic Methods; Investigative Techniques; Research Design; Methods

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 INVESTIGATOR
• PI Title: lecturer of physical therapy

Study Record Dates

• First Submitted: June 13, 2026
• First Posted: June 17, 2026
• Study Start: March 1, 2026
• Primary Completion: June 18, 2026
• Study Completion (Estimated): June 30, 2026
• Last Updated: June 17, 2026

Record last verified: 2026-06

Locations

EG (1)