Comparative Effects of Stabilization Exercises and Corrective Exercises in Administrative Staff With Upper Cross Syndrome

NCT07766070 | Completed

• 1 other identifier: 2024-MS-PT-016
• Study Type: interventional
• Target: 50
• Locations: 1 country
• Sites: 1

Brief Summary

This study compares two types of rehabilitation strategies' - the stabilization exercises and the corrective exercises - to improve pain, respiratory function, and postural alignment in administrative staff with upper cross syndrome. Participants undertook a six-week intervention program. Random sampling technique was employed and 50 participants were included out of which 4 participants drops out. Randmoization was done via computer generator.The participants were divided into two groups: group A (Stabilization Exercises) and group B (Corrective Exercises). The process of data collection was conducted at MTH, and united hospital and participants will have included according to inclusion criteria. Pain was assessed by using the numeric pain rating. Respiratory function was assessed by using a digital spirometer. Postural alignment i.e., CVA \& SHA was assessed by using kinovea-2D video analysis. Mid thoracic curve was assessed by using Flexi curve rule.This study aims to determine which treatment produces greater improvement, which may help physiotherapists to give more effective evidence based treatment patients with UCS in Pakistan.

Conditions

Administrative Staff; Upper Cross Syndrome; Forward Head Posture; Computer Workers

Keywords

Upper cross syndrome; Stabilization exercises; Corrective exercise; Respiratory function; Postural alignment; Administrative Staff

Outcome Measures

Primary Outcomes (3)

• Pain Intensity

  Pain intensity was measured by using the Numeric Pain Rating Scale (NPRS), a 0-10 scale where 0 indicates no pain and 10 indicates worst imaginable pain. Participants werel mark their perceived pain level, and the score will recorded. The Numeric Pain Rating Scale (NPRS) is a valid and reliable tool for assessing pain severity, with reported validity coefficients ranging from r = 0.71 to 0.78 and great reliability (ICC = 0.97 .

  Baseline (week 0, before first intervention session), mid-intervention; week 3, after 9th session, and post-intervention (week 6, within 48 hours after the final intervention session)

• Respiratory Function

  The Respiratory function was assessed using a CareFusion digital spirometer. Spirometric parameters including Forced Vital Capacity (FVC), Forced Expiratory Volume in 1 second (FEV1), FEV1/FVC ratio, and Peak Expiratory Flow (PEF) will be recorded according to standard spirometry procedures. It has great validity (r \> 0.99) and reliability (ICC = 0.99)

  Baseline (week 0, before first intervention session), mid-intervention; week 3, after 9th session, and post-intervention (week 6, within 48 hours after the final intervention session)

• Postural Alignment

  Postural alignment was assessed using photographic analysis. Craniovertebral angle and sagittal head angle will be measured from lateral view images using Kinovea software. Standard anatomical landmarks was used to determine head and neck posture. Tragus of ear and C7 will be used for craniovertebral angle while tragus of ear and canthus of eye will be used for saggital head angle For assessing postural angles, such as the Craniovertebral Angle (CVA) and Sagittal Head Angle (SHA), Kinovea has shown very great validity (r = 1.0) and excellent reliability (ICC = 0.99)

  Baseline (week 0, before first intervention session), mid-intervention; week 3, after 9th session, and post-intervention (week 6, within 48 hours after the final intervention session).

Secondary Outcomes (1)

• Mid-Thoracic Curve

  Baseline (week 0, before first intervention session), and post-intervention (week 6, within 48 hours after the final intervention session.

Study Arms (2)

Stabilization Exercises Group

EXPERIMENTAL

The participants within group A had received stabilization exercises. Exercise to activate the serratus anterior muscle was serratus anterior punches with thera band. Exercise to activate middle trapezius and rhomboids was retraction plus external rotation exercise with thera band. Exercise to activate the lower trapezius muscle was resistance band overhead press with thera band. The dosage of these exercises was 3 sets × 10 reps with 5 sec hold for 3 days /week for 6 weeks. The length of treatment session was 45 minutes supervised.

Other: Stabilization Exercises

Corrective Exercises Group

ACTIVE COMPARATOR

Participants were receiving baseline treatment including hot pack and static stretching of the trapezius, levator scapulae of the affected side with 2 sets of 5 repetitions with 5-second hold, followed by corrective exercises focused on chin tuck, seated stability ball T exercises with swiss ball, foam roller shoulder opener, prone T, Y \& W raises. The dosage of these exercise was from 10 s hold ×7 to 15 s hold ×10 for 3 days /week for 6 weeks. The length of treatment session was 45 minutes supervised by clinical physiotherapist. There was no HEP

Other: Corrective Exercises

Interventions

Stabilization Exercises OTHER

What: A supervised scapular stabilization exercise program designed to improve scapular muscle activation, strength, and postural alignment in computer workers with Upper Cross Syndrome. The program includes serratus anterior punches with resistance band, scapular retraction with external rotation using resistance band, and resistance band overhead press targeting the lower trapezius. Exercises are performed under supervision three times per week for 6 weeks. When:45 minutes per session, 3 sessions per weeks for 6 weeks (total 18 sessions). How much : The dosage of these exercises was 3 sets × 10 reps with 5 sec hold for 3 days /week for 6 weeks. By Whom: by licensed physiotherapist trained in stabilization exercise Where: outpatient rehabilitation department of MTH (Madinah Teaching Hospital) and United Hospital, Faisalabad, Punjab, Pakistan

Stabilization Exercises Group

Corrective Exercises OTHER

What: A supervised comprehensive postural corrective exercise program designed to address postural muscle imbalance and improve cervical, thoracic, and scapular alignment in computer workers with Upper Cross Syndrome. The program includes chin tuck exercises for activation of the deep cervical flexors, seated stability ball T exercises for core and back extensor activation, foam roller shoulder opener, and prone T, Y, and W exercises. Exercises are performed under supervision three times per week for 6 weeks. When:45 minutes per session, 3 sessions per weeks for 6 weeks (total 18 sessions). How much : The dosage of these exercises was 10 s hold ×7 to 15 s hold ×10 hold for 3 days /week for 6 weeks. By Whom: by licensed physiotherapist trained in corrective exercise Where: outpatient rehabilitation department of MTH (Madinah Teaching Hospital) and United Hospital, Faisalabad, Punjab, Pakistan.

Corrective Exercises Group

Eligibility Criteria

• Age: 24 Years - 40 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64)

You may qualify if:

• Age 24-40 years.
• Prolonged computer working hours =6 hours/day .
• Prolonged computer working years for =6 months .
• Clinical features of UCS i.e.;
• Participant must meet =3 of the following on clinical exam:
• Cranio-vertebral angle (CVA) \< 50°.
• Visible FHP and rounded shoulders on the lateral view.
• Abnormality in the position and rhythm of the scapula.
• Excessive thoracic kyphosis \>42 .
• Non-specific chronic cervical pain =3 months.
• NPRS 3-6 (mild-moderate) .

You may not qualify if:

• Pregnant females.
• Reported history of smoking.
• Having a medical prescription that specifically dictated therapeutic exercises for posture.
• History of any fracture of upper limb and spine.
• History of any operations involving the neck, upper extremity and trunk.
• Reported history of recent spinal trauma .
• Reported any history of respiratory disorder i.e: COPD, TB, asthma etc.
• Reported any history of cardiac disorder i.e: angina, myocardial infarction, cardiac failure etc.
• Congenital spinal deformity i.e: structural kyphosis and scoliosis etc.
• Any history of neurological disease i.e: stroke, epilepsy, myasthenia gravis etc .
• Reported history of any cancer i.e: bone cancer, breast cancer etc

Sponsors & Collaborators

• University of Faisalabad: lead

Study Sites (1)

Department of Rehabilitation Sciences, The University of Faisalabad

Faisalabad, Punjab Province, 38000, Pakistan

Location

Related Publications (5)

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  BACKGROUND

• Nemati M, Saki F and Ramezani F (2025) Adding respiratory exercises to scapular stabilization training in adolescent girls with upper cross syndrome: A randomized controlled trial. BioMed Central Sports Science, Medicine and Rehabilitation 17(1): 1-12. Nitayarak H and Charntaraviroj P (2021) Effects of scapular stabilization exercises on posture and muscle imbalances in women with upper crossed syndrome: A randomized controlled trial. Journal of Back and Musculoskeletal Rehabilitation 34(6): 1031-1040. Pathak A, Sharma S and Jensen MP (2018) The utility and validity of pain intensity rating scales for use in developing countries. Pain Reports 3(5): e672. Pathan H, Pawar A, Rao R et al. (2022) A structured exercise program for upper cross syndrome. Journal of Medicine and Pharmceutical Chemistry Allied Sci 11(S1): 259-63. Prince R, Devine A and Dick I (2007) The clinical utility of measured kyphosis as a predictor of the presence of vertebral deformities. Osteoporosis International 18(5): 621-627. Ranđelović I, Jorgić B, Antić V et al. (2020) Effects of exercise programs on upper crossed syndrome: A systematic review. Fizičko Vaspitanje I Sport Kroz Vekove 7(2); 152-68. Rezaei H, Gheitasi M and Hosseini S (2025) Does corrective exercises influence the performance, posture, range of motion and shoulder pain of swimmers with upper crossed syndrome? A randomized clinical trial. BioMed Center Sports Science, Medicine and Rehabilitation 17(1): 193. Russin NH, Robertson C and Montalvo A (2026) Upper crossed syndrome in the workplace: A narrative review with clinical recommendations for non-pharmacologic management. International Journal of Environmental Research and Public Health 23(1): 120.

  BACKGROUND

• Kirthika S, Sudhakar S, Padmanabhan K et al. (2018) Impact of upper crossed syndrome on pulmonary function among the recreational male players: A preliminary report. Saudi Journal of Sports Medicine 18(2): 71-74. Kothari VN (2022) Effect of deep cervical flexor training v/s scapular stabilisation exercises on forward head posture among it professionals: A randomized clinical trial. Abhinav Bindra Sports Medicine and Research Institute 12(1): 1-68. Liaqat K, Basit L, Ibrar I et al. (2025) Correlation of upper cross syndrome with prolonged sitting among it workers in lahore. The Professional Medical Journal 32(11): 1568-1574. Mehri A, Letafatkar A (2018) Efficacy of corrective exercise intervention on forward head angle, pain and timing of superficial neck muscles activation during posterior-anterior perturbation in women with chronic neck pain. Medical Journal of Tabriz University of Medical Sciences 40(1): 66-76. Mehri A, Letafatkar A and Khosrokiani Z (2020) Effects of corrective exercises on posture, pain, and muscle activation of patients with chronic neck pain exposed to anterior-posterior perturbation. Journal of Manipulative and Physiological Therapeutics 43(4): 311-324. Murali S (2021) Prevalence of upper crossed syndrome among software professionals. International Journals of Medical and Exercise Science 7(3): 1061-1071. Muscolino J (2015) Upper crossed syndrome. Journal of the Australian Traditional-Medicine Society 21(2): 80-85. Mylonas K, Tsekoura M, Billis E et al. (2022) Reliability and validity of non-radiographic methods of forward head posture measurement: A systematic review. Cureus 14(8): e27696.

  BACKGROUND

• Hrvatin I and Puh U (2021) Measurement properties of the numerical pain rating scale in patients with musculoskeletal impairments of the limbs: A systematic literature review. Slovenian Medical Journal 90(9-10): 512-20. Hu X, Bao G, Quan X et al. (2025) The effect of neuromuscular combined with biomechanical scapular stabilizer muscle corrective exercises on upper crossed syndrome in chinese secondary school students: A randomized controlled trial. Research Square 4(1): 1-33. Jeong GH and Lee BH (2024) 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. Journal of Clinical Medicine 13(6): 1612. Kamble A, Naik S, Phadke S et al. (2022) Analysis of working posture using kinovea software to identify the incidence of forward head among bank employees: A cross-sectional study. International Journal for Multidisciplinary Research 4(6): 1-8. Kang N, Im S, Kim K et al. (2021) Effects of a combination of scapular stabilization and thoracic extension exercises for office workers with forward head posture on the craniovertebral angle, respiration, pain, and disability: A randomized-controlled trial. Turkish Journal of Physical Medicine and Rehabilitation 67(3): 291.

  BACKGROUND

• Abd El-Azeim AS, Mahmoud AG, Mohamed MT et al. (2022) Impact of adding scapular stabilization to postural correctional exercises on symptomatic forward head posture: A randomized controlled trial. European journal of physical and rehabilitation medicine 58(5): 757. Abdollahzade Z, Shadmehr A, Malmir K et al. (2017) Effects of 4 week postural corrective exercise on correcting forward head posture. Journal of Modern Rehabilitation 11(2): 85-92. Arshadi R, Ghasemi GA and Samadi H (2019) Effects of an 8-week selective corrective exercises program on electromyography activity of scapular and neck muscles in persons with upper crossed syndrome: A randomized controlled trial. Physical Therapy in Sport 37(2):113-119. Baek C, Ahn J, Lee J et al. (2025) Effect of digital health corrective posture exercise program on head and shoulder posture in adolescents: A cluster randomized controlled trial. Medicine 104(12): e41893. Bayattork M, Seidi F, Minoonejad H et al. (2020) The effectiveness of a comprehensive corrective exercises program and subsequent detraining on alignment, muscle activation, and movement pattern in men with upper crossed syndrome: Protocol for a parallel-group randomized controlled trial. Trials 21(1): 255. Chang M, Choo Y, Hong K et al. (2023) Treatment of upper crossed syndrome: A narrative systematic review. Healthcare 11(16): 2328. Daneshjoo A, Mousavi SSK and Pourahmad F (2021) Effect of corrective exercise vs corrective games on upper crossed syndrome in female students. Physical Treatments 11(1): 13-24. De Oliveira T, Candotti C, La Torrem M et al. (2012) Validity and reproducibility of the measurements obtained using the flexicurve instrument to evaluate the angles of thoracic and lumbar curvatures of the spine in the sagittal plane. Rehabilitation Research and Practice 2012(1): 1-9. Gao Y, Liang B, Su X et al. (2025) Reliability and usability of a portable spirometer compared to a laboratory spirometer. BMC Pulmonary Medicine 25(1): 228.

  BACKGROUND

MeSH Terms

Conditions

Oculocerebral hypopigmentation syndrome type Preus; Respiratory Aspiration

Condition Hierarchy (Ancestors)

Respiration Disorders; Respiratory Tract Diseases; Pathologic Processes; Pathological Conditions, Signs and Symptoms

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: August 10, 2026
• First Posted: August 14, 2026
• Study Start: April 24, 2026
• Primary Completion: July 10, 2026
• Study Completion: August 9, 2026
• Last Updated: August 14, 2026

Record last verified: 2026-08

Locations

PA (1)