Scapular Stabilization Exercises Combined With Thoracic Mobilization in Breast Feeding Mothers With Upper Back Pain

NCT07766148 | Completed DMC

• 1 other identifier: UOL/IREB/26/19/01/0015
• Study Type: interventional
• Target: 70
• Locations: 1 country
• Sites: 1

Brief Summary

Upper-back pain is common among breastfeeding mothers and may be associated with prolonged feeding positions, forward-bent posture, reduced thoracic mobility, and weakness of the muscles controlling the shoulder blades. This study will compare scapular stabilization exercises combined with thoracic spine mobilization with scapular stabilization exercises alone in breastfeeding mothers experiencing upper-back pain. Seventy eligible breastfeeding mothers aged 18-35 years will be assigned to one of two treatment groups. Both groups will receive scapular stabilization exercises, while one group will additionally receive thoracic mobilization performed by a trained physiotherapist. Treatment will be provided three times per week for eight weeks. Pain intensity, functional ability, and spinal range of motion will be assessed at baseline, Week 4, and Week 8. The study aims to determine whether adding thoracic mobilization to scapular stabilization exercises provides greater improvement in pain, mobility, and daily functioning than scapular stabilization exercises alone.

Conditions

Breast Feeding

Keywords

Breast Feeding; Exercise Therapy; Musculoskeletal Pain; Postpartum Period; Thoracic Vertebrae

Outcome Measures

Primary Outcomes (1)

• Change in Pain Intensity Assessed Using the Numeric Pain Rating Scale

  Pain intensity will be assessed using the Numeric Pain Rating Scale (NPRS), an 11-point self-reported scale ranging from 0 ("no pain") to 10 ("worst imaginable pain"). Participants will rate their average upper-back pain experienced during the previous 24 hours. Higher scores indicate greater pain intensity. Change in NPRS score from baseline to post-intervention will be analyzed.

  Baseline and immediately after completion of the intervention

Secondary Outcomes (2)

• Change in Thoracic and Cervicothoracic Range of Motion

  Baseline and immediately after completion of the intervention

• Change in Functional Ability Assessed Using the Patient-Specific Functional Scale

  Baseline and immediately after completion of the intervention

Study Arms (2)

Scapular Stabilization Exercises With Thoracic Mobilization

EXPERIMENTAL

Participants will receive scapular stabilization exercises combined with thoracic spine mobilization three times per week for eight weeks. Exercises will include scapular retraction and depression, serratus anterior punches, wall slides, and prone horizontal abduction with scapular setting. Each exercise will be performed in three sets of 10-12 repetitions, with 5-second holds where appropriate. Exercise intensity will be progressively increased every two weeks by increasing repetitions and adding resistance bands. A trained physiotherapist will also provide thoracic mobilization for approximately 10-15 minutes per session to improve thoracic mobility and reduce stiffness.

Other: Scapular Stabilization Exercises; Other: Thoracic Spine Mobilization

Scapular Stabilization Exercises Alone

ACTIVE COMPARATOR

Participants will receive scapular stabilization exercises alone three times per week for eight weeks. Exercises will include scapular retraction and depression, serratus anterior punches, wall slides, and prone horizontal abduction with scapular setting. Each exercise will be performed in three sets of 10-12 repetitions, with 5-second holds where appropriate. Exercise intensity will be progressively increased every two weeks by increasing repetitions and adding resistance bands. Thoracic mobilization will not be provided to this group.

Other: Scapular Stabilization Exercises

Interventions

Scapular Stabilization Exercises OTHER

Participants will perform a structured scapular stabilization programme three times per week for eight weeks. Each session will include scapular retraction and depression, serratus anterior punches, wall slides, and prone horizontal abduction with scapular setting. Exercises will be performed in three sets of 10-12 repetitions, with 5-second holds where appropriate. The programme will be progressively advanced every two weeks by increasing repetitions and introducing resistance bands. Sessions will include a standardized warm-up and stretching of the upper trapezius and levator scapulae.

Scapular Stabilization Exercises Alone; Scapular Stabilization Exercises With Thoracic Mobilization

Thoracic Spine Mobilization OTHER

A trained physiotherapist will administer manual mobilization to clinically identified hypomobile thoracic spinal segments. The intervention will focus on improving thoracic extension and segmental mobility and reducing stiffness and pain around the cervicothoracic region. Mobilization will be performed before the exercise programme for approximately 10-15 minutes per session, three times per week for eight weeks. The mobilization technique and intensity will be selected according to the participant's clinical presentation and tolerance.

Scapular Stabilization Exercises With Thoracic Mobilization

Eligibility Criteria

• Age: 18 Years - 35 Years
• Gender Eligibility Details: Only Breast Feeding Female
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64)

You may qualify if:

• Women in the early postpartum period (0-3 months following childbirth) (Ratajczak \& Górnowicz, 2024).
• Women who were exclusively breastfeeding and experiencing upper back pain associated with breastfeeding activities within the first 3 months postpartum (Ojukwu et al., 2025).
• Participants reporting moderate upper back pain, defined as a score of 4-7 on the Numeric Pain Rating Scale (NPRS) at the time of recruitment (Bharti et al., 2024).

You may not qualify if:

• History of cervical spine trauma, surgery, or fracture (Yan et al., 2023).
• Presence of neurological disorders, cervical radiculopathy, myelopathy, or musculoskeletal conditions unrelated to breastfeeding that could influence neck pain, cervical mobility, or functional performance (Yonus et al., 2025).
• Diagnosed systemic illnesses or medical conditions that may contraindicate exercise participation, such as rheumatoid arthritis, ankylosing spondylitis, osteoporosis, uncontrolled hypertension, cardiovascular disease, or other inflammatory or metabolic disorders affecting the musculoskeletal system (Womsi et al., 2025).
• Concurrent pain in other body regions (e.g., shoulder, thoracic spine, upper back, or upper extremity pain) that could interfere with exercise participation or influence outcome measurements (Rana et al., 2024).
• Ongoing physiotherapy, rehabilitation, or medical treatment for neck pain during the study period (Ratajczak \& Górnowicz, 2024).

Sponsors & Collaborators

• University of Lahore: lead

Study Sites (1)

The University of Lahore Teaching Hospital

Lahore, 54590, Pakistan

Location

Related Publications (2)

• El-Sadany, A., Mohamed, N., & Ibrahim, M. (2024). Effect of scapular stabilization training on pain and function in patients with postural neck pain: A randomized controlled study. Physiotherapy Theory and Practice, 40(5), 621-630. https://doi.org/10.1080/09593985.2023.2254771

  BACKGROUND

• Ashfaq, A., Awan, W. A., & Ahmad, S. (2024). Responsiveness of numeric pain rating scale and visual analogue scale in patients with musculoskeletal pain: A prospective study. BMC Musculoskeletal Disorders, 25(1), 118. https://doi.org/10.1186/s12891-024-07245-8

  BACKGROUND

MeSH Terms

Conditions

Breast Feeding; Musculoskeletal Pain

Condition Hierarchy (Ancestors)

Feeding Behavior; Behavior; Muscular Diseases; Musculoskeletal Diseases; Pain; Neurologic Manifestations; Signs and Symptoms; 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: PRINCIPAL INVESTIGATOR
• PI Title: Student

Study Record Dates

• First Submitted: August 10, 2026
• First Posted: August 14, 2026
• Study Start: February 24, 2026
• Primary Completion: July 14, 2026
• Study Completion: July 21, 2026
• Last Updated: August 14, 2026

Record last verified: 2026-08

Data Sharing

• IPD Sharing: Will not share

Locations

PA (1)