Sequential Core Stability Corrective Exercise Approach in Lower Crossed Syndrome (SCSCRLCS)

Sequential Core Stability Corrective Exercise Approach for Alignment And Muscle Function In Lower Crossed Syndrome

The objective of the study will be to determine the effects of Sequential Core Stability Corrective Exercise Approach for Alignment and Muscle Function in Lower Crossed Syndrome.

Lower Crossed Syndrome is one of common postural disorder which occurs due to the muscular imbalance. It refers to specific altered muscle activation and movement patterns along with some postural deviations. Alterations in muscle activation include overactivity of hip flexors and lower back muscles paired underactivity of abdominals and gluteus muscle. This pattern of imbalance creates dysfunction. Postural correction exercise with inner and outer core muscles are necessary. There are different traditional structural approach, functional approach and biomechanics and are presumed to lead to adjustments in the length and strength of local muscles while ignoring other related malalignments and core stability. The objective of the study will be to determine the effects of Sequential Core Stability Corrective Exercise Approach for Alignment and Muscle Function in Lower Crossed Syndrome. It will be a randomized controlled trial. Sample size will be collected after running the pilot study. The participants will be recruited through convenient sampling technique and then allocated randomly to Groups. Outcome measures will be alignment and muscle function. Pre and post reading and after one month follow-up will be recorded. Data will be analyzed using statistical package for social sciences software version 25. After assessing normality of data by Shapiro-Wilk test, it will be decided either parametric or nonparametric test will be use within a group or between two groups. Keywords: Alignment, Core Stability, Diaphragm, Muscular Imbalance, Muscle thickness Pelvic floor.

Corrective Exercises Hip Flexor Stretch 30 seconds hold 3 repetitions on each side Thoracolumbar extensors stretch 30 second holds 3 repetitions Abdominal Curl ups with hands at side 10 repetitions 2 sets Progression: • Abdominal curl up with arms crossed • Abdominal curl ups with hands behind head Pelvic bridging 10 seconds hold 10 repetitions 2 sets

Corrective Exercises Diaphragm Training Program As per standardized pulmonary rehabilitation guidelines,. Participant will be advised to breathe in gently with an improved tidal volume for ten repetitions, then after a short interval of break 15 repetitions will be done again. 30 Repetitions in set of 15, 15 with the interval rest. 2 sets. Pelvic floor Muscle training Participants will be asked to do pelvic floor training with high intensity (close to maximum) contractions with holding each muscle contraction for 6-8 seconds with relaxation of 6 seconds. Total 8 to 12 contractions. Core Stability exercises Beginning Progressing Advanced

Hip Flexor Stretch 30 seconds hold 3 repetitions on each side Thoracolumbar extensors stretch 30 second holds 3 repetitions Abdominal Curl ups with hands at side 10 repetitions 2 sets Progression: • Abdominal curl up with arms crossed • Abdominal curl ups with hands behind head Pelvic bridging 10 seconds hold 10 repetitions 2 sets

Corrective Exercises Diaphragm Training Program As per standardized pulmonary rehabilitation guidelines,. Participant will be advised to breathe in gently with an improved tidal volume for ten repetitions, then after a short interval of break 15 repetitions will be done again. 30 Repetitions in set of 15, 15 with the interval rest. 2 sets. Pelvic floor Muscle training Participants will be asked to do pelvic floor training with high intensity (close to maximum) contractions with holding each muscle contraction for 6-8 seconds with relaxation of 6 seconds. Total 8 to 12 contractions. Core Stability exercises Beginning Progressing Advanced

Angle of Chest expansion will be measured at Nipple line, Xiphoid level and at waist level, Through a Reliable and validated camera.

diaphragmatic thicknesses and thickening will be assessed by B-mode ultrasonography during various respiratory maneuvers

Levator ani thicknesses and thickening will be assessed by B-mode ultrasonography during various respiratory maneuvers

Inclusion Criteria: • Age group between 18 to 28 years No current incidence of low back pain or past history of low back dysfunction Kendall double leg lowering test: Abdominal muscle weakness to the extent of not being able to maintain posterior pelvic tilt during a double leg lowering test in supine position. Diagnosed with lower cross syndrome through assessment criteria of Janda muscle testing and assessment Exclusion Criteria: • Having any history of low back pain, spinal trauma, Joint dysfunction in past 3 months Congenital deformities at hip or lumbar region, Recent fracture to related joints in past 6 months Any family history of cardiopulmonary disease Any disease or urogenital tract Participants having BMI above 30. Recent history of hepatitis or Fatty liver or Any athlete having high physical activity. History of abdominal, hip or lumbar surgeries in past 3 months