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Effect of Cervicothoracic Mobilization on Upper Crossed Syndrome

Primary Purpose

Upper Crossed Syndrome

Status
Not yet recruiting
Phase
Not Applicable
Locations
Study Type
Interventional
Intervention
cervicothoracic mobilization
CCE
Sponsored by
Cairo University
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Upper Crossed Syndrome focused on measuring Forward head posture, Rounded Shoulders, Thoracic kyphosis, UCS, Mobilization

Eligibility Criteria

20 Years - 50 Years (Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria: Age between 20-50 years . Participants will included if their CVA less than 48° ( SSA less than 52°) , as above these values are considered normal and thoracic kyphosis (with flexicurve angle more than 45 degrees) . Subjects who have weakness in deep neck flexors, serratus anterior, middle and lower trapezius and rhomboid muscles and tightness in upper trapezius, levator scapulae, scalene, posterior neck and suboccipital muscles, pectoralis major and minor and sternocleidomastoid muscles. Subject complaining of this symptom for more than 3mothes. Marking pain intensity score visual analog scale (VAS) ≥3 in neck and shoulder Exclusion Criteria: History of surgery or joint diseases of the spine or shoulder. Osteoporosis, or fracture ,cervical instability or any sign those with other contraindications against joint mobilization. Individuals with any cervical condition e.g. radiculopathy, cervical rib, whiplash injury and individuals with any neurological/ condition . History of congenital spinal deformity (congenital scoliosis) . Any malignancy related to soft tissue and joints . Subjects taking analgesics and/or muscle relaxants. pregnancy. Being in weight out of the normal range (18 ≥ BMI ≥ 25). Cognitive impairment and inability to understand the scale.

Sites / Locations

    Arms of the Study

    Arm 1

    Arm 2

    Arm Type

    Experimental

    Active Comparator

    Arm Label

    cervicothoracic mobilization

    control group: comprehensive corrective exercise (CCE).

    Arm Description

    This group will receive cervicothoracic mobilization with comprehensive corrective exercise

    This group will receive traditional treatment comprehensive corrective exercise (CCE).

    Outcomes

    Primary Outcome Measures

    change in Craniovertebral angle (CVA) .
    Craniovertebral angle (CVA) will be measured using Computerized photogrammetry is utilized markers, Digital camera and Kinovea software.
    change in Sagittal shoulder angle (SSA).
    Sagittal shoulder angle (SSA) will be measured using Computerized photogrammetry is utilized markers, Digital camera and Kinovea software.
    change in thoracic kyphosis angle.
    thoracic kyphosis angle will be measured using the flexicurve ruler
    change in pain level
    pain severity will be measured using visual analogue scale Each participant will be asked to put a mark on a 10-cm horizontal line that is marked with 'zero' at one end to indicate no pain and marked with'10' at the other end to indicate maximum pain.

    Secondary Outcome Measures

    Full Information

    First Posted
    December 16, 2022
    Last Updated
    April 8, 2023
    Sponsor
    Cairo University
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    1. Study Identification

    Unique Protocol Identification Number
    NCT05665296
    Brief Title
    Effect of Cervicothoracic Mobilization on Upper Crossed Syndrome
    Official Title
    Effect of Cervicothoracic Mobilization on Upper Crossed Syndrome
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    April 2023
    Overall Recruitment Status
    Not yet recruiting
    Study Start Date
    April 2023 (Anticipated)
    Primary Completion Date
    August 2023 (Anticipated)
    Study Completion Date
    September 2023 (Anticipated)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Principal Investigator
    Name of the Sponsor
    Cairo University

    4. Oversight

    Studies a U.S. FDA-regulated Drug Product
    No
    Studies a U.S. FDA-regulated Device Product
    No

    5. Study Description

    Brief Summary
    PURPOSE: To investigate the effect of cervicothoracic mobilization on Craniovertebral angle (CVA), sagittal shoulder angle (SSA), kyphotic angle and pain intensity level in upper crossed syndrome.
    Detailed Description
    Upper crossed syndrome and its associated neck pain is considered to be the fourth most frequent cause of disability with an annual 30% increase in the rate of prevalence. According to the report on Global burden of diseases (GBD) 2010, neck pain is ranked 21st in terms overall burden of diseases. Musculoskeletal pain in the neck and upper limbs is common; population studies suggest that 6-48% of adults have pain in one of these areas . Recently, joint mobilization has proven to be effective, and it is now frequently used in clinics .Cervical mobilization combined with thoracic mobilization is recommended as a clinical intervention for neck pain patients with forward head posture ( FHP) rather than cervical mobilization alone. This study has two groups; one will receive cervicothoracic Mobilization + conventional treatment and the second will receive conventional treatment for eight weeks.

    6. Conditions and Keywords

    Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
    Upper Crossed Syndrome
    Keywords
    Forward head posture, Rounded Shoulders, Thoracic kyphosis, UCS, Mobilization

    7. Study Design

    Primary Purpose
    Treatment
    Study Phase
    Not Applicable
    Interventional Study Model
    Parallel Assignment
    Masking
    Participant
    Allocation
    Randomized
    Enrollment
    60 (Anticipated)

    8. Arms, Groups, and Interventions

    Arm Title
    cervicothoracic mobilization
    Arm Type
    Experimental
    Arm Description
    This group will receive cervicothoracic mobilization with comprehensive corrective exercise
    Arm Title
    control group: comprehensive corrective exercise (CCE).
    Arm Type
    Active Comparator
    Arm Description
    This group will receive traditional treatment comprehensive corrective exercise (CCE).
    Intervention Type
    Other
    Intervention Name(s)
    cervicothoracic mobilization
    Intervention Description
    Each participant in study group will receive cervicothoracic mobilization (central PA and transverse Grade III or grade IV) with comprehensive corrective exercise. The duration will eight weeks three sessions per week.
    Intervention Type
    Other
    Intervention Name(s)
    CCE
    Intervention Description
    Each participant will receive comprehensive corrective exercise include three phases: Initial phase -Improvement phase and Maintenance phase. The initial phase exercises progress in frequency and intensity during this phase, as long as participants are able to demonstrate good quality movement. The initial phase duration is 2 weeks and the exercises will be performed for seven sets of 10-s hold . Improvement phase exercises are progressed by considering individual characteristics of each participant and by observing the overload principle and the progression in the number of repetitions of each set during the 4 weeks of the improvement phase. The exercises will be performed from five sets of ten repetitions to six sets of 15 repetitions . Maintenance phase exercises:The exercises are the same as in the improvement phase without any progression in intensity and frequency. The maintenance phase duration is 2 weeks
    Primary Outcome Measure Information:
    Title
    change in Craniovertebral angle (CVA) .
    Description
    Craniovertebral angle (CVA) will be measured using Computerized photogrammetry is utilized markers, Digital camera and Kinovea software.
    Time Frame
    before treatment,and after eight weeks of treatment.
    Title
    change in Sagittal shoulder angle (SSA).
    Description
    Sagittal shoulder angle (SSA) will be measured using Computerized photogrammetry is utilized markers, Digital camera and Kinovea software.
    Time Frame
    before treatment,and after eight weeks of treatment.
    Title
    change in thoracic kyphosis angle.
    Description
    thoracic kyphosis angle will be measured using the flexicurve ruler
    Time Frame
    before treatment,and after eight weeks of treatment.
    Title
    change in pain level
    Description
    pain severity will be measured using visual analogue scale Each participant will be asked to put a mark on a 10-cm horizontal line that is marked with 'zero' at one end to indicate no pain and marked with'10' at the other end to indicate maximum pain.
    Time Frame
    before treatment,and after eight weeks of treatment.

    10. Eligibility

    Sex
    All
    Minimum Age & Unit of Time
    20 Years
    Maximum Age & Unit of Time
    50 Years
    Accepts Healthy Volunteers
    No
    Eligibility Criteria
    Inclusion Criteria: Age between 20-50 years . Participants will included if their CVA less than 48° ( SSA less than 52°) , as above these values are considered normal and thoracic kyphosis (with flexicurve angle more than 45 degrees) . Subjects who have weakness in deep neck flexors, serratus anterior, middle and lower trapezius and rhomboid muscles and tightness in upper trapezius, levator scapulae, scalene, posterior neck and suboccipital muscles, pectoralis major and minor and sternocleidomastoid muscles. Subject complaining of this symptom for more than 3mothes. Marking pain intensity score visual analog scale (VAS) ≥3 in neck and shoulder Exclusion Criteria: History of surgery or joint diseases of the spine or shoulder. Osteoporosis, or fracture ,cervical instability or any sign those with other contraindications against joint mobilization. Individuals with any cervical condition e.g. radiculopathy, cervical rib, whiplash injury and individuals with any neurological/ condition . History of congenital spinal deformity (congenital scoliosis) . Any malignancy related to soft tissue and joints . Subjects taking analgesics and/or muscle relaxants. pregnancy. Being in weight out of the normal range (18 ≥ BMI ≥ 25). Cognitive impairment and inability to understand the scale.
    Central Contact Person:
    First Name & Middle Initial & Last Name or Official Title & Degree
    Reem M El-kaffas, ass lecturer
    Phone
    01124434473
    Email
    reem_elqaffas@yahoo.com
    First Name & Middle Initial & Last Name or Official Title & Degree
    Abeer Yamany, professor
    Phone
    01006899872
    Email
    abeer.yamany@pt.cu.edu.eg
    Overall Study Officials:
    First Name & Middle Initial & Last Name & Degree
    Abeer Yamany, professor
    Organizational Affiliation
    Professor of physical therapy, Cairo University
    Official's Role
    Study Chair

    12. IPD Sharing Statement

    Citations:
    PubMed Identifier
    33244045
    Citation
    Seidi F, Bayattork M, Minoonejad H, Andersen LL, Page P. Comprehensive corrective exercise program improves alignment, muscle activation and movement pattern of men with upper crossed syndrome: randomized controlled trial. Sci Rep. 2020 Nov 26;10(1):20688. doi: 10.1038/s41598-020-77571-4.
    Results Reference
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    Effect of Cervicothoracic Mobilization on Upper Crossed Syndrome

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