Immediate and Prolonged Effects of Breathing Exercises on Pain, Quality of Life & Functional Disability in Patient of Upper Cross Syndrome: A Randomized controlled trial

Abstract

Background: The advent of smartphone technology and its increased use, especially during the COVID-19 pandemic, has led to a rise in musculoskeletal disorders, including upper cross syndrome. This condition, characterized by muscle imbalances around the cervical spine and shoulder girdle, results in pain, functional disability, and decreased quality of life. Breathing exercises have been suggested as a therapeutic intervention to address these issues, yet empirical evidence on their effectiveness remains sparse. Objective: This study aimed to evaluate the immediate and prolonged effects of breathing exercises on pain, functional disability, and quality of life in patients with upper cross syndrome, filling a gap in the literature regarding non-pharmacological interventions for this condition. Methods: Conducted as a single-blinded randomized controlled trial at Jinnah Memorial Trust Hospital, Gujranwala, Pakistan, this study involved 76 participants with upper cross syndrome, randomized into control (standard physical therapy) and experimental (standard physical therapy plus breathing exercises) groups. Pain was assessed using the Numeric Pain Rating Scale (NPRS), functional disability with the Neck Disability Index (NDI), and quality of life through the SF-36 questionnaire. Assessments were made at baseline, after the first session, and after four weeks. Data analysis was performed using SPSS version 25, employing the Mann-Whitney U Test for between-group comparisons and the Paired Sample T-test for within-group analyses. Results: The experimental group demonstrated significantly superior improvement compared to the control group in NPRS scores after the first session (p<0.001) and after four weeks (p<0.001), NDI scores (p<0.001 at both intervals), and all eight domains of the SF-36 (p<0.05 for each domain after four weeks), indicating that breathing exercises significantly reduce pain and functional disability while enhancing quality of life. Conclusion: Breathing exercises are a safe and effective adjunct to standard physical therapy for patients with upper cross syndrome, significantly improving pain management, functional disability, and quality of life. This study underscores the potential of integrating breathing exercises into rehabilitation programs for musculoskeletal disorders related to excessive technology use.