Upper Crossed Syndrome Research Articles

Upper Crossed Syndrome and Scapulae Upper-Trapping: A Mesotherapy Protocol in Cervicoscapulobrachial Pain-The 8:1 Block.

Upper Crossed Syndrome (UCS), described by Vladimir Janda, is characterized by postural changes involving the cervical spine and trunk, leading to biomechanical limitations and cervicoscapulobrachial pain. This study proposes a mesotherapy protocol, termed the 8:1 block, to address cervicoscapulobrachialgia by targeting the scapulae and associated musculature. The scapula, central to shoulder girdle kinematics, often exhibits dyskinesis and muscular imbalances, notably the pattern referred to as scapular upper trapping (SUT). SUT involves scapular elevation, medial rotation, and shoulder protraction, contributing to cervicobrachial pain. The protocol includes a comprehensive assessment of muscle tone changes and biomechanical considerations, highlighting the importance of the scapula in upper limb movement and posture. Key anatomical changes involve tightened upper trapezius, levator scapulae, and pectoralis minor muscles, with weakened middle trapezius and serratus anterior. The mesotherapy approach targets these imbalances through specific injection points to alleviate muscle tension and correct postural deviations. Case studies from our clinic demonstrate the protocol's effectiveness in reducing pain and restoring scapular biomechanics. Patients reported significant improvements in pain relief and functional outcomes, underscoring the clinical utility of the 8:1 block in treating cervicoscapulobrachialgia. This protocol offers a feasible, cost-effective intervention that enhances the efficacy of traditional therapeutic exercises by addressing underlying muscular and biomechanical dysfunctions. In conclusion, the 8:1 block mesotherapy protocol provides a novel approach to managing cervicoscapulobrachial pain by focusing on scapular biomechanics and muscle tension. Further studies are needed to validate these findings and refine the protocol for broader clinical application.

Electromyographic comparison of exercises for scapulothoracic muscle activation in men with upper crossed syndrome: A cross-sectional study

ObjectiveThis study aimed to determine the optimal exercise for improving Upper Crossed Syndrome (UCS) using electromyographic (EMG) activity of upper trapezius (UT), middle trapezius (MT), lower trapezius (LT), and serratus anterior (SA) during ten exercises. MethodA cross-sectional study involved 30 male students (mean age: 25.3 ± 2.5 years; height: 176.8 ± 7.2 cm; weight: 77.7 ± 2.5 kg; BMI: 23.8 ± 0.72 kg/m2) with UCS. Participants were selected based on postural assessments (forward head posture ≥44°, rounded shoulder ≥49°, thoracic kyphosis ≥42°). EMG was used to measure activation levels of UT, MT, LT, and SA, and the UT activation ratio relative to MT, LT, and SA during ten exercises. One-way ANOVA was applied for data analysis. ResultsSide-lying external rotation, standing diagonal flexion with Thera-band, and lying prone “V” demonstrated the least UT activity, with the highest MT and LT activation. The standing diagonal flexion with Thera-band elicited the highest SA activity. UT/MT, UT/LT, and UT/SA ratios were less than one in multiple exercises. Significant differences in muscle activation levels and ratios were observed across all exercises (P ≤ 0.05). ConclusionThe findings suggest significant clinical implications for UCS rehabilitation. The identified exercises effectively engage MT and LT while minimizing UT activation, addressing muscular imbalances. Favorable UT/MT, UT/LT, and UT/SA ratios further support these exercises in correcting UCS. These exercises may help counteract the underlying muscular imbalance in UCS by promoting a more balanced activity ratio among the shoulder girdle muscles, potentially improving posture and reducing UCS symptoms.

Global postural re-education versus Egoscue exercises in upper cross syndrome on neck pain, forward head and rounded shoulder posture: a randomised clinical trial

Abstract Upper crossed syndrome (UCS) is a condition that is caused due to alternating tightness and weakness in the opposite muscle groups of the neck, shoulders, and upper back which results in abnormal postural deviations. Global postural re-education (GPR) and Egoscue exercises (EE) aim to improve postural alignment and reduce musculoskeletal discomfort by maintaining certain postures. There is a lack of literature where these approaches are not compared and hence the need arises to evaluate their efficacy in the management of UCS. A randomised clinical trial was conducted on 34 individuals with UCS, where 17 individuals were randomly allocated into two groups, i.e. Group A (GPR) and Group B (EE). Both groups received conventional therapy (hot moist pack and interferential current therapy) 3 times/week for 4 weeks. Outcome measures like craniovertebral angle (CVA), pectoralis minor index (PMI), tragus to wall test (TTW), deep cervical flexors endurance, neck disability index (NDI), and patient satisfaction were assessed at baseline and on day 12 post-treatment. Within group analysis has shown statistical significant improvement in all the outcomes (). Between group analysis has shown both interventions to be equally effective in CVA (), PMI (), TTW (), deep cervical flexors endurance (), NDI () and patient satisfaction scale (PSS) () in individuals with UCS. In conclusion, both the interventions were equally effective and can be included in the protocol for the better outcomes in musculoskeletal dysfunctions. This present trial was prospectively registered in the Clinical Trial Registry of India with registration number CTRI/2023/10/059361.

Effects of 60 versus 30 Minutes of Pilates Exercise on Cervicothoracic Alignment, Muscle Strength, and Endurance in University Students with Upper Crossed Syndrome.

Background/Objectives: This study determined the effects of 60 min or 30 min Pilates program on cervicothoracic alignment, muscular strength, and endurance in university students with upper-crossed syndrome (UCS). Methods: Twenty-six university students with UCS were randomly allocated into 60 min Pilates (60 PG, n = 9), 30 min Pilates (30 PG, n = 9), and control (CG, n = 8) groups. The 60 and 30 PG students participated in the Pilates program, focusing on relaxation, stability, mobility, and strengthening of the cervical, thoracic, and scapular muscles for 60 or 30 min per session, twice a week, for 12 weeks. Cervicothoracic alignment was measured using BodyStyle to determine craniovertebral angle (CVA), forward shoulder angle (FSA), head position angle (HPA), head tilt angle (HTA), and kyphosis angle (KA). We measured the muscular strength and endurance of the shoulder on the dominant side. Results: After the intervention, CVA, HPA, HTA, and KA significantly improved in the 60 and 30 PG (all p < 0.01) but not in the CG (p > 0.05). There were no significant differences between the 60 and 30 PG at 4, 8, and 12 weeks. Shoulder strength differed between shoulder flexion and horizontal abduction (p < 0.01). Shoulder endurance differed between extension, flexion, and horizontal abduction (p < 0.05, p < 0.01, and p < 0.001, respectively). Conclusions: This study confirmed the effectiveness of the Pilates program in improving cervicothoracic sagittal alignment and shoulder muscular function in university students with UCS. Additionally, the effects of participating in 60 and 30 min Pilates programs were found to be equivalent. Therefore, encouraging busy university students to participate in at least 30 min of the Pilates program is important.

Efficacy of Post-Isometric Relaxation vs. Sustained Stretching for Improving Cervical Spine Mobility in Upper Cross Syndrome-A Randomized Controlled Trial

Background: Upper Crossed Syndrome (UCS) is a common musculoskeletal disorder characterized by muscle imbalance in the head and shoulder areas, often exacerbated by poor posture. Muscle Energy Technique (MET), including Post-Isometric Relaxation (PIR) and sustained stretching, is commonly used to alleviate symptoms associated with UCS. Methodology: This randomized controlled trial compared the efficacy of PIR versus sustained stretching in reducing muscle tightness of the upper trapezius and levator scapulae muscles among 30 participants at Al-Sehat Rehabilitation Centre, Karachi, Pakistan. Pain intensity was assessed using the Numeric Pain Rating Scale (NRS), and cervical range of motion (ROM) was measured with an inclinometer. Results: PIR and sustained stretching significantly reduced pain and improved cervical ROM. PIR showed superior pain reduction, while sustained stretching enhanced ROM, particularly in left rotation and lateral flexion. Conclusion: PIR and sustained stretching are effective treatments for managing UCS-related symptoms. PIR excels in pain management, whereas sustained stretching enhances cervical ROM. Clinicians should consider these findings when designing treatment protocols for UCS. Keywords: Disability, Pain Management, Range of Motion, Upper Cross Syndrome.

Comparing the Effect of Postural Corrective Exercises and Cawthorne-Cooksey Exercises on Dynamic Stability and Upper Body Posture of Dyslexic Children With Upper Crossed Syndrome

Background and Aims Dyslexia is a learning disability associated with impaired balance and coordination. The present study aimed to compare the effect of postural corrective and Cawthorne-Cooksey exercises on dynamic stability and upper body posture of dyslexic children with upper cross syndrome. Methods The method of the present study was quasi-experimental with a pretest-posttest design. The statistical population in this study comprised dyslexic male students (8 to 10 years old) with upper cross syndrome. From the statistical population, 30 students were purposefully and conveniently selected and divided into postural correction exercises and Cawthorne-Cooksey exercises groups. The Y equilibrium test was used to measure dynamic stability. To analyze the data, the normality of the data and the homogeneity of variances were first assessed using the Shapiro-Wilk test and F-Levene’s test. Then, the analysis of covariance at the level of 0.05 was used to examine the intragroup effects and compare the groups. Results Comparing two training programs in kyphosis angle, forward head posture, round shoulder, dominant leg dynamic balance, and total dynamic balance showed a significant difference between the two groups (P≤0.05). The angle of kyphosis, forward head posture, and round shoulder were significantly lower in the corrective exercises group than in the Cawthorne-Cooksey group (P≤0.05). The dominant dynamic balance of the dominant leg and the total dynamic balance in the Cawthorne-Cooksey group were significantly better than those in the corrective exercises group (P≤0.05). Conclusion A comparison of postural corrective and Cawthorne-Cooksey exercises performed in this study showed that the latter exercises had a greater effect on improving dynamic stability, and corrective exercises had a greater effect on improving upper cross syndrome. Therefore, it is suggested that to improve the balance and correct posture of children with upper cross syndrome, posture corrective exercises in combination with Cawthorne-Cooksey balance exercises should be included in the exercise program of children with upper cross syndrome.

The effect of various therapeutic exercises on forward head posture, rounded shoulder, and hyperkyphosis among people with upper crossed syndrome: a systematic review and meta-analysis

ObjectivesThis review study aimed to evaluate the impact of therapeutic exercises on Upper-Crossed Syndrome (UCS). The study utilized a systematic review and meta-analysis approach to investigate the effects of various therapeutic exercises on forward head posture, rounded shoulders, and hyperkyphosis associated with upper crossed syndrome.MethodsThe study identified relevant keywords for each independent and dependent variable and conducted a search in scientific databases, including PubMed, Web of Science, Scopus, and Google Scholar, without any time limitations until 12 August 2023. Overall, 4625 articles were found in the selected databases, which were reduced to 1085 after being entered into the EndNote software and removing duplicate data. The full texts of 30 remaining studies were reviewed; ten articles meeting the criteria were included. Additionally, 12 studies from the Google Scholar database were included, resulting in 22 studies. Using Comprehensive meta-analysis software (CMA ver 3), data heterogeneity was measured with I2 and the Q tests. The Funnel Plot and Egger test methods were utilized to determine the possibility of publication bias. The JBI checklist was used to assess the quality of the studies.ResultsThe results of the meta-analysis showed that therapeutic exercises were effective in improving forward head, rounded shoulders, and thoracic kyphosis angles (CI 95% = -1.85–1.161, P = 0.001, P = 0.001, CI95%=-1.822–1.15, and P = 0.001, CI 95%= -1.83–1.09, respectively).ConclusionBased on the results, it appears that performing therapeutic exercises in the form of strength exercises, stretching, shoulder-based exercises, and incredibly comprehensive exercises that target all muscles may be effective in reducing forward head, rounded shoulders, thoracic kyphosis, and overall UCS.Level of evidence1

The Effect of Corrective Exercises on Ground Reaction Forces in Male Students With Upper Crossed Syndrome During Throwing.

Poor posture has a negative impact on physical capability and is associated with changes in biomechanics and motor control. The purpose of this study was to assess the effect of corrective exercises on ground reaction forces (GRFs) in male student handball players with upper crossed syndrome (UCS) during throwing. Thirty male handball students with UCS participated in this single-blind randomized controlled trial (IRCT20200622047888N2; IR.HUMS.REC.1402.135). Fifteen received an 8-week corrective exercise intervention (exercise-intervention group [EG]), consisting of exercise targeting muscles involved in the UCS, and 15 served as the control group (CG). During handball throwing, GRF was measured by force plate. The forward head and rounded shoulder angles were measured with a photogrammetric method. All measurements were repeated 8weeks later. Significant interactions for virtually all parameters indicated that changes over 8weeks differed between the CG and EG.A reduction in GRFs and a delayed occurrence of peak GRFs were observed in the EG,but not in the CG (P < .05). This was accompanied by a significant reduction in forward head (P < .03; effect size: 0.87; 95% confidence interval, -2.34 to 0.13), rounded shoulder (P < .05; effect size: 0.68; 95% confidence interval, 0.32 to 1.22) and thoracic kyphosis (P < .02; effect size: 0.64; 95% confidence interval, 0.54 to 1.25) angles in the EG (P < .05) with no significant change over 8weeks in the CG. Corrective exercises targeting muscles directly involved in UCS induces functional and postural improvements in male student handball players with UCS.

Ab. No. 170 Impact of Dynamic Postural Exercises on Electromyographic Activity, Co-Contraction and Joint Position Sense in Upper Cross Syndrome: A Pilot Study

Introduction: A greater prevalence with no strong rehabilitation program for Upper Crossed Syndrome (UCS) accompanied the purpose to find out the efficacy of dynamic postural exercise developed on the basis of identification of muscle activation pattern in UCS.This will help in effective management of patients suffering from UCS. Methods: 14 subjects with diagnosed UCS were randomly allocated to experimental and control groups (N=14; n=7). Participants were asked to perform 4 exercises (YTWL) using elastic resistance band during which amplitude of muscle activation and cocontraction ratio with Surface electrodes using 4 channel electromyographic system were measured.12 muscles of both side (Upper, middle and lower trapezius, serratus anterior, pectoralis major, anterior scalene) were assessed. The intervention of experimental group consisted of seven exercises. Both groups were given hot pack, TENS and cervical AROM exercises. The intervention was prescribed for three days a week for 8 weeks. Cervical kinesthesia was measured using joint position sense error (JPSE) test. All the outcome variables were recorded at the baseline and after 8 weeks. Result: Statistically significant difference (p≤0.05) of mean amplitude in pre-post values of experimental group as well as between group were found. Between group analysis of UT:LT, SC:AS contraction ratio and joint position sense also found to be significant(p≤0.05). Conclusion: There was a significant improvement in mean amplitude and cocontraction of cervicothoracic muscles in Dynamic Postural Exercise group. Kinesthesia also improved in experimental group. Implications: A focused rehabilitation program for UCS will help in improving the quality of life and functional efficacy.

Prevalence of Cervicogenic Headache and Its Association with Upper Crossed Syndrome in Dentists

Cervicogenic headaches refer to a type of headache that originates from the cervical spine can be exacerbated by certain neck movements. Recognizing the link between cervicogenic headaches and Upper Cross Syndrome allows for targeted diagnostic assessments. Objective: To examine the relationship between cervicogenic headaches and USC in dental professionals and deeper understanding of the impact of occupational factors on the occurrence and severity of these headaches. Methods: This cross-sectional study was conducted on 180 participants selected through purposive sampling technique. Inclusion Criteria was both genders between 20 and 50 years age dentist · Having sitting duration of 3 hour or more than 3 hours. Exclusion Criteria was any malignancy related to soft tissues and joints. Study ran from 1 March 2022 to 30 September 2022. Results: The cervical flexion rotation test was positive in 40.7% i.e. 44 participants and is negative in 59.3% i.e. 64 participants. The pectoralis major contracture test was positive in 45.4% i.e. 45 participants and is negative in 54.6% i.e. 59 participants and there is a relation between cervicogenic headache and upper crossed syndrome and in dentists. Conclusions: The findings of this research highlight a substantial prevalence of cervicogenic headache among dentists 45.4% and emphasize a significant association between cervicogenic headache and the presence of upper crossed syndrome. These results provide valuable insights for dental professionals, clinicians, and policymakers to implement appropriate interventions and ergonomic strategies to mitigate the burden of cervicogenic headache in dental practice.

IoT-Based Solution for Detecting and Monitoring Upper Crossed Syndrome.

A sedentary lifestyle has caused adults to spend more than 6 h seated, which has led to inactivity and spinal issues. This context underscores the growing sedentary behavior, exemplified by extended sitting hours among adults and university students. Such inactivity triggers various health problems and spinal disorders, notably Upper Crossed Syndrome (UCS) and its association with thoracic kyphosis, which can cause severe spinal curvature and related complications. Traditional detection involves clinical assessments and corrective exercises; however, this work proposes a multi-layered system for a back brace to detect, monitor, and potentially prevent the main signs of UCS. Building and using a framework that detects and monitors signs of UCS has facilitated patient-doctor interaction, automated the detection process for improved patient-physician coordination, and helped improve patients' spines over time. The smart wearable brace includes inertial measurement unit (IMU) sensors targeting hunched-back postures. The IMU sensors capture postural readings, which are then used for classification. Multiple classifiers were used where the long short-term memory (LSTM) model had the highest accuracy of 99.3%. Using the classifier helped detect and monitor UCS over time. Integrating the wearable device with a mobile interface enables real-time data visualization and immediate feedback for users to correct and mitigate UCS-related issues.

The Effect Of Corrective Exercises Focused On Chain Reactions, On Scapular Position, Proprioception And Shoulder Functional Stability Of Female Students With Upper-Crossed Syndrome

The Effect Of Corrective Exercises Focused On Chain Reactions, On Scapular Position, Proprioception And Shoulder Functional Stability Of Female Students With Upper-Crossed Syndrome

The Effect of Corrective Exercise on Pain Referred to The Jaw Joint (TMJ) in Elderly Women With Upper Crossed Syndrome

Background: Upper crossed syndrome is a muscular imbalance disorder associated with various referred pains, especially jaw discomfort. Complications like temporomandibular joint (TMJ) osteoarthritis may link to forward head posture and mechanical head pains resulting from this syndrome.&#x0D; Objectives: The objective of this study was to compare the impact of corrective exercise on pain of TMJ in elderly women with upper cross syndrome.&#x0D; Methods: A total of 30 elderly women with upper crossed syndrome were enrolled at the Kahrizak Elderly Care Center and randomly assigned to either a corrective exercise group or a control group. The experiment group underwent an eight-week training program. Pain levels and neck range of motion were assessed using a pain ruler and goniometer, respectively. In order to measure neck extension, the mean difference and effect size were determined using paired t-test and Cohen’s d, respectively. Referred pain ratings were analyzed using Mann-Whitney U and Wilcoxon signed-rank tests, with effect size calculations, to further understand the intervention’s effect on pain perception.&#x0D; Results: Both groups demonstrated significant changes in referred pain perceptions (P = 0.0441) post-intervention. However, regarding neck extension, neither the control nor the experiment group exhibited statistically significant alterations in neck extension (P = 0.4309)&#x0D; Conclusions: These findings indicate that corrective exercises have a positive effect on alleviating referred pain in the jaw joint caused by muscle imbalance. Given the merits of corrective exercises as a non-pharmacological intervention, they are recommended as an effective approach for improving referred pain in the jaw.

Upper-crossed syndrome and disability in shoulder adhesive capsulitis

Study designCross-sectional analytical study. IntroductionAdhesive capsulitis (AC) is a long-standing condition with varying extents of disability seen among patients. The role of postural manifestations and contractile tissue involvement in this condition is poorly understood and yet to be explored. PurposeThis study aimed to analyze if individuals with adhesive capsulitis demonstrated the characteristics of an upper crossed syndrome (UCS) postural manifestation and whether or not its presence affected the extent of disability experienced by this population. MethodsSixty-five individuals with AC were assessed for the presence of UCS. Scapular muscle strength and length alterations, forward head posture (FHP), and disability were assessed and compared between those with and without UCS. Paired T test and an independent T test were utilized to compare means within and between these groups, respectively, while non-parametric measures were utilized for their skewed counterparts. Phi coefficient (φ) was used to determine the strength of association between the descriptive patient characteristics. The correlation between symptom duration and degree of postural involvement was analyzed using Pearson's correlation coefficient. Results43.1% of the study population demonstrated UCS and 80% FHP with a significant negative correlation between Cranio Vertebral Angle and chronicity of AC (r = −0.27). Individuals with AC demonstrated significantly decreased scapular muscle strength (p = <.001) and pectoralis minor length on the affected side (p = .03). No differences were seen between groups with and without UCS. The mean SPADI scores between groups demonstrated a more significant level of perceived pain and disability in individuals with UCS (p = .049). ConclusionsAs seen in UCS, individuals with AC demonstrated alterations in movement patterns and posture. UCS was seen to contribute towards the existing disability in AC. This study suggests a careful evaluation and intervention based on these findings to document its effect on pain and dysfunction in AC.

Treatment of Upper Crossed Syndrome: A Narrative Systematic Review.

Upper crossed syndrome (UCS) is a common musculoskeletal condition that is characterized by tightness and weakness of the muscles of the neck, shoulders, and upper back. The aim of this current study is to summarize and provide an overview of the treatment in patients with UCS. A MEDLINE (PubMed), Cochrane library, Embase, Scopus, and Web of Science database search was conducted for English-language articles about upper crossed syndrome that were published until 19 January 2023. To identify potentially relevant articles, the following key search phrases were combined: "upper crossed syndrome", "upper cross syndrome", "diagnosis", and "treatment". A total of 233 articles were identified. After reading the titles and abstracts and assessing their eligibility based on the full-text articles, 11 articles were finally included in this review. The risk of bias (RoB) was assessed using RoB-2 and ROBINS-I for the randomized controlled trials (RCTs) and the non-randomized clinical trial (non-RCT), respectively. Among eleven studies that investigated the effect of treatment programs for UCS, five studies compared the therapeutic effect of exercise programs with controls, whereas six compared different rehabilitative treatment strategies, such as the muscle energy technique, soft-tissue mobilization, and stretching exercises. In addition, regarding the study design, ten studies were RCTs and only one study was a prospective observational study. Treatment programs including various types of exercises and techniques to correct an abnormal posture and restore neuromuscular imbalances are effective for decreasing pain and improving neck disabilities and postural deviations in patients with UCS.

Association of Upper Crossed Syndrome with Neck Pain in Lactating Women

Background and Introduction: Physiotherapy benefits women both in the antenatal and postnatal periods. Postnatal education is essential for guiding women about correct breastfeeding positioning. However, studies on the efficacy of this approach in developing countries like Pakistan are limited in the literature. This study is aimed to assess the association of upper crossed syndrome in lactating women. Methods: Descriptive study design was used for this cross-sectional study in which the following inclusion criteria interviewed 141 lactating women of Age 15-47 years. All these women were inpatients in Gynecology Ward at District Head Quarters Hospital, Sheikhupura. The neck disability index, Reedco posture assessment, and Numeric pain rating scale were used for data collection. Data were analyzed using SPSS version 21. The Reedco scale assessed the posture alignment of the head, shoulders, and spine. Results: 53% of the participants were from the 15-25 age group, and the rest were from different age groups ranging from 26-47 years.79.4% had a cesarean section for the birth of their child.80.9% had 1-3 children.58.9% belong to the lower socioeconomic status. When the chi-square test was applied to check the association between all variables, it was evident that the patient's age is significantly associated with Reedco posture assessment and Neck disability index, Mode of delivery with Neck disability index. Still, there is no significant association between age and the Numeric pain rating scale, Birth history with the Numeric pain scale, and Reedco posture assessment. In the end, it was also revealed that Upper crossed syndrome and Neck pain had a statistically significant association of 0.033.(p-value&lt;0.05). This study has potential benefits for the community as it sheds light on an important issue that affects lactating women. By identifying a possible association between upper crossed syndrome and neck pain in lactating women, healthcare professionals can develop more effective treatment plans to alleviate the discomfort experienced by these women. This can lead to an improvement in their overall quality of life and mental health. Conclusion: This study found an association between upper-crossed syndrome and neck pain. It was found that the lactating mothers with upper crossed syndrome were somehow related to bad Posture and suffered from musculoskeletal pain, especially neck pain. A lack of knowledge and awareness about correct positioning during breastfeeding is evidenced in this study. Women were unaware of the importance of physical therapy and the role of it during and after pregnancy. Keywords: Lactation, Neck pain, Kyphosis, Lordosis, over inhibition, Antenatal, Postnatal, Winging of scapula, Posture

Efficacy of various exercises in the management of upper crossed syndrome

Abstract Upper crossed syndrome (UCS) is characterised by distortion or imbalances of various muscles that put tension on the nearby tendons, bones, and joints leads to muscle weakness, tiredness, sore shoulder blades, headache and limitation of movements. The rationale of the present study was to evaluate the efficacy of various exercises (McKenzie and TheraBand exercises) on posture, pain and strength in patients suffering with upper crossed syndrome. The participants were randomly allocated into two groups: Group 1 (McKenzie group, n=15) and Group 2 (exercise group, n=15). Outcome measures were pain and disability using SPADI questionnaire and muscle strength using manual muscle testing. Group I received McKenzie exercises for 3 weeks, 5 sessions per week, whereas Group II received TheraBand exercises for 3 weeks, 5 sessions per week. Data analysis was done by using paired t-test for within group comparison and unrelated t-test to evaluate the between group differences in each outcome variable. The results indicated a statistically significant improvement in pre-/post values of pain &amp; disability in the McKenzie group (t=7.60 and P=0.0001), and in the exercise group (t=8.25 and P=0.0001). Results also suggested a statistically significant improvement in the strength of serratus anterior (t=4.52 and P=0.0001), cervical flexors (t=4.12 and P=0.001), and rhomboids (t=4.14 and P=0.001) in the McKenzie group and strength of serratus anterior (t=5.17 and P=0.0001), cervical flexors (t=4.18 and P=0.001), rhomboids (t=4.18 and P=0.001) in the exercise group. Results indicated that the exercise group showed better improvement as compared to McKenzie group in terms of pain and disability. Results also stated that both groups were equally effective in improving muscle strength.

Upper crossed syndrome in secondary school students: A mixed-method study

ObjectiveThe study objectives were to identify the prevalence of upper crossed syndrome (UCS) and its associated factors in a population of Spanish adolescents, and to explore these associations through focus groups. MethodsThe study used a sequential explanatory mixed method design. The quantitative phase consisted of a cross-sectional study in which 45 students underwent photogrammetry measurements and evaluations with the Kiddo-KINDL and VISA-TEEN questionnaires. Subsequently, several focus groups were conducted to discuss the quantitative results. ResultsThe results indicated a 37.8% prevalence of UCS, a 48.9% prevalence of forward head posture (FHP) and an 80% prevalence of forward shoulder posture (FSP). A positive FSP was indicated by an angle represented by the intersection of the line between the midpoint of the humerus and the spinous process of C7 of <52°. FSP was significantly higher in boys (mean [M] = 43.59, standard deviation [SD] = 6.9) than in girls (M = 47.98, SD = 6.33; p < 0.05). Boys showed significant moderate associations of FSP with body mass index (BMI) (r = −0.48, p < 0.05) and hygiene habits (r = −0.46, p < 0.05), and of FHP with worse use of technology (r = 0.53, p < 0.05). Those with UCS showed significant differences in school performance (M = 47.22, SD = 8.33, p < 0.05). Analysis of the qualitative results led to the identification of 33 codes and five categories. ConclusionsUCS was associated with factors such as BMI, school performance, use of technology and physical activity. Correcting posture in adolescence was generally believed to be necessary. Physical exercise and postural health were considered highly important among adolescents.

Research On Diagnostic Criteria Of Upper Crossed Syndrome Based On WOS And CNKI Literature

The incidence of upper crossed syndrome (UCS) has become younger, but now, the diagnosis and screening criteria of UCS are different, and researchers can not quickly and intuitively understand the research trend. PURPOSE: Analyze and sort out the research on UCS in Chinese and English databases, and sort out the current diagnostic screening criteria of UCS research, so as to provide some reference for researchers related to UCS in the future. METHODS: All relevant literature on UCS published in CNKI and WOS databases were searched and analyzed by the literature method. RESULTS: WOS research is mainly screened by observing three factors related to UCS, including body angle, muscle activation and movement mode. The scapula is the cornerstone of UCS evaluation, so the scapula dyskinesia test will be conducted. Meanwhile, it will also be measured by photogrammetry and the forward head (≥ 44°), round shoulder (≥ 49°) or thoracic kyphosis (≥ 42°); Some researchers only set the criteria as rake angle, round shoulder angle and kyphosis, and some set the inclusion criteria of Craniovertebral angle as greater than 46°. Haifah considered that skull angle and shoulder angle met one or both of the inclusion criteria of UCS. Moreover, there are also criteria for selecting the deviation of cervical spine line from the centre greater than 2.5 cm based on GPS test, or the horizontal distance from the centre of the external auditory canal to acromioclavicular joint greater than 1 cm. CNKI's clinical diagnostic criteria for UCS mainly start from the three aspects of shoulder and neck pain, head forward and round shoulder. It also includes the situation of pterygoid scapula but almost does not directly include the relevant angles of neck and shoulder as the diagnostic criteria, but as the observation index before and after an intervention. In short, the diagnostic criteria of CNKI's research are more functional symptoms, combined with the history of chronic strain, pain signs, cervical spine imaging data, etc. CONCLUSION: The diagnostic criteria of CNKI are pain and functional symptoms, and WOS focuses on the measurement angle. Supported by Education Science Project of "14th Five-year Plan" of Henan Province Grant ROI 2021YB0031, and Science and Technology Development Project of Kaifeng Grant ROI 2104006.

Comparative Effects of Comprehensive Corrective Exercises Versus Muscle Energy Techniques in Patients with Upper Cross Syndrome: A Randomized Controlled Trial

Upper crossed Syndrome is one of the most prominent anomalous alignments currently. Janda defines 4 Upper Crossed Syndrome as the involvement of several skeletal system muscles that results in shortness and tightness of the anterior and upper trunk or weakening of the posterior section of the skeletal muscles. Objective: To compare the effects of Comprehensive corrective exercises versus muscle energy techniques in patients with upper cross syndrome. Methods: Randomized controlled trial with non-probability convenient sampling was conducted. Fifty-two patients were randomly allocated into 2 groups. The exercise duration period was of eight weeks and three sessions were conducted in one week. Group A was given muscle energy techniques and Group B was given comprehensive corrective exercises. The study was single (assessor) blinded. NDI and VAS were used as an outcome measure to quantify pain and disability in patients with upper cross syndrome. Measurements were taken at baseline (pretest), 8th week (posttest) and 12th week (follow up). Results: There were 52 diagnosed patients having upper cross syndrome with the mean age of 26.03 in group A (METS) in which 46.2% male and 53.8% females. The mean age of 28.76 in group B (CCEP) in which 65.4% males and 34.6% females. It was resulted that there was significant improvement at each level assessment. Statistically, comparison showed no significant difference were found between comprehensive corrective exercises and muscle energy techniques. However, both VAS and NDI showed better improvement in the CCEP group as compared to the MET group. Conclusion: Both techniques relived the pain and lowered the disability in upper cross syndrome patients; Whereas, Comprehensive corrective exercises are convenient and easy approach. Furthermore, these set of exercises maintained the effectiveness till 4 weeks post intervention.