This study aims at investigating the effects of application of twelve sessions of Global Postural Re-education Technique (GPR) and Kendall Exercises (KE) on Craniovertebral angle (CVA), Gaze Angle (GA), Shoulders Angle (SA), Pain, functional abilities, Range of Motion, stability of sense of position, cervical muscle strength and endurance, Spinal mobility, and Chest Expansion.
A sample of 43 participants with a CVA less than 50 degrees will be randomly assigned to one of the two groups either receiving global postural reeducation added to traditional Kendall exercises or a group that receives Kendall Exercises only. Treatment sessions will be continued for a total of 12 sessions with a rate of 3 sessions per week. The effect of these two treatments will be assessed by various variables including: forward head angle, Gaze Angle and Shoulder angle via photogrammetry and Kinovea App, Pain intensity (VAS), functional abilities via neck disability index (NDI), cervical Range of motion and sense of position stability by Cervical Range of Motion instrument (CROM), Spinal mobility and chest expansion by tape measurement.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
43
treatment techniques include corrective exercises both local and global to correct forward head posture. first session will be to educate participants on the treatment sequence. This will be a session of Kendall's exercises as described below. This will followed be by performing GPR techniques of Anterior Chain stretch in the supine frog-like position for 20 minutes followed by posterior chain stretch against the wall for another 20 minutes. This is repeated in the first 6 sessions. Starting from the seventh session the time of holding each position is decreased to 15 minutes and a third position (standing against the wall) is introduced and performed for 15 minutes. Starting from the eighth session fourth position of sitting on the floor position is introduced and performed for another 15 minutes. total of a session will then take about 90 minutes. Pre-treatment diaphragmatic release and deep breathing exercises are applied at the beginning of each session
exercises that correct upper crossed syndrome: The treatment sequence will be: a) Strengthen deep Cervical Flexors via Chin tucks. Repetition will be repeated 10 times for 5 sets. (b) Stretching the cervical extensors. This is held for 1 minute and repeated 5 times. (c) Strengthening shoulder retraction. Repetition will be repeated 10 times for 5 sets. (d) Stretching the pectoralis muscle. This is held for 1 minute and repeated 5 times. Exercises will be progressed as the sessions develop.
Horus University
Damietta, Egypt
craniovertebral angle
the angle formed between a horizontal line and a line extending from ear meatus and C7
Time frame: before and after 12 sessions
Gaze Angle
the angle formed between the line extending from the tragus of the ear to the canthus of the eye.
Time frame: before and after 12 sessions
Shoulder Angle
the angle formed between the line extending from C7 to acromion with horizontal line
Time frame: before and after 12 sessions
Proprioceptive stability test
By utilizing CROM testing the patients' sense of location precision
Time frame: before and after 12 sessions
Spinal mobility
Fingers to floor test using a tape measurement
Time frame: before and after 12 sessions
Chest expansion
Axillary and Xyphoid chest expansion by the tape measurement
Time frame: before and after 12 sessions
Cervical muscle strength and endurance
Biofeedback stabiliser is used to measure the maximum time the muscles could hold in addition to time the contraction of 50% maximum muscle contractionis maintained.
Time frame: before and after 12 sessions
Neck disability index
a scale that tests the effect of treatment on functional abilities of patients.
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Time frame: before and after 12 sessions
Pain intensity
Visual analogue scale is given to participants to select their pain scale level.
Time frame: before and after 12 sessions