Scapular Stabilization Exercises Versus Eccentric Muscle Energy Techniques in Patients With Upper Crossed Syndrome

Riphah International University34 enrolled

Overview

This study will be a Randomized Clinical Trial in which Scapular Stabilization Exercises and Eccentric Muscle Energy technique will be applied on the individuals with upper crossed syndrome and changes will be recorded using different method and tools. Convenient sampling technique will be used to collect the data. The sample size of 34 patients will be recruited. Patients will be randomly allocated into two different groups through sealed envelope method. 17 patients will be allocated in each group. Group A will be treated with Scapular Stabilization Exercises along with hot pack; Group B will be treated with Eccentric Muscle Energy Technique along with hot pack. Craniovertebral Angle (CVA), Numeric Pain Rating Scale (NPRS), and Neck Disability Index (NDI) will be used as Data collecting tools.

Upper Crossed Syndrome is defined byJanda as the involvement of different muscles of skeletal system which leads to shortness and tightness of anterior and upper trunk or weakness of posterior part of skeletal muscles. Alteration of muscles activity such as facilitation of different muscles as levator scapula, sternocleidomastoid, pectoralis muscles and inhibition of cervical flexors, serratus anterior The muscular imbalance occurs because of weak/tight and tonic muscles. Neck pain is the most frequent problem in developed countries. The prevalence of neck pain is approximately 10-15%. Neck pain is the most common reason for patients visiting healthcare professionals. Poor posture typically causes upper cross syndrome (UCS), resulting in neck pain. This syndrome can cause dysfunctional tone in posture and muscular disparity of head, neck and shoulder region.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

DOUBLE

Enrollment

Interventions

Protocol of Scapular Stabilization Exercises;OTHER

Exercise for the middle trapezius and rhomboid muscles: Participants were instructed to stand with their arms hanging beside their bodies. Then, they were instructed to flex their elbows 90◦ holding an elastic band and performing an external rotation of the shoulder, pulling both scapula together. Subsequently, they returned to a neutral shoulder position with elbow flexion. Exercise for the lower trapezius muscle: Participants were instructed to lie down in a prone position while holding an elastic band attached at one end under a mattress. They were then instructed to raise their shoulder 140◦. Exercise for the serratus anterior muscle: Participants were instructed to stand and flex their elbows 90◦ while holding an elastic band fixed behind the participants. Next, they were instructed to move the arm forward with a protracted scapula.

Protocol of Muscle Energy technique;OTHER

During upper trapezius stretching, the participants were in seated position by holding the chair with one arm, and laterally tilted the head to the opposite side with the other hand pushing the head to increase lateral stretch. For pectoralis muscle stretch, participants were asked to stand in front of the Doorframe with elbow bent at 90 degree and was asked to lean forward without Taking a step forward. The stretch is felt across the anterior chest, which is held for 15-30 seconds with 2-3 repetitions. For levator scapulae stretch, the subjects were asked to take the seated position while holding the chair with one hand in order to maintain shoulder depression, then To flex and rotate neck to the opposite side by placing the other hand at the back of their head and to slowly pull it down toward the armpit.

Eligibility

Sex: ALLMin age: 18 YearsMax age: 35 Years

Medical Language ↔ Plain English

Inclusion Criteria: * • Age: participants having range 18-35 years both male and female are included. * Craniovertebral angle\<52 * NPRS\>3 and NDI\>10 * Patients having neck pain during movements. * Patients having neck pain due to sustained posture and after activity Exclusion Criteria: * Inflammation malignancy, neurological disorder * Metabolic disorders * Neck pain radiating into arms and upper extremity * Neck pain associated with headache and facial pain * Recent surgery * History of recent trauma and fractures of cervical spine * Patients having any other therapeutic intervention or medical treatment.

Outcomes

Primary Outcomes

Numeric pain rating scale (NPRS)

The NPRS was used to capture the patient's level of pain. Patients were asked to indicate the intensity of their current pain level using an 11-point scale, ranging from 0 (no pain) to 10 (worst pain imaginable)(8). 0 = no pain 1 to 4 indicate mild pain 5 or 6 indicate moderate pain 7 to 10 indicate severe pain NPRS exhibited moderate reliability (ICC = 0.67) in t

Time frame: 4 weeks

Secondary Outcomes

Neck Disability Index (NDI)

The NDI consists of ten items. Each item has six different assertions expressing progressive levels of pain or limitation in activities. Item scores range from 0 (no pain or limitation) to 5 (as much pain as possible or maximal limitation). The total NDI score ranges from 0 to 5 points.