Proprioceptive Neuromuscular Facilitation Combined With Postural Education in Upper Cross Syndrome

Phase 1: Active Rhythmic Initiation The exercise was demonstrated to the students in a seated position, as sitting is considered the functional position for neck motion and stability. Then, the exercises was passively practiced on the students using tactile input. After passive demonstration, students were asked to perform the same exercise actively and verbal commands were used to guide and correct them. Phase 2: Resisted Rhythmic Initiation "Modified" The investigators applied resistance by placing the palm of one hand on the right side of the chin to strengthen the muscles. Then, resisted scapular posterior depression PNF exercise also employed. Also received a comprehensive postural education program to emphasize the importance of proper posture. The program was divided into three sections, which focused on the effects of good and bad posture, as well as practical demonstration.

Phase 1: Active Muscle Stretching In this phase, participants were instructed on performing active muscle stretching exercises for all cervical muscles, including neck flexors, extensors, lateral flexors and neck rotators. Each stretch was held for a period of 25-30 seconds and repeated three times. Phase 2: Self-Isometric Strengthening Participants were provided with a demonstration of self-isometric strengthening exercise for the neck muscles. The exercises involved six movement patterns: cervical flexion, cervical extension, right/left lateral flexion and right/left rotation. For each exercise the participants were required to apply resistance against the direction of movement using their hand without allowing any motion in the neck. Also received a comprehensive postural education program to emphasize the importance of proper posture. The program was divided into three sections, which focused on the effects of good and bad posture, as well as practical demonstration.