The Effects of Dynamic Taping Combined With Corrective Exercises on Cervical Proprioception and Muscle Imbalance in Patients With Upper Crossed Syndrome

China Medical University Hospital36 enrolled

Overview

Upper Crossed Syndrome (UCS) is a pattern of muscle imbalance that leads to forward head posture, rounded shoulders, or excessive thoracic kyphosis, thereby affecting posture and cervical-shoulder function. Dynamic Taping is a taping technique aimed at enhancing movement control and muscle support through its elastic material and tension, influencing the skin and neuromuscular system. When applied to UCS patients, Dynamic Taping can assist in posture correction, improve posture control, and increase scapular dynamic stability. Additionally, Dynamic Taping can enhance proprioception, helping patients maintain proper posture through sensory feedback. Corrective exercises improve posture and stability by strengthening weakened muscles and stretching tight muscles. Combining these two interventions is expected to help address poor posture.

This study aims to investigate the effects of Dynamic Taping combined with corrective exercises on cervical proprioception and muscle imbalance in UCS patients. A two-factor repeated measures ANOVA will be used to evaluate the effects before and after the intervention. Participants recruited for this study must be adults aged 20 years or older. The study will evaluate their posture, including craniovertebral angle (CVA), sagittal shoulder angle (SSA), thoracic kyphosis angle, subacromial space, coracoid-humeral distance (CHD), cervical proprioception, muscle strength (deep cervical flexors, upper, middle, and lower trapezius, serratus anterior, rhomboid muscles), and electromyographic (EMG) to evaluate muscle activation (upper, middle, and lower trapezius, serratus anterior).

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

SINGLE

Enrollment

Interventions

Dynamic TapeDEVICE

Dynamic Tape is a viscoelastic tape designed to assist movement and absorb load. The material is composed of either Nylon/Lycra or Recycled PET/Lycra.

Swiss BallDEVICE

A 75 cm diameter Swiss ball was used to provide an unstable surface during the exercise intervention.

DumbbellsDEVICE

During the exercise intervention, 1 kg and 2 kg dumbbells were used as external resistance.

Visual Feedback Laser DeviceDEVICE

A headband was prepared to attach the laser pointer securely, allowing participants to wear it . This visual feedback laser device was used during proprioceptive training to provide real-time feedback.

Eligibility

Sex: ALLMin age: 20 YearsMax age: 35 YearsHealthy volunteers:

Medical Language ↔ Plain English

Inclusion Criteria: 1. Age: \>20years 2. Craniovertebral angle (CVA) of \<48 3. Sagittal plane acromial angle of \<52° 4. Thoracic kyphosis angle of \>42° Meeting any one of these three angle conditions qualifies for inclusion. Exclusion Criteria: 1. Allergic reactions to dynamic taping 2. Bodyweight outside the normal range (BMI between 18 and 25) 3. Any evident misalignment in the cervical spine, pelvis, or lower/upper limbs 4. Trunk rotation exceeding 5°during forward bending tests due to scoliosis 5. History of inherited muscle diseases, soft tissue lesions, or joint diseases involving the spine, scapulae, shoulders, abdomen, or pelvis 6. History of fractures or surgeries. 7. Inability to understand instructions

Outcomes

Primary Outcomes

Posture (CVA and SSA and Kyphosis Angle)

The craniovertebral angle (CVA) and shoulder sagittal angle (SSA) were measured using the Physiomaster mobile application. During the measurement, the examiner positioned the smartphone to align the subject's image with the vertical and horizontal reference lines on the screen and then captured a photograph. The anatomical landmarks used for angle determination included the lateral canthus of the eye, the tragus of the ear, the spinous process of the seventh cervical vertebra (C7), and the midpoint of the line connecting the acromial processes. The thoracic kyphosis angle was measured using the Angle Meter mobile application. First, the device was calibrated to 0°. The smartphone was then placed at the level just inferior to T1 and subsequently at the level superior to T12. The kyphosis angle was calculated by summing the two measured angles.

Time frame: Participants were assessed at time points: prior to the intervention (baseline), immediately three weeks after the intervention, and at a one-month follow-up.

Cervical Proprioception

Cervical proprioception was assessed using the Head Repositioning Accuracy (HRA) test with a cervical range of motion (CROM) device. Participants were instructed to adopt and recognize the neutral head position (0°). The head was then passively guided to 30° of flexion, extension, lateral flexion, and rotation. After each movement, participants actively returned to the perceived neutral position under both eyes-open and eyes-closed conditions. The repositioning error was defined as the angular difference between the actual and the perceived 0° position