The purpose of the study will be to investigate dynamic neuromuscular stabilization versus National American Academy of Sports Medicine (NASM) corrective exercises on pain, functional disability, cranio-vertebral angle, forward shoulder angle, and thoracic kyphosis in upper cross syndrome.
Upper Cross Syndrome (UCS) is a frequent condition that is most commonly encountered in musculoskeletal disorders, showing a typical pattern of imbalance in muscles and neck and shoulder region joint dysfunction. It causes pain in shoulders, upper back, thoracic and cervical spine. It is frequently associated with inadequate posture or forward head position, muscular weakness, and alterations in movement patterns, leading to pain, restricted mobility, and dysfunction in the affected areas of patients suffering from UCS. Dynamic Neuromuscular Stabilization (DNS) is a developing rehabilitation approach based on reflex locomotion. The idea of reflex locomotion describes particular involuntary motor reactions/movement patterns that occur when firm pressure is applied to specific muscle zones. These movement patterns are standard and referred to as "global patterns". The global pattern generated from the prone position is known as "reflex creeping," whereas the one from the supine or side lying posture is known as "reflex rolling". Furthermore, some motor motions such as gripping, turning, crawling, and eventually walking occur automatically without the need for specific training in normal babies. The National American Academy of Sports Medicine (NASM) provided a corrective exercise protocol for postural malalignment. It includes 4 steps: inhibition (self-mobilization release technique targeting trigger points), lengthening (stretching techniques for tight muscles), third: activation (strengthening techniques for weak muscles), and integration (retraining all muscles through functionally progressive movements). It was successful in treating UCS.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
45
Dynamic neuromuscular stabilization involves precise co-activation of the intrinsic muscles of the spine which forms the Integrated spinal stabilization system (ISSS) and includes cervical flexors and extensors, diaphragm, transverses abdominis, multifidus and pelvic floor.
It is corrective exercise protocol, which includes four phases, i.e. inhibit, lengthen, activate, and integrate stage
Outpatient clinic at faculty of physical therapy - Cairo University
Cairo, Cairo Governorate, Egypt
Neck pain intensity
Neck pain intensity will be measured through Numerical pain rating scale. A scale from 0 to 10, with 0 indicating no pain and 10 signifying excruciating pain.
Time frame: At baseline at the first session and reassessed at the end of six weeks of intervention.
Neck disability
The patient will be asked to fill the 10- section of the questionnaire. Higher score indicate higher disability.
Time frame: At baseline at the first session and after 6 weeks of intervention.
Craniovertebral angle
craniovertebral angle will be measured using Kinovea software to assess forward head posture
Time frame: At baseline and after 6 weeks of intervention
Forward shoulder angle
Forward shoulder angle will be measured using Kinovea software to assess rounded shoulder posture
Time frame: At baseline and after 6 weeks of intervention
Thoracic kyphosis angle
Thoracic kyphosis angle will be measured using a bubble inclinometer
Time frame: At baseline and after 6 weeks of intervention
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