Comparative Effects of Stabilization Exercises and Corrective Exercises in Administrative Staff With Upper Cross Syndrome

University of Faisalabad50 enrolled

Overview

This study compares two types of rehabilitation strategies' - the stabilization exercises and the corrective exercises - to improve pain, respiratory function, and postural alignment in administrative staff with upper cross syndrome. Participants undertook a six-week intervention program. Random sampling technique was employed and 50 participants were included out of which 4 participants drops out. Randmoization was done via computer generator.The participants were divided into two groups: group A (Stabilization Exercises) and group B (Corrective Exercises). The process of data collection was conducted at MTH, and united hospital and participants will have included according to inclusion criteria. Pain was assessed by using the numeric pain rating. Respiratory function was assessed by using a digital spirometer. Postural alignment i.e., CVA \& SHA was assessed by using kinovea-2D video analysis. Mid thoracic curve was assessed by using Flexi curve rule.This study aims to determine which treatment produces greater improvement, which may help physiotherapists to give more effective evidence based treatment patients with UCS in Pakistan.

Background: Upper cross syndrome describes a pattern of muscle imbalance over the head and shoulder region, which is mostly brought on by misalignment. The rounded forward shoulder girdle and arm posture associated with upper crossed syndrome are commonly referred to as rounded shoulders. Studies show that upper cross syndrome affects 67% of computer workers. IT professionals should spend less time sitting down because prolonged sitting can lead to poor posture. Rehabilitation strategies like stabilization exercises are the mainstay of conventional treatment, but new research shows that corrective exercises are a promising way to improve postural alignment and restore respiratory function. Objectives: The primary objective of this study was to compare the effects of stabilization exercises and corrective exercises in improving pain and respiratory function in administrative staff with upper cross syndrome. Secondary objectives included determining to compare the effects of stabilization exercises and corrective exercises in improving postural alignment and mid-thoracic curve in administrative staff with upper cross syndrome.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Interventions

Stabilization ExercisesOTHER

What: A supervised scapular stabilization exercise program designed to improve scapular muscle activation, strength, and postural alignment in computer workers with Upper Cross Syndrome. The program includes serratus anterior punches with resistance band, scapular retraction with external rotation using resistance band, and resistance band overhead press targeting the lower trapezius. Exercises are performed under supervision three times per week for 6 weeks. When:45 minutes per session, 3 sessions per weeks for 6 weeks (total 18 sessions). How much : The dosage of these exercises was 3 sets × 10 reps with 5 sec hold for 3 days /week for 6 weeks. By Whom: by licensed physiotherapist trained in stabilization exercise Where: outpatient rehabilitation department of MTH (Madinah Teaching Hospital) and United Hospital, Faisalabad, Punjab, Pakistan

Corrective ExercisesOTHER

What: A supervised comprehensive postural corrective exercise program designed to address postural muscle imbalance and improve cervical, thoracic, and scapular alignment in computer workers with Upper Cross Syndrome. The program includes chin tuck exercises for activation of the deep cervical flexors, seated stability ball T exercises for core and back extensor activation, foam roller shoulder opener, and prone T, Y, and W exercises. Exercises are performed under supervision three times per week for 6 weeks. When:45 minutes per session, 3 sessions per weeks for 6 weeks (total 18 sessions). How much : The dosage of these exercises was 10 s hold ×7 to 15 s hold ×10 hold for 3 days /week for 6 weeks. By Whom: by licensed physiotherapist trained in corrective exercise Where: outpatient rehabilitation department of MTH (Madinah Teaching Hospital) and United Hospital, Faisalabad, Punjab, Pakistan.

Eligibility

Sex: ALLMin age: 24 YearsMax age: 40 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Age 24-40 years. * Prolonged computer working hours =6 hours/day . * Prolonged computer working years for =6 months . * Clinical features of UCS i.e.; * Participant must meet =3 of the following on clinical exam: * Cranio-vertebral angle (CVA) \< 50°. * Visible FHP and rounded shoulders on the lateral view. * Abnormality in the position and rhythm of the scapula. * Excessive thoracic kyphosis \>42 . * Non-specific chronic cervical pain =3 months. * NPRS 3-6 (mild-moderate) . Exclusion Criteria: * Pregnant females. * Reported history of smoking. * Having a medical prescription that specifically dictated therapeutic exercises for posture. * History of any fracture of upper limb and spine. * History of any operations involving the neck, upper extremity and trunk. * Reported history of recent spinal trauma . * Reported any history of respiratory disorder i.e: COPD, TB, asthma etc. * Reported any history of cardiac disorder i.e: angina, myocardial infarction, cardiac failure etc. * Congenital spinal deformity i.e: structural kyphosis and scoliosis etc. * Any history of neurological disease i.e: stroke, epilepsy, myasthenia gravis etc . * Reported history of any cancer i.e: bone cancer, breast cancer etc

Outcomes

Primary Outcomes

Pain Intensity

Pain intensity was measured by using the Numeric Pain Rating Scale (NPRS), a 0-10 scale where 0 indicates no pain and 10 indicates worst imaginable pain. Participants werel mark their perceived pain level, and the score will recorded. The Numeric Pain Rating Scale (NPRS) is a valid and reliable tool for assessing pain severity, with reported validity coefficients ranging from r = 0.71 to 0.78 and great reliability (ICC = 0.97 .

Time frame: Baseline (week 0, before first intervention session), mid-intervention; week 3, after 9th session, and post-intervention (week 6, within 48 hours after the final intervention session)

Respiratory Function

The Respiratory function was assessed using a CareFusion digital spirometer. Spirometric parameters including Forced Vital Capacity (FVC), Forced Expiratory Volume in 1 second (FEV1), FEV1/FVC ratio, and Peak Expiratory Flow (PEF) will be recorded according to standard spirometry procedures. It has great validity (r \> 0.99) and reliability (ICC = 0.99)

Time frame: Baseline (week 0, before first intervention session), mid-intervention; week 3, after 9th session, and post-intervention (week 6, within 48 hours after the final intervention session)

Postural Alignment

Postural alignment was assessed using photographic analysis. Craniovertebral angle and sagittal head angle will be measured from lateral view images using Kinovea software. Standard anatomical landmarks was used to determine head and neck posture. Tragus of ear and C7 will be used for craniovertebral angle while tragus of ear and canthus of eye will be used for saggital head angle For assessing postural angles, such as the Craniovertebral Angle (CVA) and Sagittal Head Angle (SHA), Kinovea has shown very great validity (r = 1.0) and excellent reliability (ICC = 0.99)

Time frame: Baseline (week 0, before first intervention session), mid-intervention; week 3, after 9th session, and post-intervention (week 6, within 48 hours after the final intervention session).

Secondary Outcomes

Mid-Thoracic Curve

Mid-thoracic curvature was assessed using a flexicurve ruler. The ruler was be molded along the thoracic spine (typically T1-T12), and the traced curve will be used to calculate thoracic kyphosis angle using standard methods A Flexi curve Ruler, which has been shown to have good to excellent reliability (ICC ≈ 0.80-0.97) and moderate to high validity (r ≈ 0.60-0.90), was used to measure thoracic kyphosis

Time frame: Baseline (week 0, before first intervention session), and post-intervention (week 6, within 48 hours after the final intervention session.