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Completed

NCT Number: NCT07841639

Comparative Effect of Janda's Approach and Mckenzie Exercises in Patients With Upper Cross Syndrome

This study was conducted compare the effect Janda's Approach and Mckenzie Excercises in patients with Upper Crossed Syndrome

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Key information

Conditions

Upper Crossed Syndrome Oculocerebral hypopigmentation syndrome type Preus

Age range

20 year–35 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Shagufta Medical Complex

Sheikhupura, Punjab Province, 39460, Pakistan

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Both male and females
  • Age between 20-35 years
  • Excessive Forward Head > 46
  • Excessive Forward shoulder > 52
  • Excessive kyphosis > 42
  • Neck pain scores 4-8 on NPRS
  • Sedentary or moderately active individuals with prolonged desk/workstation use
  • Functional disability ≥10% on the Neck Disability Index

Exclusion criteria

  • Cervical and upper limb fracture history.
  • Has vertebrobasilar insufficiency.
  • History of surgery to the cervical spine.
  • Infections or neoplastic processes of the spine.
  • Diagnosed cases of osteoporosis.
  • Rheumatoid or other inflammatory arthritis.
  • Pregnancy
  • Neurological disorder

Treatment and study plan

McKenzie Treatment

Other
  • Cervical Retraction (Chin Tucks) and Basic Postural Drills: 5-10 reps for, 3-4 times/day.
  • Cervical Extension in lying and Thoracic Extension: 10-15 reps for 30-35 minutes.
  • Shoulder Retraction, Prone Scapular Squeeze and Wall Angels: 5-10 sec hold, more sets.
  • Standing Shoulder Rows (with resistance band) and Neck Isometrics: Functional drills for 40 mins.
  • Sitting Posture Drills and Computer Ergonomics Practice: Stimulate workstation posture tasks for 40-45 minutes.
  • Full McKenzie Cervical Series and Posture Checklist: Emphasize home program, relapse prevention for 45 minutes.

Janda's Approach

Other

Week 1:

  • Chin Tucks (Deep Neck Flexors): 3 sets x 10-12 reps
  • Scapular Retraction (Low Resistance):3 sets x 10-12 reps
  • Pectoralis Stretch (Doorway Stretch): 30 seconds x 2
  • Upper Trapezius Stretch (Lateral Neck Flexion): 30 seconds x 2
  • Educate on sitting posture and workstation ergonomics

Week 2:

  • Chin Tucks: 3 sets x 12-15 reps
  • Prone Y/T/W: 3 sets x 10-12 reps
  • Levator Scapulae Stretch: 30 seconds x 2
  • Pectoralis Stretch: 30 seconds x 2
  • Begin postural correction during daily activities (sitting, standing)

Week 3:

  • Chin Tucks: 3 sets x 15 reps
  • Prone Y/T/W: 3 sets x 15 reps
  • Upper Trapezius Stretch: 45 seconds x 2
  • Levator Scapulae Stretch: 45 seconds x 2
  • Correct head positioning during tasks like typing or sitting

Week 4:

  • Scapular Retraction with Resistance Bands: 3 sets x 10 reps
  • Shoulder Retraction: 3 sets x 10-12 reps
  • Pectoralis Stretch: 45 seconds x 2
  • Upper Trapezius Stretch: 45 seconds x 2
  • Focus on functional postural exercises (standing rows)

Baseline treatment

Other
  • Application of a heating pad for muscle relaxation (10 minutes)
  • TENS therapy (10 minutes) to alleviate pain
  • Range-of-motion exercises for the cervical spine and shoulders to maintain flexibility.
  • Stretching exercises targeted the upper trapezius, levator scapulae, and pectoralis muscles

Primary outcomes

  1. Numeric Pain Rating Scale

    Time frame: From enrollment to the end of treatment at 6 weeks.

    The 11-point Numeric Pain Rating Scale (NPRS) ranged from 0 to 10, with 10 denoting "the highest level of pain imaginable" and 0 denoting "no pain". It was a simple indicator of pain intensity since patients chose the number that most accurately represented their level of pain.

  2. Neck Disability Index

    Time frame: From enrollment to the end of treatment at 6 weeks

    The Neck Disability Index (NDI) was a standardized, self-administered questionnaire used to evaluate how neck pain affected a person's ability to perform everyday activities. It consisted of 10 items that assessed different aspects of life impacted by neck pain, including pain intensity, personal care, lifting, reading, headaches, concentration, work, driving, sleeping, and recreation. Each item was scored on a scale from 0 to 5, where higher scores indicated greater disability. The total score could range from 0 to 50 and was often converted into a percentage to interpret the level of disability. A score between 0-8% suggested no disability, 10-28% indicated mild disability, 30-48% moderate disability, 50-64% severe disability, and 70% or higher reflected complete disability.

  3. Photogrammetry Method for Craniovertebral Angle

    Time frame: From enrollment to the end of treatment at 6 weeks

    A photogrammetric method was used to evaluate forward head posture (craniovertebral angle), rounded shoulders, and thoracic kyphosis from a lateral view. Key anatomical landmarks-tragus, acromion, C7, and T12-were marked on participants. Individuals stood in a natural posture, barefoot, on a marked board while facing forward. A digital camera, placed 265 cm away, captured three side-view photographs.

    The images were analyzed using USC software, which measured:

    • Forward head angle: angle between the line from tragus to C7 and the vertical.
    • Rounded shoulder angle: angle from acromion to the vertical.
    • Kyphosis angle: arc between C7 and T12.

  4. ROM Cervical Spine (Flexion)

    Time frame: From enrollment to the end of treatment at 6 weeks

    Changes in cervical spine flexion ROM at baseline and 6th week of intervention was measured using goniometer.

  5. ROM Cervical Spine (Extension)

    Time frame: From enrollment to the end of treatment at 6 weeks

    Changes in cervical spine extension ROM at baseline and 6th week of intervention was measured using goniometer.

  6. ROM Cervical Spine (Lateral Flexion) Right Side

    Time frame: From enrollment to the end of treatment at 6 weeks

    Changes in cervical spine lateral flexion on right side ROM at baseline and 6th week of intervention was measured using goniometer.

  7. ROM Cervical Spine (Lateral Flexion) Left Side

    Time frame: From enrollment to the end of treatment at 6 weeks

    Changes in cervical spine lateral flexion on left side ROM at baseline and 6th week of intervention was measured using goniometer.

  8. ROM Cervical Spine (Rotation) Right Side

    Time frame: From enrollment to the end of treatment at 6 weeks

    Changes in cervical spine rotation on right side ROM at baseline and 6th week of intervention was measured using goniometer.

  9. ROM Cervical Spine (Rotation) Left Side

    Time frame: From enrollment to the end of treatment at 6 weeks

    Changes in cervical spine rotation on left side ROM at baseline and 6th week of intervention was measured using goniometer.

Interested in participating?

Completed

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Sponsors and collaborators

Lead sponsor

Riphah International University

Other

Registry information

Official study title

Comparative Effect of Janda's Approach and Mckenzie Exercises on Pain Intensity, Craniovertebral Angle and Functional Disability in Patients With Upper Cross Syndrome

Acronym: JAM-USC

Important dates

Study start
2025
Primary completion
2026
Study completion
2026
First posted
Sep 25, 2026
Registry last updated
Sep 25, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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