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Completed

NCT Number: NCT07058272

Effect Of PNF Techniques Versus CCEP On Pain, Function and Quality of Life In Patients With Upper Cross Syndrome

The study aims to determine which approach either PNF Techniques or Comprehensive Corrective Exercise Protocol provides better outcomes for pain relief, functional improvement, and quality of life in patients with upper cross syndrome.

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Key information

Conditions

Upper Cross Syndrome Oculocerebral hypopigmentation syndrome type Preus

Age range

25 year–65 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Al-Raee Hospital

Gujranwala, Punjab Province, Pakistan

About this study

Upper crossed syndrome is caused due to altered muscle activation and movement patterns of the neck, shoulders, head and back muscles. In addition to postural deviations (forward head and rounded shoulders, and an excessive curve of the thoracic spine), upper cross syndrome is characterized by abnormal posture brought on by changed muscle activation patterns and varied movement patterns. Most cases of this condition occurred in people over 20. The symptoms of upper cross syndrome managed by correcting posture, stretching and strengthening the affected muscles, and making ergonomic adjustments.

It will be a Randomized Clinical Trial with sample size of 38. They will be randomly allocated into two groups by using chit and draw method. 19 participants in Group 1 will get PNF protocol while 19 participants in Group 2 get CCEP .For eight weeks, each patient will receive four sessions per week through which their neck disability index, visual analogue scale, and quality of life would measure .Data will be collected at the start of the trial, after four weeks of treatment, and again at the end of treatment. In participants with upper cross syndrome, the goal for applying a comprehensive corrective exercise program and a proprioceptive neuromuscular facilitation technique is to alleviate pain and improve functioning, posture, and quality of life.

Who can participate

Healthy volunteers accepted: Yes

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

Inclusion criteria

  • Age : 25-65
  • Symptoms of upper cross syndrome appeared from maximum 6 months
  • Occiput to wall test positive
  • Patients presenting postural changes e.g: severe kyphosis

Exclusion criteria

  • Any apparent misalignment in the pelvis or lower limbs.
  • Rotation exceeding 5 degrees during forward bending as a result of scoliosis.
  • Prior history of joint disorders in the spine, shoulders, and pelvis.
  • Body weight that falls outside the normal range (BMI between 18 and 25)

Treatment and study plan

Comprehensive corrective exercise protocol

Other

Initial phase exercises include lying supine on a foam roll with the arms in 3 different abduction angles, side-lying external rotation, side-lying forward flexion, standing diagonal flexion , and military press .Initial phase lasts for 2 weeks, with exercises progressing from 7 Reps of 10-second holds to 10 Reps of 15-second hold.

Improvement phase consist of exercises including side-lying external rotation with a dumbbell , side-lying forward flexion with a dumbbell , standing diagonal flexion with a dumbbell, standing external rotation with Thera-Band, standing diagonal flexion with Thera-Band, abduction while sitting on a training ball, prone lying V, T, and W exercises, and standing abduction on a balance board. The improvement phase lasts for 2 weeks, with exercises progressing from seven sets of 10-seconds hold to 10 sets of 15 secs hold.

The exercises in the maintenance phase are the same as those in the improvement phase, with no increase in intensity and frequency

Proprioceptive Neuromuscular Facilitation (PNF) Techniques

Other

In this study following PNF Stretching techniques are used

  • Hold-relax or Contract-relax
  • Hold-relax with agonist contraction In the Hold-Relax or Contract-Relax technique, stretching is performed 4sessions per week for each muscle group, with each session lasting 40 min. The protocol includes a 10-sec hold phase followed by a 10-sec contraction phase, repeated for 7 reps . The total duration of this program is 8weeks including 6 weeks of treatment phase and last 2 weeks of detraining.

In Hold-Relax with Agonist contract, the same procedure is followed as in Hold-Relax method, with 4sessions per week for each muscle group. The patient is asked to hold the initial stretch for 10 sec, followed by a relaxation phase. Afterward, the agonist muscle is contracted to actively move further into the stretch, which is then held for 10 sec. This protocol is performed for 7 reps per session, and the total duration of study is 8 weeks including 6 weeks of treatment program with last 2 weeks

Primary outcomes

  1. Neck Disability Index

    Time frame: 8 weeks

    NDI comprises 10 items. Each item is rated on a 6-point scale from 0 (no disability) to 5 (complete disability), yielding a total score ranging from 0 to 50. This score can be converted into a percentage by multiplying by 2, resulting in a range from 0% (no disability) to 100% (complete disability).

    Severity Classification:

    0-4: No disability 5-14: Mild disability 15-24: Moderate disability 25-34: Severe disability 35-50: Complete disability

  2. SF-12 Health Survey

    Time frame: 8 weeks

    The SF-12 Health Survey is a concise, 12-item instrument derived from the SF-36, designed to assess health-related quality of life (HRQoL) across two primary domains: physical health and mental health. It comprises 8 domains. Scores above 50 indicate better health than the average population, while scores below 50 suggest worse health. Each point difference corresponds to a 0.1 standard deviation change

Secondary outcomes

  1. Numeric Pain Rating Scale

    Time frame: 8 weeks

    Numerical Pain Rating Scale, used to assess pain intensity. Patients rate their pain on a scale from 0 (no pain) to 10 (worst possible pain), providing healthcare providers with a quantifiable measure to evaluate and manage pain.

Sponsors and collaborators

Lead sponsor

Elite College of Management Sciences, Gujranwala, Pakistan

Other

Registry information

Official study title

Effect of PNF Techniques Versus Comprehensive Corrective Exercise Protocol on Pain, Function and Quality of Life in Patients With Upper Cross Syndrome

Important dates

Study start
2025
Primary completion
2025
Study completion
2025
First posted
Jul 10, 2025
Registry last updated
May 11, 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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