Effects of Rhomboids Strength Training Regime Among Patients With Upper Crossed Syndrome

Official title

Effects of Rhomboids Strength Training Regime on Pain, Craniovertebral Angle and Disability Among Patients With Upper Crossed Syndrome

Overview

Upper Cross Syndrome (UCS) is characterized by weakening of the neck flexors and rhomboids and stiffness in the pectoralis major, upper trapezius, and levator scapulae. Rhomboids major and minor need to be strengthened in order to enhance scapular stability and regain proper posture. The aim of this study is to determine effect of rhomboids strength training regime on pain, craniovertebral angle and disability among patients with upper crossed syndrome.

Detailed description

This study will be a randomized controlled trial and will be conducted in Haleema Surgical Hospital, Shorkot city. Non-probability convenient sampling will be used to collect the data. Sample size of 38 subjects with age group between 20-45 years will be taken. Data will be collected from the patients having present complaint of upper crossed syndrome pain. Outcome measures will be taken using Numeric pain rating scale (NPRS) for pain, craniovertebral angle, and neck disability index questionnaire for disability. An informed consent will be taken. Subjects will be selected on the basis of inclusion and exclusion criteria and will be equally divided into two groups by computer-generated stratified randomization. The study will be a single-blind assessor. Both the Groups will receive Hot Pack, TENS, posture training and stretching exercises while group A will receive rhomboids strengthening exercises additionally. Outcome measures will be measured at baseline and after 4 weeks. Data analysis will be done by SPSS version 25.

Interventions

• Other Rhomboids Strengthening Exercise
  1. Seated Bent Row in Sitting position,3 sets of the exercise program with 12 repetitions per set, 3 times per week. 2. Bent Over Row in standing position, 3 sets, 12 repetitions, 3 times per week. 3. Lat Pull Down in sitting position with 12 repetitions per set, 3 times per week. 4. Shoulder Horizontal Abduction in lying position with 3 sets of the exercise program with 12 repetitions per set, 3 times per week. 5. Band pull apart performed 4sets, 12 repetitions, and 10 seconds rest for 2 mints,
• Other Conventional Exercises
  Conventional Treatment 1. hot pack for 10 min, 2. Trans-cutaneous Electric Nerve Stimulation (TENS) will be applied, with pulse duration of 250 microseconds at a frequency of 80 Hz for 15 min in the sub occipital region and the trapezius bilaterally. 3. Stretching exercises of tight muscles 2 sets of 15 min. 4. Posture correction exercises: releasing muscles of anterior part of the trunk, neck, shoulder.

Primary outcome measures

• Numerical Pain Rating Scale (NPRS) [Time frame: upto 4 weeks]
• Neck Disability Index (NDI_ [Time frame: upto 4 weeks]
• Craniovertebral Angle [Time frame: upto 4 weeks]

Eligibility criteria

Inclusion criteria

• Age group between 20 and 45 years
• Both gender male and female
• Subject with head neck angle less than 50 degrees(for forward head posture).
• Subject with positive JANDAS upper crossed syndrome tests .
• Population with occupation tailor, computer users and students.

Exclusion criteria

• • Exclusion criteria Patients were excluded if they were diagnosed with the following conditions for ˃6 months

• Tuberculosis, carcinoma, heart disease, and osteoporosis
• Neural disorders due to prolapsed intervertebral disc
• Any trauma or localized infection in upper back region

Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.

Healthy volunteers: No

Study design

Allocation

Randomized

Model

Parallel assignment

Masking

Single blind

Primary purpose

Treatment

Study locations

Pakistan · 1 center

• Haleema Surgical Hospital — Jhang

Publications

• Mujawar JC, Sagar JH. Prevalence of Upper Cross Syndrome in Laundry Workers. Indian J Occup Environ Med. 2019 Jan-Apr;23(1):54-56. doi: 10.4103/ijoem.IJOEM_169_18. PMID 31040591
• Jeong GH, Lee BH. Effects of Telerehabilitation Combining Diaphragmatic Breathing Re-Education and Shoulder Stabilization Exercises on Neck Pain, Posture, and Function in Young Adult Men with Upper Crossed Syndrome: A Randomized Controlled Trial. J Clin Med. 2024 Mar 11;13(6):1612. doi: 10.3390/jcm13061612. PMID 38541838
• Naseer R, Tauqeer S. Prevalence of upper cross syndrome in different occupations. Pakistan Journal of Physical Therapy (PJPT). 2021:03-7.
• Huang JF, Meng Z, Zheng XQ, Qin Z, Sun XL, Zhang K, Tian HJ, Wang XB, Gao Z, Li YM, Wu AM. Real-World Evidence in Prescription Medication Use Among U.S. Adults with Neck Pain. Pain Ther. 2020 Dec;9(2):637-655. doi: 10.1007/s40122-020-00193-1. Epub 2020 Sep 17. PMID 32940899
• Chu EC, Butler KR. Resolution of Gastroesophageal Reflux Disease Following Correction for Upper Cross Syndrome-A Case Study and Brief Review. Clin Pract. 2021 May 21;11(2):322-326. doi: 10.3390/clinpract11020045. PMID 34063944
• Kirthika SV, Sudhakar S, Padmanabhan K, Ramanathan K. Impact of upper crossed syndrome on pulmonary function among the recreational male players: A preliminary report. Saudi Journal of Sports Medicine. 2018;18(2):71-4.
• Gull M, Akbar UU, Asim HM. FREQUENCY OF CHRONIC NECK PAIN IN UPPER CROSS SYNDROME IN FEMALE SCHOOL TEACHERS. Independent Journal of Allied Health Sciences. 2018;1(01):33-8.
• Firouzjah MH, Firouzjah EMAN, Ebrahimi Z. The effect of a course of selected corrective exercises on posture, scapula-humeral rhythm and performance of adolescent volleyball players with upper cross syndrome. BMC Musculoskelet Disord. 2023 Jun 14;24(1):489. doi: 10.1186/s12891-023-06592-7. PMID 37316911

Identifiers

NCT: NCT06996002 · REC/RCR &AHS/24/0145 Bisma

Primary sources (government registries)

• ClinicalTrials.gov (US NIH)

View this study on ClinicalTrials.gov ↗