Comparative Effect of Maitland Mobilization Combined With Kendall Exercises for Pain and Postural Alignment in Adults With Upper Cross Syndrome
For patients and families
In plain language
An automatic summary of structured registry data. It is an orientation aid, not a substitute for the official protocol or a physician assessment.
- What is being studied
- The protocol lists: Kendall Exercises combined Maitland Mobilization, Kendall Exercise alone.
- Who it may be relevant to
- Registry conditions: Upper Cross Syndrome. Basic parameters: 18 years — 45 years · All.
- What needs checking
- Age, condition and sex are only basic indicators. Prior treatment, laboratory values and other mandatory requirements appear in the eligibility criteria below.
- Where it takes place
- Pakistan
- Next step
- Save the trial, show it to the treating physician, and confirm current recruitment with the study center. Costs, documents and travel →
Unsure about the terms? Read our patient guide →
Official title
Comparative Effect of Maitland Mobilization Combined With Kendall Exercises on Pain and Postural Alignment in Adults With Upper Cross Syndrome
Overview
This randomized controlled trial aims to compare the effects of Maitland mobilization combined with Kendall exercises versus Kendall exercises alone on pain and postural alignment in adults with Upper Cross Syndrome (UCS). Upper Cross Syndrome is characterized by muscle imbalance leading to forward head posture, rounded shoulders, and increased thoracic kyphosis. The study will evaluate pain intensity, craniovertebral angle, thoracic kyphosis, and rounded shoulder posture
Interventions
- Other Kendall Exercises combined Maitland Mobilization
Group A (Experimental) received Kendall exercises combined with Maitland mobilization, including strengthening of deep cervical flexors, lower trapezius, and serratus anterior, along with stretching of upper trapezius, levator scapulae, and pectoralis major/minor. Maitland mobilization was applied to the cervical and upper thoracic spine using central and unilateral PA oscillations for 50-60 seconds per segment at 2-3 oscillations per second, in addition to warm-up (cervical AROM and shoulder mo - Other Kendall Exercise alone
Participants in this group will receive a structured Kendall exercise program only, without any manual therapy or mobilization techniques. The intervention will focus on postural correction through strengthening of weakened muscles (deep cervical flexors, scapular retractors) and stretching of tight muscles (pectoralis major/minor, upper trapezius, levator scapulae) associated with upper cross syndrome.
Primary outcome measures
- Thoracic Kyphosis Assessed With Flexicurve Ruler [Time frame: baseline to last week (8 week)]
- Forward Head Posture Assessed with Protractor mobile application [Time frame: baseline to last week (8 week)]
- Rounded Shoulder Assessed with Vernier Caliper [Time frame: baseline to last week (8 week)]
- Visual Analogue Scale [Time frame: baseline to last week]
Eligibility criteria
Inclusion criteria
- Age 18 to 45 years
- Neck and/or upper thoracic pain for a duration of > 6 weeks
- Pain Severity: VAS > 5 (Afzal, Noor, Mumtaz, Bashir, \& Saqulain, 2023)
- Pain exacerbated by prolonged postures
- Adults diagnosed with Upper Cross Syndrome
- Diagnostic criteria: Upper Cross Syndrome will be diagnosed when individuals demonstrate: thoracic kyphosis > 40°, craniovertebral angle < 50°, and acromion-to-couch distance > 2.5 cm based on established normative values.
Exclusion criteria
- History of neck or shoulder surgery or trauma
- Inflammatory conditions such as rheumatoid arthritis or gout
- Pregnancy
- Neurological conditions affecting upper limb function, and
- Cardiovascular Problems
- Congenital issues i.e.; torticollis, and scoliosis
- Disc prolapse and other spine issues
- Currently taking any medication or taking physical therapy
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
- Ibadat International University, Islamabad (Iiui) — Peshawar
Publications
- Zappala M, Lightbourne S, Heneghan NR. The relationship between thoracic kyphosis and age, and normative values across age groups: a systematic review of healthy adults. J Orthop Surg Res. 2021 Jul 9;16(1):447. doi: 10.1186/s13018-021-02592-2. PMID 34243795
- van Niekerk SM, Louw Q, Vaughan C, Grimmer-Somers K, Schreve K. Photographic measurement of upper-body sitting posture of high school students: a reliability and validity study. BMC Musculoskelet Disord. 2008 Aug 20;9:113. doi: 10.1186/1471-2474-9-113. PMID 18713477
- Usman, T., Babur, M. N., Aslam, E., Rashid, M. A. B., Aslam, K., & Azam, A. (2024). Effects of Kendall Exercises vs Gong's Mobilization on Upper Cross Syndrome: Kendall Exercises vs. Gong's Mobilization in UCS. Journal of Health and Rehabilitation Research, 4(3), 1-6.
- Syinta, A. N., & Komalasari, D. R. (2024). Reliability and Validity of The Visual Analogue Scale in Non-Myogenic Low Back Pain Patients. Paper presented at the Academic Physiotherapy Conference Proceeding.
- Singla D, Veqar Z, Hussain ME. Photogrammetric Assessment of Upper Body Posture Using Postural Angles: A Literature Review. J Chiropr Med. 2017 Jun;16(2):131-138. doi: 10.1016/j.jcm.2017.01.005. Epub 2017 Mar 18. PMID 28559753
- Singh, N., Kumar, P., & Parasher, R. K. Inter-tester and Intra-tester Reliability of Physical Examination Test Used to Measure Positional Faults of the Shoulder Girdle in Healthy Individuals. International Journal of Health Sciences, 6(S7), 3771-3780.
- Sepehri S, Sheikhhoseini R, Piri H, Sayyadi P. The effect of various therapeutic exercises on forward head posture, rounded shoulder, and hyperkyphosis among people with upper crossed syndrome: a systematic review and meta-analysis. BMC Musculoskelet Disord. 2024 Feb 1;25(1):105. doi: 10.1186/s12891-024-07224-4. PMID 38302926
- Salahzadeh Z, Maroufi N, Ahmadi A, Behtash H, Razmjoo A, Gohari M, Parnianpour M. Assessment of forward head posture in females: observational and photogrammetry methods. J Back Musculoskelet Rehabil. 2014;27(2):131-9. doi: 10.3233/BMR-130426. PMID 23963268
Identifiers
NCT: NCT07588061 · IIUI/RERC/ADT/2026/04/282