Upper Cross SyndromeNCT06185322
Effectiveness of Exercise in the Treatment of Upper Cross Syndrome
A study testing Physical therapy program with upper cross syndrome specific exercises and Physical therapy program with conventional neck strengthening exercises in people with Upper Cross Syndrome, run by Baskent University.
Trial summary
Upper cross syndrome (UCS) is a common postural deformity characterized by a change in neck, torso and shoulder muscle activity and shoulder movement. UCS results in a shortening of the upper back and chest muscles as well as the muscles which provide movement to the shoulder blade. Read more about this study
- Who is it for?
- Ages 30 to 50 years
- Conditions the study is for
- Upper Cross Syndrome
- What is being tested?
- Physical therapy program with upper cross syndrome specific exercises and Physical therapy program with conventional neck strengthening exercises
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 30 participants
- Where
- No sites listed yet
- Study dates
- 1 Jan 2024to 30 Jan 2025
- Phase
- Interventional
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 30 to 50 years
- All sexes
- No healthy volunteers
- Adult
Who may be able to join
None listed.
Who cannot join
- History of cervical spine trauma or surgery
- Congenital postural deformity
- A history of inflammatory arthritis
- A diagnosis of torticollis, vertigo, pregnancy, vertebrobasilar insufficiency, heart failure, ischaemic heart disease, hypertension.
About this study
Official title: The Effectiveness of Exercise on Neck Pain, Posture, Function and Quality of Life in Individuals With Upper Cross Syndrome: a Randomized Double Blind Control Study
Upper cross syndrome (UCS) is a common postural deformity characterized by a change in neck, torso and shoulder muscle activity and shoulder movement. UCS results in a shortening of the upper back and chest muscles as well as the muscles which provide movement to the shoulder blade. This is accompanied by weakness of the upper back muscles, shoulder blade stabilizor muscles and deep neck muscles. The resultant muscle imbalance leads to elevation of the shoulders, elongation of the neck and rounding of the back.
The change in posture which occurs in UCS changes the biomechanics of the neck and upper back and can results in neck pain, adverse effects on daily activities and productivity. To date, studies have been done on treatment of elongation of the neck using muscle relaxation techniques and manipulation of the local structures. To date, there is no study which investigates the efficacy of a specific exercise program targeting the muscles affected by UCS. The aim of this study is to investigate the effects of UCS-specific exercises on neck-back pain, cervical posture, disability and quality of life.
Read the detailed description
Upper cross syndrome (UCS) is a common postural deformity characterised by a change in neck, torso and scapular muscle activity and scapular mobility. UCS results in a shortening of the upper trapezius, pectoralis majör and levator scapula muscles and weakness of the rhomboid, serratus anterior, middle and lower trapezii and deep cervical muscles such as the scalene muscles. The resultant muscle imbalance results in elevation and protraction of the shoulders, protraction of the neck and increase in kyphosis of the thoracic spine.
The change in posture seen in UCS reuslts in a change in the biomechanics of the vertebral bodies, neural arcus, musculature, faset joints, ligaments and discs which in turn can result in pain. Neck pain can negatively affect activities of daily living and function, causing disabiltiy and thus having a detrimental affect quality of life and productivity. Furthermore, studies have shown that UCS is frequently seen occuring in individuals with facet joint degeneration, myofacial pain syndrome and cervical radiculopathy. , In the literature, forward head position is treated craniocervical flexion training, muscle energy techniques, cervical coordination exercises, mobilization, manipulation and stabilization exercises. However, to date, there are no studies which investigate the effect of specific exercises aimed at resolving the muscle imblance which occurs in UCS. The aim of this study is to investigate the effects of UCS-specific exercises on neck-back pain, cervical posture and alignment, disability and quality of life. ,
- Conditions
- Upper Cross Syndrome
- Being tested
- Physical therapy program with upper cross syndrome specific exercises, Physical therapy program with conventional neck strengthening exercises
- Keywords
- upper cross syndrome, forward head position, posture, neck pain, cervicalgia, pain ,cervical, posture balance
- Medical subject headings
- Oculocerebral hypopigmentation syndrome type Preus, Neck Pain
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Physical therapy program with upper cross syndrome specific exercisesOther
Ten physical therapy sessions consisting of electrotherapy and upper cross syndrome -specific exercise program.
Physical therapy program with conventional neck strengthening exercisesOther
Ten physical therapy sessions consisting of electrotherapy and conventional neck strenthening exercises
| Study group | Role | What they receive |
|---|---|---|
| Neck strengthening exercises group | Active comparator | 10 sessions of physical therapy over two weeks.Each session will consist of 20 minutes of hotpack and transcutaneous electrical nerve stimulation and 10minutes of therapeutic ultrasound. Exercise sessions lasting 20minutes will consist of conventional neck isometric strengthening exercises under the supervision of a single physiotherapist. These exercises will be repeated 5 times each, twice daily. A brochure depicting each exercise,accompanied by a description,will be given to the patient.The patient will continue with the exercise program for 3 months and be reminded once a week via telephone. Receives: Other: Physical therapy program with conventional neck strengthening exercises |
| Upper Cross Syndrome exercises group | Experimental | 10sessions of physical therapy over two weeks.Each session will consist of 20minutes of hotpack and transcutaneous electrical nerve stimulation and 10minutes of therapeutic ultrasound.Exercise sessions lasting 20minutes will consist of stretching and strengthening exercises under the supervision of a single physiotherapist.Strengthening exercises for the deep neck flexors,upper and middle trapezius,serratus anterior will be performed by the patient.Ten repetitions of each exercise,three times daily will be recommended.Stretching exercises will include those for the upper trapezius,pectoralis majör,levator scapula,suboccipital and sternocleidemastoid muscles and izometric neck flexion-extension exercises.These will be repeated 5times each,twice daily.A brochure depicting each exercise,accompanied by a description,will be given to the patient.The patient will continue with the exercise program for 3 months and be reminded once a week via telephone. Receives: Other: Physical therapy program with upper cross syndrome specific exercises |
What is being measured
The primary outcome is the main question the study is designed to answer.
Visual analogue scale measurement of severity of neck pain
A subjective measure of neck pain severity in the past week measured using a visual analogue scale from 0-100mm. 0mm signifies no pain, 100mm signifies the worst pain imaginable.
Measured: Before physcial therapy treatment is commenced, after 10 sessions of physical therapy has been completed (2 weeks after commencement of therapy), three months after physical therapy has been completed.
Secondary outcomes (6)
Neck disability index (NDI)
A subjective measure of effect of neck pain on disability and activities of daily living. A ten part questionnaire on intensity of neck pain, effects of neck pain on self-care, heavy lifting, association between neck pain and headaches, ability to work and sleep. Each question scores between 0-5 with an increase in score signifying worsening disablity.
Measured: Before physcial therapy treatment is commenced, three months after physical therapy has been completed.
Nottingham Health Profile (NHP)
A quality of life measure focusing on the effects of a health issue on daily activities. Measures of pain and energy levels, emotional wellbeing, sleep quality, social isolation and physical activity are conducted. A total score between 0-600 is obtained. Higher scores signify poorer quality of life. ,
Measured: Before physcial therapy treatment is commenced, three months after physical therapy has been completed.
Goniometric measurement of cervical range of motion
Goniometric measurement of cervical flexion and extension
Measured: Before physcial therapy treatment is commenced, three months after physical therapy has been completed.
Occiput to wall distance and tragus to wall distance
Measurement of the distance between the occiput and wall and tragus and wall in the sagittal plane when standing with feet against wall, head in the neutral position as a measure of cervical mobility and thoracic kyphosis.
Measured: Before physcial therapy treatment is commenced, three months after physical therapy has been completed.
Radiographic evaluation of cervical posture and cervicothoracic alignment: Measure of cervical lordotic angle
Cervical lordotic angle will be evaluated by measuring the Cobb angle and absolute rotation angle (ARA). Cobb angle will be measured using a lateral cervical radiograph. A line will be drawn parallel to the C2 and C7 vertebral endplate. A second line will bisect these lines. The angle between the two bisecting lines is the Cobb angle. The ARA is formed by the intersection of tangents drawn at the posterior body margins of C2 and C7.
To investigate the position of the head in the sagittal plane and sagittal alignment of the spine, the sagittal vertical axis (SVA) - distance between the posterior superior corner of C7 and a plumb line dropped from C2 - will be measured.
Measured: Before physcial therapy treatment is commenced, three months after physical therapy has been completed.
Radiographic evaluation of cervicothoracic alignment
SCA refers to a new sagittal parameter, defined as the angle between a line from the sella turcica center and C7 endplate and the C7 plateau line.
Measured: Before physcial therapy treatment is commenced, three months after physical therapy has been completed.
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted29 Dec 2023
- Study start1 Jan 2024 (estimated)
- Primary completion30 Dec 2024 (estimated)
- Study completion30 Jan 2025 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Upper Cross SyndromeStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Triple blind
- Who is masked
- Participant, Investigator, Outcomes assessor
- Enrolment
- 30 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Baskent University
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Selin Ozen, Baskent University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT06185322
- Sponsor's protocol ID
- KA23/139
- Status last verified
- Dec 2023
- First submitted
- 6 Dec 2023
- Last updated
- 29 Dec 2023
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
Study at a glance
From the registry record, last updated by the sponsor on 29 Dec 2023. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- The Effectiveness of Exercise on Neck Pain, Posture, Function and Quality of Life in Individuals With Upper Cross Syndrome: a Randomized Double Blind Control Study
- ClinicalTrials.gov ID
- NCT06185322
- Acronym / sponsor ID
- KA23/139
- Conditions
- Upper Cross Syndrome
- Keywords
- upper cross syndrome, forward head position, posture, neck pain, cervicalgia, pain ,cervical, posture balance
- Study type
- Interventional
- Recruitment status
- Unknown status
- Enrolment
- 30 participants (estimated)
- Lead sponsor
- Baskent UniversityUniversity, hospital or other
- Study start
- 1 Jan 2024 (estimated)
- Primary completion
- 30 Dec 2024 (estimated)
- Study completion
- 30 Jan 2025 (estimated)
- First posted
- 29 Dec 2023 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
Upper cross syndrome (UCS) is a common postural deformity characterized by a change in neck, torso and shoulder muscle activity and shoulder movement. UCS results in a shortening of the upper back and chest muscles as well as the muscles which provide movement to the shoulder blade. This is accompanied by weakness of the upper back muscles, shoulder blade stabilizor muscles and deep neck muscles. The resultant muscle imbalance leads to elevation of the shoulders, elongation of the neck and rounding of the back.
The change in posture which occurs in UCS changes the biomechanics of the neck and upper back and can results in neck pain, adverse effects on daily activities and productivity. To date, studies have been done on treatment of elongation of the neck using muscle relaxation techniques and manipulation of the local structures. To date, there is no study which investigates the efficacy of a specific exercise program targeting the muscles affected by UCS. The aim of this study is to investigate the effects of UCS-specific exercises on neck-back pain, cervical posture, disability and quality of life.
Detailed description
Upper cross syndrome (UCS) is a common postural deformity characterised by a change in neck, torso and scapular muscle activity and scapular mobility. UCS results in a shortening of the upper trapezius, pectoralis majör and levator scapula muscles and weakness of the rhomboid, serratus anterior, middle and lower trapezii and deep cervical muscles such as the scalene muscles. The resultant muscle imbalance results in elevation and protraction of the shoulders, protraction of the neck and increase in kyphosis of the thoracic spine.
The change in posture seen in UCS reuslts in a change in the biomechanics of the vertebral bodies, neural arcus, musculature, faset joints, ligaments and discs which in turn can result in pain. Neck pain can negatively affect activities of daily living and function, causing disabiltiy and thus having a detrimental affect quality of life and productivity. Furthermore, studies have shown that UCS is frequently seen occuring in individuals with facet joint degeneration, myofacial pain syndrome and cervical radiculopathy. , In the literature, forward head position is treated craniocervical flexion training, muscle energy techniques, cervical coordination exercises, mobilization, manipulation and stabilization exercises. However, to date, there are no studies which investigate the effect of specific exercises aimed at resolving the muscle imblance which occurs in UCS. The aim of this study is to investigate the effects of UCS-specific exercises on neck-back pain, cervical posture and alignment, disability and quality of life. ,
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Triple blind (participant, investigator, outcomes assessor)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Neck strengthening exercises group | Active comparator | Other: Physical therapy program with conventional neck strengthening exercises10 sessions of physical therapy over two weeks.Each session will consist of 20 minutes of hotpack and transcutaneous electrical nerve stimulation and 10minutes of therapeutic ultrasound. Exercise sessions lasting 20minutes will consist of conventional neck isometric strengthening exercises under the supervision of a single physiotherapist. These exercises will be repeated 5 times each, twice daily. A brochure depicting each exercise,accompanied by a description,will be given to the patient.The patient will continue with the exercise program for 3 months and be reminded once a week via telephone. |
| Upper Cross Syndrome exercises group | Experimental | Other: Physical therapy program with upper cross syndrome specific exercises10sessions of physical therapy over two weeks.Each session will consist of 20minutes of hotpack and transcutaneous electrical nerve stimulation and 10minutes of therapeutic ultrasound.Exercise sessions lasting 20minutes will consist of stretching and strengthening exercises under the supervision of a single physiotherapist.Strengthening exercises for the deep neck flexors,upper and middle trapezius,serratus anterior will be performed by the patient.Ten repetitions of each exercise,three times daily will be recommended.Stretching exercises will include those for the upper trapezius,pectoralis majör,levator scapula,suboccipital and sternocleidemastoid muscles and izometric neck flexion-extension exercises.These will be repeated 5times each,twice daily.A brochure depicting each exercise,accompanied by a description,will be given to the patient.The patient will continue with the exercise program for 3 months and be reminded once a week via telephone. |
Who may qualify
- Ages
- 30 to 50 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult
Key inclusion criteria (0 listed)
Key exclusion criteria (4 listed)
- History of cervical spine trauma or surgery
- Congenital postural deformity
- A history of inflammatory arthritis
- A diagnosis of torticollis, vertigo, pregnancy, vertebrobasilar insufficiency, heart failure, ischaemic heart disease, hypertension.
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Physical therapy program with upper cross syndrome specific exercisesTen physical therapy sessions consisting of electrotherapy and upper cross syndrome -specific exercise program. | Other | Upper Cross Syndrome exercises group |
| Physical therapy program with conventional neck strengthening exercisesTen physical therapy sessions consisting of electrotherapy and conventional neck strenthening exercises | Other | Neck strengthening exercises group |
Primary outcome
Visual analogue scale measurement of severity of neck pain
Time frame: Before physcial therapy treatment is commenced, after 10 sessions of physical therapy has been completed (2 weeks after commencement of therapy), three months after physical therapy has been completed.
A subjective measure of neck pain severity in the past week measured using a visual analogue scale from 0-100mm. 0mm signifies no pain, 100mm signifies the worst pain imaginable.
6 secondary outcomes
Neck disability index (NDI)
Time frame: Before physcial therapy treatment is commenced, three months after physical therapy has been completed.
Nottingham Health Profile (NHP)
Time frame: Before physcial therapy treatment is commenced, three months after physical therapy has been completed.
Goniometric measurement of cervical range of motion
Time frame: Before physcial therapy treatment is commenced, three months after physical therapy has been completed.
Occiput to wall distance and tragus to wall distance
Time frame: Before physcial therapy treatment is commenced, three months after physical therapy has been completed.
Radiographic evaluation of cervical posture and cervicothoracic alignment: Measure of cervical lordotic angle
Time frame: Before physcial therapy treatment is commenced, three months after physical therapy has been completed.
Radiographic evaluation of cervicothoracic alignment
Time frame: Before physcial therapy treatment is commenced, three months after physical therapy has been completed.
Results and safety
Results are not available in the source record.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 29 Dec 2023.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
The record lists no contact. Use the official record to reach the sponsor.
Questions about this trial
What is this clinical trial studying?
A study testing Physical therapy program with upper cross syndrome specific exercises and Physical therapy program with conventional neck strengthening exercises in people with Upper Cross Syndrome, run by Baskent University.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 0 inclusion and 4 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: status not confirmed, as of the sponsor's last update on 29 Dec 2023. Status can change between updates, so confirm with the study contact before making plans.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
Results are not available in the source record.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Visual analogue scale measurement of severity of neck pain (time frame: Before physcial therapy treatment is commenced, after 10 sessions of physical therapy has been completed (2 weeks after commencement of therapy), three months after physical therapy has been completed.). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 29 Dec 2023.