Upper Cross SyndromeNCT07058272
Effect Of PNF Techniques Versus CCEP On Pain, Function and Quality of Life In Patients With Upper Cross Syndrome
A study testing Comprehensive corrective exercise protocol and Proprioceptive Neuromuscular Facilitation (PNF) Techniques in people with Upper Cross Syndrome, run by Elite College of Management Sciences, Gujranwala, Pakistan at 1 site in Pakistan.
Trial summary
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. Read more about this study
- Who is it for?
- Ages 25 to 65 yearsHealthy volunteers can take part
- Conditions the study is for
- Upper Cross Syndrome
- What is being tested?
- Comprehensive corrective exercise protocol and Proprioceptive Neuromuscular Facilitation (PNF) Techniques
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 38 participants
- Where
- 1 sitePakistan
- Study dates
- 8 May 2025to 1 Jul 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 25 to 65 years
- All sexes
- Healthy volunteers accepted
- Adult, Older adult
Who may be able to join
- 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
Who cannot join
- 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)
Trial locations and contacts
1 site in 1 country.
About this study
Official title: Effect of PNF Techniques Versus Comprehensive Corrective Exercise Protocol 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.
Read the detailed description
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.
- Conditions
- Upper Cross Syndrome
- Being tested
- Comprehensive corrective exercise protocol, Proprioceptive Neuromuscular Facilitation (PNF) Techniques
- Keywords
- Postural Balance, Range of Motion, Muscle Stretching Exercises, Neck Muscles
- Medical subject headings
- Oculocerebral hypopigmentation syndrome type Preus
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Comprehensive corrective exercise protocolOther
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) TechniquesOther
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
| Study group | Role | What they receive |
|---|---|---|
| Group 1 | Active comparator | CCEP and TENS Receives: Other: Comprehensive corrective exercise protocol |
| Group 2 | Experimental | PNF and TENS Receives: Other: Proprioceptive Neuromuscular Facilitation (PNF) Techniques |
What is being measured
The primary outcome is the main question the study is designed to answer.
Neck Disability Index
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
Measured: 8 weeks
SF-12 Health Survey
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
Measured: 8 weeks
Secondary outcomes (1)
Numeric Pain Rating Scale
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.
Measured: 8 weeks
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted10 Jul 2025
- Study start8 May 2025
- Primary completion30 Jun 2025
- Study completion1 Jul 2025
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (3)Papers the sponsor has linked to this study.
- 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
- Double blind
- Who is masked
- Participant, Investigator
- Enrolment
- 38 participants (actual)
Sponsor and investigators
- Lead sponsor
- Elite College of Management Sciences, Gujranwala, Pakistan
- Sponsor type
- University, hospital or other
- Responsible party
- Sponsor
- Investigators
- Usman Iqbal Janjua, Principal investigator, Ellite College of Managment Sciences, Gujranwala
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07058272
- Sponsor's protocol ID
- 2020-079297
- Status last verified
- May 2026
- First submitted
- 12 May 2025
- Last updated
- 11 May 2026
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Publications
(3)Asad, A., Farooq, N., Kafeel, S., Hassan, T., & Zubair, M. (2021). Association of upper crossed syndrome and posture among general population having neck pain in Islamabad. Journal of Rehman Medical Institute, 7(2), 07-11.
Seidi F, Bayattork M, Minoonejad H, Andersen LL, Page P. Comprehensive corrective exercise program improves alignment, muscle activation and movement pattern of men with upper crossed syndrome: randomized controlled trial. Sci Rep. 2020 Nov 26;10(1):20688. doi: 10.1038/s41598-020-77571-4.
PubMed 33244045Chang MC, Choo YJ, Hong K, Boudier-Reveret M, Yang S. Treatment of Upper Crossed Syndrome: A Narrative Systematic Review. Healthcare (Basel). 2023 Aug 17;11(16):2328. doi: 10.3390/healthcare11162328.
PubMed 37628525
Study at a glance
From the registry record, last updated by the sponsor on 11 May 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Effect of PNF Techniques Versus Comprehensive Corrective Exercise Protocol on Pain, Function and Quality of Life in Patients With Upper Cross Syndrome
- ClinicalTrials.gov ID
- NCT07058272
- Acronym / sponsor ID
- 2020-079297
- Conditions
- Upper Cross Syndrome
- Keywords
- Postural Balance, Range of Motion, Muscle Stretching Exercises, Neck Muscles
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 38 participants (actual)
- Lead sponsor
- Elite College of Management Sciences, Gujranwala, PakistanUniversity, hospital or other
- Study start
- 8 May 2025 (actual)
- Primary completion
- 30 Jun 2025 (actual)
- Study completion
- 1 Jul 2025 (actual)
- First posted
- 10 Jul 2025 (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.
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.
Detailed description
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.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Double blind (participant, investigator)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Group 1 | Active comparator | Other: Comprehensive corrective exercise protocolCCEP and TENS |
| Group 2 | Experimental | Other: Proprioceptive Neuromuscular Facilitation (PNF) TechniquesPNF and TENS |
Who may qualify
- Ages
- 25 to 65 years
- Sex
- All
- Healthy volunteers
- Accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (4 listed)
- 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
Key exclusion criteria (4 listed)
- 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)
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 |
|---|---|---|
| Comprehensive corrective exercise protocolInitial 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 | Other | Group 1 |
| Proprioceptive Neuromuscular Facilitation (PNF) TechniquesIn 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 | Other | Group 2 |
Primary outcome
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
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
1 secondary outcome
Numeric Pain Rating Scale
Time frame: 8 weeks
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 11 May 2026.
- Background(3)Asad, A., Farooq, N., Kafeel, S., Hassan, T., & Zubair, M. (2021). Association of upper crossed syndrome and posture among general population having neck pain in Islamabad. Journal of Rehman Medical Institute, 7(2), 07-11.
- Background: PubMed 33244045Seidi F, Bayattork M, Minoonejad H, Andersen LL, Page P. Comprehensive corrective exercise program improves alignment, muscle activation and movement pattern of men with upper crossed syndrome: randomized controlled trial. Sci Rep. 2020 Nov 26;10(1):20688. doi: 10.1038/s41598-020-77571-4.
- Background: PubMed 37628525Chang MC, Choo YJ, Hong K, Boudier-Reveret M, Yang S. Treatment of Upper Crossed Syndrome: A Narrative Systematic Review. Healthcare (Basel). 2023 Aug 17;11(16):2328. doi: 10.3390/healthcare11162328.
- Individual participant dataSharing planned: No
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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.
Usman Iqbal Janjua principal investigator
Ellite College of Managment Sciences, Gujranwala
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Comprehensive corrective exercise protocol and Proprioceptive Neuromuscular Facilitation (PNF) Techniques in people with Upper Cross Syndrome, run by Elite College of Management Sciences, Gujranwala, Pakistan at 1 site in Pakistan.
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 4 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: finished, as of the sponsor's last update on 11 May 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Pakistan. Whether a site is taking part right now should be confirmed with that site. See every site.
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?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
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?
Neck Disability Index (time frame: 8 weeks). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT07058272, which also lists 3 linked publications.
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 11 May 2026.