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Upper Crossed SyndromeNCT07921030

Effect of Kendall Versus McKenzie Exercises in Patients With Upper Crossed Syndrome

A study testing Kendall Excercise, Mckenzie Excercise and Standard Physical Therapy in people with Upper Crossed Syndrome, run by Riphah International University at 1 site in Pakistan.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
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Trial summary

The study was conducted to evaluate effects of Kendall versus McKenzie exercise on pain ,functional disability and craniovertebral angle in upper cross syndrome over the course of 6 week Read more about this study

Who is it for?
Ages 20 to 60 years
Conditions the study is for
Upper Crossed Syndrome
What is being tested?
Kendall Excercise, Mckenzie Excercise and Standard Physical Therapy
Could I receive a placebo?
No, everyone receives an active treatment
How many people
58 participants
Where
1 sitePakistan
Study dates
1 Jan 2026to 15 Jan 2027
Phase
Interventional
Are there results?
Not yet: the study is under way

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 20 to 60 years
  • All sexes
  • No healthy volunteers
  • Adult

Who may be able to join

  • Male and female Age between 20 -60 years Neck pain duration ≥ 3 months NDI score >20 Forward head posture ≥ 45° Round shoulders ≥ 52 ° Round back > 40° Pain intensity ≥ 3

Who cannot join

  • History of any trauma, surgery, or disease of shoulder,spine,pelvis Specific neck pathologies (cervical disc herniation,cervical radiculopathy,inflammatory condition like rheumatoid arthritis or gout, spinal infection and tumor,myelopathy,upper cervical instability,dizziness,vertebral artery insufficiency) Presence of neurological deficit, Diagnosed psychiatric disorder Current participant in other neck/shoulder rehab Having any visible malalignment in the pelvis or lower extremities. Skin allergies and lesions. Pregnancy Uncontrolled cardiovascular or respiratory conditions

Trial locations and contacts

1 site in 1 country. Contact the study team or a site near you to ask about taking part.

Imran Amjad, Phd contact

03324390125

imran.amjad@riphah.edu.pk

Pakistan1 site, 1 recruiting
  • MS OMPT

    Gujranwala, Punjab Province

    Nida Shaukat, DPT, 03144566582, nidashoukat29000@gmail.com

    Recruiting

Other trials in Pakistan

About this study

Official title: Effects of Kendall Versus McKenzie Exercises on Pain, Functional Disability, and Craniovertebral Angle in Patients With Upper Crossed Syndrome

The study was conducted to evaluate effects of Kendall versus McKenzie exercise on pain ,functional disability and craniovertebral angle in upper cross syndrome over the course of 6 week

Read the detailed description

Upper Crossed Syndrome is a common postural disorder characterized by muscle imbalance between tight cervical extensor,upper trapezius, levator scapulae,pectoralis major,pectoralis minor .And weak deep cervical flexors, lower trapezius, serratus anterior.This result in pain and reduce functional ability and altered craniovertebral angle.This study aims to evaluate effects of Kendall versus McKenzie exercise on pain ,functional disability and craniovertebral angle in upper cross syndrome.

Randomized clinical trial will be conducted in upper cross syndrome patient in Asharab Health Clinic Gujranwala using non probability convenience sampling technique.58 Participants will be selected according to inclusion and exclusion criteria and then randomly allocated into two groups.Conventional treatment will be given to both groups .But group A will be given Kendall exercise and group B will be given McKenzie exercise.Treatment will be given for 6 week.Outcome measure will included pain assessed by Numeric Pain Rating scale ,functional disability assessed by Neck Disability Index and craniovertebral angle by Image J software,neck flexor endurance by Neck Flexor Muscle Endurance Test .Informed consent will be obtained from all participants prior to inclusion in this study. Outcome will be recorded at baseline, at 6 week intervention.Data will be analyze by using SPSS version 25.

Being tested
Kendall Excercise, Mckenzie Excercise, Standard Physical Therapy
Keywords
Exercise therapy, Kendall Exercise, McKenzie Exercise, Posture, Range of Motion
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.

  • Kendall ExcerciseOther

    Excercise Dose Description and Progression Strengthening of deep cervical flexors 5 sets of 10 rep, 30 sec break after each set In supine lying, Chin tucks with head in contact with the floor.From 3rd week progress by lifting head off the floor in chin tucked in position and hold it for 2-8 sec.

    Stretching the cervical extensors 5 rep .each repetition held for 60 sec.And 60 sec break after each rep In sitting a chin drop-in is progress by chin drop with the help of hand on the occipital area.

    Strengthening shoulder retraction 5 set of 10 repetition,30 sec break after each set In standing, shoulder retraction by holding thera band moving scapular blades inwards.Progression to prone lying without weights then using the weight of 1 kg.

    Stretching the pectoralis muscle 5 repetition held for 60 sec each, after each rep 60 sec break Unilateral pectoral stretch with the help of door frame or wall,progresses to bilateral stretch .Increases the force of stretch as tolerated.

  • Mckenzie ExcerciseOther

    Cervical Retraction 10-15 repetitions Cervical Retraction with Patient Overpressure 10-15 repetitions Cervical Retraction with Therapist Overpressure 10-15 repetitions Cervical Retraction with Extension 10-15 repetitions Cervical Retraction with Extension and Rotation 5-6 repetitions Slouch-overcorrect from Mckenzie 10 cycles

  • Standard Physical TherapyOther

    Heating pack for 15 minutes,Static stretching of upper trapezius 5 repetitions per side; hold 30 seconds; rest 30 seconds between repetitions.

    Static stretching of levator scapulae 5 repetitions per side; hold 30 seconds; rest 30 seconds between repetitions.

    PA maitland glide cervical and thoracic t1-t3

Study groups in NCT07921030
Study groupRoleWhat they receive
Kendall Excercise groupExperimentalNot described
Receives: Other: Kendall Excercise; Other: Standard Physical Therapy
Mckenzie Excercise groupExperimentalNot described
Receives: Other: Mckenzie Excercise; Other: Standard Physical Therapy

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Numeric Pain Rating Scale

    patient select a whole number (0-10 integers) that best reflects the intensity of their pain. The rating scale is as follows: 0 = No pain 1-3 = Mild pain 4-6 = Moderate pain 7-10 = Severe Pain

    Measured: From enrollment to the end of the treatment at 6 week

  2. Neck disability index

    Instructions to the client should be given to fill the questionnaire and scoring should be done by the therapist. Clients choose one of six possible replies ranging from no disability (0) to entire disability (5). The total score is calculated by adding the ten items together, ranging from 0 (no disability) to 50 (disability) (maximum disability). This score is sometimes converted to a percentage by some authors. A score of less than 4 indicates no disability, 5-14 mild disability, 15-24 moderate disability, 25-34 severe disability, and scores greater than 35 full disabilities

    Measured: From enrollment to the end of the treatment at 6 week

  3. Craniovertebral angle (CVA)

    To measure the craniovertebral angle (CVA), participants were seated on a standard chair with their feet flat on the floor and thighs parallel to the ground. A digital phone was positioned 1.5 meters from the dominant side of each participant at shoulder height.To measure the craniovertebral angle (CVA), the angle measurement tool within the software was selected. From the file menu, the desired image was opened. Using the mouse pointer, the examiner first clicked on the tragus marker and then drew a line to the C7 marker by clicking again at that point. This line, connecting the tragus and the C7 spinous process, was then fixed. Subsequently, a horizontal line was drawn from the C7 spinous process marker, and the software calculated the angle between the two lines, which was recorded as the craniovertebral angle (CVA).Intraclass Correlation Coefficient (ICC) values was 0.89 to 0.94.The Standard Error of Measurement (SEM) ranged from 0.92° to 1.02°.

    Measured: From enrollment to the end of the treatment at 6 week

Secondary outcomes (2)
  1. Neck Flexor Muscle Endurance test

    Position the participant in supine crook lying, with knees bent and the head in a neutral position.

    Ask the participant to slightly flex the upper cervical spine (chin tuck).

    Instruct the participant to gently lift the head off the plinth while maintaining upper cervical flexion.

    Record the maximum holding time in seconds.

    Stop when the participant cannot maintain the position, increases neck flexion, or lowers the head.

    Measured: From enrollment to the end of the treatment at 6 week

  2. Rounded Shoulder

    Where a horizontal line passing through the lateral shoulder meets the line drawn from C7 to the lateral shoulder, the point of intersection forms the sagittal shoulder-C7 angle . It indicates the degree of roundness of the shoulders.It is measure by through Image J. Software

    Measured: From enrollment to the end of the treatment at 6 week

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted6 Nov 2026
  2. Study start1 Jan 2026
  3. Primary completion27 Oct 2026 (estimated)
  4. Study completion15 Jan 2027 (estimated)

Resources

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
Model description
Model Description
Masking
Double blind
Who is masked
Participant, Outcomes assessor
Enrolment
58 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07921030
Sponsor's protocol ID
REC/RCR&AHS/25/0188
Status last verified
Nov 2026
First submitted
2 Nov 2026
Last updated
6 Nov 2026
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Abu-Taleb W, Yamany AA, Aneis YM, Abu El Kasem ST. Effect of adding global postural reeducation to kendall exercises for treating asymptomatic forward head posture: A single-blinded randomized controlled trial. J Bodyw Mov Ther. 2025 Jun;42:938-947. doi: 10.1016/j.jbmt.2025.01.039. Epub 2025 Feb 6.

    PubMed 40325777
  • Abdel-Aziem AA, Mohamed RR, Draz AH, Azab AR, Hegazy FA, Diab RH. The effect of McKenzie protocol vs. deep neck flexor and scapulothoracic exercises in subjects with chronic neck pain - a randomized controlled study. Eur Rev Med Pharmacol Sci. 2022 May;26(9):3138-3150. doi: 10.26355/eurrev_202205_28731.

    PubMed 35587064
  • Binaei F, Kahlaee AH, Mohseni Bandpei MA, Rahmani N, Taghizadeh Delkhoush C, Saatchi M, Goudarzi H. Reliability of Image J. Software to Evaluate the Craniovertebral Angle in Participants with and without Neck Pain. Arch Bone Jt Surg. 2025;13(12):849-856. doi: 10.22038/ABJS.2025.86598.3935.

    PubMed 41509052
  • Barrett E, McCreesh K, Lewis J. Intrarater and interrater reliability of the flexicurve index, flexicurve angle, and manual inclinometer for the measurement of thoracic kyphosis. Rehabil Res Pract. 2013;2013:475870. doi: 10.1155/2013/475870. Epub 2013 Dec 12.

    PubMed 24396603
  • Mahmood T, Afzal W, Ahmad U, Arif MA, Ahmad A. Comparative effectiveness of routine physical therapy with and without instrument assisted soft tissue mobilization in patients with neck pain due to upper crossed syndrome. J Pak Med Assoc. 2021 Oct;71(10):2304-2308. doi: 10.47391/JPMA.03-415.

    PubMed 34974559
  • 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 33244045
  • Rezaei H, Gheitasi M, Hosseini SM. Does corrective exercises influence the performance, posture, range of motion and shoulder pain of swimmers with upper crossed syndrome? randomized clinical trial. BMC Sports Sci Med Rehabil. 2025 Jul 10;17(1):193. doi: 10.1186/s13102-025-01200-8.

    PubMed 40640904

Questions about this trial

What is this clinical trial studying?

A study testing Kendall Excercise, Mckenzie Excercise and Standard Physical Therapy in people with Upper Crossed Syndrome, run by Riphah International University 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 1 inclusion and 1 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: looking for participants now, as of the sponsor's last update on 6 Nov 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?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Imran Amjad, Phd (03324390125, imran.amjad@riphah.edu.pk), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Numeric Pain Rating Scale (time frame: From enrollment to the end of the treatment at 6 week). The study lists 3 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 NCT07921030, which also lists 7 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 6 Nov 2026.

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