Effects of Sahrmann's Approach in Patients With Cervical Extension Syndrome

June 8, 2026 updated by: Riphah International University

Effects of Sahrmann's Approach on Pain, Range of Motion, Craniovertebral Angle and Function in Patients With Cervical Extension Syndrome

Cervical Extension Syndrome (CES) is a form of postural dysfunction under the Movement System Impairment (MSI) classification. It has more prevalence among adults due to prolonged poor posture and sedentary lifestyles. This condition involves a forward head position,, increased thoracic curve, and altered movement patterns. This resulting in neck pain and impaired function. The Sahrmann's approach is a biomechanical principle that puts emphasizes on muscle activation, correction of postural impairments, and restoration of movement control through targeted exercises. The objective of the study will be to compare the effects of Sahrmann's Approach on Pain, ROM, craniovertebral angle and function in patients with Cervical Extension Syndrome.

Study Overview

Status

Status

Indicates the current recruitment status or the expanded access status.
Not yet recruiting

Conditions

Conditions

The disease, disorder, syndrome, illness, or injury that is being studied. On ClinicalTrials.gov, conditions may also include other health-related issues, such as lifespan, quality of life, and health risks.

Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.

Detailed Description

This randomized controlled trial will investigate the effects of Sahrmann's corrective exercises on pain, range of motion, craniovertebral angle, thoracic curve and function in individuals with CFS. Total sample size 54 is calculated by GPower and participants aged 20-40 years will be recruited from Femwell Physio Clinic, Sir Ganga Ram Hospital and University of Lahore Teaching Hospital Lahore using non- probability consecutive sampling. Subjects will be randomly assigned to either Group A (conventional physiotherapy) or Group B (Sahrmann's approach) through sealed opaque envelopes. Group A will follow a standard treatment, while Group B will perform Sahrmann's corrective exercises for cervical extension syndrome. Numeric Pain Rating Scale (NPRS) for pain, Universal Goniometer (UG) for craniovertebral angle, Inclinometer for thoracic kyphosis and cervical range of motion and Neck Disability Index (NDI) for function will be assessed at baseline and after 6 weeks. Data will be analyzed using SPSS v25 to determine the comparative effects of both interventions.

Study Type

Study Type

Describes the nature of a clinical study. Study types include interventional studies (also called clinical trials), observational studies (including patient registries), and expanded access.
Interventional

Enrollment (Estimated)

Enrollment

The number of participants in a clinical study. The "anticipated" enrollment is the target number of participants that the researchers need for the study.
54

Phase

Phase

The stage of a clinical trial studying a drug or biological product, based on definitions developed by the U.S. Food and Drug Administration (FDA). The phase is based on the study's objective, the number of participants, and other characteristics. There are five phases: Early Phase 1 (formerly listed as Phase 0), Phase 1, Phase 2, Phase 3, and Phase 4. Not Applicable is used to describe trials without FDA-defined phases, including trials of devices or behavioral interventions.
  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Contact

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Study Locations

  • Pakistan
    • Punjab Province
      • Lahore, Punjab Province, Pakistan, 54000
        • University of Lahore Teaching Hospital, Lahore HOD Physio Department
        • Contact:

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Eligibility Criteria

The key requirements that people who want to participate in a clinical study must meet or the characteristics they must have. Eligibility criteria consist of both inclusion criteria (which are required for a person to participate in the study) and exclusion criteria (which prevent a person from participating). Types of eligibility criteria include whether a study accepts healthy volunteers, has age or age group requirements, or is limited by sex.

Ages Eligible for Study

  • Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • Adults between 20-40 years, NPRS score 4-6 , positive tests cervical flexion, extension, protraction and retraction and Cervical Nodding Against Wall

Exclusion Criteria:

Scoliosis, Pregnant females, Any active infection or disese

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Single

Arms and Interventions

Participant Group / Arm

Participant Group / Arm

A group or subgroup of participants in a clinical trial that receives a specific intervention/treatment, or no intervention, according to the trial's protocol.
Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.
Experimental: Sahrmann's exercises

Shirley Sahrmann's approach is based on the concept that repetitive movement and sustained postures can create movement impairments, leading to pain and dysfunction. Rather than simply strengthening weak muscles or stretching tight ones, Sahrmann focuses on identifying and correcting faulty movement patterns.

Patients will receive Sahrmann's Corrective Exercises for Cervicale Extension Syndrome.
Other: Sahrmann's Exercises
capital flexion, capital flexion with and without head tilt, Shoulder flexion, Abduction And Lateral Rotation, Cervical Extensors Muscle strengthening along with baseline treatment moist heat pack and TENS.
Active Comparator: Standard Physical therapy
this group will receive conventional physiotherapy. receive muscle stretching of trapezius, pectoralis and levator scapulae. and Active ROM as retractions of scapula and neck
Other: conventional physiotherapy
this group will receive conventional physiotherapy. receive muscle stretching of trapezius, pectoralis and levator scapulae. and Active ROM as retractions of scapula and neck. along with baseline treatment moist heat pack and TENS.

What is the study measuring?

Primary Outcome Measures

Primary Outcome Measures

In a clinical study's protocol, the planned outcome measure that is the most important for evaluating the effect of an intervention/treatment. Most clinical studies have one primary outcome measure, but some have more than one.
Outcome Measure
Measure Description
Time Frame
Numerical Pain Rating Scale (NPRS)
Time Frame: upto 4 weeks

he NPRS is an 11-point self-reported scale used to assess the intensity of neck pain. Participants rate their average pain over the previous 24 hours on a scale from 0 to 10.

Scoring:

0 = No pain 1-3 = Mild pain 4-6 = Moderate pain 7-10 = Severe pain

Direction of Improvement:

Lower scores indicate less pain and improvement.
upto 4 weeks
Craniovertebral Angle (CVA) - Forward Head Posture
Time Frame: upto 4 weeks

Description:

The CVA is used to quantify forward head posture. It is measured as the angle formed between:

A horizontal line passing through the spinous process of C7. A line connecting C7 to the tragus of the ear.

Scoring:

Smaller angle = Greater forward head posture. Larger angle = Better head-neck alignment.

Typical values:

<48° = Forward head posture

≥50° = More normal alignment

Direction of Improvement:

Increase in CVA indicates improvement.
upto 4 weeks
Neck Disability Index (NDI) - Functional Disability
Time Frame: upto 4 weeks

Description:

The NDI is a self-administered questionnaire consisting of 10 items assessing the impact of neck pain on daily activities.Scoring:

Each item scored from 0-5.

Total score:

0-50 points

Interpretation:

0-4 = No disability 5-14 = Mild disability 15-24 = Moderate disability 25-34 = Severe disability

≥35 = Complete disability

Direction of Improvement:

Lower scores indicate reduced disability and better function.
upto 4 weeks
Cervical Range of Motion (CROM)
Time Frame: upto 4 weeks

Description:

Cervical ROM will be measured in:

Flexion Extension Right lateral flexion Left lateral flexion Right rotation Left rotation

The participant performs active cervical movements while the examiner records the maximum range in degrees.

Units:

Degrees (°)

Typical Normal Values:

Flexion: 45-50° Extension: 60-70° Lateral flexion: 45° Rotation: 70-90°

Direction of Improvement:

Greater ROM values indicate improvement.
upto 4 weeks
Thoracic Kyphosis Angle
Time Frame: upto 4 weeks

Description:

Thoracic kyphosis will be measured in standing using a dual inclinometer technique. One inclinometer is placed over the spinous process of T1-T2 and the second over T12-L1. The difference between the two readings represents the thoracic kyphosis angle.

Units:

Degrees (°)

Interpretation:

Increased angle = Greater thoracic kyphosis Reduced angle = Improved thoracic posture

Typical values:

Approximately 20-40° in healthy adults

Direction of Improvement:

Reduction toward normal values indicates improvement.
upto 4 weeks

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Sponsor

The organization or person who initiates the study and who has authority and control over the study.
Riphah International University

Investigators

Investigators

A researcher involved in a clinical study. Related terms include site principal investigator, site sub-investigator, study chair, study director, and study principal investigator.
  • Principal Investigator: Komal Qayyum, MSPT*, Riphah International University

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

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Study Major Dates

Study Start (Estimated)

Study Start

The actual date on which the first participant was enrolled in a clinical study. The "anticipated" study start date is the date that the researchers think will be the study start date.
July 1, 2026

Primary Completion (Estimated)

Primary Completion

The date on which the last participant in a clinical study was examined or received an intervention to collect final data for the primary outcome measure. Whether the clinical study ended according to the protocol or was terminated does not affect this date. For clinical studies with more than one primary outcome measure with different completion dates, this term refers to the date on which data collection is completed for all the primary outcome measures. The "anticipated" primary completion date is the date that the researchers think will be the primary completion date for the study.
October 1, 2026

Study Completion (Estimated)

Study Completion

The date on which the last participant in a clinical study was examined or received an intervention/treatment to collect final data for the primary outcome measures, secondary outcome measures, and adverse events (that is, the last participant's last visit). The "anticipated" study completion date is the date that the researchers think will be the study completion date.
November 1, 2026

Study Registration Dates

First Submitted

First Submitted

The date on which the study sponsor or investigator first submitted a study record to ClinicalTrials.gov. There is typically a delay of a few days between the first submitted date and the record's availability on ClinicalTrials.gov (the first posted date).
June 8, 2026

First Submitted That Met QC Criteria

First Submitted That Met QC Criteria

The date on which the study sponsor or investigator first submits a study record that is consistent with National Library of Medicine (NLM) quality control (QC) review criteria. The sponsor or investigator may need to revise and submit a study record one or more times before NLM's QC review criteria are met. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
June 8, 2026

First Posted (Actual)

First Posted

The date on which the study record was first available on ClinicalTrials.gov after National Library of Medicine (NLM) quality control (QC) review has concluded. There is typically a delay of a few days between the date the study sponsor or investigator submitted the study record and the first posted date.
June 11, 2026

Study Record Updates

Last Update Posted (Actual)

Last Update Posted

The most recent date on which changes to a study record were made available on ClinicalTrials.gov. There may be a delay between when the changes were submitted to ClinicalTrials.gov by the study's sponsor or investigator (the last update submitted date) and the last update posted date.
June 11, 2026

Last Update Submitted That Met QC Criteria

Last Update Submitted That Met QC Criteria

The most recent date on which the study sponsor or investigator submitted changes to a study record that are consistent with National Library of Medicine (NLM) quality control (QC) review criteria. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
June 8, 2026

Last Verified

Last Verified

The most recent date on which the study sponsor or investigator confirmed the information about a clinical study on ClinicalTrials.gov as accurate and current. If a study with a recruitment status of recruiting; not yet recruiting; or active, not recruiting has not been confirmed within the past 2 years, the study's recruitment status is shown as unknown.
June 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

Other Study ID Numbers

Identifiers or ID numbers other than the NCT number that are assigned to a clinical study by the study's sponsor, funders, or others. These numbers may include unique identifiers from other trial registries and National Institutes of Health grant numbers.
  • REC/RCR & AHS/25/0114 Komal

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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