Dry Cupping Therapy and Muscle Energy Technique on Upper Crossed Syndrome

June 13, 2026 updated by: Amira saad mohamed

Effect of Combined Dry Cupping Therapy and Muscle Energy Technique on Upper Crossed Syndrome Patients. A Randomized Control Study

This study evaluated and compared the therapeutic efficacy of combining Dry Cupping therapy with the Muscle Energy Technique (MET) against each intervention applied independently, focusing on three core parameters: Neck Disability Index (NDI), Craniovertebral Angle (CVA), and Sagittal Shoulder-C7 Angle (SSA).

Study Overview

Status

Status

Indicates the current recruitment status or the expanded access status.
Active, not 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 study evaluated and compared the therapeutic efficacy of combining Dry Cupping therapy with the Muscle Energy Technique (MET) against each intervention applied independently, focusing on three core parameters: Neck Disability Index (NDI), Craniovertebral Angle (CVA), and Sagittal Shoulder-C7 Angle (SSA).

Methods: A pre-test post-test double-blinded randomized controlled trial design was employed. Seventy-six adults (aged 20-40 years) diagnosed with UCS were randomly allocated into four equal experimental groups (n = 19 per group): Group A received combined dry cupping and MET with conventional therapy; Group B received dry cupping with conventional therapy; Group C received MET with conventional therapy; and Group D received conventional therapy alone. Interventions were conducted over an 8-week period. Primary outcomes included functional impairment via the Arabic version of the NDI, and objective sagittal alignment parameters (CVA and SSA) measured using precision photometry via the Kinovea software application.

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 (Actual)

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.
76

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 Locations

  • Egypt
      • Giza, Egypt
        • Cairo University

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:

  • Participant inclusion was restricted to individuals between 20 and 40 years of age.
  • The exact diagnostic criteria required a baseline craniovertebral angle (CVA) of less than 48 degrees.
  • a sagittal shoulder-C7 angle (SSA) of less than 52 degrees.

Exclusion Criteria:

  • acute post-surgical conditions
  • structural spinal deformities (e.g., severe fixed structural scoliosis)
  • cervical radiculopathy, or localized dermal infections contradicting cupping application.

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: Group A (Combined group)
Group A (Combined group): This group of nineteen subjects received combined dry cupping therapy, Muscle energy techniques, and conventional physical therapy.
Procedure: combined therapy teatment

19 subjects received combined dry cupping therapy, Muscle energy technique, and conventional physical therapy for eight weeks.

  1. Dry cupping was applied to the regional hypertonic target sites. Standard plastic cups ranging from 25 to 50 mm were placed directly over each subject's levator scapulae trigger point (SI-14) and upper trapezius trigger point (GB-21) bilaterally. The treatment duration was set at exactly 8 minutes per session.
  2. Muscle Energy Technique The Post-Isometric Relaxation (PIR) manual protocol targeted the hypertonic muscles of the upper crossed syndrome quadrant, including the upper trapezius, levator scapulae, sternocleidomastoid, scalenes, and suboccipital groups. Participants were placed in a supine position on the treatment table with their head free from the edge of the plinth, supported by the physical therapist.
  3. conventional physical therapy treatment
Experimental: Group B (Cupping group)
Group B (Cupping group): This group of nineteen subjects received dry cupping therapy and conventional physical therapy.
Procedure: cupping therapy group

19 subjects received combined dry cupping therapy and conventional physical therapy for eight weeks.

  1. Dry cupping was applied to the regional hypertonic target sites. Standard plastic cups ranging from 25 to 50 mm were placed directly over each subject's levator scapulae trigger point (SI-14) and upper trapezius trigger point (GB-21) bilaterally. The treatment duration was set at exactly 8 minutes per session.
  2. conventional physical therapy treatment
Experimental: Group C (MET group)
Group C (MET group): This group of nineteen subjects received Muscle energy techniques and conventional physical therapy.
Procedure: muscle energy techniques group

19 subjects received combined Muscle energy technique, and conventional physical therapy for eight weeks.

  1. Muscle Energy Technique The Post-Isometric Relaxation (PIR) manual protocol targeted the hypertonic muscles of the upper crossed syndrome quadrant, including the upper trapezius, levator scapulae, sternocleidomastoid, scalenes, and suboccipital groups. Participants were placed in a supine position on the treatment table with their head free from the edge of the plinth, supported by the physical therapist.
  2. conventional physical therapy treatment
Active Comparator: Group D (Control group)
Group D (Control group): This group of nineteen subjects received conventional physical therapy alone
Procedure: control group
19 subjects received only conventional physical therapy for eight weeks.

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
Neck Disability Index (NDI)
Time Frame: At baseline and re assessed following 8 weeks
Perceived functional limitations resulting from regional impairment were measured using the validated Arabic version of the NDI questionnaire. This instrument evaluates 10 clinical sections (including activities of daily living, concentration, and pain profiles) scored from 0 to 5 per item, yielding a cumulative score out of 50. Higher aggregate indices represent greater functional disability.
At baseline and re assessed following 8 weeks
craniovertebral angle (CVA)
Time Frame: At baseline and re assessed following 8 weeks
This biomechanical index reflects the architectural severity of forward head posture. It is defined as the angle formed between a horizontal line drawn through the spinous process of C7 and an intersecting line extending from the tragus of the ear to the C7 landmark. CVA was measured using precision digital photogrammetry via the Kinovea software application.
At baseline and re assessed following 8 weeks
Sagittal Shoulder-C7 Angle (SSA)
Time Frame: At baseline and re assessed following 8 weeks
This geometric marker quantifies shoulder roundedness and anterior protraction. It is formed by the intersection of a horizontal reference line passing through the lateral aspect of the acromion with a line drawn from the C7 spinous process to the lateral acromion. SSA was measured using precision digital photogrammetry via the Kinovea software application.
At baseline and re assessed following 8 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.
Amira saad mohamed

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

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.
March 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.
June 18, 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.
June 30, 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 13, 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 13, 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 17, 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 17, 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 13, 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

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.
  • 012/006489

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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