Dynamic Neuromuscular Stabilization Versus Corrective Exercises in Upper Cross Syndrome (DNS/NASM)

July 8, 2026 updated by: Passant Moustafa Kamal Mahmoud Mohamed Zaid, Cairo University

Effect of Dynamic Neuromuscular Stabilization Versus Corrective Exercises on Pain, Functional Disability, and Postural Alignment in Upper Crossed Syndrome.

The purpose of the study will be to investigate dynamic neuromuscular stabilization versus National American Academy of Sports Medicine (NASM) corrective exercises on pain, functional disability, cranio-vertebral angle, forward shoulder angle, and thoracic kyphosis in upper cross 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

Upper Cross Syndrome (UCS) is a frequent condition that is most commonly encountered in musculoskeletal disorders, showing a typical pattern of imbalance in muscles and neck and shoulder region joint dysfunction. It causes pain in shoulders, upper back, thoracic and cervical spine. It is frequently associated with inadequate posture or forward head position, muscular weakness, and alterations in movement patterns, leading to pain, restricted mobility, and dysfunction in the affected areas of patients suffering from UCS.

Dynamic Neuromuscular Stabilization (DNS) is a developing rehabilitation approach based on reflex locomotion. The idea of reflex locomotion describes particular involuntary motor reactions/movement patterns that occur when firm pressure is applied to specific muscle zones. These movement patterns are standard and referred to as "global patterns". The global pattern generated from the prone position is known as "reflex creeping," whereas the one from the supine or side lying posture is known as "reflex rolling". Furthermore, some motor motions such as gripping, turning, crawling, and eventually walking occur automatically without the need for specific training in normal babies.

The National American Academy of Sports Medicine (NASM) provided a corrective exercise protocol for postural malalignment. It includes 4 steps: inhibition (self-mobilization release technique targeting trigger points), lengthening (stretching techniques for tight muscles), third: activation (strengthening techniques for weak muscles), and integration (retraining all muscles through functionally progressive movements). It was successful in treating UCS.

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.
45

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

The name and contact information for the person who can answer enrollment questions for a clinical study. Each location where the study is being conducted may also have a specific contact, who may be better able to answer those questions.

Study Contact Backup

Study Locations

  • Egypt
    • Cairo Governorate
      • Cairo, Cairo Governorate, Egypt, 11432
        • Outpatient clinic at faculty of physical therapy - Cairo University
        • Contact:
        • 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:

  1. Having non-specfic neck Pain.
  2. Patients having a CVA of < 52 .
  3. Forward shoulder angle > 52 degrees.

Exclusion Criteria:

  • Participants having conditions such as osteoporosis, blood disease, congestive heart disease, cancer, severe skin sensitization, major mental disease, and frozen shoulder, will be excluded from the study. Neck pain has a specific underlying pathology such as fractures, rheumatoid arthritis, osteoporosis, or whiplash injuries as well as neck pain associated with radiculopathy.

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: None (Open Label)

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: Dynamic neuromuscular stabilization

Dynamic neuromuscular stabilization involves precise co-activation of the intrinsic muscles of the spine which forms the Integrated spinal stabilization system (ISSS) and includes cervical flexors and extensors, diaphragm, transversus abdominis, multifidus and pelvic floor.

Participants will receive DNS for 6 weeks.
Other: Dynamic neuromuscular stabilization
Dynamic neuromuscular stabilization involves precise co-activation of the intrinsic muscles of the spine which forms the Integrated spinal stabilization system (ISSS) and includes cervical flexors and extensors, diaphragm, transverses abdominis, multifidus and pelvic floor.
Experimental: Corrective exercises

National Academy of sports medicine corrective exercises that involve 4 steps : First: Inhibition for tight muscles Second: Lengthening for tight muscles Third: Activation for weak muscles fourth: Intergration to retrain all muscles through functionally progressive movements using integrated dynamic movements.

Participants will receive NASM corrective exercises for 6 weeks.
Other: NASM corrective exercises
It is corrective exercise protocol, which includes four phases, i.e. inhibit, lengthen, activate, and integrate stage
Experimental: Combined Dynamic neuromuscular stabilization and corrective exercises group
Participants will receive both DNS and NASM for 6 weeks.
Other: Dynamic neuromuscular stabilization
Dynamic neuromuscular stabilization involves precise co-activation of the intrinsic muscles of the spine which forms the Integrated spinal stabilization system (ISSS) and includes cervical flexors and extensors, diaphragm, transverses abdominis, multifidus and pelvic floor.
Other: NASM corrective exercises
It is corrective exercise protocol, which includes four phases, i.e. inhibit, lengthen, activate, and integrate stage

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 pain intensity
Time Frame: At baseline at the first session and reassessed at the end of six weeks of intervention.
Neck pain intensity will be measured through Numerical pain rating scale. A scale from 0 to 10, with 0 indicating no pain and 10 signifying excruciating pain.
At baseline at the first session and reassessed at the end of six weeks of intervention.

Secondary Outcome Measures

Secondary Outcome Measures

In a clinical study's protocol, a planned outcome measure that is not as important as the primary outcome measure for evaluating the effect of an intervention but is still of interest. Most clinical studies have more than one secondary outcome measure.
Outcome Measure
Measure Description
Time Frame
Neck disability
Time Frame: At baseline at the first session and after 6 weeks of intervention.
The patient will be asked to fill the 10- section of the questionnaire. Higher score indicate higher disability.
At baseline at the first session and after 6 weeks of intervention.
Craniovertebral angle
Time Frame: At baseline and after 6 weeks of intervention
craniovertebral angle will be measured using Kinovea software to assess forward head posture
At baseline and after 6 weeks of intervention
Forward shoulder angle
Time Frame: At baseline and after 6 weeks of intervention
Forward shoulder angle will be measured using Kinovea software to assess rounded shoulder posture
At baseline and after 6 weeks of intervention
Thoracic kyphosis angle
Time Frame: At baseline and after 6 weeks of intervention
Thoracic kyphosis angle will be measured using a bubble inclinometer
At baseline and after 6 weeks of intervention

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.
Cairo 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: Karima A Hassan, PhD, Cairo University

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 (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.
November 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.
February 1, 2027

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.
September 30, 2028

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).
July 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.
July 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.
July 13, 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.
July 13, 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.
July 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.
July 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.
  • P.T.REC/012/006422

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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