Effects of Scapular Posterior Tilt Exercises and Cross-Body Stretching in Postpartum Women With Rounded Shoulders

May 4, 2026 updated by: Riphah International University

Comparative Effects of Scapular Posterior Tilt Exercises and Cross-Body Stretching on Breastfeeding Efficiency Latch Quality and Posture in Postpartum Women With Rounded Shoulders

This study aims to compare the effects of scapular posterior tilt exercises and cross-body stretching on breastfeeding efficiency, latch quality, and posture in postpartum women with rounded shoulders.

Study Overview

Status

Recruiting

Conditions

Intervention / Treatment

Detailed Description

This randomized clinical study will include 30 postpartum women (2 weeks to 6 months postpartum) who will meet the inclusion criteria for rounded shoulders and will be actively breastfeeding. The study will be conducted at Sheik Zaid Hospital and will include multiparous women. Participants will be randomly allocated into two intervention groups: Group A, which will perform scapular posterior tilt exercises, and Group B, which will engage in cross-body stretching exercises. Both groups will undergo their respective intervention protocols three times per week over a period of four weeks. All participants will receive standardized ergonomic education focused on proper breastfeeding posture. The tools that will be used for assessment include the Bristol Breastfeeding Assessment Tool (BBAT) for latch quality, the Breastfeeding Self-Efficacy Scale (BSES) for breastfeeding efficiency, and a posture analysis using the AI Posture Evaluation and Correction System (APECS). Assessments will be conducted before and after the intervention. Data will be entered and analyzed using SPSS version 16.

Study Type

Interventional

Enrollment (Estimated)

34

Phase

  • 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 Locations

  • Pakistan
    • Punjab Province
      • Lahore, Punjab Province, Pakistan, 6400
        • Recruiting
        • Sheikh Zaid Hospital
        • Contact:
        • Principal Investigator:
          • Ramisha Saeed, MSPT(WH)

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

Ages Eligible for Study

  • Adult

Accepts Healthy Volunteers

Yes

Description

Inclusion Criteria:

  • Mutiparous females.
  • previous cesarean section deliveries
  • Postpartum women between 2 weeks and 6 months postpartum.
  • Experiencing shoulder discomfort or poor posture

Exclusion Criteria:

  • History of recent trauma or surgery such a Arthroscopy for Impingement Syndrome, Shoulder Replacement that affecting the shoulder complex.
  • Mother with history of breast cancer and hepatitis
  • History of shoulder surgery, trauma, or musculoskeletal disorders affecting the upper back/shoulder (Trapezius muscles train, Levator scapulae and rhomboid overuse)
  • Severe postnatal complications (e.g., mastitis, postpartum depression, uncontrolled hypertension or diabetes.

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
Intervention / Treatment
Experimental: Scapular Posterior Tilt exercises
To improve scapular posterior tilt, focus on exercises that strengthen the lower trapezius and serratus anterior, which are crucial for shoulder stability and function
Other: Scapular Posterior Tilt exercises
  • 3 sessions per week
  • Duration: 20-30 minutes per session
  • Total duration: 6 weeks
Experimental: Cross-Body Stretching
The cross-body stretch is an effective exercise for improving shoulder flexibility and relieving tension in the shoulder muscles
Other: Cross-Body Stretching
3 sessions per week, Duration: 20-30 minutes per session. for 6 weeks

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
BREASTFEEDING SELF EFFICACY SCALE:
Time Frame: 6th week
The BSES-SF was a 14-item self-administered instrument derived from the original 33-item BSES that measured breastfeeding confidence. All items were preceded by the phrase "I can always" and were rated on a 5-point Likert scale, ranging from 1 (not at all confident) to 5 (always confident). Total scores ranged from 14 to 70, with higher scores reflecting more significant levels of breastfeeding self-efficacy.
6th week
Bristol Breastfeeding Assessment Tool:
Time Frame: 6th week
Jenny Ingram developed this tool in 2022; Cronbach's alpha value was found to be 0.77. The scale is a Likert-type scale comprising the 4 items of "positioning," "holding," "sucking" and "swallowing." Each item is scored between 0- 2 points. The lowest possible score on the scale is 0, the highest is 8. Lower scores indicate that the breastfeeding is not successful, the higher scores signify successful breastfeedin
6th week
APESC:
Time Frame: 6th week
The APECS mobile app uses photo-based posture analysis and scores alignment across body segments using virtual markers. It has excellent reliability, with inter-rater ICCs above 0.90 for most measures and strong intra-rater consistency. Its validity is supported by its ability to detect postural differences between groups
6th week

Collaborators and Investigators

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

Sponsor

Riphah International University

Investigators

  • Principal Investigator: hina gul, PhD*, 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

  • Algabbani MF, Alazmi AA, Alqabbani S, Almurdi MM, Abdelkader SM, Alruwaili M, et al. Prevalence and Risk Factors for Neck and Upper Limb Musculoskeletal Disabilities Among Postpartum Women. Clinical and Experimental Obstetrics & Gynecology. 2025;52(2):25833.
  • Faisal S, Nadeem A, Waqas S. Association between Infant Carrying Methods, Duration, and Trunk Position Among Nursing Mothers of Lahore. Journal Riphah College of Rehabilitation Sciences. 2024;12(04).
  • Escribano S, Herrero-Oliver R, Oliver-Roig A, Richart-Martínez M. Psychometric properties of the maternal breastfeeding evaluation scale: a confirmatory factor analysis. BMC Pregnancy and Childbirth. 2024;24(1):486.
  • Gu Q, Pan L, Yu L, Jiang Q. Effect of scapular posterior tilting exercise on scapular muscle activities in men and women with a rounded shoulder posture. Journal of Orthopaedic Surgery and Research. 2024;19(1):383.
  • Stubbs PW, Mehta P, Trøstrup J, Tamminga SJ, Stynes SM, Koes BW, et al. Exercise interventions for treating work-related complaints of the arm, neck or shoulder in adults. The Cochrane database of systematic reviews. 2025;2025(4):CD014643.

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)

October 1, 2025

Primary Completion (Estimated)

June 1, 2026

Study Completion (Estimated)

July 1, 2026

Study Registration Dates

First Submitted

May 4, 2026

First Submitted That Met QC Criteria

May 4, 2026

First Posted (Actual)

May 8, 2026

Study Record Updates

Last Update Posted (Actual)

May 8, 2026

Last Update Submitted That Met QC Criteria

May 4, 2026

Last Verified

May 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • REC/RCR & AHS/25/0510

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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