Kendall Versus Janda's Approach Along With Diaphragmatic Breathing Exercises in Upper Crossed Syndrome
21. juli 2026 opdateret af: Riphah International University
Comparative Effects of Kendall Versus Janda's Approach Along With Diaphragmatic Breathing Exercises on Pain, Chest Expansion, Cranio Vertebral Angle, and Disability in Upper Crossed Syndrome
Upper Crossed Syndrome (UCS) is a postural imbalance in the upper body characterized by shortened and tight muscles in the front and upper back, while weak muscles in the back and neck are stretched and underactive.
This imbalance can lead to forward head posture, rounded shoulders, and increased spinal curves, causing pain, headaches, and reduced range of motion.
The study aims to compare the effects of Kendall exercises with Janda's Approach along with Diaphragmatic breathing exercises on pain, chest expansion, craniovertebral angle, and disability in upper crossed syndrome.
Studieoversigt
Status
Rekruttering
Betingelser
Intervention / Behandling
Detaljeret beskrivelse
This randomized clinical trial study will be conducted at Central Hospital and Anwer's Polyclinic, Sialkot.
We will include 50 patients (25 in each group) of Upper Crossed Syndrome with an age range of 30-50 years, both male and female will be included.
Group A will be provided Kendall Exercises with Diaphragmatic breathing exercises, and Group B will receive Janda's with diaphragmatic breathing exercises.
Both interventions will be administered for 45 minutes per session, three times per week, for a total duration of six weeks.
Outcome measures will include NPRS for pain, Neck Disability Index for disability, Universal goniometer for cranio vertebral angle, and a measuring tape for thoracic expansion will be used.
The collected data will be analyzed in the Statistical Package for the Social Sciences (SPSS) 26.0 version.
If the data is normally distributed, then a parametric if not normally distributed than a nonparametric test will be applied.
Undersøgelsestype
Interventionel
Tilmelding (Anslået)
50
Fase
- Ikke anvendelig
Kontakter og lokationer
Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.
Studiekontakt
- Navn: Samrood Akram, PhD*
- Telefonnummer: 03324806143
- E-mail: samrood.akram@riphah.edu.pk
Undersøgelse Kontakt Backup
- Navn: Amna Zia, PhD*
- Telefonnummer: 03244686993
- E-mail: amna.zia@kemu.edu.pk
Studiesteder
-
-
Punjab Province
-
Sialkot, Punjab Province, Pakistan
- Rekruttering
- Anwars Polyclinic
-
Kontakt:
- Shaban Anwar, MS-OMPT
- Telefonnummer: 0332 8609425
- E-mail: shani_gh85@yahoo.com
-
-
Deltagelseskriterier
Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.
Berettigelseskriterier
Aldre berettiget til at studere
- Voksen
Tager imod sunde frivillige
Ingen
Beskrivelse
Inclusion Criteria:
Age between 30 to 50 years old Both male and female are included, Craniovertebral angle less than 50°, Rounded shoulders (on photogrammetry)
Exclusion Criteria:
- Cervical trauma or surgery Congenital scoliosis Spasmodic torticollis Any tumor or trauma History of surgical procedures on neck or lower back Disc issues in neck or lower back
Studieplan
Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.
Hvordan er undersøgelsen tilrettelagt?
Design detaljer
- Primært formål: Behandling
- Tildeling: Randomiseret
- Interventionel model: Parallel tildeling
- Maskning: Enkelt
Våben og indgreb
Deltagergruppe / Arm |
Intervention / Behandling |
|---|---|
|
Eksperimentel: Kendall exercises
Kendall exercisesare a set of physical therapy movements designed to correct postural faults like Forward Head Posture (FHP), kyphosis, and rounded shoulders.
They focus on correcting muscle imbalances through targeted stretching and strengthening.
|
Stretching: Pectoralis, Upper Trapezius, Levator Scapulae (2 sets of 20 sec each) Strengthening: Scapular retractors with Thera band (2 sets of10 reps), Chin tucks (2 sets of 10 reps), Diaphragmatic breathing (4 mins) Strengthening: Add isometric cervical flexors (5 sec hold with 5 reps),, Chin tucks & scapular retractors (3 sets of 10 reps) Strengthening: Add scapular squeeze (5 sec hold of 5 reps), Emphasize postural control during exercises Strengthening: Functional posture tasks (e.g., seated posture with resistance), Maintain 15 reps of 3 sets Anterior (Wall Slides), Deep Neck Flexors - 2 sets of 10 reps Diaphragmatic breathing (4 mins), Neck Flexor Hold: 30 sec × 3 sets Add Dumbbell Shrugs, Table Pushes - 3 sets of 10 reps Add Serratus Anterior Upper Cuts (3 sets of 10 reps) strengthening increased to 12-15 reps per set (all muscle groups). Functional integration: Posture tasks during daily movement |
|
Aktiv komparator: Janda's Approach
Janda's approach is a functional rehabilitation method focusing on how the central nervous system controls muscles and movement.
It emphasizes correcting muscle imbalances-where some muscles are overly tight and others are weak or inhibited-to alleviate chronic pain
|
Stretching: Levator scapulae, Upper Trapezius, Pectoralis (doorway/towel) - 2 sets × 30 sec each, Strengthening: Middle & Lower Trapezius, Serratus Anterior (Wall Slides), Deep Neck Flexors - 2 sets × 10 reps, Diaphragmatic breathing (4 mins) Neck Flexor Hold: 30 sec × 3 sets Add Dumbbell Shrugs, Table Pushes 3 sets × 10 reps Add Serratus Anterior Upper Cuts (3 sets × 10 reps) strengthening increased to 12-15 reps per set (all muscle groups). Maintain 3 sets of stretching. Functional integration: Posture tasks during daily movement (e.g., reaching, sitting) |
Hvad måler undersøgelsen?
Primære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
|
NUMERIC PAIN RATE SCALE (NPRS) for pain
Tidsramme: upto 6 weeks
|
It is a self-reported scale that measures pain intensity on a scale from 0 (no pain) to 10 (worst possible pain).
It is widely used in musculoskeletal conditions for monitoring pain levels over time.
The NPRS has demonstrated high validity (r = 0.85 with VAS) and excellent test-retest reliability (ICC = 0.92-0.96).
The MCID for NPRS is generally considered to be 2 points, indicating a meaningful improvement or worsening in pain perception
|
upto 6 weeks
|
|
NECK DISABILITY INDEX (NDI)
Tidsramme: upto 6 weeks
|
It is a validated questionnaire consisting of 10 items that assess the functional impact of neck pain on daily activities such as personal care, work, driving, and recreation.
It is specific to cervical conditions.
The NDI has strong content validity, with excellent internal consistency (α = 0.87) and test-retest reliability (ICC = 0.89).
The MCID for NDI has been reported to range from 5 to 7 points, representing a clinically important change in neck-related disability
|
upto 6 weeks
|
|
UNIVERSAL GONIOMETER for ROM
Tidsramme: Upto 6 weeks
|
It is used to measure the craniovertebral angle (CVA), an objective indicator of forward head posture in individuals.
A CVA less than 50° typically indicates abnormal posture.
This tool shows good validity and excellent intra-rater reliability (ICC = 0.80-0.98)
for cervical spine angle measurements.
While an exact MCID for CVA is not firmly established, a change of 3-5 degrees is often considered clinically meaningful in postural correction studies
|
Upto 6 weeks
|
|
MEASURING TAPE
Tidsramme: Upto 6 weeks
|
t is a simple and cost-effective tool used to assess chest expansion, which reflects thoracic mobility and respiratory function.
The measurement is taken by placing the tape around the chest at the level of the fourth intercostal space during full inhalation and exhalation.
It has acceptable criterion validity and demonstrates high intra-rater reliability (ICC = 0.91-0.94),
making it suitable for tracking changes in chest mobility during postural or breathing interventions.
The MCID for chest expansion is not universally defined, but an increase of 0.5 to 1.0 cm is generally considered clinically relevant in pulmonary and postural rehabilitation contexts
|
Upto 6 weeks
|
Samarbejdspartnere og efterforskere
Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.
Sponsor
Efterforskere
- Ledende efterforsker: Amna Zia, PhD*, King Edward Medical University
- Ledende efterforsker: Kinza Saif, Riphah International University, Lahore
Publikationer og nyttige links
Den person, der er ansvarlig for at indtaste oplysninger om undersøgelsen, leverer frivilligt disse publikationer. Disse kan handle om alt relateret til undersøgelsen.
Generelle publikationer
- Mujawar JC, Sagar JH. Prevalence of Upper Cross Syndrome in Laundry Workers. Indian J Occup Environ Med. 2019 Jan-Apr;23(1):54-56. doi: 10.4103/ijoem.IJOEM_169_18.
- Chang MC, Choo YJ, Hong K, Boudier-Reveret M, Yang S. Treatment of Upper Crossed Syndrome: A Narrative Systematic Review. Healthcare (Basel). 2023 Aug 17;11(16):2328. doi: 10.3390/healthcare11162328.
- Joshi R, Poojary N. The Effect of Muscle Energy Technique and Posture Correction Exercises on Pain and Function in Patients with Non-specific Chronic Neck Pain Having Forward Head Posture-a Randomized Controlled Trail. Int J Ther Massage Bodywork. 2022 Jun 1;15(2):14-21. doi: 10.3822/ijtmb.v15i2.673. eCollection 2022 Jun.
- Yang S, Boudier-Reveret M, Yi YG, Hong KY, Chang MC. Treatment of Chronic Neck Pain in Patients with Forward Head Posture: A Systematic Narrative Review. Healthcare (Basel). 2023 Sep 22;11(19):2604. doi: 10.3390/healthcare11192604.
- Aneis YM, El-Badrawy NM, El-Ganainy AA, Atta HK. The effectiveness of a multimodal approach in the treatment of patients with upper crossed syndrome: A randomized controlled trial. J Bodyw Mov Ther. 2022 Oct;32:130-136. doi: 10.1016/j.jbmt.2022.05.011. Epub 2022 May 18.
- Mubashir M. A cross-sectional survey on prevalence of upper cross syndrome and its correlation to WRMSDS in working physiotherapists. Pakistan Journal of Rehabilitation. 2021;10(1):42-50.
- Oakley PA, Moustafa IM, Haas JW, Betz JW, Harrison DE. Two Methods of Forward Head Posture Assessment: Radiography vs. Posture and Their Clinical Comparison. J Clin Med. 2024 Apr 8;13(7):2149. doi: 10.3390/jcm13072149.
- Mol N, Abeeshna A, Kumar D. Upper crossed syndrome: trends and recent advances in the physiotherapy treatment a narrative review. J Pharm Res Int. 2021;33(64B):359-67
- Yu L, Gu Q, Kim T. The effects of cervical stabilization exercises with breathing exercises on respiratory function in subjects with forward head posture. WSEAS Transactions on Systems and Control. 2021;16:486-92.
- Koo D-J, Park S-C, Park J-Y, Jung J-W, Kwon H-G. Effect of Breathing TechniqueBased Exercises on Alignment and Mechanical Properties of Muscles Related to Upper Cross Syndrome. Journal of the Korean Society of Physical Medicine. 2024;19(4):21-33
Datoer for undersøgelser
Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.
Studer store datoer
Studiestart (Faktiske)
20. juni 2026
Primær færdiggørelse (Anslået)
20. august 2026
Studieafslutning (Anslået)
20. september 2026
Datoer for studieregistrering
Først indsendt
21. juli 2026
Først indsendt, der opfyldte QC-kriterier
21. juli 2026
Først opslået (Faktiske)
24. juli 2026
Opdateringer af undersøgelsesjournaler
Sidste opdatering sendt (Faktiske)
24. juli 2026
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
21. juli 2026
Sidst verificeret
1. juli 2026
Mere information
Begreber relateret til denne undersøgelse
Nøgleord
Yderligere relevante MeSH-vilkår
Andre undersøgelses-id-numre
- REC/RCR & AHS/25/0134 Kinza
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