Kendall Versus Janda's Approach Along With Diaphragmatic Breathing Exercises in Upper Crossed Syndrome
2026년 7월 21일 업데이트: 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.
연구 개요
상세 설명
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.
연구 유형
중재적
등록 (추정된)
50
단계
- 해당 없음
연락처 및 위치
이 섹션에서는 연구를 수행하는 사람들의 연락처 정보와 이 연구가 수행되는 장소에 대한 정보를 제공합니다.
연구 연락처
- 이름: Samrood Akram, PhD*
- 전화번호: 03324806143
- 이메일: samrood.akram@riphah.edu.pk
연구 연락처 백업
- 이름: Amna Zia, PhD*
- 전화번호: 03244686993
- 이메일: amna.zia@kemu.edu.pk
연구 장소
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Punjab Province
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Sialkot, Punjab Province, 파키스탄
- 모병
- Anwars Polyclinic
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연락하다:
- Shaban Anwar, MS-OMPT
- 전화번호: 0332 8609425
- 이메일: shani_gh85@yahoo.com
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-
참여기준
연구원은 적격성 기준이라는 특정 설명에 맞는 사람을 찾습니다. 이러한 기준의 몇 가지 예는 개인의 일반적인 건강 상태 또는 이전 치료입니다.
자격 기준
공부할 수 있는 나이
- 성인
건강한 자원 봉사자를 받아들입니다
아니
설명
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
공부 계획
이 섹션에서는 연구 설계 방법과 연구가 측정하는 내용을 포함하여 연구 계획에 대한 세부 정보를 제공합니다.
연구는 어떻게 설계됩니까?
디자인 세부사항
- 주 목적: 치료
- 할당: 무작위
- 중재 모델: 병렬 할당
- 마스킹: 하나의
무기와 개입
참가자 그룹 / 팔 |
개입 / 치료 |
|---|---|
|
실험적: 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.
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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 |
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활성 비교기: 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
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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) |
연구는 무엇을 측정합니까?
주요 결과 측정
결과 측정 |
측정값 설명 |
기간 |
|---|---|---|
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NUMERIC PAIN RATE SCALE (NPRS) for pain
기간: 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
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upto 6 weeks
|
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NECK DISABILITY INDEX (NDI)
기간: upto 6 weeks
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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
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upto 6 weeks
|
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UNIVERSAL GONIOMETER for ROM
기간: 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
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Upto 6 weeks
|
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MEASURING TAPE
기간: Upto 6 weeks
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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
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Upto 6 weeks
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공동 작업자 및 조사자
여기에서 이 연구와 관련된 사람과 조직을 찾을 수 있습니다.
수사관
- 수석 연구원: Amna Zia, PhD*, King Edward Medical University
- 수석 연구원: Kinza Saif, Riphah International University, Lahore
간행물 및 유용한 링크
연구에 대한 정보 입력을 담당하는 사람이 자발적으로 이러한 간행물을 제공합니다. 이것은 연구와 관련된 모든 것에 관한 것일 수 있습니다.
일반 간행물
- 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
연구 기록 날짜
이 날짜는 ClinicalTrials.gov에 대한 연구 기록 및 요약 결과 제출의 진행 상황을 추적합니다. 연구 기록 및 보고된 결과는 공개 웹사이트에 게시되기 전에 특정 품질 관리 기준을 충족하는지 확인하기 위해 국립 의학 도서관(NLM)에서 검토합니다.
연구 주요 날짜
연구 시작 (실제)
2026년 6월 20일
기본 완료 (추정된)
2026년 8월 20일
연구 완료 (추정된)
2026년 9월 20일
연구 등록 날짜
최초 제출
2026년 7월 21일
QC 기준을 충족하는 최초 제출
2026년 7월 21일
처음 게시됨 (실제)
2026년 7월 24일
연구 기록 업데이트
마지막 업데이트 게시됨 (실제)
2026년 7월 24일
QC 기준을 충족하는 마지막 업데이트 제출
2026년 7월 21일
마지막으로 확인됨
2026년 7월 1일
추가 정보
이 연구와 관련된 용어
추가 관련 MeSH 약관
기타 연구 ID 번호
- REC/RCR & AHS/25/0134 Kinza
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아니요
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