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Kendall Exercises With and Without Positional Release Therapy in Upper Crossed Syndrome

2026年9月27日 更新者：Riphah International University

Effects of Kendall Exercises With and Without Positional Release Therapy on Pain, Range of Motion, Craniovertebral Angle and Disability in Patients With Upper Crossed Syndrome

Upper Cross Syndrome (UCS) is a prevalent musculoskeletal disorder characterized by a specific pattern of muscular imbalance and postural dysfunction. This condition arises from prolonged poor posture. The resulting imbalance often manifests as visible postural changes, including rounded shoulders, forward head posture, and increased thoracic kyphosis. UCS is characterized by tightness and weakness of the neck, shoulders, and upper back muscles that cross between the dorsal and the ventral sides of the body. Postural abnormalities associated with UCS include a forward head posture (FHP), cervical lordosis, thoracic hyper kyphosis, protracted and elevated shoulders (round shoulders), and scapular winging with increased internal rotation and abduction.

In UCS, neck and chest muscles, such as the sternocleidomastoid (SCM), levator scapulae, Pectoralis major and minor, Scalenes, and Upper Trapezius (UT), are tightened or shortened, whereas muscles of the neck and posterior upper back, such as the Deep Neck Flexors (DNFs), Serratus Anterior (SA), Rhomboids, Middle Trapezius (MT), and Lower Trapezius (LT), are weakened, stretched, and restrained. Opposite-group muscle imbalances in UCS bring postural disturbances, misalignments in the upper limbs, and atlanto-occipital, cervicothoracic, and glenohumeral joint dysfunction. The muscular imbalances may also lead to various musculoskeletal symptoms, such as headaches, neck pain, chest pain, upper back pain, tingling in the upper arms, or a limited range of motion in the neck or shoulders.

The alteration in scapula muscles in UCS affects the movement of the scapula, which acts as a bridge and provides mobility and stability to the shoulders and neck. A proper posture is necessary for optimal functional performance in daily activities. The awkward positions put constant pressure on the joints, and degenerative changes in joints progress rapidly when exposed to sustained pressure, causing muscle imbalances and pain. If a muscle imbalance continues and progresses, this may lead to altered movement patterns and joint damage, creating further dysfunction.

The main risk factor for developing UCS is maintaining an abnormal posture for a prolonged duration. Some daily activities that involve bad postures are often occupation-related. Repetitive tasks or continuous work for long hours can aggravate postural deviations. For example, patients with improper postures are more prone to musculoskeletal injuries after handling or lifting heavy objects than others with a proper posture. Musculoskeletal pain, most commonly neck pain, may present as the main symptom of UCS. Musculoskeletal pain may increase in relation to standing continuously or improperly sitting for long hours.

研究概览

地位

招聘中

条件

干预/治疗

详细说明

With the rise in sedentary lifestyles and prolonged use of digital devices, the prevalence of UCS has significantly increased. Individuals with UCS often experience cervical pain, limited range of motion, headaches, and functional impairments. Effective rehabilitation strategies are essential to correct muscle imbalances, reduce pain, and restore mobility. Diagnostic criteria for UCS involve assessing the imbalance of shoulder, neck, and chest muscles, the inward curving of the spine at the neck, and the protrusion of shoulder blades. Management of UCS focuses on correcting abnormal posture, restoring neuromuscular balance, and alleviating pain. Various physiotherapeutic approaches, including manual therapy, stretching, strengthening, and postural training, are employed.

Two commonly used interventions in the management of UCS are Kendall exercises and Positional Release Therapy (PRT). Kendall's exercises are a system of therapeutic movements developed by Florence Peterson Kendall and colleagues, grounded in the principles outlined in their influential textbook Muscles: Testing and Function with Posture and Pain .These exercises are specifically designed to address postural abnormalities by correcting muscle imbalances through targeted stretching and strengthening techniques.

Positional Release Therapy (PRT) is a gentle, passive manual therapy technique developed by Dr. Lawrence Jones in the 1950s. It involves placing the body in a position of comfort often shortening the affected muscle for a sustained period (usually 90 seconds), which helps to reduce muscle spindle activity, relieve pain, and restore normal tissue tone. The technique is believed to facilitate a resetting of the proprioceptive and nociceptive responses in the affected tissues.

This study will help to determine the more effective intervention between Kendall exercises alone and Kendall exercises combined with Positional Release Therapy in individuals with Upper Crossed Syndrome. The findings will assist clinical physiotherapists in developing optimal treatment plans for managing postural dysfunction, pain, and mobility limitations associated with upper crossed syndrome.

研究类型

介入性

注册 (估计的)

48

阶段

  • 不适用

联系人和位置

本节提供了进行研究的人员的详细联系信息，以及有关进行该研究的地点的信息。

学习联系方式

学习地点

  • 巴基斯坦
      • Lahore、巴基斯坦、54000
        • 招聘中
        • Riphah International University
    • Punjab Province
      • Lahore、Punjab Province、巴基斯坦、54000
        • 招聘中
        • Riphah Rehabilitation Clinic
        • 接触：

参与标准

研究人员寻找符合特定描述的人，称为资格标准。这些标准的一些例子是一个人的一般健康状况或先前的治疗。

资格标准

适合学习的年龄

20年 至 40年 (成人)

接受健康志愿者

不

有资格学习的性别

全部

描述

Inclusion Criteria:

  • Age 20 and 40 years.
  • Both Male and Female.
  • Clinical diagnosis of Upper Crossed Syndrome (Pectoralis major contracture test, Pectoralis minor contracture test, Upper trapezius muscle length test, Lower and Middle trapezius weakness tests will be done).
  • Forward Head Posture (Craniovertebral angle (CVA) ≤ 48°).
  • Numeric Pain Rating Scale (NPRS) score of ≥ 4).
  • Neck pain for more than 4 weeks but less than 6 months NDI.

Exclusion Criteria:

  • History of cervical spine trauma, fractures, or surgery
  • Systemic musculoskeletal disorders
  • Spinal Deformities
  • Ongoing physiotherapy or chiropractic treatment
  • Severe scoliosis or spinal deformities

学习计划

本节提供研究计划的详细信息，包括研究的设计方式和研究的衡量标准。

研究是如何设计的？

设计细节

  • 主要用途：治疗
  • 分配：随机化
  • 介入模型：并行分配
  • 屏蔽：双倍的

武器和干预

参与者组/臂
干预/治疗
实验性的：Group A

Kendall Exercises with Positional Release Therapy
其他：Kendall Exercises with Positional Release Therapy

Kendall's exercises and the Positional Release Technique (PRT) offer complementary physical therapy approaches for managing Upper Cross Syndrome.

Kendall's framework, grounded in manual muscle testing and detailed postural analysis, restores alignment by pairing selective strengthening of weak muscles with selective stretching of tight ones. Its protocol incorporates chin tucks, shoulder blade squeezes, scapular depression, chest stretches, wall slides, and thoracic extensions. Exercises are executed in 3-6 sets of 10-15 reps, holding each for 10 seconds to enhance scapular control and correct forward head posture.

Conversely, PRT-developed by Dr. Lawrence Jones-is an indirect soft-tissue therapy aimed at reducing muscle spasms and hypertonicity without stretching. Clinicians identify tender points and passively position the tissue into a shortened state of ease, holding it for 90 seconds to reset muscle spindle activity before returning to neutral.
有源比较器：Group B

Kendall Exercises
其他：Kendall Exercises

Kendall's exercises, derived from the foundational work of Florence and Henry Kendall, provide a targeted physical therapy framework for addressing Upper Cross Syndrome through precise postural analysis and manual muscle testing. The core strategy centers on correcting muscle imbalances by selectively strengthening inhibited, weak muscles while stretching tight, shortened ones to restore proper posture and alignment.

To counteract forward head posture and scapular dysfunction, the protocol incorporates chin tucks to strengthen deep cervical flexors, prone shoulder blade squeezes for middle trapezius and rhomboids, and scapular depression or retraction for lower and upper trapezius control. Flexibility is restored using doorway stretches for tight pectoralis muscles, along with targeted stretches for the upper trapezius and levator scapulae. Wall slides and foam roller thoracic extension further improve scapular movement and spine mobility. Exercises are routinely performed for 3 to 6

研究衡量的是什么？

主要结果指标

结果测量
措施说明
大体时间
Numeric Pian Rating Scale
大体时间：Baseline; Week 3; Week 6

Numeric Pain Rating Scale (NPRS). It is a uni-dimensional scale to measure pain intensity, particularly in adults. It is a 10-rating scale and an 11-point numeric scale in the form of a horizontal bar or line. Zero is no pain, and 10 is intolerable/worst pain.
Baseline; Week 3; Week 6
Neck Diability Index (NDI)
大体时间：Baseline; Week 3; Week 6

This questionnaire will be used to assess disability. It comprises of 10 items; 7 related to daily living activities, 2 related to pain and 1 related to concentration. Each item is scored from 0 to 5. Total score is expressed as a percentage, with higher scores related to greater disability
Baseline; Week 3; Week 6
Craniovertebral Angle
大体时间：Baseline; 3 Week; 6 Week

The craniovertebral angle (CVA) is a commonly used clinical indicator for evaluating forward head posture, which is a prominent feature of Upper Crossed Syndrome (UCS). It is measured by drawing a horizontal line through the spinous process of the seventh cervical vertebra (C7) and a second line from C7 to the tragus of the ear. A smaller CVA reflects a greater degree of forward head posture, with angles less than 50 degrees typically considered abnormal
Baseline; 3 Week; 6 Week

合作者和调查者

在这里您可以找到参与这项研究的人员和组织。

赞助

Riphah International University

调查人员

  • 首席研究员：Syed Shakil ur Rehman, PhD、Riphah International University

出版物和有用的链接

负责输入研究信息的人员自愿提供这些出版物。这些可能与研究有关。

一般刊物

研究记录日期

这些日期跟踪向 ClinicalTrials.gov 提交研究记录和摘要结果的进度。研究记录和报告的结果由国家医学图书馆 (NLM) 审查，以确保它们在发布到公共网站之前符合特定的质量控制标准。

研究主要日期

学习开始 (实际的)

2026年6月1日

初级完成 (估计的)

2026年11月1日

研究完成 (估计的)

2026年12月1日

研究注册日期

首次提交

2026年9月27日

首先提交符合 QC 标准的

2026年9月27日

首次发布 (实际的)

2026年10月2日

研究记录更新

最后更新发布 (实际的)

2026年10月2日

上次提交的符合 QC 标准的更新

2026年9月27日

最后验证

2026年9月1日

更多信息

与本研究相关的术语

关键字

其他相关的 MeSH 术语

其他研究编号

  • Tania Ziaullah Khan

计划个人参与者数据 (IPD)

计划共享个人参与者数据 (IPD)？

不

药物和器械信息、研究文件

研究美国 FDA 监管的药品

不

研究美国 FDA 监管的设备产品

不

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