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the aim of this study is to investigate the efficacy of mulligan snag mobilisation and diaphragmatic release on upper crossed syndrome
Acquired postural disorders can be a consequence, to a large extent, of contemporary living and working conditions. Some of the most typical factors include continuous use of mobile phones and computers, working in sedentary jobs. Prolonged incorrect posture and reduced physical activity present a dis-balance in the musculature . It can also lead to vision issues, as well as headaches, musculoskeletal issues, and pain, as well as a multitude of other symptoms.
Upon the available research studies, there is not study conducted to investigate the effect of mulligan SNAG mobilization and diaphragmatic release in upper crossed syndrome patients this trial has four groups; one will receive diaphragmatic release + conventional, the second will receive mulligan SNAG mobilization, and conventional, the third will receive mulligan SNAG mobilization+diaphragmatic release+conventional, the fourth subjects will receive conventional
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| diaphragmatic release, and conventional | Experimental | Diaphragmatic release: The patients will be positioned in the supine position. The therapist stood at the head of the patient. The therapist makes manual contact bilaterally under the costal cartilages of the lower ribs (7th to 10th ) with hypothenar regions of the hands and the last three fingers. During the patient's inspiration, the therapist will gently pull the points of hand contacts toward the head and slightly laterally, while elevating the ribs simultaneously. During exhalation, the therapist will deepen hand contact toward the inner coastal margins for 5 to 7 minute conventional therapy: the patient will receive chin-in, interscapular exercises, and pectoralis stretch |
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| mulligan SNAG mobilization, and conventional | Experimental | mulligan snag: Apply a passive intervertebral movement in a superior anterior direction along the facet plane. While maintaining this "glide" as the patient actively moves in any range of physiological movement and then sustains it at the end range position for a few seconds. (3 sets,10 repetitions) conventional therapy: the patient will receive chin-in, interscapular exercises, and pectoralis stretch |
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| mulligan SNAG mobilization, diaphragmatic release, and conventional | Experimental | Diaphragmatic release: The patients will be positioned in the supine position. The therapist stood at the head of the patient. The therapist makes manual contact bilaterally under the costal cartilages of the lower ribs (7th to 10th ) with hypothenar regions of the hands and the last three fingers. During the patient's inspiration, the therapist will gently pull the points of hand contacts toward the head and slightly laterally, while elevating the ribs simultaneously. During exhalation, the therapist will deepen hand contact toward the inner coastal margins. (5 to 7 minutes) mulligan snag: Apply a passive intervertebral movement in a superior anterior direction along the facet plane. While maintaining this "glide" as the patient actively moves in any range of physiological movement and then sustains it at the end range position for a few seconds(3 sets,10 repetitions) conventional therapy: the patient will receive chin-in, interscapular exercises, and pectoralis stretch |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| mulligan snag mobilization and diaphragmatic release | Other | The patients will be in the supine position. The therapist makes manual contact bilaterally under the costal cartilages of the lower ribs (7th to 10th ). During the patient's inspiration, the therapist will gently pull the points of hand contacts toward the head and slightly laterally. During exhalation, the therapist will deepen hand contact toward the inner coastal margins. mulligan snag, Apply a passive intervertebral movement in a superior anterior direction along the facet plane. While maintaining this "glide" as the patient actively moves in any range of physiological movement |
| Measure | Description | Time Frame |
|---|---|---|
| pain intensity | The scale that will be used is the Visual analogue scale;each subject will be instructed to put point on a line from no pain to tolerable pain | up to four weeks |
| Measure | Description | Time Frame |
|---|---|---|
| cervical range of motion | theCROM device will placed on patient's head while he/she seated and looking forward the difference between the ponter value and the value after movement will be recorded as the motion angle of the cervical vertebrae | up to four weeks |
| Measure | Description | Time Frame |
|---|---|---|
| forward head | the craniovertebral angle (CVA) (the angle between the horizontal lines passing through and a line extending from the tragus of the ear to C7 notably). Lesser CVA indicates greater FHP | up to four weeks |
| kyphotic angle |
Inclusion Criteria:
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Faculty of physical therapy Cairo university | Cairo | Giza Governorate | 12613 | Egypt | ||
| Faculty of physical therapy |
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EFFECT OF MULLIGAN SNAG MOBILISATION AND DIAPHRAGMATIC RELEASE
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| the conventional therapy | Active Comparator | the patient will receive chin-in, inter-scapular exercises, and pectoralis stretch (3 sets,10 repetitions) |
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the bubble inclinometer is gravity-dependent, it is first zeroed on a vertical wall prior to measurement. Using a standard clinical procedure. the cephalic foot of the inclinometer will be placed on the pencil mark already on the C7 spinous process. This procedure will be repeated for the lower thoracic spine, with the caudal foot of the inclinometer placed on the pencil mark for T12. Both inclinometer angles will be recorded, taking care to minimize parallax error with each measurement by ensuring the recorder's eyes are on the same horizontal plane as the inclinometer. The thoracic kyphosis measure from the inclinometer readings will be obtained by taking the difference between the two measurements.
| up to four weeks |
| chest expansion | Measurements will be taken with the participants in a standing position with their arms along the body. The physiotherapist placed the "0" of the cloth tape measure on the appropriate vertebrae. The cloth tape will be held with an index finger between the participant's body and the cloth tape, without generating any deformation or cutaneous folds. The inspiratory diameter will be subtracted from the expiratory diameter to calculate the CE value. | up to four weeks |
| Cairo |
| Giza Governorate |
| 12613 |
| Egypt |