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Upper cross syndrome is relative prevalent 67% musculoskeletal disorder among general population due to increased usage of smart gadgets and poor postural habits. Upper cross syndrome is known for initiating malfunction of cervical and upper back muscles also associated with respiration. Individuals with upper cross syndrome may present with relaxed supine positioning, they may having normal respiratory mechanics but might be converted to accessory muscles activated pattern. Neck pain is the most common type of pain in non-traumatic conditions, affecting about 75.7% of people. The aim of this study is to compare the effects of segmental and pursed lip breathing exercises on pain, functional disability and quality of life in population with upper cross syndrome.
Current study will be randomized controlled trial conducted at Ismail Medicare Jhang, 40 patients according to inclusion criteria will be included in the study. They will be allocated into 2 groups by non-probability purposive sampling technique. Group A (control group) will receive conventional physical therapy treatment (hot pack, electrical stimulation, myofascial release, ROM and strengthening exercises) while Group B (experimental group) receive conventional physical therapy treatment with segmental and pursed lip breathing exercises. Outcome measures are Pain Numeric Scale, Quality of life (SF 36) and Functional disability (neck disability index). These tools will measure neck function and neck pain intensity. Treatment time will be 4 weeks, 3 sessions per week, each session will be 45 minutes long, and measurements will be taken after 4 weeks. Data will be analyzed by SPSS version 25. After assessing normality of data by Shapiro - wilk test, it will be decided either parametric or non-parametric test will be used within a group or between two groups analysis.
Key Words: Breathing Exercises, Cervical Pain, Disability, Upper Cross
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Experimental | Experimental | Experimental Group A (Manual PT/ Conventional PT Treatment + Segmental and Pursed Lip Breathing Exercise) |
|
| Controlled | Other | Group B (Manual PT/Conventional PT Treatment) |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Manual PT/ Conventional PT Treatment + Segmental and Pursed Lip Breathing Exercise | Other | 20 patients will receive conventional physical therapy treatment (hot pack, electrical stimulation, myofascial release, ROM and strengthening exercises) along with segmental and pursed lip breathing exercises. |
| Measure | Description | Time Frame |
|---|---|---|
| NPRS | An outcome measure used to gauge adult pain intensity is the Numeric Pain Rating Scale (NPRS). "No pain" is represented by a score of '0' on the11-point numeric scale, while "pain as bad as you can imagine" or "worst pain imaginable" are represented by a score of '10'. An 11-point numerical scale goes from '0', which indicates no discomfort, to 10 symbolizing the most excruciating agony conceivable. Pre-post readings will be taken | 4 Weeks |
| Quality of Life (SF-36 questionnaire) | The Short Form Survey (SF-36) is a tool used to measure various aspects of quality of life, such as body pain, physical well-being or functionality. Restrictions on role performance brought on by issues with one's physical, mental, or social well-being as well as one's general sense of health. Pre-post readings will be taken. | 4 Weeks |
| Neck Disability Index (NDI) | The Oswestry Low Back Pain Disability Index was modified to create the Neck Disability Index (NDI). The purpose of this questionnaire is to gather information on how your neck pain has impacted your day-to-day functioning. The NDI is now a commonly used tool to assess neck pain-related self-rated disability. All ten items have a score ranging from 0 to 5. The purpose of this questionnaire is to gather information on how your neck pain has impacted your day-to-day functioning. The NDI is now a commonly used tool to assess neck pain-related self-rated disability. All ten items have a score ranging from 0 to 5. Pre-post readings will be taken. | 4 Weeks |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Hafiza Muriam Ghani, MSCPPT | Ripha International University-LHR | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Ismail Medicare | Jhang | Punjab Province | 35200 | Pakistan |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 35079583 | Background | Baradaran Mahdavi S, Riahi R, Vahdatpour B, Kelishadi R. Association between sedentary behavior and low back pain; A systematic review and meta-analysis. Health Promot Perspect. 2021 Dec 19;11(4):393-410. doi: 10.34172/hpp.2021.50. eCollection 2021. | |
| 35329415 | Background | Csepregi E, Gyurcsik Z, Veres-Balajti I, Nagy AC, Szekanecz Z, Szanto S. Effects of Classical Breathing Exercises on Posture, Spinal and Chest Mobility among Female University Students Compared to Currently Popular Training Programs. Int J Environ Res Public Health. 2022 Mar 21;19(6):3728. doi: 10.3390/ijerph19063728. |
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| ID | Term |
|---|---|
| C537866 | Oculocerebral hypopigmentation syndrome type Preus |
| D019547 | Neck Pain |
| ID | Term |
|---|---|
| D010146 | Pain |
| D009461 | Neurologic Manifestations |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |
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|
| Manual PT/Conventional PT Treatment | Other | 20 patients will receive conventional physical therapy treatment (hot pack, electrical stimulation, myofascial release, ROM and strengthening exercises). |
|
| 36852233 | Background | de-la-Iglesia L, Bravo C, Rubi-Carnacea F. Upper crossed syndrome in secondary school students: A mixed-method study. J Taibah Univ Med Sci. 2023 Jan 24;18(4):894-907. doi: 10.1016/j.jtumed.2023.01.008. eCollection 2023 Aug. |
| 33090945 | Background | Ghan GM, Babu VS. Immediate Effect of Cervico-thoracic Mobilization on Deep Neck Flexors Strength in Individuals with Forward Head Posture: A Randomized Controlled Trial. J Man Manip Ther. 2021 Jun;29(3):147-157. doi: 10.1080/10669817.2020.1834321. Epub 2020 Oct 22. |
| 30928841 | Background | Arshadi R, Ghasemi GA, Samadi H. Effects of an 8-week selective corrective exercises program on electromyography activity of scapular and neck muscles in persons with upper crossed syndrome: Randomized controlled trial. Phys Ther Sport. 2019 May;37:113-119. doi: 10.1016/j.ptsp.2019.03.008. Epub 2019 Mar 21. |
| 31040591 | Background | 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. |