Dynamic Neuromuscular Stabilization Versus Corrective Exercises in Upper Cross Syndrome

Effect of Dynamic Neuromuscular Stabilization Versus Corrective Exercises on Pain, Functional Disability, and Postural Alignment in Upper Crossed Syndrome.

The purpose of the study will be to investigate dynamic neuromuscular stabilization versus National American Academy of Sports Medicine (NASM) corrective exercises on pain, functional disability, cranio-vertebral angle, forward shoulder angle, and thoracic kyphosis in upper cross syndrome.

Upper Cross Syndrome (UCS) is a frequent condition that is most commonly encountered in musculoskeletal disorders, showing a typical pattern of imbalance in muscles and neck and shoulder region joint dysfunction. It causes pain in shoulders, upper back, thoracic and cervical spine. It is frequently associated with inadequate posture or forward head position, muscular weakness, and alterations in movement patterns, leading to pain, restricted mobility, and dysfunction in the affected areas of patients suffering from UCS.

Dynamic Neuromuscular Stabilization (DNS) is a developing rehabilitation approach based on reflex locomotion. The idea of reflex locomotion describes particular involuntary motor reactions/movement patterns that occur when firm pressure is applied to specific muscle zones. These movement patterns are standard and referred to as "global patterns". The global pattern generated from the prone position is known as "reflex creeping," whereas the one from the supine or side lying posture is known as "reflex rolling". Furthermore, some motor motions such as gripping, turning, crawling, and eventually walking occur automatically without the need for specific training in normal babies.

The National American Academy of Sports Medicine (NASM) provided a corrective exercise protocol for postural malalignment. It includes 4 steps: inhibition (self-mobilization release technique targeting trigger points), lengthening (stretching techniques for tight muscles), third: activation (strengthening techniques for weak muscles), and integration (retraining all muscles through functionally progressive movements). It was successful in treating UCS.

Inclusion Criteria:

1. Having non-specfic neck Pain.
2. Patients having a CVA of < 52 .
3. Forward shoulder angle > 52 degrees.

Exclusion Criteria:

• Participants having conditions such as osteoporosis, blood disease, congestive heart disease, cancer, severe skin sensitization, major mental disease, and frozen shoulder, will be excluded from the study. Neck pain has a specific underlying pathology such as fractures, rheumatoid arthritis, osteoporosis, or whiplash injuries as well as neck pain associated with radiculopathy.