Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
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.
Not provided
Not provided
Not provided
Not provided
Not provided
| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Dynamic neuromuscular stabilization | Experimental | Dynamic neuromuscular stabilization involves precise co-activation of the intrinsic muscles of the spine which forms the Integrated spinal stabilization system (ISSS) and includes cervical flexors and extensors, diaphragm, transversus abdominis, multifidus and pelvic floor. Participants will receive DNS for 6 weeks. |
|
| Corrective exercises | Experimental | National Academy of sports medicine corrective exercises that involve 4 steps : First: Inhibition for tight muscles Second: Lengthening for tight muscles Third: Activation for weak muscles fourth: Intergration to retrain all muscles through functionally progressive movements using integrated dynamic movements. Participants will receive NASM corrective exercises for 6 weeks. |
|
| Combined Dynamic neuromuscular stabilization and corrective exercises group | Experimental | Participants will receive both DNS and NASM for 6 weeks. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Dynamic neuromuscular stabilization | Other | Dynamic neuromuscular stabilization involves precise co-activation of the intrinsic muscles of the spine which forms the Integrated spinal stabilization system (ISSS) and includes cervical flexors and extensors, diaphragm, transverses abdominis, multifidus and pelvic floor. |
| Measure | Description | Time Frame |
|---|---|---|
| Neck pain intensity | Neck pain intensity will be measured through Numerical pain rating scale. A scale from 0 to 10, with 0 indicating no pain and 10 signifying excruciating pain. | At baseline at the first session and reassessed at the end of six weeks of intervention. |
| Measure | Description | Time Frame |
|---|---|---|
| Neck disability | The patient will be asked to fill the 10- section of the questionnaire. Higher score indicate higher disability. | At baseline at the first session and after 6 weeks of intervention. |
| Craniovertebral angle |
Not provided
Inclusion Criteria:
Exclusion Criteria:
Not provided
Not provided
Not provided
Not provided
| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Passant M Assistant lecturer, MSc | Contact | 01004139949 | passant.moustafa@cu.edu.eg | |
| Nesreen F Lecturer, PhD | Contact | 01127283925 | dr_nesreenfawzy@cu.edu.eg |
| Name | Affiliation | Role |
|---|---|---|
| Karima A Hassan, PhD | Cairo University | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Outpatient clinic at faculty of physical therapy - Cairo University | Cairo | Cairo Governorate | 11432 | Egypt |
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
| ID | Term |
|---|---|
| C537866 | Oculocerebral hypopigmentation syndrome type Preus |
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
|
| NASM corrective exercises | Other | It is corrective exercise protocol, which includes four phases, i.e. inhibit, lengthen, activate, and integrate stage |
|
craniovertebral angle will be measured using Kinovea software to assess forward head posture
| At baseline and after 6 weeks of intervention |
| Forward shoulder angle | Forward shoulder angle will be measured using Kinovea software to assess rounded shoulder posture | At baseline and after 6 weeks of intervention |
| Thoracic kyphosis angle | Thoracic kyphosis angle will be measured using a bubble inclinometer | At baseline and after 6 weeks of intervention |