Comparison of Proprioceptive Neuromuscular Facilitation and Patient Education in Upper Crossed Syndrome

Investigation and Comparison of the Effects of a Proprioceptive Neuromuscular Facilitation Technique and Patient Education on Pain, Range of Motion, Muscle Strength, and Posture in Individuals With Upper Crossed Syndrome

The aim of this study is to investigate the effects of exercises applied using the Proprioceptive Neuromuscular Facilitation (PNF) technique on pain, joint range of motion, muscle strength, and posture in individuals with Upper Crossed Syndrome, and to compare these effects with patient education. Individuals diagnosed with Upper Crossed Syndrome will be included in the study and allocated into two groups: a PNF-based exercise combined with patient education group and a patient education-only group.

In the PNF group, Stabilizing Reversals for scapular anterior elevation-posterior depression and Replication techniques for posterior depression will be applied. In the patient education group, education including postural awareness and exercise will be provided. Assessments will be conducted at two time points, before and after the intervention. Pain level, joint range of motion, muscle strength and endurance, and postural parameters will be analyzed.

This study is expected to provide evidence regarding the clinical effectiveness of PNF approaches targeting scapular control in individuals with Upper Crossed Syndrome and to contribute to the management of postural disorders in the field of physiotherapy and rehabilitation.

Inclusion Criteria:

• Age 18 years or older
• Clinically diagnosed with Upper Crossed Syndrome and referred by a specialist physician (e.g., Physical Medicine and Rehabilitation, Orthopedics)
• Upper Crossed Syndrome diagnosis confirmed at baseline based on postural characteristics (e.g., forward head posture, rounded shoulders, thoracic kyphosis etc.)
• Willingness to participate in the study and provision of written informed consent

Exclusion Criteria:

• History of spinal surgery or spinal fracture
• Presence of structural spinal deformities (e.g., structural kyphosis or scoliosis)
• Presence of neuromuscular diseases affecting the spine or upper quadrant
• Presence of congenital or acquired severe structural spinal anomalies
• Any medical condition that contraindicates participation in exercise programs
• History of severe psychiatric disorders
• History of chronic pain in the cervical or lumbopelvic regions
• History of postural control disorders
• Any condition expected to prevent regular participation or adherence during the study period.