An interventional study of Kendall Excercise and Mckenzie Excercise in Upper Crossed Syndrome, sponsored by Riphah International University. Recruiting at 1 site in Pakistan. Open to participants aged 20 Years to 60 Years. Per ClinicalTrials.gov, last updated 2026-11-06.
Sponsored by Riphah International University · Not applicable, Interventional, and Treatment
The study was conducted to evaluate effects of Kendall versus McKenzie exercise on pain ,functional disability and craniovertebral angle in upper cross syndrome over the course of 6 week
Upper Crossed Syndrome is a common postural disorder characterized by muscle imbalance between tight cervical extensor,upper trapezius, levator scapulae,pectoralis major,pectoralis minor .And weak deep cervical flexors, lower trapezius, serratus anterior.This result in pain and reduce functional ability and altered craniovertebral angle.This study aims to evaluate effects of Kendall versus McKenzie exercise on pain ,functional disability and craniovertebral angle in upper cross syndrome.
Randomized clinical trial will be conducted in upper cross syndrome patient in Asharab Health Clinic Gujranwala using non probability convenience sampling technique.58 Participants will be selected according to inclusion and exclusion criteria and then randomly allocated into two groups.Conventional treatment will be given to both groups .But group A will be given Kendall exercise and group B will be given McKenzie exercise.Treatment will be given for 6 week.Outcome measure will included pain assessed by Numeric Pain Rating scale ,functional disability assessed by Neck Disability Index and craniovertebral angle by Image J software,neck flexor endurance by Neck Flexor Muscle Endurance Test .Informed consent will be obtained from all participants prior to inclusion in this study. Outcome will be recorded at baseline, at 6 week intervention.Data will be analyze by using SPSS version 25.
Riphah International University is the lead sponsor of 2,193 studies on the registry; 650 are open to participants now.
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Male and female Age between 20 -60 years Neck pain duration ≥ 3 months NDI score >20 Forward head posture ≥ 45° Round shoulders ≥ 52 ° Round back > 40° Pain intensity ≥ 3
Exclusion Criteria:
History of any trauma, surgery, or disease of shoulder,spine,pelvis Specific neck pathologies (cervical disc herniation,cervical radiculopathy,inflammatory condition like rheumatoid arthritis or gout, spinal infection and tumor,myelopathy,upper cervical instability,dizziness,vertebral artery insufficiency) Presence of neurological deficit, Diagnosed psychiatric disorder Current participant in other neck/shoulder rehab Having any visible malalignment in the pelvis or lower extremities. Skin allergies and lesions. Pregnancy Uncontrolled cardiovascular or respiratory conditions
Other: Kendall Excercise · Other: Standard Physical Therapy
Other: Mckenzie Excercise · Other: Standard Physical Therapy
Excercise Dose Description and Progression Strengthening of deep cervical flexors 5 sets of 10 rep, 30 sec break after each set In supine lying, Chin tucks with head in contact with the floor.From 3rd week progress by lifting head off the floor in chin tucked in position and hold it for 2-8 sec. Stretching the cervical extensors 5 rep .each repetition held for 60 sec.And 60 sec break after each rep In sitting a chin drop-in is progress by chin drop with the help of hand on the occipital area. Strengthening shoulder retraction 5 set of 10 repetition,30 sec break after each set In standing, shoulder retraction by holding thera band moving scapular blades inwards.Progression to prone lying without weights then using the weight of 1 kg. Stretching the pectoralis muscle 5 repetition held for 60 sec each, after each rep 60 sec break Unilateral pectoral stretch with the help of door frame or wall,progresses to bilateral stretch .Increases the force of stretch as tolerated.
Cervical Retraction 10-15 repetitions Cervical Retraction with Patient Overpressure 10-15 repetitions Cervical Retraction with Therapist Overpressure 10-15 repetitions Cervical Retraction with Extension 10-15 repetitions Cervical Retraction with Extension and Rotation 5-6 repetitions Slouch-overcorrect from Mckenzie 10 cycles
Heating pack for 15 minutes,Static stretching of upper trapezius 5 repetitions per side; hold 30 seconds; rest 30 seconds between repetitions. Static stretching of levator scapulae 5 repetitions per side; hold 30 seconds; rest 30 seconds between repetitions. PA maitland glide cervical and thoracic t1-t3
Numeric Pain Rating Scale
patient select a whole number (0-10 integers) that best reflects the intensity of their pain. The rating scale is as follows: 0 = No pain 1-3 = Mild pain 4-6 = Moderate pain 7-10 = Severe Pain
Time frame: From enrollment to the end of the treatment at 6 week
Neck disability index
Instructions to the client should be given to fill the questionnaire and scoring should be done by the therapist. Clients choose one of six possible replies ranging from no disability (0) to entire disability (5). The total score is calculated by adding the ten items together, ranging from 0 (no disability) to 50 (disability) (maximum disability). This score is sometimes converted to a percentage by some authors. A score of less than 4 indicates no disability, 5-14 mild disability, 15-24 moderate disability, 25-34 severe disability, and scores greater than 35 full disabilities
Time frame: From enrollment to the end of the treatment at 6 week
Craniovertebral angle (CVA)
To measure the craniovertebral angle (CVA), participants were seated on a standard chair with their feet flat on the floor and thighs parallel to the ground. A digital phone was positioned 1.5 meters from the dominant side of each participant at shoulder height.To measure the craniovertebral angle (CVA), the angle measurement tool within the software was selected. From the file menu, the desired image was opened. Using the mouse pointer, the examiner first clicked on the tragus marker and then drew a line to the C7 marker by clicking again at that point. This line, connecting the tragus and the C7 spinous process, was then fixed. Subsequently, a horizontal line was drawn from the C7 spinous process marker, and the software calculated the angle between the two lines, which was recorded as the craniovertebral angle (CVA).Intraclass Correlation Coefficient (ICC) values was 0.89 to 0.94.The Standard Error of Measurement (SEM) ranged from 0.92° to 1.02°.
Time frame: From enrollment to the end of the treatment at 6 week
Neck Flexor Muscle Endurance test
Position the participant in supine crook lying, with knees bent and the head in a neutral position. Ask the participant to slightly flex the upper cervical spine (chin tuck). Instruct the participant to gently lift the head off the plinth while maintaining upper cervical flexion. Record the maximum holding time in seconds. Stop when the participant cannot maintain the position, increases neck flexion, or lowers the head.
Time frame: From enrollment to the end of the treatment at 6 week
Rounded Shoulder
Where a horizontal line passing through the lateral shoulder meets the line drawn from C7 to the lateral shoulder, the point of intersection forms the sagittal shoulder-C7 angle . It indicates the degree of roundness of the shoulders.It is measure by through Image J. Software
Time frame: From enrollment to the end of the treatment at 6 week
Plan to share: No
Started Jan 2026 (actual). Primary completion is estimated for Oct 2026, 9 months after the start.
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From the registry record's own update history. This site started tracking changes on Sep 25, 2026; for anything earlier, see the record history on ClinicalTrials.gov ↗
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