An interventional study of Home-based corrective exercise program with incentive spirometer and remote reinforcement and Home-based corrective exercise program (no spirometer, minimal follow-up) in Upper Cross Syndrome, Forward Head Posture and Rounded Shoulder Posture, sponsored by Cardenal Herrera University. Not yet recruiting. Open to participants aged 18 Years to 65 Years. Per ClinicalTrials.gov, last updated 2026-11-09.
Sponsored by Cardenal Herrera University · Not applicable, Interventional, and Treatment
Upper Crossed Syndrome (UCS) is a musculoskeletal condition defined by simultaneous forward head posture (craniovertebral angle, CVA \< 52°), rounded shoulders (RSP > 52°), and thoracic hyperkyphosis (> 42°). It is highly prevalent in sedentary workers and musicians and is associated with neck pain, shoulder pain, and reduced pulmonary function. This two-arm parallel randomized controlled trial will compare two home-based corrective exercise programs over 12 weeks in adults with confirmed UCS. Both groups (Experimental, EG; Control, CG) perform the same 20-minute program three times per week: diaphragmatic breathing re-education and targeted muscle strengthening and stretching. The EG additionally uses a volumetric incentive spirometer (Coach2, 4000 mL) as respiratory biofeedback and receives active remote reinforcement (biweekly video calls + asynchronous educational material from a physiotherapist); the CG performs the same exercises without the spirometer and receives only minimal adherence monitoring. Outcomes are assessed at baseline (week 0) and at weeks 4, 8, and 12. Primary outcome: craniovertebral angle (CVA) measured by lateral photogrammetry. Secondary outcomes: rounded shoulder angle (RSP), thoracic kyphosis (bubble inclinometer and smartphone inclinometer), pain (Visual Analogue Scale), cervical disability (Neck Disability Index), shoulder pain and disability (SPADI), exercise adherence, and pulmonary function (spirometry: FVC, FEV₁/FVC, MVV) at weeks 0 and 12. Recruitment will take place at the Associació Amics de la Música de Meliana, Fisioterapia A Punto, and Universidad Cardenal Herrera CEU (Valencia, Spain). A total of 96 participants (48 per arm) will be enrolled over a 2-year recruitment window.
752 studies on the registry are indexed under Musculoskeletal Diseases; 164 are open to participants now.
This study's planned enrollment of 96 is above the median of 76 across 518 interventional studies indexed under Musculoskeletal Diseases.
Browse Musculoskeletal Diseases studies →Cardenal Herrera University is the lead sponsor of 107 studies on the registry; 22 are open to participants now.
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Confirmed UCS diagnosis, defined by the simultaneous presence of: (a) craniovertebral angle (CVA) \< 52°; (b) rounded shoulder posture angle (RSP) > 52°; and (c) thoracic kyphosis angle > 42°.
Exclusion Criteria:
Severe cervical or thoracic pathology: vertebral fracture, neoplasm, infection, or active systemic inflammatory disease.
Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.
You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.
Chronic obstructive pulmonary disease: long-term lung disease that makes it hard to breathe out, including emphysema and chronic bronchitis.
Informed consent
Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.
You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
COPD
Chronic obstructive pulmonary disease: long-term lung disease that makes it hard to breathe out, including emphysema and chronic bronchitis.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
Home-based corrective exercise program (3 sessions/week × 12 weeks, 20 min/session) combining: (1) diaphragmatic breathing re-education with a volumetric incentive spirometer (Coach2, 4000 mL, Smiths Medical) as biofeedback - 4 progressive levels, 10 repetitions; (2) muscle strengthening and stretching targeting the deep cervical flexors, lower and middle trapezius, rhomboids, and pectoral/suboccipital muscles. The EG additionally receives active remote reinforcement: a biweekly video call with a physiotherapist and asynchronous educational material (written guides and video tutorials) delivered via a messaging platform.
Device: Home-based corrective exercise program with incentive spirometer and remote reinforcement
Identical home-based corrective exercise program (3 sessions/week × 12 weeks, 20 min/session) with the same muscle strengthening and stretching exercises. The CG does not use an incentive spirometer (diaphragmatic breathing performed without device) and does not receive active remote reinforcement; adherence monitoring is minimal (standardized paper diary).
Behavioral: Home-based corrective exercise program (no spirometer, minimal follow-up)
Home-based corrective exercise program (3 sessions/week × 12 weeks, 20 min/session) combining: (1) diaphragmatic breathing re-education with a volumetric incentive spirometer (Coach2, 4000 mL, Smiths Medical) as biofeedback - 4 progressive levels, 10 repetitions; (2) muscle strengthening and stretching targeting the deep cervical flexors, lower and middle trapezius, rhomboids, and pectoral/suboccipital muscles. The EG additionally receives active remote reinforcement: a biweekly video call with a physiotherapist and asynchronous educational material (written guides and video tutorials) delivered via a messaging platform.
Identical home-based corrective exercise program (3 sessions/week × 12 weeks, 20 min/session) with the same muscle strengthening and stretching exercises. The CG does not use an incentive spirometer (diaphragmatic breathing performed without device) and does not receive active remote reinforcement; adherence monitoring is minimal (standardized paper diary).
Craniovertebral Angle (CVA)
Angle formed between the horizontal line at the C7 spinous process and the line connecting C7 to the ipsilateral ear tragus, measured by lateral photogrammetry using standardized adhesive markers and Kinovea software. A lower CVA indicates greater forward head posture (normal \> 52°).
Time frame: Baseline (Week 0), Week 4, Week 8, Week 12
Rounded Shoulder Posture Angle (RSP)
Angle between the line connecting the C7 spinous process to the right acromion and the horizontal, measured by lateral photogrammetry (Kinovea). Values \> 52° indicate rounded shoulder posture.
Time frame: Baseline (Week 0), Week 4, Week 8, Week 12
Thoracic Kyphosis Angle - Bubble Inclinometer
Single-inclinometer sequential method: the instrument (Baseline, Fabrication Enterprises Inc., White Plains, NY) is zeroed at T1 and the angle is read at T12. Three measurements per time point; mean used for analysis.
Time frame: Baseline (Week 0), Week 4, Week 8, Week 12
Thoracic Kyphosis Angle - Smartphone Inclinometer
Same T1-T12 sequential method using the Clinometer app (Plaincode) on iPhone 17. The upper corner of the narrow side of the phone is placed at T1 (zeroed to 0°), then moved to T12 (angle read). Three measurements per time point; mean used for analysis.
Time frame: Baseline (Week 0), Week 4, Week 8, Week 12
Pain Intensity - Visual Analogue Scale (VAS)
100-mm horizontal VAS (0 = no pain; 100 = worst imaginable pain) for neck and interscapular pain during the past week. Minimum clinically important difference (MCID): 15 mm.
Time frame: Baseline (Week 0), Week 4, Week 8, Week 12
Cervical Disability - Neck Disability Index (NDI)
10-item self-reported questionnaire assessing the impact of neck pain on daily activities; total score 0-50. Spanish validated version used. MCID: 5 points (10%). Interpretation: 0-8% no disability; 10-28% mild; 30-48% moderate; 50-64% severe; ≥ 64% complete disability.
Time frame: Baseline (Week 0), Week 4, Week 8, Week 12
Shoulder Pain and Disability - SPADI
13-item self-reported questionnaire with two subscales (Pain: 5 items; Disability: 8 items), each item scored 0-10. Total score 0-100 (higher = worse). MCID: 13-18 points. Spanish validated version used.
Time frame: Baseline (Week 0), Week 4, Week 8, Week 12
Exercise Adherence
Percentage of prescribed sessions completed out of 36 planned sessions (3/week × 12 weeks), recorded in standardized session diaries. Adequate adherence defined as ≥ 70%
Time frame: Weeks 1-12 (cumulative at each assessment point)
Forced Vital Capacity (FVC, % predicted)
Spirometric measurement (forced vital capacity as percentage of age-sex-height-weight predicted value). ATS acceptability and reproducibility criteria applied; 3 measurements per session, mean used.
Time frame: Baseline (Week 0), Week 12
FEV₁/FVC Ratio (% predicted)
Ratio of forced expiratory volume in 1 second to forced vital capacity, expressed as percentage of predicted value.
Time frame: Baseline (Week 0), Week 12
Maximum Voluntary Ventilation (MVV, % predicted)
Spirometric measure of maximum airflow over 12-15 seconds, expressed as percentage of predicted value.
Time frame: Baseline (Week 0), Week 12
No study locations are listed for this record.
Plan to share: No
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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