Effect of adding cervicothoracic mobilization to comprehensive corrective exercises on postural alignment and neck functional level in upper crossed syndrome: randomized controlled trial

Introduction. Upper crossed syndrome (UCS) is a prevalent musculoskeletal ailment marked by shortening and weakness in the neck, shoulders, and upper back muscles. Poor posture, including forward head posture (FHP), rounded shoulders, and hyperkyphosis, often induces the syndrome, particularly when individuals engage with gadgets, read, or drive. Objectives. To explore the efficacy of integrating cervicothoracic mobilization into comprehensive corrective exercises on FHP angle, rounded shoulder (RS), kyphosis, neck pain, and functional level among patients suffering from UCS. Material and methods. Sixty patients of both sexes with UCS took part in this study. Patients were randomly assigned using computerized block randomization into two equal groups. Group A consisted of thirty patients who underwent cervicothoracic mobilization in addition to comprehensive corrective exercises, while Group B included thirty patients who received only comprehensive corrective exercises. The assessment was performed before and after the treatment period. FHP and RS were assessed using the lateral view of the craniovertebral angle (CVA) and the sagittal shoulder angle (SSA). The kyphotic angle was assessed using a flexicurve, pain level was evaluated via the Visual Analogue Scale (VAS), and neck functional level was assessed using the Arabic version of the Neck Disability Index (NDI-Ar). The intervention was performed three times weekly for eight weeks for all patients. Results. Group A exhibited a statistically significant increase in CVA and SSA, along with a reduction in thoracic kyphosis angle, VAS, and NDI, in comparison to Group B. Conclusion. Cervicothoracic mobilization was effective in treating UCS by improving FHP, rounded shoulders, kyphotic angle, neck pain, and neck dysfunction when combined with comprehensive corrective exercises.