The effectiveness of a comprehensive corrective exercises program and subsequent detraining on alignment, muscle activation, and movement pattern in men with upper crossed syndrome: protocol for a parallel-group randomized controlled trial

The effects of an 8-week selective corrective exercises program on the worker's productivity with the upper crossed syndrome - a randomized controlled trial

BACKGROUND

The purpose of this study was to investigate the effectiveness of a corrective exercise program on workers' productivity with Upper Crossed Syndrome (UCS).

METHODS

We used Randomized Controlled Trial (RCT) with parallel groups, double-blind, randomized. The participants were workers recruited at a company of Markazi Province that 23 persons in test group and 25 in control group participated. Before and after the intervention, work productivity and activity impairment was measured by the WPAI-GH questionnaire. In addition, angles of FH and RS were measured by Goniometer, and kyphosis angle was measured by a flexible ruler. The exercise program consisted of stretching, strengthening, and stabilization exercises, conducted three times a week for eight weeks. The primary outcome was work productivity and activity impairment, and the secondary outcomes were FH, RS, and KY. All primary and secondary outcomes were measured before the interventions, one week after intervention.

RESULTS

Results revealed significant differences for KY (MD = 3.84, 95% CI: 0.75,6.94, p = 0.017), RS (MD = -1.83, 95% CI: -2.88, -0.88, p = 0.001), and FH (MD = 3.01, 95% CI: 1.98,4.04, p = 0.001) before and after the intervention. In addition, within-group differences showed a significant difference in work time missed (MD = -2.60, CI: -4.84, -0.37, p = 0.003**), and overall work productivity loss (MD = -2.02, CI: -3.78, -0.26, p = 0.013**) in exercise group. However, there were no significant effects on impairment at work and activity.

CONCLUSIONS

Since significant differences were detected in a selective exercise program on productivity, a continuous exercise program for more than 8-week could be effective in managing productivity and increasing practical working hours.

Upper-crossed syndrome and disability in shoulder adhesive capsulitis

STUDY DESIGN

Cross-sectional analytical study.

INTRODUCTION

Adhesive capsulitis (AC) is a long-standing condition with varying extents of disability seen among patients. The role of postural manifestations and contractile tissue involvement in this condition is poorly understood and yet to be explored.

PURPOSE

This study aimed to analyze if individuals with adhesive capsulitis demonstrated the characteristics of an upper crossed syndrome (UCS) postural manifestation and whether or not its presence affected the extent of disability experienced by this population.

METHODS

Sixty-five individuals with AC were assessed for the presence of UCS. Scapular muscle strength and length alterations, forward head posture (FHP), and disability were assessed and compared between those with and without UCS. Paired T test and an independent T test were utilized to compare means within and between these groups, respectively, while non-parametric measures were utilized for their skewed counterparts. Phi coefficient (φ) was used to determine the strength of association between the descriptive patient characteristics. The correlation between symptom duration and degree of postural involvement was analyzed using Pearson's correlation coefficient.

RESULTS

43.1% of the study population demonstrated UCS and 80% FHP with a significant negative correlation between Cranio Vertebral Angle and chronicity of AC (r = -0.27). Individuals with AC demonstrated significantly decreased scapular muscle strength (p = <.001) and pectoralis minor length on the affected side (p = .03). No differences were seen between groups with and without UCS. The mean SPADI scores between groups demonstrated a more significant level of perceived pain and disability in individuals with UCS (p = .049).

CONCLUSIONS

As seen in UCS, individuals with AC demonstrated alterations in movement patterns and posture. UCS was seen to contribute towards the existing disability in AC. This study suggests a careful evaluation and intervention based on these findings to document its effect on pain and dysfunction in AC.

Lower trapezius muscle function in people with and without shoulder and neck pain: a systematic review

CONTEXT

Shoulder and neck pain are leading causes of disability worldwide. Rotator cuff pathology has strong associations with such pain and is extensively targeted by healthcare practitioners. A dysfunctional lower trapezius muscle has also been shown to contribute to neck and shoulder pain, yet it is often overlooked.

OBJECTIVES

This systematic review analyzes those with a history of, or who are currently managing, shoulder or neck pain to indicate differences in measures of lower trapezius function when compared to subjects without that pain.

METHODS

Studies with no age restrictions were included in the study. Studies could determine lower trapezius muscle function with any quantifiable measurement tool or clinical assessment. If the study included a control group (no pain) and a comparator group (pain), and if lower trapezius muscle function was assessed in both, the study was typically included. The significance of the lower trapezius muscle function change was summarized in these pain patients. From a final total of 18 studies identified, level of muscle activity, muscle activation, time to onset, muscle strength, and muscle thickness were reported.

RESULTS

The 18 included articles involved 485 participants with shoulder and/or neck pain and 455 without. Half of the shoulder pain studies (6/12), and all of the neck pain studies (6/6), demonstrated that the lower trapezius had a noticeable impact. The lower trapezius muscle in participants with shoulder and neck pain tended to show decreased muscle strength, and decreased time to onset/latency.

CONCLUSIONS

The findings from this systematic review should be taken into consideration when assessing and treating patients with shoulder and neck pain. Future studies that define the type and duration of shoulder and neck pain, as well as prospectively assessing lower trapezius muscle function in those with and without that pain, are needed.

The effectiveness of the comprehensive corrective exercise program on kinematics and strength of lower extremities in males with dynamic knee valgus: a parallel-group randomized wait-list controlled trial

Background

Dynamic knee valgus (DKV) is a prevalent movement impairment widely regarded as a risk factor for lower extremity disorders such as patellofemoral pain syndrome. The present study aimed to investigate the effectiveness of the comprehensive corrective exercise program (CCEP) on kinematics and strength of lower extremities in males with DKV.

Methods

Thirty asymptomatic young men with DKV between the ages of 18 and 28 years participated in this study. They were randomly assigned to the intervention (n = 15) and control groups (n = 15). The intervention group performed the CCEP for three sessions per week for eight weeks, while the control group only did activities of daily living. Hip external rotator and abductor muscle strength and three-dimensional lower extremity kinematics consisting of knee varus/valgus, femur adduction/abduction, femur medial/lateral rotation, and tibial medial/lateral rotation were measured at the baseline and post-test. The data were analyzed using the analysis of covariance (ANCOVA).

Results

There were significant improvements in all kinematics variables in the intervention group after the 8-week CCEP. Moreover, the strength of abductor and external rotator muscle improved in the intervention group (P < 0.05).

Conclusions

The CCEP led to substantial improvements in the selected variables of lower extremity kinematics and muscle strength in participants with DKV during a single-leg squat. These results imply that practitioners should adopt a comprehensive approach to pay simultaneous attention to both proximal and distal segments for improving DKV.

Trial registration

The protocol has been approved in the Registry of Clinical Trials (Registration N: IRCT20180821040843N1) on 2018-12-30.

Static Model of Athlete's Upper Limb Posture Rehabilitation Training Indexes

With the gradual expansion of the development of sports, the level of sports has been rapidly improved. Athletes have to carry out high-intensity and systemic technical movements in training and competition. Some sports have the greatest burden on the shoulder joint. From the observation and investigation of the injured parts of athletes, it is found that the shoulder joint is the most common sports injury, which is the most typical sports injury. Based on the problem of insufficient strength and endurance reserve after rehabilitation of shoulder external rotator injury, it will cause muscle tension and poor extensibility. To prove the improvement effect of functional training and posture index calibration on the poor posture of the shoulder, considering the measurement of global passive torque, this paper uses a limited set of joint angles and corresponding passive torque data in the upper arm lifting trajectory to train the neural network and uses the trained network to predict the passive torque in other upper arm trajectories. The kinematics model of the shoulder joint is established, and the human-computer interaction experiment is designed on the platform of the gesture index manipulator. The passive and active torque components of the shoulder joint in the human-computer interaction process are calculated by measuring the man-machine interaction force of the subjects in the motion state, which is used as the basis for evaluating the active motion intention of the subjects. Surface electromyography (SEMG) was used to calibrate and verify the attitude index of shoulder active torque. The method proposed in this paper is helpful to achieve more efficient on-demand assisted rehabilitation training exercises, which is of great significance to improve the level of rehabilitation training.

Efficacy of Six Weeks Stability Exercises on the Glenohumeral Joint of Female Tennis Players with Scapular Dyskinesia

BACKGROUND

Stabilizing exercises reduce pain intensity, improves shoulder position and scapular function, and provides an appropriate strategy for the improvement of scapular dyskinesia. The purpose of this study was to investigate the effect of six weeks of stability exercises (stretching-strengthening) on joint proprioception, strength, and range of motion of the glenohumeral joint in female tennis players with scapular dyskinesia.

METHODS

Thirty-six female elite tennis players with scapular dyskinesia in both experimental and control groups participated in this study. Goniometer, Isokinetic and Biodex devices were used to evaluate the range of motion, internal and external rotation strength in 60° and 180°, and joint proprioception at 45° and 60°, respectively. Also, the lateral scapular slide test (LSST) was used to evaluate the scapulohumeral rhythm. For analyzing dependent variables and determining statistical significance the ANCOVA and an alpha of 5% was used.

RESULTS

The results of this study indicated the effect of the stability exercise program on the range of motion of internal (p = 0.016) and external (p = 0.023) rotation of the shoulder. Also, significant differences were observed between the control and training groups for internal rotation strength 60° (p = 0.013), 180° (p = 0.017) and external rotation strength 60° (p = 0.005), 180° (p = 0.045) and strength ratio 60° (p = 0.001) and 180° (p = 0.023). However, there were no significant differences for proprioception.

CONCLUSION

In general, the findings of this study support the effectiveness of exercise therapy as a safe intervention for improving scapular function in tennis players with scapular dyskinesia.

Online supervised versus workplace corrective exercises for upper crossed syndrome: a protocol for a randomized controlled trial

Background and objective

Musculoskeletal disorders (MSDs) including upper crossed syndrome (UCS) are considered as the leading cause of work-related issues worldwide among office workers. Therefore, the present study aims to evaluate the effect of workplace-based versus online-supervised home-based corrective exercises among office workers with UCS.

Methods and design

To this end, 45 subjects within the age range of 30–45 years are randomly assigned to three groups in the present parallel-group, randomized control trial using a pretest-posttest design. These groups include the subjects who receive online-supervised exercise and workplace exercise containing three sessions of intervention for 8 weeks and the control group receives no intervention while performing routine activities. The primary outcome variables are neck-shoulder pain (NSP) and consequent sick leave due to NSP, followed by alignment, workability, and the surface electromyography of upper, middle, and lower trapezius (UT, MT, and LT), sternocleidomastoid (SCM), and serratus anterior (SA) as the secondary variables.

Discussion

The present study seeks to assess the effect of workplace versus online-supervised corrective exercise interventions among 45 office workers suffering from UCS. It is expected to improve and reduce the related symptoms including postural malalignment and imbalance muscles after 8 weeks of corrective exercises. If effective, the findings may lead to adherence and work performance among the office workers, and individuals subjected to UCS can use the benefits of an online-supervised intervention. In addition, the findings may be useful in different workplaces as the evidence for employers to benefit from the reduction in the related costs and side effects of work-related neck/shoulder disorders including work disability, productivity loss, time expense, social insurance, work absenteeism, and treatment costs. Finally, clinicians and corrective exercise therapists can consider it as a clinical based-evidence intervention for their further actions.

Trial registration

Iranian Registry of Clinical Trials IRCT20200729048249N1. Registered on 5 October 2020 (https://en.irct.ir/user/trial/49992/view)

Resolution of Gastroesophageal Reflux Disease Following Correction for Upper Cross Syndrome-A Case Study and Brief Review

Upper cross syndrome (UCS) is a condition caused from prolonged poor posture manifesting as thoracic hyperkyphosis with forward head and shoulder postures. It has been associated with several other secondary conditions, causing pain and discomfort to those with the condition. This is a case report of a 35-year-old female presenting to clinic with a sharp pain in the neck, upper back, and sternum area for 4 weeks and gastroesophageal reflux disease (GERD). She had been working at home for several months after the shelter at home order was issued. Following evaluation and corrective treatment with cervical adjustment and soft tissue massage, the patient's posture improved and reported full pain resolution. Her symptoms of GERD concurrently resolved as well. She continued to receive chiropractic adjustment two times per month for correcting spinal misalignment. Full restoration of posture was attained on the full spine radiographs at 9 months follow-up. The patient remained symptom-free at 12 months follow-up. Manipulative and preventive therapies aimed at treating and preventing UCS should be more widely adopted to prevent secondary conditions.

Comprehensive corrective exercise program improves alignment, muscle activation and movement pattern of men with upper crossed syndrome: randomized controlled trial

Upper crossed syndrome (UCS) refers to the altered muscle activations and movement patterns in scapulae along with some abnormal alignment in the upper quarter, which may contribute to the dysfunction of the cervicothoracic and glenohumeral joints. The present study aimed to investigate the effectiveness of a comprehensive corrective exercise program (CCEP) and subsequent detraining on alignment, muscle activation, and movement pattern in men with the UCS. This randomized controlled trial included 24 men. The intervention group conducted CCEP (8 weeks), followed by four weeks of detraining and the control group maintained normal daily activities. Electromyography of selected muscles, scapular dyskinesis test, head, shoulder, and thoracic spine angle were measured at baseline, post-test, and follow-up. There were significant differences for Group x time interaction and also for within-group from pre-test to post-test and follow-up in all outcomes. Also, significant differences were observed in three outcomes at post-test and follow-up between the CCEP and control group in favor of the CCEP. In Conclusion, the present study demonstrates that the CCEP for individuals with UCS is feasible and effective, improving muscle activation imbalance, movement patterns, and alignment. Importantly, these improvements were maintained after four weeks of detraining, suggesting lasting neuromuscular re-training adaptations.