Corrective exercises administered online vs at the workplace for pain and function in the office workers with upper crossed syndrome: randomized controlled trial

Effect of digital health corrective posture exercise program on head and shoulder posture in adolescents: A cluster randomized controlled trial

BACKGROUND

Poor posture, particularly forward head posture and rounded shoulders, has become increasingly prevalent among adolescents due to prolonged screen use and sedentary behaviors. This study aimed to investigate the effects of a 6-week digital health corrective posture exercise (DHCPE) program on head and shoulder posture in adolescents.

METHODS

A total of 36 subjects were recruited and randomly allocated to 3 groups: the DHCPE group, the face-to-face exercise (FTFE) group, and a control group. The DHCPE and FTFE groups participated in the same corrective posture exercise programs. The DHCPE group conducted the digital health intervention remotely through a monitored screen, while the FTFE group engaged in corrective posture exercises on-site with therapists. Each intervention lasted 50 minutes and was conducted 3 times a week over a period of 6 weeks for both groups. The outcome measurements included protracted head and shoulder distances, trunk lean (the angle of shoulder inclination relative to the pelvis), trunk deviation, shoulder and pelvic height levels, and the absolute differences and inequality ratios between both sides. All assessments were conducted both preintervention and postintervention.

RESULTS

Both the DHCPE and FTFE groups demonstrated significant improvements in protracted head, left protracted shoulder, and trunk lean following the intervention. The interaction effect revealed that both the DHCPE and FTFE groups exhibited significant improvements in these measurements compared with the control group. Furthermore, no significant differences were found between the improvements observed in the DHCPE group and those in the FTFE group.

CONCLUSION

DHCPE and FTFE were effective in improving head and shoulder posture in adolescents. The improvements in the DHCPE group were comparable to those achieved in the FTFE group. DHCPE has the potential to serve as a viable alternative to FTFE for enhancing head and shoulder posture in this population.

Effect of the cervical and thoracic "Daoyin" training on posture and pulmonary function in patients with upper crossed syndrome: a randomized controlled trial

OBJECTIVES

With the growing ubiquity of electronic devices, the incidence of upper crossed syndrome (UCS) is increasing every year and tends to affect younger populations. The study was designed to assess the effect of cervical and thoracic "Daoyin" training on pain, posture, pulmonary function, cervical range of motion, and emotional state in college students with UCS.

DESIGN

We conducted a parallel-group randomized control study.

SETTING

The Fujian Medical University in China.

PARTICIPANTS

74 patients with UCS fulfilled the study requirement and were assigned to the intervention group (IG) and the control group (CG).

INTERVENTION

Instructed cervical and thoracic "Daoyin" training was given to students in the IG for eight weeks, five days a week for 45 min, whereas students in the CG continued with their usual activities.

MAIN OUTCOME MEASURES

Primary outcomes, including forward head and shoulder angles, pain and cervical spine function, as well as secondary outcomes, such as pulmonary function, cervical range of motion and emotional state, were measured at baseline and a follow-up of 8-week. These measurements were conducted using photogrammetry, visual analog scale (VAS), Neck Disability Index (NDI), pulmonary function, cervical range of motion test and Self-rating Anxiety Scale (SAS), respectively. The statistical analysis used the change value between the baseline and the 8-week intervention measurements.

RESULTS

74 patients (IG = 37; CG = 37) were randomized. All participants were included in the analysis. There were significant differences of the change values between groups in Forward Head Angle (FHA) (d = 1.113, P < 0.001), Forward Shoulder Angle (FSA) (d = 1.052, P < 0.001), VAS (d = 0.854, P < 0.001), NDI (d = 0.754, P = 0.005), pulmonary function (Forced Expiratory Volume in 1 s/Forced Vital Capacity (FEV1/FVC) (d = 0.516, P = 0.002), maximal voluntary ventilation (MVV) (d = 0.504, P = 0.033), cervical range of motion in Left Rotation (LR) (d = 0.647, P = 0.014) and emotional state (d = 0.587, P = 0.014). No side effects were observed in this study.

CONCLUSION

Cervical and thoracic "Daoyin" training can improve the abnormal posture of head forward and round shoulders, reducing pain and anxiety, improving cervical spine function, and improving lung function to a certain extent.

TRIAL REGISTRATION

ChiCTR2300072669 (20/06/2023), Prospective registration, www.chictr.org.cn .

Comparing the effects of Pilates, corrective exercises, and Alexander's technique on upper cross syndrome among adolescent girls student (ages 13-16): a six-week study

INTRODUCTION

Upper Cross Syndrome is a pattern of muscle imbalance and postural dysfunction that can cause discomfort and pain. This study's objective was to compare the effects of Pilates exercises, corrective exercises, and Alexander's technique on upper cross syndrome in adolescent girls aged 13-16 years: a six-week intervention study.

METHODS

The present study was Quasi-experimental, and its statistical population consisted of 13 to 16-year-old female students. Forty-five students who were diagnosed with upper cross syndrome were purposefully selected as samples and randomly assigned to three groups: Pilates exercises (N = 15), corrective exercises (N = 15), and Alexander's technique (N = 15). The participants performed exercises for 60 min per session, three sessions per week, and six weeks. This study's objective was to compare the effects of Pilates exercises, corrective exercises, and Alexander's technique on upper cross syndrome in adolescent girls aged 13-16 years: a six-week intervention study. This study was retrospectively registered in the Iranian Registry of Clinical Trials (IRCT) on 2023-09-19 to comply with the journal's policies. The assigned trial registration number is IRCT20230810059106N1.

RESULTS

The results of the dependent t-test showed significant decreases in forward head angle (p = 0.0001), rounded shoulder (p = 0.001), and kyphosis (p = 0.0001) as a result of corrective exercises. There were also significant decreases in forward head angle (p = 0.0001), rounded shoulder (p = 0.002), and kyphosis (p = 0.001) after six weeks of practising Alexander's technique. However, in the case of Pilates exercises, a significant decrease in forward head angle (p = 0.110), rounded shoulder (p = 0.598), and kyphosis (p = 0.371) was not observed. The one-way analysis of variance revealed a significant difference in the forward head angle (p = 0.012), rounded shoulders (p = 0.013), and kyphosis (p = 0.009).

CONCLUSIONS

The effect of Alexander's technique and corrective exercises on forward head angle, rounded shoulder, and kyphosis abnormalities was almost similar and more effective than pilates exercises.

A Comprehensive Workplace Exercise Intervention to Reduce Musculoskeletal Pain and Improve Functional Capacity in Office Workers: A Randomized Controlled Study

The high levels of musculoskeletal pain, in conjunction with the low levels of functional capacity, may negatively affect workers' health, efficiency, and productivity. This randomized controlled study investigated the efficacy of a 6-month comprehensive workplace exercise program on musculoskeletal pain and functional capacity in office workers. Seventy male and female office workers with musculoskeletal pain in any body area were randomly assigned to either an intervention (IG; n = 35) or a control group (CG; n = 35). The IG participated every working day (during working hours) in a 6-month supervised combined (flexibility, strength, and balance) exercise program (120 training sessions; five times/week) for the total body. The CG did not participate in any intervention. Musculoskeletal pains in nine body areas and functional capacity (flexibility, balance, and strength) of the lower and upper body were measured before and following the intervention. The IG significantly reduced duration and intensity of pain (43.1-70%; p = 0.000) as well as days of work absenteeism (84.6%; p = 0.000), while improving work capacity (87.1%; p = 0.000). Furthermore, the IG significantly increased cervical, handgrip, back, and leg maximal strength (10.3-27.1%; p = 0.000) and flexibility and balance (12.3-73.7%; p = 0.000). In CG, all musculoskeletal pain and functional capacity indices remained unchanged. In conclusion, this program may be effectively used to reduce musculoskeletal pain and improve functional capacity.

The effect of various therapeutic exercises on forward head posture, rounded shoulder, and hyperkyphosis among people with upper crossed syndrome: a systematic review and meta-analysis

OBJECTIVES

This review study aimed to evaluate the impact of therapeutic exercises on Upper-Crossed Syndrome (UCS). The study utilized a systematic review and meta-analysis approach to investigate the effects of various therapeutic exercises on forward head posture, rounded shoulders, and hyperkyphosis associated with upper crossed syndrome.

METHODS

The study identified relevant keywords for each independent and dependent variable and conducted a search in scientific databases, including PubMed, Web of Science, Scopus, and Google Scholar, without any time limitations until 12 August 2023. Overall, 4625 articles were found in the selected databases, which were reduced to 1085 after being entered into the EndNote software and removing duplicate data. The full texts of 30 remaining studies were reviewed; ten articles meeting the criteria were included. Additionally, 12 studies from the Google Scholar database were included, resulting in 22 studies. Using Comprehensive meta-analysis software (CMA ver 3), data heterogeneity was measured with I2 and the Q tests. The Funnel Plot and Egger test methods were utilized to determine the possibility of publication bias. The JBI checklist was used to assess the quality of the studies.

RESULTS

The results of the meta-analysis showed that therapeutic exercises were effective in improving forward head, rounded shoulders, and thoracic kyphosis angles (CI 95% = -1.85-1.161, P = 0.001, P = 0.001, CI95%=-1.822-1.15, and P = 0.001, CI 95%= -1.83-1.09, respectively).

CONCLUSION

Based on the results, it appears that performing therapeutic exercises in the form of strength exercises, stretching, shoulder-based exercises, and incredibly comprehensive exercises that target all muscles may be effective in reducing forward head, rounded shoulders, thoracic kyphosis, and overall UCS.

LEVEL OF EVIDENCE: 1

Effects of Interactive Telerehabilitation Practices in Office Workers with Chronic Nonspecific Neck Pain: Randomized Controlled Study

Aim: Aim of this study is to investigate the effects of interactive telerehabilitation exercises in office workers with chronic nonspecific neck pain. Methods: Office workers (n = 120) were randomly divided into three groups between February and July 2022, taking into account the inclusion and exclusion criteria, and office ergonomics training was given to all of the participants. Group 1 participants were given an interactive telerehabilitation program (strengthening, motor control, and posture correction exercises) for 45 min per day, 3 days a week, for a total of 6 weeks. Group 2 participants were trained to do the home exercise program on their own for 45 min per day, 3 days a week, for a total of 6 weeks. Only office ergonomics training was given to Group 3 patients. Results: Statistically significant improvement in pain (p < 0.001), range of motion (ROM) (p < 0.001), neck disability status (p < 0.001), functional status (p < 0.001), and quality of life (p < 0.001) of 6-week interactive telerehabilitation application in office workers was found. Discussion: In addition to office ergonomics training, interactive telerehabilitation program is the most effective method on pain, ROM, and neck disability compared with home exercise program and office ergonomics training alone, and studies are needed on the long-term effectiveness of telerehabilitation applications and telerehabilitation treatment diversity.

Physiotherapeutic Interventions for Upper Cross Syndrome: A Systematic Review and Meta-Analysis

Upper cross syndrome is a postural dysfunction that can cause a variety of upper-body musculoskeletal problems. Early detection and physiotherapy can help to prevent further complications. However, no systematic review has evaluated the effect of various physiotherapy intervention strategies to treat this syndrome. Therefore, this study aims to conduct a detailed methodological literature search of the most effective treatment strategies available for the correction of upper cross syndrome. Prospective human subject studies published in the English language that report the assessment and rehabilitation of upper cross syndrome were included. Clinical trials (randomized and non-randomized) were included when compared to a comparator, control group, and no treatment. The search was limited to human subjects and English-language articles. Outcome measures included craniovertebral angle, kyphotic angle, rounded shoulder, neck or shoulder pain, neck range of motion, electromyographic activity of neck or scapular muscles, and functional limitations. To evaluate the methodological quality of randomized controlled trials, the Cochrane collaboration tool was employed. For non-randomized studies, the Risk of Bias in Non-randomized Studies of Intervention was used. The Grading of Recommendations, Assessment, Development, and Evaluation system was used to rate the effectiveness of the evidence. A random-effect meta-analysis was performed for quantitative analysis to report significant differences based on calculated mean differences, with matching 95% confidence intervals (CIs) whenever possible. Out of the 34 potentially relevant articles, 18 were included. The postural variables including craniovertebral angle, kyphotic angle, and rounded shoulder showed a significant improvement with the physiotherapy group compared to the no-treatment group (standardized mean difference = -1.78; 95% CI = -2.68 to -0.87; p = 0.0001). Secondary outcomes such as pain and functional limitation showed a significant difference when advanced manual therapy techniques were used compared to conventional therapy (standardized mean difference = -0.71; 95% CI = -1.04 to -0.39; p< 0.0001; and standardized mean difference = -0.57; 95% CI = -1.00 to -0.14; p = 0.009, respectively). Exercise therapy was found to be beneficial in correcting postural alignment and movement patterns, while manual therapy was found to be similarly effective in pain reduction and functional improvement.

Treatment of Upper Crossed Syndrome: A Narrative Systematic Review

BACKGROUND AND OBJECTIVES

Upper crossed syndrome (UCS) is a common musculoskeletal condition that is characterized by tightness and weakness of the muscles of the neck, shoulders, and upper back. The aim of this current study is to summarize and provide an overview of the treatment in patients with UCS.

MATERIALS AND METHODS

A MEDLINE (PubMed), Cochrane library, Embase, Scopus, and Web of Science database search was conducted for English-language articles about upper crossed syndrome that were published until 19 January 2023. To identify potentially relevant articles, the following key search phrases were combined: "upper crossed syndrome", "upper cross syndrome", "diagnosis", and "treatment". A total of 233 articles were identified. After reading the titles and abstracts and assessing their eligibility based on the full-text articles, 11 articles were finally included in this review. The risk of bias (RoB) was assessed using RoB-2 and ROBINS-I for the randomized controlled trials (RCTs) and the non-randomized clinical trial (non-RCT), respectively.

RESULTS

Among eleven studies that investigated the effect of treatment programs for UCS, five studies compared the therapeutic effect of exercise programs with controls, whereas six compared different rehabilitative treatment strategies, such as the muscle energy technique, soft-tissue mobilization, and stretching exercises. In addition, regarding the study design, ten studies were RCTs and only one study was a prospective observational study.

CONCLUSIONS

Treatment programs including various types of exercises and techniques to correct an abnormal posture and restore neuromuscular imbalances are effective for decreasing pain and improving neck disabilities and postural deviations in patients with UCS.

Physiological State Evaluation in Working Environment Using Expert System and Random Forest Machine Learning Algorithm

Healthy lifestyle is one of the most important factors in the prevention of premature deaths, chronic diseases, productivity loss, obesity, and other economic and social aspects. The workplace plays an important role in promoting the physical activity and wellbeing of employees. Previous studies are mostly focused on individual interviews, various questionnaires that are a conceptual information about individual health state and might change according to question formulation, specialist competence, and other aspects. In this paper the work ability was mostly related to the employee's physiological state, which consists of three separate systems: cardiovascular, muscular, and neural. Each state consists of several exercises or tests that need to be performed one after another. The proposed data transformation uses fuzzy logic and different membership functions with three or five thresholds, according to the analyzed physiological feature. The transformed datasets are then classified into three stages that correspond to good, moderate, and poor health condition using machine learning techniques. A three-part Random Forest method was applied, where each part corresponds to a separate system. The obtained testing accuracies were 93%, 87%, and 73% for cardiovascular, muscular, and neural human body systems, respectively. The results indicate that the proposed work ability evaluation process may become a good tool for the prevention of possible accidents at work, chronic fatigue, or other health problems.

Evaluation of a Workplace Active Rest Program in Office Workers With Comparison of a Prospective and Retrospective Survey

Physical activity-related workplace interventions can be counterstrategies for physical inactivity due to office work. Newly introduced programs should be evaluated for success. This study aimed to evaluate the intervention of a workplace active rest program and to compare a prospective and retrospective design of evaluation. A Germany-wide multicenter evaluation of a 3-month workplace active rest program (30 min, once a week) was carried out at 14 locations with a longitudinal pre/post design by means of an anonymous questionnaire (npre = 405, npost = 369). The participants' program-related changes in targeted characteristics regarding posture, function, complaints and physical awareness were collected with a questionnaire in a prospective design and afterward retrospectively. The prospective evaluation showed a significant improvement in the target characteristic "postural muscles in the neck area". In the retrospective survey, all target characteristics improved significantly. There were no differences between locations. The workplace active rest program in this study had positive effects on the perception of postural neck muscle status regardless of prospective or retrospective approach. Selection of survey mode should depend on desired outcome and consecutive influencing factors. In this specific case, retrospective survey could give more indirect information about overall satisfaction with the program and job although being influenced by response bias. Recall bias should be relatively small for shorter time periods assessed. Future studies should account for corresponding bias and specifics of target characteristics regardless of the chosen approach to survey.

Measuring the Efficacy of Myofascial Rollers and Post-isometric Relaxation Technique in Relieving Pain Intensity and Postural Deviation Using Plumb Line Assessment for the Treatment of Upper Cross Syndrome in Dental Undergraduate (UG) Students

BACKGROUND

In today's world, the upper cross syndrome is growing more common and becoming very prevalent among dental undergraduate practitioners. One of the most important conditions for which dentists seek physiotherapy treatment is neck pain. It is characterized by overactive pectoralis and trapezius muscles. It is frequently linked to poor posture in dental students' daily life, causing them to miss their work.

OBJECTIVES

The first objective of our study was to find the efficacy of myofascial rollers and post-isometric relaxation technique along with conventional therapy for pain relief and correction of postural deviation in undergraduate dental students. And, the second objective of the study was to compare the effect of myofascial rollers and post-isometric relaxation techniques in upper cross syndrome.

METHODS

The study was conducted with pre-test and post-test methods. The study consisted of 80 participants who were included based on our inclusion and exclusion criteria. The study sample was randomly assigned into two groups. Each group consisted of a total of 40 participants. Group A was treated using myofascial rollers and hot packs, and Group B was treated using the post-isometric relaxation technique and hot packs. Patients were asked to mark their intensity of pain on the Numerical Pain Rating Scale and an assessment of postural deviations (in mm) was noted through a plumb line in the posture grid. Posture assessment was done in lateral view. The protocol covered four weeks of treatment based on the defined protocol. Finally, the t-square test and Chi-square test were used to compare the difference in the result. Also, the level of significance was kept at <0.05.

RESULT

Statistical analysis was done using descriptive and inferential statistics using student paired, unpaired, and chi-square test. IBM SPSS Statistics for Windows, Version 27.0 (Released 2020; IBM Corp., Armonk, New York, United States) was used. The Numerical Pain Rating Scale showed mean deviations of (4.15±1.29) for Group A and (3.30±1.01) for Group B. Plumb line assessment showed mean deviations of (9.09±4.31) for Group A and (6.33±2.36) for Group B. Also, Numerical Pain Rating Scale showed (t=3.26, p=0.002) and Plumb line deviation showed (t=3.57, p=0.001).

CONCLUSION

Through our study, we conclude that statistically no significant differences were found in pre-intervention and post-intervention, but myofascial rollers gave better results as compared to the post-isometric relaxation technique in alleviating pain and correcting postural deviation.