Effect of a Comprehensive Corrective Exercise Program With and Without Instrument-Assisted Soft Tissue Mobilization on Cervical Range of Motion, Muscle Strength, Disability, and Postural Alignment in Individuals With Upper-Crossed Syndrome

This study is a double-blind, parallel-group randomized controlled trial designed to evaluate the effectiveness of a Comprehensive Corrective Exercise Program (CCEP) with and without Instrument-Assisted Soft Tissue Mobilization (IASTM) in individuals with Upper-Crossed Syndrome (UCS). UCS is a common postural dysfunction characterized by muscular imbalance, including tightness of the upper trapezius, levator scapulae, and pectoral muscles, along with weakness of the deep cervical flexors and scapular stabilizers. This imbalance leads to forward head posture, rounded shoulders, neck pain, reduced cervical mobility, and functional limitations, particularly in individuals exposed to prolonged sedentary activities and poor ergonomic conditions. A total of 60 participants aged 18-40 years diagnosed with Upper-Crossed Syndrome will be recruited and randomly allocated into two groups. The control group will receive a structured Comprehensive Corrective Exercise Program (CCEP), while the experimental group will receive the same exercise program combined with Instrument-Assisted Soft Tissue Mobilization (IASTM). Both interventions will be administered three times per week for six weeks under the supervision of a trained physiotherapist. Outcome measures will be assessed at baseline and after completion of the intervention period. Primary outcomes include cervical range of motion, muscle strength assessed by the Deep Neck Flexor endurance test, functional disability measured using the Neck Disability Index, and postural alignment assessed using a plumb line method. The aim of this study is to determine whether the addition of IASTM to a corrective exercise program results in superior improvements in cervical mobility, muscle strength, functional disability, and postural alignment compared to corrective exercise alone. It is hypothesized that the combined intervention will produce greater clinical improvements in individuals with Upper-Crossed Syndrome.

Inclusion Criteria: * Age between 18-40 years * Both males and females * Diagnosed with Upper-Crossed Syndrome * Presence of forward head posture and rounded shoulders * Chronic neck pain related to postural dysfunction Exclusion Criteria: * History of cervical spine surgery or fracture * Neurological conditions (e.g., radiculopathy, myelopathy) * Systemic musculoskeletal disorders (e.g., rheumatoid arthritis) * Current physiotherapy treatment for neck pain * Skin conditions preventing IASTM application