Global postural re-education versus Egoscue exercises in upper cross syndrome on neck pain, forward head and rounded shoulder posture: a randomised clinical trial

Upper crossed syndrome (UCS) is a condition that is caused due to alternating tightness and weakness in the opposite muscle groups of the neck, shoulders, and upper back which results in abnormal postural deviations. Global postural re-education (GPR) and Egoscue exercises (EE) aim to improve postural alignment and reduce musculoskeletal discomfort by maintaining certain postures. There is a lack of literature where these approaches are not compared and hence the need arises to evaluate their efficacy in the management of UCS. A randomised clinical trial was conducted on 34 individuals with UCS, where 17 individuals were randomly allocated into two groups, i.e. Group A (GPR) and Group B (EE). Both groups received conventional therapy (hot moist pack and interferential current therapy) 3 times/week for 4 weeks. Outcome measures like craniovertebral angle (CVA), pectoralis minor index (PMI), tragus to wall test (TTW), deep cervical flexors endurance, neck disability index (NDI), and patient satisfaction were assessed at baseline and on day 12 post-treatment. Within group analysis has shown statistical significant improvement in all the outcomes (P < 0.05). Between group analysis has shown both interventions to be equally effective in CVA (P = 0.375), PMI (P = 0.658), TTW (P = 0.085), deep cervical flexors endurance (P = 0.812), NDI (P = 0.708) and patient satisfaction scale (PSS) (P = 0.245) in individuals with UCS. In conclusion, both the interventions were equally effective and can be included in the protocol for the better outcomes in musculoskeletal dysfunctions. This present trial was prospectively registered in the Clinical Trial Registry of India with registration number CTRI/2023/10/059361.