The Efficacy of Manual Therapy and Muscle Energy Techniques in the management of the Upper (Proximal) crossed syndrome: a randomized controlled cross-sectional study.

Prof. Umasankar Mohanty, B.P.T, M.P.T (Manual Therapy), F.A.G.E

Background and Purpose of the study: The muscles of the cervical spine play a major role in maintaining proper neck orientation. According to Vladimir Janda there are certain muscles like levator scapulae, upper trapezius, pectoral muscles and sternocleidomastoid go for tightness and certain other muscles like deep neck flexors and lower stabilizers of the scapulae exhibit muscular weakness. In established cases the symptoms arises because of muscular and joint (cervical and shoulder) dysfunctions. The above condition arising because of important muscle imbalance is called as the Proximal (Upper) Crossed syndrome (Vladimir Janda). The purpose of the study was to determine the efficacy of the different manipulative techniques in intervention of upper Crossed Syndrome.  

Materials and methods: The study was conducted by the investigator in the Govt. Wenlock hospital, A.J. Hospital and Laxmi Memorial College of Physiotherapy in last 2 years. Thirty Four subjects (25 males+ 9 females) were selected for the study. The subjects were randomly assigned into two groups i.e. experimental (13 males+5 females) and control group (12 males+4 females). Subjects in the Experimental group were treated by mobilization of the joint (cervical spine and the shoulder complex), PIR techniques for the shortened muscles and the RIM’s for the weak muscles. The control group was treated with conventional treatment with the electrotherapy modalities. The implication of the study was determined by VAS scale and the McGill pain questionnaire.      

Results: The results were analysed by T-test for independent samples using SPSS package 7.5 version. The result of the experimental group was found to be superior than the control group at p<.005.