Concentric Versus Eccentric Muscle Energy Technique on Upper Cross Syndrome
Condition: Neck Syndrome
MeSH terms: Syndrome
Study type: Interventional

Summary: 
      This project was a Randomized control trial conducted to check the effects of eccentric and
      concentric muscle energy techniques on patients with upper cross syndrome so that we can have
      best treatment option for patients with upper cross syndrome, duration was of
      6months,convenient sampling was done, subject following eligibility criteria from Mansoura
      hospital female physiotherapy department, Lahore were randomly allocated in two groups via
      lottery method, baseline assessment was done, Group A participants were given conservative
      treatment along with eccentric muscle energy technique and Group B participants were given
      conservative treatment along with concentric muscle energy technique than on 1st,3rdand 6th
      week post intervention assessment was done via neck disability index, Numeric rating scale,
      inches tape method,3 sessions per week were given, data was analyzed by using SPSS version
      26.
    

Detailed description: 
      In Upper cross syndrome upper trapezius, pectoralis major, and levator scapulae become tight
      and rhomboids , serratus anterior, middle and lower trapezius, and deep neck flexors,
      including scalene becomes weak. The postural muscles have tendency to become tight while the
      phasic muscles have tendency to become weak and inhibited. Thus typical pattern of altered
      posture and muscular imbalance occurs whenever dysfunction of muscle start. mainly muscular
      imbalance between weak and tonic muscles leads toward this upper cross syndrome. Soft tissue
      and cervical spine disorders are found out to be the major contributor in neck pain but when
      postural abnormality becomes the reason behind neck ache than this is categorized as Upper
      cross syndrome due to this imbalance in muscles our body has to suffer from severe
      consequences.rounded shoulder posture is a result of protracted girdle of shoulder due to
      muscular imbalances between agonist and antagonist muscles resulting in extreme pain and
      exaggerated cervical curvature.Imbalanced stress on cervical vertebrae is responsible in
      creating extra pull on neck and head similarly change in normal posture is responsible in
      overloading, weakening or tightening of cervical area. Characteristics of patient presenting
      with UCS will have forward head posture, kyphosis ,hunch of thoracic spine (rounded
      shoulder),winged scapulae, protracted and elevated shoulder and reduced thoracic spine
      mobility. UCS with the passage of time can detoriate persons physical fitness and health ,it
      is not only responsible for changes in posture of upper back i.e hypokyphosis over time, but
      it is also responsible for inducing respiratory problems including asthma. It also cause neck
      back shoulder and chest wall pain, this pain can be caused by muscular imbalance leading to
      overuse and fatigue of muscle because of movement dysfunction of back and neck.when muscles
      become fatigued they start generating more amount of inflammatory chemicals resulting in
      becoming more sore and increased spasticity. With the passage of time biomechanical and
      postural changing will induce osteoarthritis in upper thoracic and lower cervical spine in
      early ages. Functional Shoulder impingement syndrome is also considered to be another
      complication of Upper cross syndrome. Therefore it is necessary to correctly diagnose and
      treat this condition before its complication starts worsening.
    

Intervention name(s): Eccentric Muscle Energy Technique; Concentric muscle energy technique
Intervention type(s): Other; Other
Intervention description(s): Conventional Treatment given to both groups (Hot pack for 15 minutes, Mobilization, AROM Exercises 10 sets x 3days in a week)
Reciprocal inhibition of target muscle (i.e. levator scapulae ,pectoralis major, upper trapezius) causing relaxation, patient force is minimal towards maximal therapist force, 5-7 repetition for 2-4seconds 3 days in a week up to 6 weeks.
Muscle is taken from shortened to lengthened position.; Group B: Concentric Muscle Energy Technique: (Autogenic inhibition of target muscle (i.e. levator scapulae ,pectoralis major, upper trapezius) patient force is greater than therapist force, 5-7repitition for 3-4seconds)Muscle is taken from lengthened to shortened position.
On eligible participants baseline assessment was done,3 session were given 3days per week, post intervention assessment was taken at 1st 3rd and 6th week
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: upper cross syndrome,; MET,; NDI,; NPRS