ELDOA's Effect in Upper Cross Syndrome

The aim of this randomized clinical trial is to find the effects of ELDOA on decreasing pain ,kyphosis , improving range of motion and reducing disability

Upper Cross Syndrome(UCS) is stress over the neck region due to poor posture and ergonomics, particularly sitting or standing. This syndrome can cause joint impairments, mainly targeting the atlanto-occipital joint, shoulder joint, C4-C5, and T4-T5 region . Poor posture can lead to stress on the cervico-thoracic or cervico-cranial junction. Upper crossed syndrome is given its name because an "X," in other words, a cross, can be drawn across the upper body. One arm of the cross indicates the muscles that are typically tight, and the other arm of the cross shows the muscles that are usually weak. Predominantly, the syndrome mainly occurs as a result of muscular imbalance that usually develops between tonic and weak muscles. This imbalance causes postural changes including forward head posture (FHP), hunching of the thoracic spine (rounded upper back), increased cervical lordosis, elevated and protracted shoulders, and scapular winging. The upper cross syndrome can lead to cervical and upper back pain and movement restrictions due to muscle imbalances, consequently causing poor quality of life.

ELDOA is a French acronym. The myofascial ELDOA technique was first described by Guy Voyer in 1979, which is also called LOADS (longitudinal osteoarticular de-coaptation stretching.It is based on active traction exercises for spacing the joint, fascial and spinal stretching by assuming a specific posture for 1 min. It targets spinal strengthening and decompression. ELDOA has originated from various treatment approaches and creates local and general effects. It allows decompression of zygopopheasal joints, more absorption of fluids in the disc, increase circulation, improve tone and end range. It also allows the correction of impaired posture, improving respiration and proprioceptive facilitation of the concerned segment. Myofascial tension induced between superior vertebra which is a wandering point and the inferior vertebrae which is a fixed point. Verbal cues are given to the subject for the encouragement goals and for maintaining proper position and not dropping a pose. Several conditions have been treated with ELDOA, including prolapsed intervertebral discs, piriformis syndrome, chronic low back pain, cervical radiculopathy, active trigger points, and forward head posture. Disc encryption existing at any level of the spine can be addressed through specific ELDOA poses.

The Rational of the present study is to determine the effects of ELDOA on decreasing pain, kyphosis, improving range of motion and reducing disability.

Eligibility Criteria:
Inclusion Criteria:

* Forward head posture (Measuring Tape used to record the tragus and wall distance in (cm) ,with considering the normative value 10 to 1055 cm in females and male respectively)
* Limited cervical range of motion (Flexion: less than 80◦, Extension: less than 70◦, Rotation: less than 90◦ both sides., Lateral flexion: less than 20◦)
* Kyphosis measure through flexi curve ruler
* Neck Pain more than 3 on NPRS scale

Exclusion Criteria:

* Participants having complaints of dizziness
* History of surgery or fracture
* Severe skin sensitization
* Cervical radiculopathy
* Trauma of upper extremity
* Malignancy of the upper limb or thorax
* Scoliosis