Effects of Bruegger's Versus Kendall Exercises in Cervical Postural Syndrome

Cervical Postural Syndrome is an uncomfortable and painful condition characterized by a protruding chin and rounded shoulders, commonly resulting from poor posture in the neck, middle back, and shoulders. This syndrome often leads to an excessive forward curvature of the upper back, causing the chin to jut forward and the shoulders to hunch forward. A prevalent cervical abnormality associated with this condition is the forward head position, which increases the risk of neck pain. The entire clinical condition is referred to as "sterno-symphyseal syndrome" by Bruegger. He describes the muscles involved as "painfully tense and painfully weak." Bruegger's exercises are designed to align the spine correctly by strengthening the scapular and neck muscles. Similarly, Kendall's exercises focus on restoring cervical spine alignment, particularly for individuals with forward head posture, by targeting the shoulder extensors and deep neck flexors. While numerous studies have examined the direct effects of forward head posture on the cervical spine, there is limited research comparing the effectiveness of Bruegger's exercises and Kendall's exercises, particularly regarding exercises that do not directly target the neck.

Cervical Postural Syndrome is a common and painful condition characterized by a projecting chin and rounded shoulders, resulting from poor posture in the neck, middle back, and shoulders. This syndrome often causes an exaggerated forward curvature of the upper back, leading to a forward-protruding chin and forward-sitting shoulders. The forward head position is a prevalent cervical issue that increases the risk of neck pain. Bruegger refers to this condition as "sterno-symphyseal syndrome," describing the involved muscles as "painfully tense and painfully weak." Bruegger's exercises aim to correct spinal alignment by strengthening the scapular and neck muscles. Kendall's exercises focus on restoring cervical spine alignment, especially for those with forward head posture, by strengthening the shoulder extensors and deep neck flexors. While many studies have examined the direct impact of forward head posture on the cervical spine, there is limited research comparing the effectiveness of Bruegger's exercises and Kendall's exercises, particularly for exercises that do not directly target the neck.

The objective of this study will be to compare the effects of Bruegger's exercises and Kendall's exercises on pain, range of motion, craniovertebral angle, and functional disability in patients with Cervical Postural Syndrome.

A randomized clinical trial will be conducted at Rasheed Hospital, using a non-probability convenient sampling technique on 36 patients who will be divided into two groups. One group will follow the Bruegger's exercises protocol, while the other group will follow Kendall's exercises. The protocol duration will be six weeks, with sessions three times a week. Each session will consist of one set of 10 repetitions for each movement, repeated for three sets, with a 10-second rest per repetition, a one-minute rest after each set, and a three-minute rest between each movement. Outcome measures will include pain, range of motion, craniovertebral angle, and functional disability. Data will be collected before and after the training sessions. The data will be entered and analyzed using SPSS version 25, and the Shapiro-Wilk test will be applied to determine the normality of the data.

Eligibility Criteria:
Inclusion Criteria:

* Age range: 20-40
* A patient who has neither "specific pain" nor "poor posture."
* A cranio-vertebral angle (CVA) of less than 52 degrees
* A Numeric Pain Rating Scale (NPRS) score of fewer than 7
* A Neck Disability Index score of greater than 10 (NDI)

Exclusion Criteria:

* Surgery on the neck or back
* Recent trauma history
* Malignancy
* Cervical dysfunction-related neurological symptoms
* Temporomandibular joint surgery
* Recent fractures or injuries