Effects of Comprehensive Correcting Exercise Program and Mckenzie Exercises in Patients With Sternosymphyseal Syndrome

A Randomized Clinical Trial will be conducted at Horizon Hospital Physiotherapy Department and Riphah Clinic Lahore through consecutive sampling technique on 36 patients which will be allocated using simple random sampling through sealed opaque enveloped into Group A and Group B. Group A will be treated with comprehensive correcting exercise program (three times a week for 6 weeks) into 3 phases with different intensity and frequency. Group B will receive the McKenzie's method of exercises that include Deep neck flexor (chin tucks), Shoulders shrug McKenzie exercise for neck, Repeated shoulder flexion/Extension, Neck flexion McKenzie exercises. Outcome measure will be conducted through pain and functional disability Index through questionnaire and craniovertebral angle through PhysioMaster/APECS, Thoracic kyphosis through Inclinometer and Range of motion via goniometer.

Sternosymphyseal syndrome is a postural syndrome involves excessive lumbar and thoracic kyphosis, a forward drawn head, and hyper-lordosis of the cervicocranial junction. This posture is associated with increased muscular tension and faulty respiration habits. When the slumped posture is assumed for sustained periods of time, increased load is placed on the intervertebral disc. With the sternum approximating the pubic symphysis, diaphragmatic inhibition results in over-activation of scalene and upper trapezius musculature during respiration. This muscle tension is reversible by merely having the patient sit up straight. (Brugger's relief position).

A Randomized Clinical Trial will be conducted at Horizon Hospital Physiotherapy Department and Riphah Clinic Lahore through consecutive sampling technique on 36 patients which will be allocated using simple random sampling through sealed opaque enveloped into Group A and Group B. Group A will be treated with comprehensive correcting exercise program (three times a week for 6 weeks) into 3 phases with different intensity and frequency. Group B will receive the McKenzie's method of exercises that include Deep neck flexor (chin tucks), Shoulders shrug McKenzie exercise for neck, Repeated shoulder flexion/Extension, Neck flexion McKenzie exercises. Outcome measure will be conducted through pain and functional disability Index through questionnaire and craniovertebral angle through PhysioMaster/APECS, Thoracic kyphosis through Inclinometer and Range of motion via goniometer.

Eligibility Criteria:
Inclusion Criteria:

* Age between 18-28
* Both gender male and female
* Participants who have any distance from xiphoid process to pubic symphysis less than 18cm (11 inches)
* Participants with forward head (≥ 44°), round shoulder (≥ 49°) or excessive thoracic kyphosis (≥ 42°) will be measured by photography and flexicurve. Patient agree to sign written consent

Exclusion Criteria:

* Subjects younger than 18 years of age, cardiac, respiratory, kidney, circulatory problems, systemic disease, diabetes
* Any trauma or localized infection in neck region
* Pregnancy or suspicion of pregnancy for female subjects.
* A history of fractures, treatment or surgery to the lumbar, thoracic, cervical spine and upper limbs
* Thoracic outlet syndrome.
* Any shoulder pathology causing limitation of movement.