Authors :
Swapnagandha Deepak Deokar; Dr. Vaishali Kale; Dr. R. S. Gangatharan
Volume/Issue :
Volume 11 - 2026, Issue 2 - February
Google Scholar :
https://tinyurl.com/ycdcxvr5
Scribd :
https://tinyurl.com/yfa5ymhh
DOI :
https://doi.org/10.38124/ijisrt/26feb1369
Note : A published paper may take 4-5 working days from the publication date to appear in PlumX Metrics, Semantic Scholar, and ResearchGate.
Abstract :
Background:
Upper Cross Syndrome (UCS) is a common postural disorder caused by muscle imbalance producing tight and weak
crossed muscle patterns, resulting in neck pain, poor posture, reduced strength, and functional limitations, especially in
sedentary individuals and affects occupational performance.
Aim:
To compare mirror biofeedback either versus combined with functional Proprioceptive Neuromuscular Facilitation
(PNF) on pain, disability, strength, and posture in UCS patient.
Methodology:
Comparative study on 60 participants aged 25–45 years were randomized into two groups: Mirror biofeedback either
and Mirror biofeedback + functional PNF, treated thricely/week for 4 weeks with home exercises; NPAD, MMT, Postural
assessment were measured. Treatment duration followed standardized protocol.
Results:
Both groups improved, but Mirror biofeedback + functional PNF showed greater gains (NPAD 47.33–28.67; MMT
3.07–4.83) than biofeedback either (47.2–33.53; 3.03–4.37).
Conclusion:
Mirror biofeedback is effective, but adding functional PNF provides superior improvements in pain, strength, and
posture, combined visual and proprioceptive facilitation effects, which enhance neuromuscular control, motor learning, and
postural correction supporting multimodal rehabilitation for UCS. This approach enhances neuromuscular control, motor
learning, and postural correction without adverse effects in participants.
Limitation:
Small sample size, short intervention period, convenience sampling may affect generalizability, supervised treatment
for only thricely/week, lack of long-term follow-up.
Keywords :
Upper Cross Syndrome, Mirror Biofeedback, Functional PNF, Posture Correction.
References :
- Chaudhuri S, Chawla JK, Phadke V. Physiotherapeutic interventions for upper cross syndrome: a systematic review and meta-analysis. Cureus. 2023 Sep 18;15(9):e45471. doi:10.7759/cureus.45471.
- Chang MC, Choo YJ, Hong K, Boudier-Revéret M, Yang S. Treatment of upper crossed syndrome: a narrative systematic review. Healthcare (Basel). 2023 Aug 17;11(16):2328. doi:10.3390/healthcare11162328.
- Aneis YM, El-Badrawy NM, El-Ganainy AA, Atta HK. The effectiveness of a multimodal approach in the treatment of patients with upper crossed syndrome: a randomized controlled trial. J Bodyw Mov Ther. 2022 Oct;32:130-136. doi:10.1016/j.jbmt.2022.05.011.
- Kaur S, Chatterjee S, Goyal M, Popli A, Goyal K, Saha M, Garg S, Sushma KC. Physiotherapeutic approaches in upper cross syndrome: a systematic review of systematic reviews. J Bodyw Mov Ther. 2025 Jun;42:756-762. doi:10.1016/j.jbmt.2025.01.005.
- Nemati M, Saki F, Ramezani F. Adding respiratory exercises to scapular stabilization training in adolescent girls with upper cross syndrome: a randomized controlled trial. BMC Sports Sci Med Rehabil. 2025 Nov 11;17(1):331. doi:10.1186/s13102-025-01390-1.
- Bai Z, Fong KNK, Zhang J, Hu Z. Cortical mapping of mirror visual feedback training for unilateral upper extremity: a functional near-infrared spectroscopy study. Brain Behav. 2020 Jan;10(1):e01489. doi:10.1002/brb3.1489.
- George J, Maqsood M, Ahmed HS, Muhammad AS, Abdelrehim ZM, Ezzi J, Rehman A, Abdeldayem TS. The efficacy of proprioceptive neuromuscular facilitation techniques in improving range of motion and strength: a systematic review. SEEJPH. 2025;XXVI(S1).
- Wheeler AH, Goolkasian P, Baird AC, Darden BV 2nd. Development of the Neck Pain and Disability Scale: item analysis, face, and criterion-related validity. Spine (Phila Pa 1976). 1999 Jul 1;24(13):1290-4. doi:10.1097/00007632-199907010-00004.
- Goolkasian P, Wheeler AH, Gretz SS. The neck pain and disability scale: test-retest reliability and construct validity. Clin J Pain. 2002 Jul-Aug;18(4):245-50. doi:10.1097/00002508-200207000-00005.
- Cuthbert SC, Goodheart GJ Jr. On the reliability and validity of manual muscle testing: a literature review. Chiropr Osteopat. 2007 Mar 6;15:4. doi:10.1186/1746-1340-15-4.
- Bai Z, Fong KNK, Zhang J, Hu Z. Cortical mapping of mirror visual feedback training for unilateral upper extremity: a functional near-infrared spectroscopy study. Brain Behav. 2020;10(1):e01489.
Background:
Upper Cross Syndrome (UCS) is a common postural disorder caused by muscle imbalance producing tight and weak
crossed muscle patterns, resulting in neck pain, poor posture, reduced strength, and functional limitations, especially in
sedentary individuals and affects occupational performance.
Aim:
To compare mirror biofeedback either versus combined with functional Proprioceptive Neuromuscular Facilitation
(PNF) on pain, disability, strength, and posture in UCS patient.
Methodology:
Comparative study on 60 participants aged 25–45 years were randomized into two groups: Mirror biofeedback either
and Mirror biofeedback + functional PNF, treated thricely/week for 4 weeks with home exercises; NPAD, MMT, Postural
assessment were measured. Treatment duration followed standardized protocol.
Results:
Both groups improved, but Mirror biofeedback + functional PNF showed greater gains (NPAD 47.33–28.67; MMT
3.07–4.83) than biofeedback either (47.2–33.53; 3.03–4.37).
Conclusion:
Mirror biofeedback is effective, but adding functional PNF provides superior improvements in pain, strength, and
posture, combined visual and proprioceptive facilitation effects, which enhance neuromuscular control, motor learning, and
postural correction supporting multimodal rehabilitation for UCS. This approach enhances neuromuscular control, motor
learning, and postural correction without adverse effects in participants.
Limitation:
Small sample size, short intervention period, convenience sampling may affect generalizability, supervised treatment
for only thricely/week, lack of long-term follow-up.
Keywords :
Upper Cross Syndrome, Mirror Biofeedback, Functional PNF, Posture Correction.