Effects of Telerehabilitation Combining Diaphragmatic Breathing Re-Education and Shoulder Stabilization Exercises on Neck Pain, Posture, and Function in Young Adult Men with Upper Crossed Syndrome: A Randomized Controlled Trial

Q: What was the purpose of this randomized controlled trial?

To investigate the effects of telerehabilitation that combined diaphragmatic breathing re-education with shoulder stabilization exercises on neck pain, posture, and function in young adult men with upper crossed syndrome over four weeks.

Q: How were the participants divided and how often were they trained?

Thirty-seven participants in their 20s and 30s were randomly divided into experimental and control groups. Both groups trained three times per week for four weeks via telerehabilitation.

Q: What outcomes improved after four weeks, and were there differences between groups?

After four weeks, both groups improved in measures including pain pressure threshold, craniovertebral angle, rounded shoulder posture, shoulder tilt, neck disability index, and upper extremity stability. There was a significant interaction effect for certain right-side outcomes, indicating greater benefit for the combined training group.

Sep 5, 2026

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Forward head posture and rounded shoulder posture are common postural variants in upper crossed syndrome, contributing to reduced neck mobility and respiratory-related complaints. This randomized controlled trial evaluated telerehabilitation over four weeks in young adult men with upper crossed syndrome, comparing a program combining diaphragmatic breathing re-education with shoulder stabilization exercises versus shoulder stabilization exercises alone. Thirty-seven participants were allocated into experimental and control groups and trained three times weekly.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages14

Reading Time35 min

AccessFree to download

Introduction

Upper crossed syndrome and postural impairments

Methods

Participants and group assignment

Intervention protocol and outcome evaluation

Results

Within-group pre–post changes

Time and interaction effects

Article Effects of Telerehabilitation Combining Diaphragmatic Breathing Re-Education and Shoulder Stabilization Exercises on Neck Pain, Posture, and Function in Young Adult Men with Upper Crossed Syndrome: A Randomized Controlled Trial Gyeong-Hyeon Jeong 1 and Byoung-Hee Lee 2, * Citation: Jeong, G.-H.; Lee, B.-H. Effects of Telerehabilitation Combining Diaphragmatic Breathing Re-Education and Shoulder Stabilization Exercises on Neck Pain, Posture, and Function in Young Adult Men with Upper Crossed Syndrome: A Randomized Controlled Trial. J. Clin. Med. 2024, 13, 1612. [https://](https://)[ ](https://)[doi.org/10.3390/jcm13061612](doi.org/10.3390/jcm13061612) Academic Editor: Anna Maria Malagoni Received: 28 February 2024 Accepted: 6 March 2024 Published: 11 March 2024 Copyright: © 2024 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ([https://](https://)[ ](https://)[creativecommons.org/licenses/by/](creativecommons.org/licenses/by/)[ ](creativecommons.org/licenses/by/)[4.0/](4.0/)) . 1 Graduate School of Physical Therapy, Sahmyook University, Seoul 01795, Republic of Korea; [jgh10108@naver.com](jgh10108@naver.com) 2 Department of Physical Therapy, Sahmyook University, Seoul 01795, Republic of Korea * Correspondence: [3679@syu.ac.kr](3679@syu.ac.kr); Tel.: +82-2-3399-1634 Abstract: Background: Forward head posture and rounded shoulder posture are common postural variants found in upper crossed syndrome, which can lead to limited neck mobility, respiratory problems, and other issues. The purpose of this study was to investigate the effects of telerehabilitation, combining diaphragmatic breathing re-education and shoulder stabilization exercises, on young men with upper crossed syndrome during the COVID-19 pandemic over 4 weeks. Methods: The study included 37 participants aged in their 20s and 30s who were randomly divided into two groups. The experimental group received diaphragmatic breathing re-education and shoulder stabilization exercises, while the control group only underwent shoulder stabilization exercises. Both groups were trained three times a week for four weeks using telerehabilitation. The comparison of within-group pre–post differences in the experimental and control groups was conducted using a paired t-test, while the effects of treatment were assessed using repeated-measures analysis of variance. Results: After 4 weeks, both groups showed significant improvements in the pain pressure threshold of the upper trapezius, craniovertebral angle, round shoulder posture, shoulder tilt degree, neck disability index, and closed kinetic chain upper extremity stability test (all p < 0.05) . The results showed a significant difference between the Time effect (p adj < 0.05/4) for both sides of PPT, CVA, and STD and both sides of RSP, NDI, and CKCUEST, and an interaction between the Time × Group effects (p adj < 0.05/4) for the Rt. PPT, CVA, and STD. Conclusions: These findings suggest that the telerehabilitation training group, which included diaphragmatic breathing re-education and shoulder stabilization exercises, was more effective in improving Rt. PPT, CVA, and STD in males with UCS. Keywords: shoulder; neck pain; posture; telerehabilitation; breathing exercises 1. Introduction Upper crossed syndrome (UCS), a condition first described by Janda, is characterized by a shortening of the superficial neck flexor muscles and a relaxation of the deep neck flexor and extensor muscles [1] . There are several ways to evaluate the alignment of the cervical vertebrae, with forward head posture (FHP) being a common symptom of UCS [2] . FHP caused by bending of the upper and lower cervical vertebrae can be measured using the craniovertebral angle (CVA) [3] . A CVA of 52◦ or less indicates the presence of FHP [4] . Symptoms of FHP include fatigue, limited neck mobility, d

FAQs

What was the purpose of this randomized controlled trial?

To investigate the effects of telerehabilitation that combined diaphragmatic breathing re-education with shoulder stabilization exercises on neck pain, posture, and function in young adult men with upper crossed syndrome over four weeks.

How were the participants divided and how often were they trained?

Thirty-seven participants in their 20s and 30s were randomly divided into experimental and control groups. Both groups trained three times per week for four weeks via telerehabilitation.

What outcomes improved after four weeks, and were there differences between groups?

After four weeks, both groups improved in measures including pain pressure threshold, craniovertebral angle, rounded shoulder posture, shoulder tilt, neck disability index, and upper extremity stability. There was a significant interaction effect for certain right-side outcomes, indicating greater benefit for the combined training group.

Sep 5, 2026

Upload by Theodora