Motor control training versus soft tissue therapy in the treatment of upper crossed syndrome: a randomized controlled pilot trial.

Upper crossed syndrome (UCS) is a prevalent postural pattern associated with myofascial pain and limited cervical mobility in sedentary adults. Evidence supports both motor control training (MCT) and soft-tissue therapy (STT), but their comparative effects remain uncertain. This exploratory randomized controlled pilot trial examined and compared the effects of MCT and STT on pain, cervical range of motion (ROM), and head posture in women with UCS. Thirty women aged 37–53 years with clinically identified UCS were randomly allocated to MCT (G1) or STT (G2) (n = 15 each). Interventions lasted 8 weeks. G1 performed supervised low-load MCT three times weekly (45 min/session) targeting deep cervical flexors, scapular stabilizers, and postural control. G2 received once-weekly 30-min STT (myofascial release, post-isometric relaxation, muscle energy techniques, and trigger-point techniques) targeting relevant cervical-thoracic and scapular muscles. The primary outcome was pain intensity (visual analogue scale, VAS). Secondary outcomes were Laitinen pain scale score, cervical ROM (CROM device) in habitual and corrected head positions, and head posture angles in standing and sitting. Outcomes were assessed pre- and postintervention. Analyses used appropriate parametric/non-parametric tests (α = 0.05) with effect sizes (Cohen’s d or r) and 95% confidence intervals. Both groups showed clinically meaningful pain reduction. The VAS score decreased from 3.26 ± 1.39 to 1.67 ± 1.23 in G1 (p < 0.001; d = 1.19, 95% CI 0.47–1.85) and from 3.33 ± 1.68 to 1.47 ± 0.91 in G2 (p < 0.001; d = 1.36, 95% CI 0.61–2.01). Laitinen scores also improved (G1: from 4.80 ± 1.66 to 2.93 ± 1.44, p < 0.001; d = 1.17, 95% CI 0.45–1.83; G2: from 4.47 ± 2.03 to3.00 ± 1.46, p < 0.001; d = 0.80, 95% CI 0.15–1.45). The between-group comparisons suggested larger improvements in several ROM and posture measures in G1, particularly for lateral flexion and rotation in habitual and corrected positions (e.g., corrected right lateral flexion change: 9.07° ± 5.08 vs 3.20° ± 4.28; p < 0.001). Postintervention between-group differences were observed for selected outcomes (e.g., standing retraction angle, habitual extension, and corrected extension and rotation; p ≤ 0.01). Eight weeks of both MCT and STT were associated with reduced pain in women with UCS. Pain improvements were comparable between groups, whereas MCT was associated with larger improvements in selected ROM and head-posture measures. These findings provide preliminary comparative data to inform adequately powered trials with balanced intervention dose and longer follow-up.