The Effect of Neuromuscular Combined with Biomechanical Scapular Stabilizer Muscle Corrective Exercises on Upper Crossed Syndrome in Chinese Secondary School Students: A Randomized Controlled Trial

Background and Objectives Upper crossed syndrome (UCS), characterized by poor posture, neck pain and Functional disability, is a prevalent issue among youth. This study aims to evaluate the effects of neuromuscular combined with biomechanical exercise (NCBE) on UCS among secondary school students and compares its outcomes with biomechanical exercise (BE) alone. Methods Forty-five male secondary school students (aged 15–18) were divided into three groups: NCBE (n=15), BE (n=15), and a control group (n=15). The NCBE group underwent combined neuromuscular and biomechanical exercise, the BE group performed biomechanical exercise only, and the control group participated in regular physical activities. Interventions were conducted three times a week for eight weeks. Outcome measures, including Forward Head Angle (FHA), Rounded Shoulder Distance (RSD), Neck Disability Index (NDI), Visual Analog Scale (VAS) scores, and scapular muscle strength (Middle Trapezius (MT), Lower Trapezius (LT), Serratus Anterior (SA) ), were assessed at baseline, week 4, and week 8. Results Within-group comparisons: Both BE and NCBE groups showed significant improvements in all measures by week 4 compared to baseline (p<0.05), with further improvements by week 8 (p<0.05), while the control group showed no significant changes (p>0.05). Between the group comparisons: Both BE and NCBE groups had better outcomes than the control group at weeks 4 and 8 (p<0.05). NCBE group showed superior results compared to the BE group only in the strength of MT, LT and SA (p<0.05) in week 4. NCBE group showed superior results compared to BE in FHA, NDI, VAS and the strength of MT, LT and SA (p<0.05), except for RSD (p>0.05) at week 8. Conclusion Both NCBE and BE are effective in alleviating UCS symptoms in Chinese secondary school students. However, NCBE demonstrates superior treatment effects compared to BE across multiple outcome measures, offering a promising and cost-effective therapeutic option. Additionally, regular physical activity is ineffective in treating UCS.