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Abstract

Background: Upper cross syndrome is a common postural imbalance marked by neck, shoulder, and upper back pain due to muscular dysfunction. Manual therapy techniques like muscle energy techniques and myofascial release are widely used for managing musculoskeletal pain. Objective: To compare the effects of myofascial release and muscle energy techniques in patients with upper cross syndrome. Methodology: The randomised clinical trial included 54 participants with upper cross syndrome at three hospitals in Faisalabad over four months, divided into two groups of 27, with a 20% attrition rate. Participants were selected using purposive sampling, with inclusion criteria consisting of both genders, age 20-60 years, diagnosis of UCS, pain intensity of 4 to 7 on the Numerical Pain Rating Scale, and duration of neck pain of 4 to 12 weeks. Exclusion criteria included rheumatoid arthritis, ankylosing spondylitis, cervical radiculopathy, recent trauma to the cervical spine, cancer, history of cervical spine surgery in the last 12 months, and fracture. Group A received the muscle energy techniques on the cervical region, involving 5 repetitions and a 20-second hold for each, while Group B received the myofascial release for 30-40 seconds. Measurements were taken at baseline and the end of the 4th week, with 3 sessions per week on alternate days for one month. Outcome measures included primary outcome measures of pain intensity and cervical range of motion, and secondary outcome measures of functional disability using the Neck Disability Index. Non-parametric tests, including the Wilcoxon signed-rank test and Mann-Whitney U test, were applied. Results: Group A consisted of 14 males and 8 females, while Group B contained 15 males and 7 females. Intra-group analysis utilising the Wilcoxon signed-rank test found that both groups experienced considerable pain reduction. Group A had a significant decrease in pain levels (p<0.00) after MET. Similarly, Group B saw considerable pain reduction (p<0.00) with MRT. Between-group comparisons revealed that the MET group experienced greater pain relief. Conclusion: The muscle energy techniques significantly decreased discomfort, increased neck range of motion, and facilitated functional activities in those with upper cross syndrome as compared to myofascial release.