Individualized systems-informed corrective exercise for adults meeting prespecified criteria for upper crossed syndrome: protocol for a randomized controlled trial

A 12-week randomized trial in 36 adults (18–40) with forward head/shoulder posture and increased thoracic kyphosis will test whether a systems-informed corrective exercise program improves a multivariate posture-angle profile at week 12.

• Why it matters: Prior upper crossed syndrome studies have been hard to reproduce due to inconsistent eligibility, intervention content, and progression rules, limiting confidence in what works.
• What they did: Adults meeting prespecified criteria will be randomized 1:1, stratified by sex, to an active control plus a staged, individualized program; the primary analysis uses baseline-adjusted week-12 between-group MANCOVA (Pillai’s trace).
• The result: The trial will estimate week-12 between-group effects (with 95% confidence intervals) on forward-head, forward-shoulder, and thoracic-kyphosis angles, and will assess secondary electromyography, range of motion, balance, and exploratory central relative alpha power at baseline and week 12.

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