| INTERVENTIONS |
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Intervention type
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Intervention name
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Dose
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Duration
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Intervention description
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Group size
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Nature of control
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| Experimental Group |
Neck Stabilization Exercises |
12 counts of 5 repetitions for 3 sets |
30 minutes for each seesion (two sessions per week for 8 weeks -16 sessions) |
Chin Tuck-in: Participant lies supine on the plinth with the neck supported. Participant will be instructed to tuck their chin in or look down without bending their head -12 counts, 5 repetitions for 3 sets (Anuja et al, 2012).
Shoulder Shrugs: In a standing position, the patient will be asked to shrug his or her shoulders, bringing them up towards the ears. This will be done for 12 counts of 5 repetitions, 3 sets (Kaka et al, 2016).
Cervical Extension: In a standing position, the participant will grasp the base of the neck, with both hands, while extending the neck as far as possible. This will be done for 12 counts of 5 repetitions, 3 sets (Kaka et al, 2016).
Craniocervical flexion with cervical flexion: Patient will lie supine and be instructed to tuck the chin and lift the head off so that the chin touches the chest. This will be done for 5 repetitions, 3 sets (Anuja et al, 2012).
Shoulder blade stabilization: Participants will be instructed to stand with arms by the sides and the head and neck kept in neutral position, with chest lifted patients will gently but firmly move both shoulders backward while squeezing both shoulder blades backward and downwards. Patient will hold for 12 counts and perform 2 sets of 5 repetitions.
Patients will progress to the next phase of these exercises at 4th week, if they can carry out the first phase exercises with good control and can withstand the number of holds and repetitions (Anuja et al, 2012).
Chin Tuck-in: Patient will assume a quadruped position and will be instructed to tuck in their chin without bending the neck – 3 sets of 15 repetitions (Anuja et al, 2012).
Craniocervical flexion with cervical flexion: Patients will progress by manually applying resistance and will be instructed to perform 3 sets of 12 repetitions of craniocervical and cervical flexion for 2weeks and by the 6th week, they will progress to 3 sets of 15 repetitions (Anuja et al, 2012).
Shoulder blade stabilization: 20seconds hold, 10 reps for 2set |
20 |
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| Experimental Group |
Pilates Exercises |
20-50 repititions |
30 minutes for each session (twice per week for 8 weeks - A total of 16 sessions) |
Hip Twist Level 1: Right knee moves away from and then towards midline while maintaining a neutral spine position. This challenges rotational control of the lumbar spine (APPI, 2012).
One leg stretch Level 1: The left heel slides along mat extending left leg without allowing the pelvis to anteriorly tilt (APPI, 2012).
Rolling like a ball: Participant is asked to lie supine while inhaling to engage the abdominals. The hands are placed on the knees and drawn towards the chest. The head is curled off the mat looking towards the abdominals. The hands will be slide to the back of the thighs as the participant tries to rock through the lumbosacral position for 20 counts (APPI, 2012).
Shoulder Bridge Level 1: The Pelvis is tilted posteriorly as the lumbar and thoracic spines are mobilised into flexion (APPI, 2012).
The Hundred Level 1: Participant is asked to lie supine and bend the knees while inhaling to engage the abdominals. The head, neck and upper shoulders are lifted off the plinth with eyes focusing on the abdominals. The head is kept above the level of spine – 20 counts (APPI, 2012).
Windmill Arm Level 1: The uppermost arm is lifted away from the body to open the upper chest and rotate the thoracic and lumbar spine (figure 9). This is done for 50 counts (APPI, 2012).
Breast stroke prep Level: Shoulder blades glide gently downwards away from the ears while lifting the arms 4-5 cm off the mat (figure 10) (APPI, 2012).
Breast stroke prep Level 2: In addition to level, the upper body is lengthened off the mat to hover the breastbone 3 cm from the floor while maintaining a neutral lumbo-pelvic position. Keep the back of the neck long. This exercise retrains co-activation of the deep neck flexors and extensors with upper, lower trapezius and serratus anterior (APPI, 2012).
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20 |
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| Control Group |
Dynamic Isometric exercises |
12 counts of 5 repetitions for 3 sets |
2 sessions per week for eight weeks - A total of 16 sessions |
Cervical extension- dynamic isometric: The participant sits in an upright position and at the one end, the loop of the thera-band will be attached to the participant’s head and at the other, to a sturdy stand. The participant will bend neck backwards, then hold the position for 30 seconds and slowly return to the starting position, keeping the spine posture erect throughout the exercise. This will be done for 12 counts of 5 repetitions for 3 sets (Salo et al, 2010; Kaka et al, 2016).
Cervical flexion-dynamic isometric: With patient in sitting, the participant will sit in an upright position and back a sturdy stand. One end of the thera-band loop will be securely attached to a sturdy stand and the other to the participant’s head. He or she will bend neck forward and hold the position for 30 seconds, before slowly returning to the starting point, while keeping the spine posture erect throughout the exercise. This will be done for 12 counts of 5 repititions for 3 sets (Salo et al, 2010; Kaka et al, 2016).
Chest flies exercises: With the participant in a standing position, the middle of the thera-band will be fastened securely to a sturdy stand, set at shoulder level. The participant backed the stand, with one leg slightly in front of the other. He or she grasps the bands at shoulder height, with the elbows straight and pull the bands inward, with the palms facing each other, and then slowly return to the starting position. This exercise will be done 15 repetitions (Salo et al, 2010; Kaka et al, 2016).
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20 |
Active-Treatment of Control Group |