We are to complete an PICO

1 Fig.1. Sources of Evidence Searched Google Scholar (69) Pubmed (3) EBSCOHost (5) N= 77 Studies Identified by Title Google Scholar (6) Pubmed (3) EBSCOHost (5) N = 14 Studies excluded by title or abstract N= 63 Studies Identified for possible Inclusion N= 4 Studies excluded based on exclusion criteria N= 1 Studies included in the Critical Appraisal N= 3 2 Table 1. Characteristics Article 1 Article 2 Article 3 Study Title Karimian, R., Rahnama, N., Ghasemi, G. & Lenjannejadian, S. (2019).

Photogrammetric Analysis of upper cross syndrome among teachers and the effects of national academy of sports medicine exercises with ergonomic intervention of the syndrome, Journal of Research in Health Sciences, 19 (3), 1-6. Senthil, P., Sudhakar, S., Po rcelvan, S., Francis, T.G., Rathnamala, D. & Radhakrishnan, R.

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(2017). Implication of posture analysing software to evaluate the postural changes after corrective exercise strategy on subjects with upper body dysfunction -A randomized controlled trial, Journal of Clinical and Diagnostic Research, 11 (7), 1-4, DOI:

10.7860/JCDR/2017 /26520.10229 Bayattork, M., Seidi, F., Minoonejad, H., Andersen, L.L. & Page, P. (2020). The effectiveness of a comprehensive corrective exercises program and subsequent detra ining on alignment muscle activation, and movement pattern in men with upper crossed syndrome: protocol for a parallel -group randomized controlled trial Participants 23 non -athletic teachers Experimental (n=12), mean age 45.2, weight 78.3kg, Height 178.8cm Control (n=11) mean age 44.1, weight 77.9kg, 175.8cm 60 subjects aged 25 – 55 n= 30 in experimental, 12 males, 18 females, mean age 52 years, height mean 160 cm, weight mean 69kg n= 30 in control group, 1 4 males and 16 females, mean age 50 years, mean height 155cm, mean weight 67kg 22 men aged 18 -28 years old with upper -crossed syndrome Inclusion/Exclusion Criteria Inclusion:

hyperkyphosis of more than 42 degrees, forward head posture of more than 45 d egrees and rounded shoulder Inclusion: kinematic alternation of shoulder, neck, and upper back region Exclusion:

neurological Inclusion: postural cha nges such as forward head angle greater than 44 degrees, rounded shoulders greater than 49 degrees and excessive 3 posture more than 52 degrees Exclusion: pathologic symptoms such as history of surgery, fractures, joint disease of spine, osteoarthritis, rheumatoid arthritis, blood disease, congestive heart failure, malignancy, severe skin sensitization, participation in athletic activities problems, recent surgery, fractures, tumors around upper back, neck, shoulder region thoracic kyphosis greater than 42 degrees Exclusion: sports or activities that may affect outcomes, visible misalignment in pelvis and lower ex tremities, history of fractures, surgery or joint diseases in spine, shoulder, or pelvis, scoliosis, or BMI outside normal (18 -25). Outcome Measures Forward head angle, kyphosis angle, rounded shoulders angle Postural alteration and pectoralis muscle length Scapular dykinesis test, electromyography tests, forward head, shoulder, thoracic kyphosis angles, neck flexion pattern test Results Improvement of posture via reduction in head forward, kyphosis, and rou nded shoulder angle after 12 week NASM corrective exercise program Improvement of posture alteration score (56.25%) and pectoralis minor length changes (68.69%) with experimental group more than control group which had postural alteration (24.86%) and pect oral muscle changes (21.9%) Decreased scapular dyskinesis, decreased SCM tightness (neck flexion pattern test), decreased forward head, shoulder, kyphosis angles Evidence Quality Score 6 on PED ro Scale= high quality 8 on PEDro scale= high quality 8 on PED ro scale= high quality Support for Answer YES YES YES

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