Comparative Effects of  Kendall’s Exercises versus Scapular Stabilisation in Patients with Rounded Shoulders

Anbreena Rasool; Nimra Iftikhar; Rabia Khan; Kainat Idrees; Ayesha Affi; Tahreem Munir

doi:10.55735/8vba0p23

Authors

Anbreena Rasool Department of Rehabilitation Sciences, The University of Faisalabad, Faisalabd, Pakistan https://orcid.org/0009-0007-7919-5611
Nimra Iftikhar Department of Rehabilitation Sciences, The University of Faisalabad, Faisalabad, Pakistan
Rabia Khan Department of Rehabilitation Sciences, The University of Faisalabad, Faisalabad, Pakistan
Kainat Idrees Department of Rehabilitation Sciences, The University of Faisalabad, Faisalabad, Pakistan
Ayesha Affi Department of Rehabilitation Sciences, The University of Faisalabad, Faisalabad, Pakistan
Tahreem Munir Department of Rehabilitation Sciences, The University of Faisalabad, Faisalabad, Pakistan

DOI:

https://doi.org/10.55735/8vba0p23

Keywords:

Kendall’s exercise , Rounded shoulder posture , Sahrmann Technique , Scapular stabilisation

Abstract

Background: Rounded shoulder posture is a prevalent postural malalignment that commonly occurs in girls during adolescence. Mostly girls develop slouch posture during their teenage years because of the breast development and bad postural habits that are the leading factor of RSP. Kendall’s exercise and scapular stabilisation are two effective interventions to treat rounded shoulder posture. Objective: To compare the effects of Kendall’s exercise and scapular stabilisation to treat rounded shoulder posture and to improve the alignment of the shoulder. Methodology: A randomised controlled trial was conducted at Girls High School, Faisalabad, Pakistan. Participants were randomly allocated into Group A, which received Kendall’s exercise and Group B, which received scapular stabilisation exercises, with 17 participants in each group. Female students aged 14-17 years, with rounded shoulder posture, restricted shoulder range of motion, including internal rotation <70°, external rotation >90°, and flexion <180°, were included in this trial. Participants were excluded if they had orthopaedic or neurological disorders affecting the upper limbs or any history of trauma. The primary outcome was measured by assessing the scapular distance using the scapular distance method. Secondary outcome measures included assessment of shoulder internal rotation, external rotation, and flexion using a universal goniometer, and evaluation of pectoralis minor muscle tightness through the Sahrmann technique. Baseline measurements were taken before intervention, with follow-ups at the 2^nd, 4^th, and 6^th week of the study. Ethical clearance was obtained from the university, and permission was taken from school administrators and patients. Descriptive statistics were computed, and parametric tests were applied to compare changes within and between groups over time. Results: The p-value is less than 0.05, so there was a significant difference between groups and the alternative hypothesis was accepted and the null hypothesis rejected. Both interventions showed positive results, but group A (Kendall’s exercise) showed more improvement as compared to group B (scapular stabilisation exercise). Conclusion: Although Kendall’s exercise and Scapular stabilisation exercises were both effective for the rounded shoulder posture but Kendall’s exercise showed more effectiveness in the improvement of the rounded shoulder posture.

Downloads

Download data is not yet available.

References

1. Ruivo RM, Pezarat-Correia P, Carita AI. Cervical and shoulder postural assessment of adolescents between 15 and 17 years old and association with upper quadrant pain. Brazilian Journal of Physical Therapy 2014; 18(04): 364–71. DOI: 10.1590/bjpt-rbf.2014.0027 DOI: https://doi.org/10.1590/bjpt-rbf.2014.0027

2. Dolphens M, Cagnie B, Coorevits P, et al. Sagittal standing posture and its association with spinal pain: a school-based epidemiological study of 1196 Flemish adolescents before age at peak height velocity. Spine 2012; 37(19): 1657–66. DOI: 10.1097/BRS.0b013e3182408053 DOI: https://doi.org/10.1097/BRS.0b013e3182408053

3. Do YL, Nam CW, Sung YB, Kim K, Lee HY. Changes in rounded shoulder posture and forward head posture according to exercise methods. Journal of Physical Therapy Science 2017; 29(10): 1824–7. DOI: 10.1589/jpts.29.1824 DOI: https://doi.org/10.1589/jpts.29.1824

4. Azim F, Khalid S, Yamen F, et al. The prevalence of musculoskeletal disorders among madrassa teachers and students: cross-sectional study. International Journal of Physiotherapy 2016; 3(1): 100–5. DOI: 10.15621/ijphy/2016/v3i1/88920 DOI: https://doi.org/10.15621/ijphy/2016/v3i1/88920

5. Syazwan A, Azhar MM, Anita A, et al. Poor sitting posture and a heavy schoolbag as contributors to musculoskeletal pain in children: an ergonomic school education intervention program. Journal of Pain Research 2011: 287–96. DOI: 10.2147/JPR.S22281 DOI: https://doi.org/10.2147/JPR.S22281

6. Parvin B, Dhara PC. Evaluation of the Extent of Mismatch Between Classroom Furniture and Anthropometric Measures of Girls’ Students of High Madrasah (School). 2018.

7. Singla D, Veqar Z. Association between forward head, rounded shoulders, and increased thoracic kyphosis: a review of the literature. Journal of Chiropractic Medicine 2017; 16(3): 220–9. DOI: 10.1016/j.jcm.2017.03.004 DOI: https://doi.org/10.1016/j.jcm.2017.03.004

8. Yang L, Lu X, Yan B, Huang Y. Prevalence of Incorrect Posture among Children and Adolescents: Findings from a Large Population-Based Study in China. iScience 2020; 23: 101043. DOI: 10.1016/j.isci.2020.101043 DOI: https://doi.org/10.1016/j.isci.2020.101043

9. Vidhyadhari B, Mishra P, Madhavi K, Nageswararao M. Qualitative Analysis of Postural Variations in Adolescent Girls. Indian Journal of Physiotherapy and Occupational Therapy-An International Journal 2016; 10(3): 191–9. DOI:10.5958/0973-5674.2016.00108.8 DOI: https://doi.org/10.5958/0973-5674.2016.00108.8

10. Park H-C, Kim Y-S, Seok S-H, Lee S-K. The effect of complex training on children with all of the deformities, including forward head, rounded shoulder posture, and lumbar lordosis. Journal of Exercise Rehabilitation 2014; 10: 172–5. DOI: 10.12965/jer.140113 DOI: https://doi.org/10.12965/jer.140113

11. Struyf F, Nijs J, Mottram S, Roussel N, Cools A, Meeusen R. Clinical assessment of the scapula: A review of the literature. British Journal of Sports Medicine 2014; 48(11):883-90. DOI: 10.1136/bjsports-2012-091059 DOI: https://doi.org/10.1136/bjsports-2012-091059

12. Yu J. Optimising NASM-OPT training in hybrid cheerleading education: A biomechanical approach. Molecular & Cellular Biomechanics 2025; 22(3):1330. DOI:10.62617/mcb1330 DOI: https://doi.org/10.62617/mcb1330

13. Fani M, Ghanbari A, Ebrahimi S. Evaluation of scapular mobilisation and comparison to pectoralis minor stretching in individuals with rounded shoulder posture: A randomised controlled trial. Journal of Bodywork and Movement Therapies 2020; 24(4):367-372. DOI: 10.1016/j.jbmt.2020.07.021 DOI: https://doi.org/10.1016/j.jbmt.2020.07.021

14. Kim T-W, An D-I, Lee H-Y, Jeong H-Y, Hyun K, Sung Y-H. Effects of elastic band exercise on subjects with rounded shoulder posture and forward head posture. Journal of Physical Therapy Science 2016; 28(6):1733–1737. DOI: 10.1589/jpts.28.1733 DOI: https://doi.org/10.1589/jpts.28.1733

15. Kang J-I, Choi H-H, Jeong D-K, Choi H, Moon Y-J, Park J-S. Effect of scapular stabilisation exercise on neck alignment and muscle activity in patients with forward head posture. Journal of Physical Therapy Science 2018; 30(6): 804–8. DOI: 10.1589/jpts.30.804 DOI: https://doi.org/10.1589/jpts.30.804

16. Peterson D, Blankenship K, Robb J, et al. Investigation of the Validity and Reliability of Four Objective Techniques for Measuring Forward Shoulder Posture. The Journal of Orthopaedic and Sports Physical Therapy 1997; 25(1):34-42. DOI: 10.2519/jospt.1997.25.1.34 DOI: https://doi.org/10.2519/jospt.1997.25.1.34

17. Jones A, Sealey R, Crowe M, Gordon S. Concurrent validity and reliability of the Simple Goniometer iPhone app compared with the Universal Goniometer. Physiotherapy Theory and practice 2014; 30(7): 512–6. DOI: 10.3109/09593985.2014.900835 DOI: https://doi.org/10.3109/09593985.2014.900835

18. Correll S, Field J, Hutchinson H, Mickevicius G, Fitzsimmons A, Smoot B. Reliability and validity of the halo digital goniometer for shoulder range of motion in healthy subjects. International Journal of Sports Physical Therapy 2018; 13(4): 707-714. DOI: 10.26603/ijspt20180707 DOI: https://doi.org/10.26603/ijspt20180707

19. Kluemper M, Uhl T, Hazelrigg H. Effect of stretching and strengthening shoulder muscles on forward shoulder posture in competitive swimmers. Journal of Sport Rehabilitation 2006; 15(1): 58. DOI: 10.1123/jsr.15.1.58 DOI: https://doi.org/10.1123/jsr.15.1.58

20. Roddey TS, Olson SL, Grant SE. The effect of pectoralis muscle stretching on the resting position of the scapula in persons with varying degrees of forward head/rounded shoulder posture. Journal of Manual & Manipulative Therapy 2002; 10(3): 124–8. DOI: 10.1179/106698102790819247 DOI: https://doi.org/10.1179/106698102790819247

21. Lins C, Castro A, Medina GI, et al. Alternative scapular stabilisation exercises to target strength, endurance and function of shoulders in tetraplegia: A prospective non-controlled intervention study. The Journal of Spinal Cord Medicine 2019; 42(1): 65–76. DOI: 10.1080/10790268.2017.1398943 DOI: https://doi.org/10.1080/10790268.2017.1398943

22. Kim M-K, Lee J, Yoo K-T. The effects of shoulder stabilisation exercises and pectoralis minor stretching on balance and maximal shoulder muscle strength of healthy young adults with round shoulder posture. Journal of Physical Therapy Science 2018; 30: 373–80. DOI: 10.1589/jpts.30.373 DOI: https://doi.org/10.1589/jpts.30.373

23. Shiravi S, Letafatkar A, Bertozzi L, Pillastrini P, Khaleghi Tazji M. Efficacy of abdominal control feedback and scapula stabilisation exercises in participants with forward head, round shoulder postures and neck movement impairment. Sports Health 2019; 11(3): 272–9. DOI: 10.1177/1941738119835223 DOI: https://doi.org/10.1177/1941738119835223

24. Fathollahnejad K, Letafatkar A, Hadadnezhad M. The effect of manual therapy and stabilising exercises on forward head and rounded shoulder postures: a six-week intervention with a one-month follow-up study. BMC Musculoskeletal Disorders 2019; 20(1): 86. DOI: 10.1186/s12891-019-2438-y DOI: https://doi.org/10.1186/s12891-019-2438-y