Effect of Ergonomic Advice and Postural Correction Exercises on Craniovertebral Angle in Dental Students with Upper Cross Syndrome: A Quasi-experimental Study

Abstract

Introduction: Dentistry involves prolonged static postures and repetitive movements, predisposing practitioners to Musculoskeletal Disorders (MSD), particularly affecting the neck, shoulders, and upper back. Upper Cross Syndrome (UCS), characterised by muscle imbalance and Forward Head Posture (FHP), is highly prevalent among dental professionals. Ergonomic modifications combined with postural correction exercises may provide a cost-effective and sustainable preventive strategy. Aim: To evaluate the effect of ergonomic advice and postural correction exercises on Craniovertebral Angle (CVA), muscle strength, muscle length, pain and neck disability in postgraduate dental students with UCS. Materials and Methods: The present quasi-experimental Study was conducted at the AB Shetty Memorial Institute of Dental Sciences, NITTE (Deemed to be University), Mangaluru, Karnataka, India, over a period of 10 months from February 2023 to December 2023 among 29 postgraduate dental students aged 20-30 years with neck pain measured by Numerical Pain Rating Scale (NPRS) 3-6 and FHP (CVA <49.9°). The study duration was four weeks. CVA was measured using Markus Bader (MB) ruler software. Outcome measures included Neck Disability Index (NDI), NPRS, CVA, muscle strength with handheld dynamometer, and muscle length by Janda technique. Participants underwent a structured intervention comprising pamphlet-based postural correction exercises and ergonomic advice. Data were analysed using Statistical Package for the Social Sciences (SPSS) version 20.0. Paired t-test was used for pre-post comparison and p<0.05 was considered statistically significant. Results: Post-intervention, statistically significant improvements were observed in all outcome measures. NDI decreased from 14.28±3.61 to 11.48±4.00 (p<0.001), NPRS reduced from 5.34±0.61 to 3.97±1.24 (p<0.001), and CVA increased from 46.89±1.35° to 48.08±2.13° (p<0.001). Muscle strength improved significantly in the neck flexors, middle and lower trapezius, and serratus anterior (p<0.05). Muscle length showed significant improvement, with reduced tightness in pectoralis major, pectoralis minor, and latissimus dorsi, and increased length of the upper trapezius (p<0.05). Conclusion: A four-week intervention combining ergonomic advice and postural correction exercises significantly improved CVA, muscle strength, and muscle length, and reduced pain and neck disability in dental postgraduate students with UCS. Early incorporation of ergonomic education and targeted exercise in dental training may help prevent chronic MSDs.