Abstract
BACKGROUND: Millions of computer users experience chronic neck and shoulder pain (CNSP) and reduced health-related quality of life (HRQoL) due to upper cross syndrome (UCS). While strengthening exercises for the posterior trunk alleviate symptoms, it remains unclear whether isometric or isotonic exercises are more effective. OBJECTIVES: This study aimed to compare the effects of isometric and isotonic exercises on CNSP and HRQoL in individuals with UCS, and to evaluate these outcomes against a non-intervention group. METHODS: In this randomized clinical trial (RCT), 43 UCS patients with CNSP were divided into three groups: Isometric exercises (n = 15), isotonic exercises (n = 14), and a control group (n = 14). Over 8 weeks, exercise groups completed 3 sessions per week (40 - 60 minutes each). Pain was assessed using the Visual Analog Scale (VAS) and HRQoL was assessed using the 36-item short form health survey (SF-36) questionnaire, both pre- and post-intervention. RESULTS: Both isometric and isotonic exercises significantly reduced CNSP and improved HRQoL compared to the control group. Isometric exercises yielded a 70.4% pain reduction (P < 0.001) and a 14.9% HRQoL improvement (P = 0.002), while isotonic training showed a 47.6% pain reduction (P = 0.001) and a 17.7% HRQoL improvement (P < 0.001). Between-group differences were not statistically significant (pain: P = 0.853; HRQoL: P = 0.999). Although isometric exercises slightly favored pain reduction and isotonic exercises showed marginal HRQoL gains, these differences should not be overstated. CONCLUSIONS: Both isometric and isotonic exercises improved CNSP and HRQoL in UCS patients, with no significant difference between them. Slight trends favoring each should be interpreted cautiously. Longer-term studies are warranted.