Document Type : Scientific Research

Authors

• Ainollah Sakinepoor ¹
• Saadollah Hashmi ²

¹ Department of Physical Education, Farhangian University, Tehran, Iran

² Department of Psychology and Counselling, Farhangian University, Tehran, Iran

Abstract

Objective: Proper posture reflects the coordinated alignment of body segments, minimizing muscle effort, reducing pain, and optimizing functional efficiency (Haji Hosseini et al., 2015). In contrast, postural deviations disrupt muscular function, impair appearance, increase energy expenditure, and raise the risk of musculoskeletal disorders (Beheiraei et al., 2016). These abnormalities are particularly common among students aged 11–15 years, with high rates of forward head posture, kyphosis, and rounded shoulders reported (Moghadid et al., 2022; Akbari et al., 2008). Sedentary behaviors, inappropriate furniture, and prolonged screen time significantly contribute to postural deviations, including Upper Crossed Syndrome (UCS) (Seddars et al., 2015). Janda (Chang et al., 2023) described UCS as an imbalance involving tight upper trapezius, levator scapulae, and pectoral muscles alongside weak deep cervical flexors and lower trapezius. This imbalance alters thoracic curvature, disrupts shoulder mechanics, and often causes neck and shoulder pain, headaches, and temporomandibular joint discomfort (Wirnata et al., 2024; Ghamkhar & Khallaii, 2018). Chronic musculoskeletal pain is linked to psychological consequences such as social anxiety, emotional distress, and increased stress responses (Heikinnen et al., 2019), which may promote impulsive, rapid, and unplanned behaviors in individuals with poor emotional regulation (Cashagrande et al., 2020). Pain can also interfere with emotion regulation, foster maladaptive coping strategies, and perpetuate a cycle between pain and distress (Kuyckelin et al., 2018). Corrective exercise programs targeting UCS have been shown to improve posture, functional movement, and reduce pain (Kim et al., 2015). They may also enhance psychological functioning by decreasing fear, improving mood, and increasing perceived physical competence (Wieland & Linton, 2012). Based on these findings, this study aimed to investigate the effects of corrective exercises on social–physical anxiety, impulsive behaviors, and emotional self-regulation in students with UCS. Method: The research method of the present study was semi-experimental. The statistical population consisted of students diagnosed with Upper Crossed Syndrome (UCS) in Eslamabad-e-Gharb. Sixty students who met the inclusion and exclusion criteria were convenience selected and randomly assigned to either a corrective exercise group (n = 30) or a control group (n = 30).During the pre-test phase, all participants completed validated questionnaires, and postural variables related to UCS were measured. The corrective exercises were performed for the experimental group over eight weeks, with three sessions per week, each lasting one hour.The control group received no intervention and continued routine daily activities. Post-tests were conducted simultaneously under identical conditions to assess the program’s effectiveness, and corrective sessions were later offered to the control group for ethical reasons. Inclusion criteria were age 11–18 years, signed consent, daily computer use over four hours, forward head angle >46°, rounded shoulder angle >52°, and thoracic kyphosis >42°. Exclusion criteria included psychological disorders, prior corrective training, incomplete questionnaires, psychotic or severe physical illnesses, and absence from more than two consecutive sessions. Results:  Considering that the main assumptions of the test were met, a Multivariate Analysis of Covariance (MANCOVA) was initially performed on the data to examine the effect of the corrective exercise intervention on the dependent variables in the students. Table 4 presents the results of the Multivariate Analysis of Covariance test.As observed in Table 4, the results of Wilks' Lambda test indicated a significant difference between the corrective exercise group and the control group in at least one of the measured dimensions (P < 0.001). The F statistic was 37.36, and the effect size was 0.91 (91%). In other words, 91% of the variance in the scores of social physique anxiety, impulsive behaviors, and emotional self-regulation in the students was attributed to group membership or the effect of the corrective exercise intervention. Therefore, to examine the effect of corrective exercises on each variable individually, the results of the univariate analysis of covariance (ANCOVA) within the MANCOVA framework are presented next (Table 5). According to Table 5, the results show that the F ratio for the Forward Head Angle variable in the corrective exercise and control groups is 11830.35, which is significant at the 0.05 level. These results indicate a significant difference between the corrective exercise and control groups, and the corrective exercise intervention led to a reduction in the forward head angle and an improvement in posture, with an effect size of 0.91. The F ratio for the Rounded Shoulder Angle variable is 10256.84, which is significant at the 0.05 level. These results indicate a significant difference between the corrective exercise and control groups, and the corrective exercise intervention led to a reduction in the rounded shoulder angle and an improvement in posture, with an effect size of 0.90. The F ratio for the Kyphosis Angle variable is 7623.79, which is significant at the 0.05 level. These results indicate a significant difference between the corrective exercise and control groups, and the corrective exercise intervention led to a reduction in the kyphosis angle and an improvement in posture, with an effect size of 0.89. The F ratio for the pain variable is 4420.27, which is significant at the 0.05 level. These results indicate a significant difference between the corrective exercise and control groups, and the corrective exercise intervention led to a reduction in pain and improvement in pain levels, with an effect size of 0.90. The F ratio for the Social Physique Anxiety variable is 7012.03, which is significant at the 0.05 level. These results indicate a significant difference between the corrective exercise and control groups, and the corrective exercise intervention led to an improvement in social physique anxiety, with an effect size of 0.88. The F ratio for the impulsive behaviors variable is 7204.94, which is significant at the 0.05 level. These results indicate a significant difference between the corrective exercise and control groups, and the corrective exercise intervention led to an improvement in impulsive behaviors, with an effect size of 0.89. The F ratio for the emotional self-regulation variable is 11253.93, which is significant at the 0.05 level. These results indicate a significant difference between the corrective exercise and control groups, and the corrective exercise intervention led to an improvement in emotional self-regulation, with an effect size of 0.91.Conclusion: This study examined the effectiveness of corrective exercises on social-physical anxiety, impulsive behaviors, and emotional self-regulation in individuals with Upper Crossed Syndrome (UCS). The findings demonstrated significant reductions in these psychological variables following the intervention. The observed reductions in social-physical anxiety align with existing literature. Multiple studies suggest physical activity enhances body image, perceived competence, and social acceptance, thereby reducing anxiety. Improvements in posture and physical appearance from corrective exercises likely contribute to this effect by boosting confidence in social settings. The decrease in impulsive behaviors can be explained through cognitive and physiological pathways. Chronic musculoskeletal pain consumes attentional resources, impairing self-regulation and increasing impulsivity. Corrective exercises, by alleviating pain and improving neuromuscular function, may free cognitive capacity and enhance self-control. Furthermore, pain reduction can improve mood and self-efficacy, reducing the reliance on impulsive coping strategies. Improvements in emotional self-regulation are consistent with a biopsychosocial framework. Corrective exercises may modulate physiological arousal, increase parasympathetic activity, and stimulate brain regions involved in executive control. The foundational improvements in physical condition and pain reduction likely lower emotional burden and increase perceived control, creating the psychological resources necessary for better emotional management. Important Caveats: Despite a controlled design, a purely causal interpretation is limited. The improvements may stem from the comprehensive intervention package (including regular interaction, positive expectations, and lifestyle changes) rather than the physical exercises alone. The complex interplay of physical, psychological, and contextual factors must be acknowledged. Generalizability is constrained by the specific population (UCS), and direct comparisons are hampered by a lack of identical prior studies, necessitating cautious extrapolation from research on other chronic pain conditions or different age groups. In conclusion, a structured corrective exercise program appears to be a beneficial component of intervention for individuals with UCS, associated with meaningful psychological improvements. Future research should aim to isolate the specific mechanisms of change and investigate these effects in larger, homogeneous samples.

Keywords

• Social physique anxiety
• emotional self-regulation
• corrective exercises
• impulsive behaviors
• Upper Crossed Syndrome

Main Subjects

• A