Impact of Upper Cross Syndrome on Shoulder and Cervical Range of Motion and Functional Performance in University Students

Abstract

Background: Upper Cross Syndrome (UCS) is a common postural disorder among young adults, characterized by forward head posture, rounded shoulders, and thoracic hyperkyphosis, which may adversely affect cervical and shoulder mobility and functional performance, particularly in populations exposed to prolonged screen use. Objective: To determine the impact of UCS on cervical and shoulder range of motion and functional performance in university students and to examine associations between postural deviations and functional outcomes. Methods: A cross-sectional observational study was conducted among 100 university students aged 18–25 years, classified into UCS (n=50) and control (n=50) groups using photogrammetric postural analysis. Cervical and shoulder range of motion was assessed with a universal goniometer, while functional performance was evaluated using the Neck Disability Index and the Shoulder Pain and Disability Index. Demographic characteristics and daily smartphone use were recorded. Group comparisons and correlation analyses were performed using appropriate parametric tests. Results: Students with UCS demonstrated significantly greater postural deviations, reduced cervical and shoulder range of motion, and higher disability scores compared with controls (all p<0.001). Mean daily smartphone use was significantly higher in the UCS group. Postural deviation severity showed significant negative correlations with joint range of motion and positive correlations with functional disability. Conclusion: Upper Cross Syndrome in university students is associated with meaningful impairments in cervical and shoulder mobility and functional performance. Early identification, postural correction strategies, and ergonomic interventions may help mitigate functional decline and reduce the risk of chronic musculoskeletal disorders in young adults.