A Comparative Study on the Efficacy of Mirror Biofeedback with and without Functional Proprioceptive Neuromuscular Facilitation on Pain and Functional Disability in Patients with Upper Cross Syndrome

Background: Upper Cross Syndrome (UCS) is a common postural disorder caused by muscle imbalance producing tight and weak crossed muscle patterns, resulting in neck pain, poor posture, reduced strength, and functional limitations, especially in sedentary individuals and affects occupational performance.  Aim: To compare mirror biofeedback either versus combined with functional Proprioceptive Neuromuscular Facilitation (PNF) on pain, disability, strength, and posture in UCS patient.  Methodology: Comparative study on 60 participants aged 25–45 years were randomized into two groups: Mirror biofeedback either and Mirror biofeedback + functional PNF, treated thricely/week for 4 weeks with home exercises; NPAD, MMT, Postural assessment were measured. Treatment duration followed standardized protocol.  Results: Both groups improved, but Mirror biofeedback + functional PNF showed greater gains (NPAD 47.33–28.67; MMT 3.07–4.83) than biofeedback either (47.2–33.53; 3.03–4.37).  Conclusion: Mirror biofeedback is effective, but adding functional PNF provides superior improvements in pain, strength, and posture, combined visual and proprioceptive facilitation effects, which enhance neuromuscular control, motor learning, and postural correction supporting multimodal rehabilitation for UCS. This approach enhances neuromuscular control, motor learning, and postural correction without adverse effects in participants.  Limitation: Small sample size, short intervention period, convenience sampling may affect generalizability, supervised treatment for only thricely/week, lack of long-term follow-up.