OBJECTIVE: Upper crossed syndrome (UCS) is an abnormal upper extremity movement pattern characterized by muscle tightness in the neck, shoulders, and upper back, coupled with weakness in opposing muscle groups. This study aimed to investigate the effectiveness of Pilates training combined with fascial massage as an intervention in office workers with UCS. METHODS: 34 subjects were recruited and randomly divided into an experimental group (n = 17) and a control group (n = 17). The control group underwent 12 weeks of Pilates training, and the experimental group received 12 weeks of Pilates training combined with fascial massage. Body posture was assessed using the forward head angle (FHA) and forward shoulder angle (FSA), joint mobility was evaluated using cervical spine range of motion (ROM), muscle activity was assessed using surface electromyography (sEMG), and quality of life was evaluated using pain level (VAS) and cervical spine dysfunction index (NDI). RESULTS: After 12 weeks of intervention, the FHA, FSA, VAS, and NDI of the experimental group were significantly lower than those of the pre-intervention group (p < 0.05) and significantly lower than those of the control group (p < 0.05); the extension and left-right rotation cervical spine ROM of the experimental group were significantly higher than those of the pre-intervention group (p < 0.05) and significantly higher than those of the control group (p < 0.05); and sEMG indexes (mean power frequency and median frequency) of the upper trapezius and the pectoralis major in the experimental group were significantly higher than those of the pre-intervention group (p < 0.05) and significantly higher than the control group (p < 0.05). CONCLUSION: Compared with Pilates training alone, Pilates training combined with fascial massage demonstrated a more significant effect in improving muscle activation, body posture, and pain and enhancing the quality of life for patients with UCS.

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