Introduction:
To investigate the outcomes of Pilates exercise compared to traditional treatment for management of the upper cross syndrome (UCS).

Methods:
Forty participants (females) with UCS were randomly divided into two equal groups: group A (control group) and group B (experimental group). Both groups received two sessions per week for four consecutive weeks. Group A received traditional physical therapy program in form of stretching, strengthening and postural correction exercises while Group B received Pilates exercise program. Primary outcome measures were balance, spinal curvature, Craniovertebral angle (CV), and rounded shoulders while the Neck Disability Index and Visual Analogue Scale served as secondary outcome measures. Measurements were recorded before and after treatment.

Results:
Comparison between pre-and post-treatment test results showed that all dependent variables significantly improved for both groups (p > 0.001). However, Pilates exercise resulted in greater improvement in terms of balance, spinal curvature, CVA, and pain (p > 0.001).

Conclusions:
Pilates exercise program proved better than traditional physical therapy program in improving spinal curvature, balance, and function and reducing pain in UCS.