An interventional study of Myofascial Release + Eye exercises and Active Release Technique + Eye exercises in Cervical Myofascial Pain Syndrome, sponsored by Riphah International University. Not yet recruiting at 1 site in Pakistan. Open to participants aged 18 Years to 40 Years. Per ClinicalTrials.gov, last updated 2026-06-03.
Sponsored by Riphah International University · Not applicable, Interventional, and Treatment
The aim of this randomized controlled trial is to find the comparative effect of Active Release Technique and Myofascial release, each combined with eye exercises, on asthenopia, sleep quality, stress, pain and functional disability in patients with CMPS. A total of 44 participants will be randomized into two groups, ART + eye exercises and MFR+ eye exercises with interventions provided 3 days per week for 4 weeks. Outcomes will be assessed at baseline, 2 weeks and then after 4 weeks.
A musculoskeletal condition known as myofascial pain is characterized by discomfort in the region of a muscle and the fascia, the connective tissue that surrounds it. In addition to having several trigger sites, the pain may be local or widespread. Trigger points are very sensitive muscle foci that radiate pain to the surrounding area and hurts to touch. In particular, the rhomboids, trapezius, levator scapulae, supraspinatus, and infraspinatus often affected muscles in the cervical area. Acute or chronic pain is possible, and it is most likely brought on by overuse, altered posture, or muscular injury. Cervical myofascial pain is highly prevalent globally. A 2021 study by Kamran Ezzati found that 88.9% of Iranian participants had at least one neck trigger point. Similarly, a 2024 study by Sahib Rehman et al in Pakistan reported high prevalence of Myofascial Trigger Points in cervical radiculopathy patients, with mean scores of MTrPs.
Cervical myofascial pain or neck muscle pain is often caused by poor posture or prolonged use of electronic devices, leading to muscle knots or trigger points. A component of myofascial pain is the emotional stress we carry which contributes to muscle tension (in the form of, increased activation of the "fight or flight" response) releasing stress hormones like cortisol that increase muscle tension. As a health care profession, we know that physical injuries like whiplash cause damage to the structures of the neck and may also alter how certain structures respond post injury (inflammation and stiffness). There are many other conditions, such as degenerative disc disease, osteoarthritis, and fibromyalgia, both predispose the patient to altered spinal posture. As a result, muscle may function differently resulting in myofascial pain Cervical myofascial pain can be managed with orthopedic manual techniques like Active Tissue Release (ATR) and Myofascial Release (MFR). ATR, developed by Dr. Michael Leahy, combines pressure with movement to break down adhesions, improve circulation, and reduce trigger point activity. It helps restore muscle balance and relieve postural strain. MFR, popularized by John F. Barnes, uses gentle sustained pressure to release fascial restrictions, improve blood flow, and reduce nervous system overactivity. Both techniques enhance mobility, reduce pain, and promote better posture and function in the neck.
Combining these interventions with eye exercises targets both neuromuscular and visual dysfunction, offering a holistic approach to improving sleep quality, reducing stress, and alleviating cervical pain. The study addresses a gap in evidence by directly comparing ART and MFR with integrated eye exercises, potentially guiding physiotherapists and clinicians toward the most effective treatment strategy for CMPS.
67 studies on the registry are indexed under Asthenopia; 10 are open to participants now.
This study's planned enrollment of 44 is below the median of 56 across 56 interventional studies indexed under Asthenopia.
Browse Asthenopia studies →Riphah International University is the lead sponsor of 2,193 studies on the registry; 650 are open to participants now.
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Both genders
Exclusion Criteria:
Subjects with a history of cervical trauma or surgery
Active Release Technique + Eye exercises
Other: Active Release Technique + Eye exercises
Other: Myofascial Release + Eye exercises
* MFR applied with forearm/ulnar border of palm, gliding towards neck base/upper scapula, Sustained gentle pressure is maintained, held until a release (softening/yield) of fascial tissue is felt; the pressure is gradually increased as tolerance allows. * 3-4 glides × 90 seconds each, according to tolerance. * Frequency: 3 days/week for 4 weeks. * Followed by the same Eye Exercises as in experimental group
ART applied to cervical region (upper trapezius, Levator scapula and SCM) deep tension stretch with thumb over the tender areas , repeated 3-5 times. Frequency: 3 days/week for 4 weeks Followed by Eye exercises (3 days/week for 4 weeks) * Trataka (focusing on one point) = 30s/ 3 times * Eye ball movements = 10 reps/ 2sets i. Sideways ii. Up and down iii. Two ways diagonal movement iv. Clockwise and anticlockwise rotational movements * Eye blinking and opening = 10 reps/ 2sets * Palming = 30s/1 time
: Neck Disability Index (NDI)
The Neck impairment Index (NDI) is a self-report questionnaire designed to measure the self-rated impairment of patients with neck pain and to establish how neck pain impacts a patient's everyday life. A vertical scale from 0 to 5 is used to rate the questions; After scoring, 0-4 points (0-8%) indicate no disability, 5-14 points (10-28%) indicate mild disability, 15-24 points (30-48%) indicate moderate disability, 25-34 points (50-64%) indicate severe disability, and 35-50 points (70-100%) indicate complete disability
Time frame: Baseline, 2 weeks and 4 weeks (one-month follow-up)
Numeric Pain Rating Scale NPRS
The numeric pain rating scale (NPRS) is a tool used to assess pain intensity, where patients rate their pain on a scale of 0 to 10, with 0 representing no pain and 10 representing the worst possible pain.
Time frame: Baseline, 2 weeks and 4 weeks (one-month follow-up)
Pittsburgh Sleep Quality Index (PSQI)
The Pittsburgh Sleep Quality Index (PSQI) is a standardized questionnaire used to assess sleep quality and disturbances over a one-month period. It consists of 19 self-rated questions grouped into seven components: subjective sleep quality, sleep latency, sleep duration, habitual sleep efficiency, sleep disturbances, use of sleep medication, and daytime dysfunction. a global score ranging from 0 to 21. A global PSQI score greater than 5 indicates poor sleep quality, while a score of 5 or below reflects good sleep quality.
Time frame: Baseline, 2 weeks and 4 weeks (one-month follow-up)
ASQ-17 (Asthenopia Survey Questionnaire)
The ASQ-17 (Asthenopia Survey Questionnaire) is a self-administered questionnaire that measures asthenopia (or eye strain) and associated symptoms. The ASQ-17 covers 7 items of eye strain symptoms, 6 items of visual symptoms and 4 items of systemic and psychological symptoms with a maximum total score of 51 and an optimal cut-off threshold value of 12.5, indicating the presence of asthenopia.
Time frame: Baseline, 2 weeks and 4 weeks (one-month follow-up)
Perceived Stress Scale (PSS)
The Perceived Stress Scale (PSS) is a widely used psychological instrument designed to measure the degree to which individuals perceive their lives as stressful. The scale typically includes 10 items (PSS-10), yielding a total score ranging from 0 to 40. Scoring involves reversing the scores for positively worded items (items 4, 5, 7, and 8), then summing all item scores. Interpretation of scores is generally categorized as follows: 0-13 indicates low stress, 14-26 suggests moderate stress, and 27-40 reflects high perceived stress. Higher scores indicate greater levels of perceived stress.
Time frame: Baseline, 2 weeks and 4 weeks (one-month follow-up)
Plan to share: No
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Start is estimated for Jun 2026; primary completion for Mar 2027, 9 months later.
Of 31 non-industry interventional studies with no phase under Asthenopia, half reached primary completion within 3 months of starting (the median), counting those still running; a quarter within 2 and three quarters within 9. This study's planned 9 months is above that.
Counting every sponsor, half of 38 studies reached it within 3 months; a quarter within 2 and three quarters within 9.
How these figures are worked out, and which studies are left out of them.
This study is not yet recruiting, as verified in Jun 2026. You cannot join it, but the record below documents what was studied.
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