An interventional study of Physiotherapy care, Cervical Stabilization and Eyeball Exercises and Phyisotherapy Care, Cervical Stabilization and placebo exercises in Text Neck Syndrome, sponsored by University of Lahore. Enrolling by invitation at 1 site in Pakistan. Open to participants aged 25 Years to 50 Years. Per ClinicalTrials.gov, last updated 2026-07-27.
Sponsored by University of Lahore · Not applicable, Interventional, and Treatment
The prolonged use of electronic devices in the population nowadays contributes to the development of various musculoskeletal disorders affecting the neck. One such condition is the Text neck syndrome characterized by neck pain and muscular imbalance in the region as well as development of forward head posture. Some additional symptoms include headaches, impaired range of motion and eye strain. Eyeball exercises have been shown to improve symptoms of neck pain, and cervical stabilization has demonstrated positive effects on the deep cervical flexors, thereby improving forward head posture and other neck-associated symptoms. However, the combined effect of these two interventions has not been studied to treat text neck syndrome before. The primary outcome measures include the pain measured through Numeric Pain Rating Scale (NPRS) and pain pressure threshold (algometer), whereas the secondary outcome measures include the craniovertebral angle (CVA) and functional disability measured through neck disability index (NDI).
Text neck syndrome is a musculoskeletal syndrome characterized by neck pain, forward head posture, muscular imbalance, headache, reduced range of motion and eye problems. In the present era where everything is done through electronic devices and gadgets it is difficult to maintain a proper posture, which affects most importantly the cervical region. Prolonged use of these gadgets have led to the development of text neck syndrome which is a new pandemic these days. Constant screen use has detrimental effects on eyes that effects our neck as well, therefore the use of eyeball exercises has shown to improve the symptoms of neck pain. Cervical stabilization focuses on the deep neck flexor muscles which become weak and inactive in text neck syndrome. Cervical stabilization has shown improvements in the activation of these muscles as well as improved their strength along with improving the forward head posture. the combined effects of both these treatment regimes has not been studied yet in text neck syndrome individuals therefore the purpose of this randomized clinical trial will be to assess the combined effects of these treatment approaches on text neck syndrome. The Numeric Pain Rating Scale (NPRS) will be used to assess and measure the pain intensity along with NDI (neck disability index) that will help in functional evaluation and will serve as the primary outcome measures in this study. The Craniovertebral Angle (CVA) and Pain Pressure Threshold (PPT) measured through algometer will also be measured and will be the secondary outcome measures in this study.
Exclusion Criteria:
These patients will receive physiotherapy care along with cervical stabilization exercises and eyeball exercises. Treatment schedule: 3 sessions on alternate days for 6 weeks.
Other: Physiotherapy care, Cervical Stabilization and Eyeball Exercises
These patients will receive physiotherapy care along with cervical stabilization exercises and placebo treatment in place of eyeball exercises. Treatment schedule: 3 sessions on alternate days for 6 weeks.
Other: Phyisotherapy Care, Cervical Stabilization and placebo exercises
Physiotherapy care: 30minutes of physiotherapy, including hotpack for 10 minutes,cervical stretching (3sets/15-second hold,5 repetitions), cervical isometrics (5-10 reps/3sets), postural correction exercises (5-10 reps/2-3 sets), active ROMs of the neck.•Cervical Stabilization: Pressure biofeedback unit will be used, the patient will perform chin tucks while the inflated unit is below the head at 20mmHg initially, and will be raised to 30mmHg. A 10 seconds hold with 10 repetitions, including a 10-second rest interval between. A total of 3sets will be performed with 15second interval between each set. 15 minutes total •Eyeball exercises:The patient is then asked to carry out the described eyeball movements, each movement to be held for 10 seconds and repeated 4 times through the maximum range,directions: Leftward, rightward, upper left, lower left, upper and lower right, left and right side circular, leftward and rightward figure 8 rotation. 2sets with 15seconds interval. 15 mins total.
Physiotherapy care:30minutes of physiotherapy, including hotpack for 10 minutes, cervical stretching(3sets/15second hold, 5reps), cervical isometrics(5-10 reps/3sets), postural correction exercises(5-10 reps/2-3 sets), active ROMs of the neck.•Cervical stabilization: Pressure biofeedback unit will be used, the patient will perform chin tucks while the inflated unit is below the head at 20mmHg initially, and will be raised to 30mmHg. A10seconds hold with 10 repetitions, including a 10second rest interval between. A total of 3sets will be performed with 15second interval between each set,15 minutes total. •Placebo treatment:These exercises will take 10-15 minutes and the purpose is to engage the patient. These exercises do not have any effect on the ocular muscle of the eye and will only serve as a source of relaxation and lubrication for the eyes of the patient: blink slowly \& fully (10reps,3sets with10-15seconds interval), fix gaze (10seconds, 3-5reps), eyes closed breathing 60seconds.
Pain Intensity
Change in pain intensity measured using the Numeric Pain rating Scale (NPRS, 0-10 cm). Lower limit: 0 Upper limit: 10 Lower value means less pain
Time frame: Baseline, at 3rd week and at 6th week
Neck Disability
Functional disability measured using the Neck Disability Index (NDI) - Urdu validated version. Lower limit: 0 Upper limit: 50 Lower value indicates lesser disability
Time frame: Baseline, at 3rd week and at 6th week
Craniovertebral Angle (CVA)
Postural alignment measured as the cranio-vertebral angle (CVA) using Kinovea software from standardised lateral-view photographs Lower limit: 0 Upper limit: 180 Higher values mean better posture (less forward head)
Time frame: Baseline, at 3rd week and at 6th week
Pain Pressure Threshold (PPT)
Pain sensitivity will be measured using the Algometer. Lower limit: 0 kg/cm² Upper limit: 10 kg/cm² Higher values mean less tenderness
Time frame: Baseline, at 3rd week and at 6th week
Plan to share: No
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University of Lahore