An interventional study of Proprioceptive Neuromuscular Facilitation and Post-facilitation Stretching in Text Neck Syndrome, sponsored by Cairo University. Not yet recruiting. Open to participants aged 18 Years to 44 Years. Per ClinicalTrials.gov, last updated 2026-10-21.
Sponsored by Cairo University · Not applicable, Interventional, and Treatment
this study will be conducted to investigate the effect of Proprioceptive Neuromuscular Facilitation (PNF) stretching and Post Facilitation Stretching (PFS) on neck pain intensity, Cranio Vertebral Angle (CVA), cervical ROM and neck functional disability level in patients with text neck syndrome
Text Neck Syndrome (TNS) is increasingly being recognized as a widespread health concern, particularly among adolescents and young adults due to the frequent and prolonged use of smartphones and handheld electronic devices. Maintaining a forward head posture (FHP) for extended periods places abnormal stress on the cervical spine, disrupting normal biomechanics. Around 75% of the global population spends several hours daily looking down at mobile screens, which significantly increases the mechanical load on the neck-from approximately 5 kg in a neutral position to over 27 kg at 60 degrees of cervical flexion. This repetitive strain places individuals at high risk for developing musculoskeletal disorders such as TNS.PNF has been shown to improve posture, mobility, and coordination by recruiting both deep and superficial cervical muscles through functional, multidirectional patterns. This method enhances the integration of voluntary movement and proprioceptive feedback, which are often impaired in individuals with TNS due to repetitive poor posture. As a technique, it not only helps relieve pain but also supports long-term neuromuscular adaptations. However, despite its popularity in clinical practice, further controlled research is still needed to better understand its lasting neurophysiological effects in people with postural disorders like TNS. Post facilitation stretching, in contrast, takes a more direct approach to muscle lengthening. By applying an isometric contraction to a shortened muscle followed by a sudden relaxation and stretch, this technique effectively reduces hypertonicity and improves flexibility. It is especially useful for addressing the postural tightness often seen in the upper trapezius and levator scapulae in TNS cases. The neuromuscular reset achieved by this method helps decrease muscular resistance and improve movement efficiency. Although the results are promising, there is still limited comparative evidence on how PFS performs relative to other techniques, including PNF, particularly in TNS management. This study is designed to address that gap by directly comparing the clinical outcomes of PNF and PFS in individuals with TNS. Both techniques have demonstrated individual effectiveness in enhancing cervical function and reducing discomfort, but no study to date has rigorously evaluated them against each other in a standardized clinical population. The findings of this research will therefore provide valuable insights to guide evidence-based clinical decision-making for physiotherapists and rehabilitation professionals
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Exclusion Criteria:
Seventeen patients with text neck syndrome will receive proprioceptive neuromuscular Facilitation stretching technique in addition to the traditional treatment three times per week for 4 weeks
Other: Proprioceptive Neuromuscular Facilitation · Other: traditional treatment
Seventeen patients with text neck syndrome will receive post-facilitation stretching technique in addition to the traditional treatment three times per week for 4 weeks
Other: Post-facilitation Stretching · Other: traditional treatment
Seventeen patients with text neck syndrome will receive the traditional treatment three times per week for 4 weeks
Other: traditional treatment
the patients will receive proprioceptive neuromuscular facilitation for levator scapulae, upper trapezius and sternocleidomastoid muscle in the form of Contract-Relax technique. in addition to traditional treatment in the form of postural correction exercises (chin tucks and scapular retraction) and strengthening exercises for deep cervical flexors and scapular stabilizers. Exercises are typically performed in 3 sets of 10 repetitions.
the patients will receive Post-Facilitation Stretching Technique for levator scapulae, upper trapezius and sternocleidomastoid muscle. The participant will lie supine, placing the affected hand under the ipsilateral thigh to promote shoulder depression.For the upper trapezius, the same will be applied, except ipsilateral rotation will be used.For the sternocleidomastoid muscle, the therapist will position the neck into extension, contralateral side flexion, and ipsilateral rotation until resistance is felt. This position effectively elongates the sternocleidomastoid muscle while maintaining patient comfort and control throughout the stretch.The muscle will be returned to mid-range.The participant will perform a near-maximal isometric contraction for 10 seconds.Upon rapid relaxation, the therapist will apply an aggressive stretch beyond the tissue barrier .The procedure will be repeated five times for each muscle. plus tradional treatment
the patients will receive traditional treatment in the form of postural correction exercises (chin tucks and scapular retraction) and strengthening exercises for deep cervical flexors and scapular stabilizers. Exercises are typically performed in 3 sets of 10 repetitions.
craniovertebral angle
craniovertebral angle will be measured by lateral photographe.A lateral photograph is taken at the level of the participant's shoulder using a digital camera placed at a fixed distance.The anatomical landmarks (tragus of the ear and C7 spinous process) are identified and marked either physically or digitally using posture analysis software.The craniovertebral angle is calculated as the angle between:A horizontal line passing through C7, andA line connecting C7 to the tragus.CVA \< 48-50°: Indicates forward head posture (FHP),CVA ≥ 50°: Suggests a normal or neutral head posture.
Time frame: up to four weeks
cervical range of motion
cervical range of motion will be measured by cervical range of motion device
Time frame: up to four weeks
pain intesinty
Pain intensity will be assessed using the Visual Analogue Scale (VAS). The VAS is a 10-centimeter horizontal line anchored by two descriptors: "no pain" (0) and "worst pain imaginable" (10). Each participant will be instructed to place a vertical mark along the line indicating the intensity of their pain. The distance (in cm) from the "no pain" anchor to the participant's mark will be measured and recorded as the pain score (
Time frame: up to four weeks
neck disability
The Neck Disability Index (NDI) is the most widely used and validated self-report questionnaire for assessing neck pain-related disability.Questions include activities of daily living, such as: personal care, lifting, reading, work, driving, sleeping, recreational activities, pain intensity, concentration and headache. Each question is measured on a scale from 0 (no disability) to 5.The total score will be obtained by summing the item scores, yielding a total range from 0 to 50.
Time frame: up to four weeks
No study locations are listed for this record.
From the registry record's own update history. This site started tracking changes on Sep 25, 2026; for anything earlier, see the record history on ClinicalTrials.gov ↗
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