An interventional study of Integrated Myofascial Release and Light-Touch Control in Forward Head Posture and Chronic Nonspecific Neck Pain, sponsored by Karabuk University. Not yet recruiting at 1 site in Turkey (Türkiye). Open to participants aged 18 Years to 30 Years. Per ClinicalTrials.gov, last updated 2026-10-30.
Sponsored by Karabuk University · Not applicable, Interventional, and Treatment
This study will examine how smartphone use recorded by the phone and daily sleep, sitting, and physical activity are related to neck posture, sensitivity to pressure, and body awareness in university students aged 18 to 30 years. One hundred students will complete seven days of smartphone and activity monitoring and clinical assessments. Among these students, 56 who have nonspecific neck pain for at least three months, average pain of at least 3 out of 10, and forward head posture will be randomly assigned to integrated myofascial release or a light-touch control. Both groups will receive six sessions over two weeks. An assessor who does not know the assigned group will measure outcomes before and after treatment and, where feasible, one month after treatment. The study will investigate whether myofascial release improves neck pain, pressure pain threshold, posture, movement, disability, and awareness.
This single-center prospective study at Karabuk University, Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, includes an observational assessment of 100 university students and an embedded assessor-blinded, parallel-group randomized controlled trial involving 56 eligible participants (28 per group). The interventional enrollment target is 56; the wider observational sample is 100 and is not an additional randomized arm.
Smartphone use will be recorded for seven consecutive days using Screen Time, Digital Wellbeing, or an equivalent device-based system. No message contents, contacts, photographs, passwords, or personal files will be collected. During the same period, a triaxial accelerometer will estimate sleep, sedentary behavior, light physical activity, and moderate-to-vigorous physical activity. Device placement, valid-day criteria, and processing will be standardized using a validated protocol for the selected device before data collection.
Cervical posture will be assessed with standardized lateral photogrammetry using the tragus and C7 to calculate craniovertebral angle. During a 20-minute standardized smartphone task, angle will be recorded at the start, 10 minutes, and 20 minutes. Clinical assessments include digital algometry, numerical pain ratings, cervical range of motion, the Turkish Body Awareness Questionnaire, Fremantle Neck Awareness Questionnaire, and Neck Disability Index.
Participants eligible for the randomized component will be allocated 1:1 using a computer-generated sequence with concealment by an independent person using sealed opaque envelopes or an equivalent secure method. Integrated myofascial release targets cervical-related structures including the suboccipital region, upper trapezius, levator scapulae, and sternocleidomastoid. Six sessions will be administered over two weeks. Control participants receive light manual contact in comparable positions for a comparable duration without targeted fascial stretching or therapeutic pressure. Outcomes are assessed before treatment, after six sessions, and where feasible at one month after treatment. Discomfort and adverse events will be recorded at each session.
Associations will be examined using correlations and multivariable regression. Twenty-four-hour movement behaviors will be analyzed as compositional data. Randomized outcomes will be analyzed using mixed-effects models with group, time, and group-by-time interaction, following the intention-to-treat principle. Effect sizes and 95% confidence intervals will be reported. Data collection will not begin before ethics approval and institutional permissions are in place.
Karabuk University is the lead sponsor of 142 studies on the registry; 39 are open to participants now.
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Exclusion Criteria:
The wider observational assessment includes 100 students with or without neck pain; only 56 students meeting the additional neck-pain and posture criteria enter this randomized interventional record.
Twenty-eight participants receive integrated myofascial release targeting the suboccipital region, upper trapezius, levator scapulae, and sternocleidomastoid. Six sessions are delivered by a trained physiotherapist, three sessions per week for two weeks, using a standardized sequence and duration.
Other: Integrated Myofascial Release
Twenty-eight participants receive light manual contact without targeted myofascial stretching or therapeutic pressure, in positions and for a duration comparable to the intervention group. Six sessions are delivered over two weeks, three sessions per week.
Other: Light-Touch Control
Manual myofascial release of cervical-related structures, including the suboccipital region, upper trapezius, levator scapulae, and sternocleidomastoid, delivered by a trained physiotherapist in a standardized sequence. Three sessions per week for two weeks (six sessions).
Light manual contact in positions and for a duration comparable to myofascial release, without targeted fascial stretching or therapeutic pressure. Three sessions per week for two weeks (six sessions).
Change in Pressure Pain Threshold
Pressure pain threshold measured with a digital algometer with a 1 cm2 probe at standardized cervical muscle sites. Repeated measurements at each site are averaged and reported in kPa. A higher threshold indicates lower mechanical pain sensitivity. The primary comparison is baseline to completion of six sessions.
Time frame: Baseline and immediately after six sessions (2 weeks)
Change in Craniovertebral Angle
Craniovertebral angle in degrees measured by standardized lateral photogrammetry using the tragus and C7. A larger angle indicates less forward head posture. Assessed at the start, 10 minutes, and 20 minutes of a standardized smartphone task.
Time frame: Baseline, immediately after six sessions (2 weeks), and 1 month after treatment (approximately week 6), where feasible
Change in Neck Pain Intensity
Average neck pain over the preceding week measured using a 0-10 Numerical Rating Scale, where 0 means no pain and 10 means the worst imaginable pain. Lower scores indicate less pain.
Time frame: Baseline, immediately after six sessions (2 weeks), and 1 month after treatment (approximately week 6), where feasible
Change in Cervical Range of Motion
Active cervical flexion, extension, right and left rotation, and right and left lateral flexion measured in degrees using a clinical range-of-motion device or digital inclinometer. Each direction is analyzed separately.
Time frame: Baseline, immediately after six sessions (2 weeks), and 1 month after treatment (approximately week 6), where feasible
Change in Neck Disability Index
Turkish Neck Disability Index: 10 items, each scored 0-5; total 0-50. Higher scores indicate greater neck-related disability.
Time frame: Baseline, immediately after six sessions (2 weeks), and 1 month after treatment (approximately week 6), where feasible
Change in Body Awareness
Turkish Body Awareness Questionnaire assesses awareness of bodily processes and responses. Eighteen items rated 1-7 yield a total of 18-126, with higher scores indicating greater body awareness.
Time frame: Baseline, immediately after six sessions (2 weeks), and 1 month after treatment (approximately week 6), where feasible
Change in Neck Awareness
Turkish Fremantle Neck Awareness Questionnaire: nine items scored 0-4, total 0-36. Higher scores indicate greater disturbance of neck-related perception.
Time frame: Baseline, immediately after six sessions (2 weeks), and 1 month after treatment (approximately week 6), where feasible
Pressure Pain Threshold at Follow-up
Digital algometry at the same standardized cervical sites used at baseline, with repeated measurements averaged and reported in kPa; higher values indicate lower mechanical pain sensitivity.
Time frame: Baseline and 1 month after completion of treatment (approximately week 6), where feasible
Plan to share: Undecided
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Start is estimated for Nov 2026; primary completion for Oct 2027, 11 months later.
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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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