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NCT Number: NCT07646392

Effects of Cervical Stabilization Exercises With and Without Reverse Natural Apophyseal Glides in Text Neck Syndrome

Text neck syndrome is one such disorder within that group, increasingly affecting individuals worldwide across various age groups. The phenomenon of text neck may occur in individuals who frequently and for prolonged periods adopt a forward-flexed neck and head position while looking at the screens of mobile electronic devices. This posture puts stress on the neck muscles and spine, leading to various symptoms like neck pain, stiffness, and headaches.

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Key information

Conditions

Text Neck Syndrome Neck Pain Neurologic Manifestations Pain Pathological Conditions, Signs and Symptoms Signs and Symptoms

Age range

18 year–35 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

About this study

The single blinded randomized clinical trial will be conducted at Shafqat Polyclinic and Sunrise Medicare Hospital Faisalabad. A total of 42 participants ( 21 in each group) with text neck syndrome will be recruited through non probability convenient sampling technique on which patients will be randomized through computer generated software into Group A and Group B. Group A will receive cervical stabilization exercises and reverse NAGs mobilization. Cervical stabilization exercises will be performed as 15 repetitions with 10 seconds of contraction and 5 seconds of relaxation. The mobilizations will be repeated 10 times per set, 2 to 3 oscillations per second for a total of 3 sets per treatment. Group B will receive only cervical stabilization exercises. Each exercise will be performed as 15 repetitions with 10 seconds of contraction and 5 seconds of relaxation per treatment. Each session will be last for 40 to 45min and three sessions per week will be performed.. Outcome measure will be conducted through pain (NPRS), disability (NDI) and range of motion (Universal Goniometer) at baseline and after six weeks treatment. Data will be analyzed using SPSS software version 27. After assessing normality of data by Shapiro-wilk test, it will be decided either parametric or non-parametric test will be used within group or between groups.

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • • Both male and female are taken
  • Age between 18-35 years
  • Craniovertebral angle less than 50 degree

Exclusion criteria

  • • Trauma
  • Patient undergoes cervical surgery.
  • Disc prolapse, herniation, spondylolisthesis
  • Osteoporosis
  • Torticullis
  • Pregnancy
  • Psychological Problems
  • Cervical radiculopathy

Treatment and study plan

Cervical stabilization exercises with reverse NAGs

Other
  • Cervical Stabilization Exercises: Chin tuck, Cervical Extension, shoulder Shrugs, shoulder Rolls, scapular Retraction.

Reverse NAG A mobilization takes place when you glide the inferior facet up on the superior one. This is achieved by thrusting up along the treatment plane with your bottom hand. You initially press ventrally to secure your thumb and index finger under the chosen segment transverse processes and then glide cranially along the treatment plane. Maintain your ventral pressure or you will slip over the transverse process.

Position: Patient is seated. You stand beside patient and cradle his head to your body with forearm. Therapist hand position piston grip for lower cervical spine and for upper thoracic spine will be wide grip.

Dosage: The mobilization was applied at C5 to C7 and T1 to T3.

Cervical stabilization exercises without reverse NAGs

Other
  • Cervical Stabilization Exercises: Chin tuck: In standing position, participant pulls back the chin as if trying to make double chin while keeping the eyes level. This was done for 15 repetitions.

Cervical Extension: In standing participant graps the base of neck, with both hands while extending the neck as far as possible. This was done for 15 repetitions.

Shoulder Shrugs: In standing position, participant shrugs the shoulders, bringing them up towards the ears. This was done for 15 repetitions.

Shoulder Rolls: In standing position, participant rolls the shoulder forward in a circle. Then, rolls shoulder backwards in a circle. Then participant relaxes and repeats the procedure for 15 times.

Scapular Retraction: In standing position, participant brings the shoulder blades together in the back; participant then relaxes and repeats the procedure for 15 times.

Primary outcomes

  1. 1. Numeric pain rate scale (NPRS)

    Time frame: upto 4 weeks

    Patient level of pain will be assessed using this scale. This scale ranges from 0 to 10. 0 indicates "no pain" and 10 indicates "worst pain" (25). The reliability of NPRS in patient with neck pain has been reported to be 0.76 indicated a moderate level of reliability for NPRS and moderate level of consistency and stability in the scores obtained from the measurement tool

  2. 2. Neck Disability index (NDI)

    Time frame: Upto 4 weeks

    This questionnaire will be used to assess disability. Each of the ten items in the neck disability assessment is given a score between 0 and 5. Consequently, 50 is the highest possible score. The ten elements include four activities of daily living (lifting, working, driving, and recreation), two discretionary activities of daily living (personal care, reading), and four subjective symptoms (pain intensity, headache, concentration, and sleeping). This index is the most popular and well-researched tool for evaluating patients' self-reported impairment in relation to neck discomfort (27). The intraclass correlation coefficient ICC ( 95% Confidence intervals) for NDI was 0.87(0.66, 0.94), indicating very high reliability and NDI demonstrated an adequate level of absolute reliability(9.3) and internal consistency (Cronbach alpha 0.70), along with possibility, discriminative validity, and acceptable concept validity

  3. 3. Universal Goniometer (UG):

    Time frame: Upto 4 weeks

    The Universal Goniometer was used to assess the ranges of motion of cervical flexion, extension, rotation, and lateral flexion. Throughout all range-of-motion tests, subjects sat erect, facing forward, with their arms on their laps and their feet flat on the ground(29). The goniometer application, an excellent correlation (r=0.81, p=0.000), for intra-rater 9(ICC=0.88) and inter-rater reliability (ICC=0.915) were obtained (30).

  4. 4. Craniovertebral Angle:

    Time frame: Upto 4 weeks

    Measuring craniovertebral (CV) angle is one of the common objective methods in assessing forward head posture . It is the angle formed by a horizontal line drawn through the spinous process of the seventh cervical (C7) vertebra and a line joining the spinous process of C7 vertebra with the tragus of the ear using kinovvea software 2023 version 1.2. A smaller CVA reflects a greater degree of forward head posture, with angle less than 50 degrees typically considered abnormal

Study contacts

Contact information is provided by the study sponsor or research team.

Samrood Akram, PhD*

CONTACT

[email protected]

03324806143

Sponsors and collaborators

Lead sponsor

Riphah International University

Other

Registry information

Official study title

Effects of Cervical Stabilization Exercises With and Without Reverse Natural Apophyseal Glides on Pain, Range of Motion and Disability Among Patients With Text Neck Syndrome

Important dates

Study start
2026
Primary completion
2026
Study completion
2026
First posted
Jun 12, 2026
Registry last updated
Jun 12, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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