Neck SyndromeNCT06108752
Comparative Effect of Scapular Stabilization vs Thoracic Extension Exercises in Young Adults With Text Neck Syndrome.
A study testing Scapular stabilization exercises and Thoracic extension exercises in people with Neck Syndrome and Forward Head Posture, run by Riphah International University at 1 site in Pakistan.
Trial summary
The aim of the study is to compare the effect of scapular stabilization versus thoracic extension exercises on pain, disability, range of motion, and cranio-vertebral angle in young adults with Text Neck Syndrome. Read more about this study
- Who is it for?
- Ages 19 to 30 years
- Conditions the study is for
- Neck Syndrome, Forward Head Posture
- What is being tested?
- Scapular stabilization exercises and Thoracic extension exercises
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 36 participants
- Where
- 1 sitePakistan
- Study dates
- 8 May 2023to 8 Jan 2024
- Phase
- Interventional
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 19 to 30 years
- All sexes
- No healthy volunteers
- Adult
Who may be able to join
- Both male and female participants with forward head posture or text neck syndrome
- Participants with neck pain from the past three months
- Smart-phones must be used for at least ≥3 hours each day
- Participants with craniovertebral angle <53° will be included in this study
Who cannot join
- History of cervical and thoracic spine surgery within the past three months
- Serious pathological conditions within the past three months
- Congenital spinal anomalies, or rheumatoid arthritis
- Neurological signs and severe psychological disorders
Trial locations and contacts
1 site in 1 country.
Pakistan1 site, 1 recruiting
- Recruiting
Punjab Employees Social Security Institute
Lahore, Punjab Province, 54000
Faiza Amjad, M.Phil, 03338013182, faiza.amjad@riphah.edu.pk
Aiman Zahra, 03365566001, MS-OMPT
About this study
Official title: Comparative Effect of Scapular Stabilization Versus Thoracic Extension Exercises on Pain, Disability, Range of Motion, and Craniovertebral Angle in Young Adults With Text Neck Syndrome.
The aim of the study is to compare the effect of scapular stabilization versus thoracic extension exercises on pain, disability, range of motion, and cranio-vertebral angle in young adults with Text Neck Syndrome.
Read the detailed description
Text neck has emerged as a widespread modern epidemic that affects people of all ages, particularly younger populations, as they are exposed to handheld mobile device use for several hours a day beginning at a very early age. The relation between the posture due to handheld mobile device use and neck pain is still debatable. To manage the maladaptive posture of the cervical spine, indirect treatment instead of direct treatment of the neck can be used, which is the basis for the concept of regional interdependence, i.e., the cause of pain becomes the cause of damage to other body parts. Therefore, not treating the damaged part, but indirectly treating the area of cause can alleviate the symptoms. A bio-dynamic relationship between the cervical and thoracic spine is associated with exercise, an important factor causing neck pain. Therefore, many clinicians pay attention to the thoracic spine of patients with neck pain and recommend thoracic extension exercises. On the other hand, many researchers recommended scapular stabilization exercise as a recovery treatment for imbalanced scapular muscles caused by forward head posture.
This study investigates how exercise programs not directly applied to the cervical spine affect people with text neck syndrome. The significance of the current study is to evaluate the comparison between concentric and eccentric exercise which is previously rarely investigated.
- Conditions
- Neck Syndrome, Forward Head Posture
- Being tested
- Scapular stabilization exercises, Thoracic extension exercises
- Keywords
- Craniovertebral angle, Scapular stabilization exercises, Thoracic extension, Text neck syndrome, Range of motion, Pain, Disability
- Medical subject headings
- Pain
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Scapular stabilization exercisesOther
The scapular stabilization exercises will be comprised of four exercise programs. Each exercise will be performed with two sets of 15 reps, 10 sec per rep 40 min per day, thrice per week for a total of six weeks. Baseline treatment will be the application of a hot pack for 7-10 minutes and cervical active range of motion exercises.
Thoracic extension exercisesOther
Thoracic extension exercises will be comprised of three exercise programs. Each exercise will be performed with two sets of 15 reps, 10 sec per rep 40 min per day, thrice per week for a total of six weeks. Baseline treatment will be the application of a hot pack for 7-10 minutes and cervical active range of motion exercises.
| Study group | Role | What they receive |
|---|---|---|
| Scapular Stabilization Exercises | Experimental | Scapular stabilization exercises along with the hot pack and cervical active range of motion exercises Receives: Other: Scapular stabilization exercises |
| Thoracic Extension Exercises | Experimental | Thoracic extension exercises along with the hot pack and cervical active range of motion exercises Receives: Other: Thoracic extension exercises |
What is being measured
The primary outcome is the main question the study is designed to answer.
Neck disability index (NDI)
Changes from baseline. NDI is a valid and reliable tool having values ranging from 0.50 to 0.98.
The NDI assessment involves a 10-item, 50-point index questionnaire that assesses the effects of neck pain and symptoms during a range of functional activities.
Measured: 6 weeks
Visual analogue scale (VAS)
Changes from baseline. The visual analogue scale (VAS) is a simple and frequently used method for the assessment of variations in intensity of pain. The reliability of the VAS for disability is moderate to good i.e. 0.98. However, its validity is questionable.
Measured: 6 weeks
Goniometer for cervical range of motion
Changes from baseline. Goniometer has fair inter-tester reliability ranging from 0.79-0.92. Validity of this tool is good i.e. 0.97-0.98 This tool is most commonly used in the clinical settings for evaluating joint range of motion.
Measured: 6 weeks
Photogrammetry for craniovertebral angle (image j software)
Changes from baseline. 'Image J', is an analysis software with high reliability and validity.
This study will assess the craniovertebral angle using a digital camera. The camera will be placed 1.5 m from the participant's right side to take a lateral photographic view of the participant's head and neck in a seated position. The craniovertebral angle is the angle between the horizontal line passing the 7th Cervical vertebra (C7) and the line extending from C7 to the tragus of the ear. The resulting maladaptive posture of the neck will be determined using Image J software.
Measured: 6 weeks
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted31 Oct 2023
- Study start8 May 2023
- Primary completion8 Dec 2023 (estimated)
- Study completion8 Jan 2024 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (17)Papers the sponsor has linked to this study.
- Other trials for Neck SyndromeStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Double blind
- Who is masked
- Participant, Outcomes assessor
- Enrolment
- 36 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Riphah International University
- Sponsor type
- University, hospital or other
- Responsible party
- Sponsor
- Investigators
- Faiza Amjad, M.Phil, Principal investigator, Riphah International University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT06108752
- Sponsor's protocol ID
- REC/RCR & AHS/23/0161
- Status last verified
- Nov 2023
- First submitted
- 25 Oct 2023
- Last updated
- 13 Nov 2023
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Publications
Kang NY, Im SC, Kim K. Effects of a combination of scapular stabilization and thoracic extension exercises for office workers with forward head posture on the craniovertebral angle, respiration, pain, and disability: A randomized-controlled trial. Turk J Phys Med Rehabil. 2021 Sep 1;67(3):291-299. doi: 10.5606/tftrd.2021.6397. eCollection 2021 Sep.
PubMed 34870115Warda DG, Nwakibu U, Nourbakhsh A. Neck and Upper Extremity Musculoskeletal Symptoms Secondary to Maladaptive Postures Caused by Cell Phones and Backpacks in School-Aged Children and Adolescents. Healthcare (Basel). 2023 Mar 10;11(6):819. doi: 10.3390/healthcare11060819.
PubMed 36981476Cho J, Lee E, Lee S. Upper thoracic spine mobilization and mobility exercise versus upper cervical spine mobilization and stabilization exercise in individuals with forward head posture: a randomized clinical trial. BMC Musculoskelet Disord. 2017 Dec 12;18(1):525. doi: 10.1186/s12891-017-1889-2.
PubMed 29233164Kong YS, Kim YM, Shim JM. The effect of modified cervical exercise on smartphone users with forward head posture. J Phys Ther Sci. 2017 Feb;29(2):328-331. doi: 10.1589/jpts.29.328. Epub 2017 Feb 24.
PubMed 28265167Fiebert I, Kistner F, Gissendanner C, DaSilva C. Text neck: An adverse postural phenomenon. Work. 2021;69(4):1261-1270. doi: 10.3233/WOR-213547.
PubMed 34366308Koseki T, Kakizaki F, Hayashi S, Nishida N, Itoh M. Effect of forward head posture on thoracic shape and respiratory function. J Phys Ther Sci. 2019 Jan;31(1):63-68. doi: 10.1589/jpts.31.63. Epub 2019 Jan 10.
PubMed 30774207Singla D, Veqar Z. Association Between Forward Head, Rounded Shoulders, and Increased Thoracic Kyphosis: A Review of the Literature. J Chiropr Med. 2017 Sep;16(3):220-229. doi: 10.1016/j.jcm.2017.03.004. Epub 2017 Sep 28.
PubMed 29097952Moezy A, Sepehrifar S, Solaymani Dodaran M. The effects of scapular stabilization based exercise therapy on pain, posture, flexibility and shoulder mobility in patients with shoulder impingement syndrome: a controlled randomized clinical trial. Med J Islam Repub Iran. 2014 Aug 27;28:87. eCollection 2014.
PubMed 25664288Yoo WG. Effect of thoracic stretching, thoracic extension exercise and exercises for cervical and scapular posture on thoracic kyphosis angle and upper thoracic pain. J Phys Ther Sci. 2013 Nov;25(11):1509-10. doi: 10.1589/jpts.25.1509. Epub 2013 Dec 11.
PubMed 24396221Alpayci M, Ilter S. Isometric Exercise for the Cervical Extensors Can Help Restore Physiological Lordosis and Reduce Neck Pain: A Randomized Controlled Trial. Am J Phys Med Rehabil. 2017 Sep;96(9):621-626. doi: 10.1097/PHM.0000000000000698.
PubMed 28118272Suvarnnato T, Puntumetakul R, Uthaikhup S, Boucaut R. Effect of specific deep cervical muscle exercises on functional disability, pain intensity, craniovertebral angle, and neck-muscle strength in chronic mechanical neck pain: a randomized controlled trial. J Pain Res. 2019 Mar 7;12:915-925. doi: 10.2147/JPR.S190125. eCollection 2019.
PubMed 30881101Ghamkhar L, Arab AM, Nourbakhsh MR, Kahlaee AH, Zolfaghari R. Examination of Regional Interdependence Theory in Chronic Neck Pain: Interpretations from Correlation of Strength Measures in Cervical and Pain-Free Regions. Pain Med. 2020 Feb 1;21(2):e182-e190. doi: 10.1093/pm/pnz206.
PubMed 31504861Suwaidi ASA, Moustafa IM, Kim M, Oakley PA, Harrison DE. A Comparison of Two Forward Head Posture Corrective Approaches in Elderly with Chronic Non-Specific Neck Pain: A Randomized Controlled Study. J Clin Med. 2023 Jan 9;12(2):542. doi: 10.3390/jcm12020542.
PubMed 36675471Nejati P, Lotfian S, Moezy A, Moezy A, Nejati M. The relationship of forward head posture and rounded shoulders with neck pain in Iranian office workers. Med J Islam Repub Iran. 2014 May 3;28:26. eCollection 2014.
PubMed 25250268Sindhu BS, Shechtman O, Tuckey L. Validity, reliability, and responsiveness of a digital version of the visual analog scale. J Hand Ther. 2011 Oct-Dec;24(4):356-63; quiz 364. doi: 10.1016/j.jht.2011.06.003. Epub 2011 Aug 6.
PubMed 21820864
Study at a glance
From the registry record, last updated by the sponsor on 13 Nov 2023. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Comparative Effect of Scapular Stabilization Versus Thoracic Extension Exercises on Pain, Disability, Range of Motion, and Craniovertebral Angle in Young Adults With Text Neck Syndrome.
- ClinicalTrials.gov ID
- NCT06108752
- Acronym / sponsor ID
- REC/RCR & AHS/23/0161
- Conditions
- Neck Syndrome, Forward Head Posture
- Keywords
- Craniovertebral angle, Scapular stabilization exercises, Thoracic extension, Text neck syndrome, Range of motion, Pain, Disability
- Study type
- Interventional
- Recruitment status
- Unknown status
- Enrolment
- 36 participants (estimated)
- Lead sponsor
- Riphah International UniversityUniversity, hospital or other
- Study start
- 8 May 2023 (actual)
- Primary completion
- 8 Dec 2023 (estimated)
- Study completion
- 8 Jan 2024 (estimated)
- First posted
- 31 Oct 2023 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The aim of the study is to compare the effect of scapular stabilization versus thoracic extension exercises on pain, disability, range of motion, and cranio-vertebral angle in young adults with Text Neck Syndrome.
Detailed description
Text neck has emerged as a widespread modern epidemic that affects people of all ages, particularly younger populations, as they are exposed to handheld mobile device use for several hours a day beginning at a very early age. The relation between the posture due to handheld mobile device use and neck pain is still debatable. To manage the maladaptive posture of the cervical spine, indirect treatment instead of direct treatment of the neck can be used, which is the basis for the concept of regional interdependence, i.e., the cause of pain becomes the cause of damage to other body parts. Therefore, not treating the damaged part, but indirectly treating the area of cause can alleviate the symptoms. A bio-dynamic relationship between the cervical and thoracic spine is associated with exercise, an important factor causing neck pain. Therefore, many clinicians pay attention to the thoracic spine of patients with neck pain and recommend thoracic extension exercises. On the other hand, many researchers recommended scapular stabilization exercise as a recovery treatment for imbalanced scapular muscles caused by forward head posture.
This study investigates how exercise programs not directly applied to the cervical spine affect people with text neck syndrome. The significance of the current study is to evaluate the comparison between concentric and eccentric exercise which is previously rarely investigated.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Double blind (participant, outcomes assessor)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Scapular Stabilization Exercises | Experimental | Other: Scapular stabilization exercisesScapular stabilization exercises along with the hot pack and cervical active range of motion exercises |
| Thoracic Extension Exercises | Experimental | Other: Thoracic extension exercisesThoracic extension exercises along with the hot pack and cervical active range of motion exercises |
Who may qualify
- Ages
- 19 to 30 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult
Key inclusion criteria (4 listed)
- Both male and female participants with forward head posture or text neck syndrome
- Participants with neck pain from the past three months
- Smart-phones must be used for at least ≥3 hours each day
- Participants with craniovertebral angle <53° will be included in this study
Key exclusion criteria (4 listed)
- History of cervical and thoracic spine surgery within the past three months
- Serious pathological conditions within the past three months
- Congenital spinal anomalies, or rheumatoid arthritis
- Neurological signs and severe psychological disorders
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Scapular stabilization exercisesThe scapular stabilization exercises will be comprised of four exercise programs. Each exercise will be performed with two sets of 15 reps, 10 sec per rep 40 min per day, thrice per week for a total of six weeks. Baseline treatment will be the application of a hot pack for 7-10 minutes and cervical active range of motion exercises. | Other | Scapular Stabilization Exercises |
| Thoracic extension exercisesThoracic extension exercises will be comprised of three exercise programs. Each exercise will be performed with two sets of 15 reps, 10 sec per rep 40 min per day, thrice per week for a total of six weeks. Baseline treatment will be the application of a hot pack for 7-10 minutes and cervical active range of motion exercises. | Other | Thoracic Extension Exercises |
Primary outcome
Neck disability index (NDI)
Time frame: 6 weeks
Changes from baseline. NDI is a valid and reliable tool having values ranging from 0.50 to 0.98. The NDI assessment involves a 10-item, 50-point index questionnaire that assesses the effects of neck pain and symptoms during a range of functional activities.
Visual analogue scale (VAS)
Time frame: 6 weeks
Changes from baseline. The visual analogue scale (VAS) is a simple and frequently used method for the assessment of variations in intensity of pain. The reliability of the VAS for disability is moderate to good i.e. 0.98. However, its validity is questionable.
Goniometer for cervical range of motion
Time frame: 6 weeks
Changes from baseline. Goniometer has fair inter-tester reliability ranging from 0.79-0.92. Validity of this tool is good i.e. 0.97-0.98 This tool is most commonly used in the clinical settings for evaluating joint range of motion.
Photogrammetry for craniovertebral angle (image j software)
Time frame: 6 weeks
Changes from baseline. 'Image J', is an analysis software with high reliability and validity. This study will assess the craniovertebral angle using a digital camera. The camera will be placed 1.5 m from the participant's right side to take a lateral photographic view of the participant's head and neck in a seated position. The craniovertebral angle is the angle between the horizontal line passing the 7th Cervical vertebra (C7) and the line extending from C7 to the tragus of the ear. The resulting maladaptive posture of the neck will be determined using Image J software.
Results and safety
Results are not available in the source record.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 13 Nov 2023.
- Background: PubMed 34870115Kang NY, Im SC, Kim K. Effects of a combination of scapular stabilization and thoracic extension exercises for office workers with forward head posture on the craniovertebral angle, respiration, pain, and disability: A randomized-controlled trial. Turk J Phys Med Rehabil. 2021 Sep 1;67(3):291-299. doi: 10.5606/tftrd.2021.6397. eCollection 2021 Sep.
- Background: PubMed 36981476Warda DG, Nwakibu U, Nourbakhsh A. Neck and Upper Extremity Musculoskeletal Symptoms Secondary to Maladaptive Postures Caused by Cell Phones and Backpacks in School-Aged Children and Adolescents. Healthcare (Basel). 2023 Mar 10;11(6):819. doi: 10.3390/healthcare11060819.
- Background: PubMed 29233164Cho J, Lee E, Lee S. Upper thoracic spine mobilization and mobility exercise versus upper cervical spine mobilization and stabilization exercise in individuals with forward head posture: a randomized clinical trial. BMC Musculoskelet Disord. 2017 Dec 12;18(1):525. doi: 10.1186/s12891-017-1889-2.
- Background: PubMed 28265167Kong YS, Kim YM, Shim JM. The effect of modified cervical exercise on smartphone users with forward head posture. J Phys Ther Sci. 2017 Feb;29(2):328-331. doi: 10.1589/jpts.29.328. Epub 2017 Feb 24.
- Background: PubMed 34366308Fiebert I, Kistner F, Gissendanner C, DaSilva C. Text neck: An adverse postural phenomenon. Work. 2021;69(4):1261-1270. doi: 10.3233/WOR-213547.
- Background: PubMed 30774207Koseki T, Kakizaki F, Hayashi S, Nishida N, Itoh M. Effect of forward head posture on thoracic shape and respiratory function. J Phys Ther Sci. 2019 Jan;31(1):63-68. doi: 10.1589/jpts.31.63. Epub 2019 Jan 10.
- Background: PubMed 29097952Singla D, Veqar Z. Association Between Forward Head, Rounded Shoulders, and Increased Thoracic Kyphosis: A Review of the Literature. J Chiropr Med. 2017 Sep;16(3):220-229. doi: 10.1016/j.jcm.2017.03.004. Epub 2017 Sep 28.
- Background: PubMed 25664288Moezy A, Sepehrifar S, Solaymani Dodaran M. The effects of scapular stabilization based exercise therapy on pain, posture, flexibility and shoulder mobility in patients with shoulder impingement syndrome: a controlled randomized clinical trial. Med J Islam Repub Iran. 2014 Aug 27;28:87. eCollection 2014.
- Background: PubMed 24396221Yoo WG. Effect of thoracic stretching, thoracic extension exercise and exercises for cervical and scapular posture on thoracic kyphosis angle and upper thoracic pain. J Phys Ther Sci. 2013 Nov;25(11):1509-10. doi: 10.1589/jpts.25.1509. Epub 2013 Dec 11.
- Background: PubMed 28118272Alpayci M, Ilter S. Isometric Exercise for the Cervical Extensors Can Help Restore Physiological Lordosis and Reduce Neck Pain: A Randomized Controlled Trial. Am J Phys Med Rehabil. 2017 Sep;96(9):621-626. doi: 10.1097/PHM.0000000000000698.
- Background: PubMed 30881101Suvarnnato T, Puntumetakul R, Uthaikhup S, Boucaut R. Effect of specific deep cervical muscle exercises on functional disability, pain intensity, craniovertebral angle, and neck-muscle strength in chronic mechanical neck pain: a randomized controlled trial. J Pain Res. 2019 Mar 7;12:915-925. doi: 10.2147/JPR.S190125. eCollection 2019.
- Background: PubMed 31504861Ghamkhar L, Arab AM, Nourbakhsh MR, Kahlaee AH, Zolfaghari R. Examination of Regional Interdependence Theory in Chronic Neck Pain: Interpretations from Correlation of Strength Measures in Cervical and Pain-Free Regions. Pain Med. 2020 Feb 1;21(2):e182-e190. doi: 10.1093/pm/pnz206.
- Individual participant dataSharing planned: No
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Faiza Amjad, M.Phil principal investigator
Riphah International University
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Scapular stabilization exercises and Thoracic extension exercises in people with Neck Syndrome and Forward Head Posture, run by Riphah International University at 1 site in Pakistan.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 4 inclusion and 4 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: status not confirmed, as of the sponsor's last update on 13 Nov 2023. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Pakistan. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
Results are not available in the source record.
How can a doctor refer a patient or contact the research team?
Contact Imran Amjad, PHD (03324390125, imran.amjad@riphah.edu.pk), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Neck disability index (NDI) (time frame: 6 weeks). The study lists 4 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT06108752, which also lists 17 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 13 Nov 2023.