Cervical Myofascial Pain SyndromeNCT07571655
Comparative Effect of Active Release Technique and Myofascial Release in Cervical Myofascial Syndrome
A study testing Myofascial Release + Eye exercises and Active Release Technique + Eye exercises in people with Cervical Myofascial Pain Syndrome, run by Riphah International University at 1 site in Pakistan.
Trial summary
The aim of this randomized controlled trial is to find the comparative effect of Active Release Technique and Myofascial release, each combined with eye exercises, on asthenopia, sleep quality, stress, pain and functional disability in patients with CMPS. Read more about this study
- Who is it for?
- Ages 18 to 40 years
- Conditions the study is for
- Cervical Myofascial Pain Syndrome
- What is being tested?
- Myofascial Release + Eye exercises and Active Release Technique + Eye exercises
- Type of treatment
- Injection or infusion
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 44 participants
- Where
- 1 sitePakistan
- Study dates
- 5 Jun 2026to 5 Mar 2027
- Phase
- Interventional
- Are there results?
- Not yet: the study is under way
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 18 to 40 years
- All sexes
- No healthy volunteers
- Adult
Who may be able to join
- • Both genders
- Age between 18 and 40 years
- Neck pain since last month with NPRS >3
- Cervical Myofascial pain (Presence of one or more trigger point in neck/ shoulder muscles particularly (upper trapezius, SCM and levator)
- PSQI score > 5
- Subjects with ASQ-17 score > 13
Who cannot join
- • Subjects with a history of cervical trauma or surgery
- Subjects with a history of substance abuse
- Subjects with use of sleep medications
- Subjects with psychological disturbance (stress, depression or anxiety)
- Visual impairment or ophthalmologic disease other than asthenopia
Trial locations and contacts
1 site in 1 country. Contact the study team or a site near you to ask about taking part.
Pakistan1 site
Railway General Hospital, Rawalpindi
Rawalpindi, Punjab Province, 46600
KINZA ANWAR, MS-OMPT, +92-3239735427, kinza.anwar@riphah.edu.pk
IQRA, MS-OMPT*, IFTIKHAR
About this study
Official title: Comparative Effect of Active Release Technique and Myofascial Release to Improve Asthenopia, Sleep and Stress in Patients With Cervical Myofascial Pain Syndrome
The aim of this randomized controlled trial is to find the comparative effect of Active Release Technique and Myofascial release, each combined with eye exercises, on asthenopia, sleep quality, stress, pain and functional disability in patients with CMPS. A total of 44 participants will be randomized into two groups, ART + eye exercises and MFR+ eye exercises with interventions provided 3 days per week for 4 weeks. Outcomes will be assessed at baseline, 2 weeks and then after 4 weeks.
Read the detailed description
A musculoskeletal condition known as myofascial pain is characterized by discomfort in the region of a muscle and the fascia, the connective tissue that surrounds it. In addition to having several trigger sites, the pain may be local or widespread. Trigger points are very sensitive muscle foci that radiate pain to the surrounding area and hurts to touch. In particular, the rhomboids, trapezius, levator scapulae, supraspinatus, and infraspinatus often affected muscles in the cervical area. Acute or chronic pain is possible, and it is most likely brought on by overuse, altered posture, or muscular injury. Cervical myofascial pain is highly prevalent globally. A 2021 study by Kamran Ezzati found that 88.9% of Iranian participants had at least one neck trigger point. Similarly, a 2024 study by Sahib Rehman et al in Pakistan reported high prevalence of Myofascial Trigger Points in cervical radiculopathy patients, with mean scores of MTrPs.
Cervical myofascial pain or neck muscle pain is often caused by poor posture or prolonged use of electronic devices, leading to muscle knots or trigger points. A component of myofascial pain is the emotional stress we carry which contributes to muscle tension (in the form of, increased activation of the "fight or flight" response) releasing stress hormones like cortisol that increase muscle tension. As a health care profession, we know that physical injuries like whiplash cause damage to the structures of the neck and may also alter how certain structures respond post injury (inflammation and stiffness). There are many other conditions, such as degenerative disc disease, osteoarthritis, and fibromyalgia, both predispose the patient to altered spinal posture. As a result, muscle may function differently resulting in myofascial pain Cervical myofascial pain can be managed with orthopedic manual techniques like Active Tissue Release (ATR) and Myofascial Release (MFR). ATR, developed by Dr. Michael Leahy, combines pressure with movement to break down adhesions, improve circulation, and reduce trigger point activity. It helps restore muscle balance and relieve postural strain. MFR, popularized by John F. Barnes, uses gentle sustained pressure to release fascial restrictions, improve blood flow, and reduce nervous system overactivity. Both techniques enhance mobility, reduce pain, and promote better posture and function in the neck.
Combining these interventions with eye exercises targets both neuromuscular and visual dysfunction, offering a holistic approach to improving sleep quality, reducing stress, and alleviating cervical pain. The study addresses a gap in evidence by directly comparing ART and MFR with integrated eye exercises, potentially guiding physiotherapists and clinicians toward the most effective treatment strategy for CMPS.
- Conditions
- Cervical Myofascial Pain Syndrome
- Being tested
- Myofascial Release + Eye exercises, Active Release Technique + Eye exercises
- Keywords
- Cervical Myofascial Pain Syndrome, Active Release Technique, Myofascial Release, Asthenopia, Sleep, Stress, functional Disability and Pain
- Medical subject headings
- Asthenopia, Pain
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Myofascial Release + Eye exercisesOther
- MFR applied with forearm/ulnar border of palm, gliding towards neck base/upper scapula, Sustained gentle pressure is maintained, held until a release (softening/yield) of fascial tissue is felt; the pressure is gradually increased as tolerance allows.
- 3-4 glides × 90 seconds each, according to tolerance.
- Frequency: 3 days/week for 4 weeks.
- Followed by the same Eye Exercises as in experimental group
Active Release Technique + Eye exercisesOther
ART applied to cervical region (upper trapezius, Levator scapula and SCM) deep tension stretch with thumb over the tender areas , repeated 3-5 times.
Frequency: 3 days/week for 4 weeks Followed by Eye exercises (3 days/week for 4 weeks)
- Trataka (focusing on one point) = 30s/ 3 times
- Eye ball movements = 10 reps/ 2sets i. Sideways ii. Up and down iii. Two ways diagonal movement iv. Clockwise and anticlockwise rotational movements
- Eye blinking and opening = 10 reps/ 2sets
- Palming = 30s/1 time
| Study group | Role | What they receive |
|---|---|---|
| Active Release Technique + Eye exercises | Other | Active Release Technique + Eye exercises Receives: Other: Active Release Technique + Eye exercises |
| Myofascial Release + Eye exercises | Other | Not described Receives: Other: Myofascial Release + Eye exercises |
What is being measured
The primary outcome is the main question the study is designed to answer.
: Neck Disability Index (NDI)
The Neck impairment Index (NDI) is a self-report questionnaire designed to measure the self-rated impairment of patients with neck pain and to establish how neck pain impacts a patient's everyday life. A vertical scale from 0 to 5 is used to rate the questions; After scoring, 0-4 points (0-8%) indicate no disability, 5-14 points (10-28%) indicate mild disability, 15-24 points (30-48%) indicate moderate disability, 25-34 points (50-64%) indicate severe disability, and 35-50 points (70-100%) indicate complete disability
Measured: Baseline, 2 weeks and 4 weeks (one-month follow-up)
Numeric Pain Rating Scale NPRS
The numeric pain rating scale (NPRS) is a tool used to assess pain intensity, where patients rate their pain on a scale of 0 to 10, with 0 representing no pain and 10 representing the worst possible pain.
Measured: Baseline, 2 weeks and 4 weeks (one-month follow-up)
Pittsburgh Sleep Quality Index (PSQI)
The Pittsburgh Sleep Quality Index (PSQI) is a standardized questionnaire used to assess sleep quality and disturbances over a one-month period. It consists of 19 self-rated questions grouped into seven components: subjective sleep quality, sleep latency, sleep duration, habitual sleep efficiency, sleep disturbances, use of sleep medication, and daytime dysfunction. a global score ranging from 0 to 21. A global PSQI score greater than 5 indicates poor sleep quality, while a score of 5 or below reflects good sleep quality.
Measured: Baseline, 2 weeks and 4 weeks (one-month follow-up)
ASQ-17 (Asthenopia Survey Questionnaire)
The ASQ-17 (Asthenopia Survey Questionnaire) is a self-administered questionnaire that measures asthenopia (or eye strain) and associated symptoms. The ASQ-17 covers 7 items of eye strain symptoms, 6 items of visual symptoms and 4 items of systemic and psychological symptoms with a maximum total score of 51 and an optimal cut-off threshold value of 12.5, indicating the presence of asthenopia.
Measured: Baseline, 2 weeks and 4 weeks (one-month follow-up)
Perceived Stress Scale (PSS)
The Perceived Stress Scale (PSS) is a widely used psychological instrument designed to measure the degree to which individuals perceive their lives as stressful. The scale typically includes 10 items (PSS-10), yielding a total score ranging from 0 to 40. Scoring involves reversing the scores for positively worded items (items 4, 5, 7, and 8), then summing all item scores. Interpretation of scores is generally categorized as follows: 0-13 indicates low stress, 14-26 suggests moderate stress, and 27-40 reflects high perceived stress. Higher scores indicate greater levels of perceived stress.
Measured: Baseline, 2 weeks and 4 weeks (one-month follow-up)
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted6 May 2026
- Study start5 Jun 2026 (estimated)
- Primary completion5 Mar 2027 (estimated)
- Study completion5 Mar 2027 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Cervical Myofascial Pain SyndromeStudies of the same condition, open and under way.
- More trials run by Riphah International UniversityThe sponsor's other registered studies.
- 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
- Single blind
- Who is masked
- Participant
- Enrolment
- 44 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Riphah International University
- Sponsor type
- University, hospital or other
- Responsible party
- Sponsor
- Investigators
- KINZA ANWAR, MS-OMPT, Principal investigator, Riphah International University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07571655
- Sponsor's protocol ID
- Iqra Iftikhar
- Status last verified
- Jun 2026
- First submitted
- 30 Apr 2026
- Last updated
- 3 Jun 2026
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Study at a glance
From the registry record, last updated by the sponsor on 3 Jun 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Comparative Effect of Active Release Technique and Myofascial Release to Improve Asthenopia, Sleep and Stress in Patients With Cervical Myofascial Pain Syndrome
- ClinicalTrials.gov ID
- NCT07571655
- Acronym / sponsor ID
- Iqra Iftikhar
- Conditions
- Cervical Myofascial Pain Syndrome
- Keywords
- Cervical Myofascial Pain Syndrome, Active Release Technique, Myofascial Release, Asthenopia, Sleep, Stress, functional Disability and Pain
- Study type
- Interventional
- Recruitment status
- Not yet recruiting
- Enrolment
- 44 participants (estimated)
- Lead sponsor
- Riphah International UniversityUniversity, hospital or other
- Study start
- 5 Jun 2026 (estimated)
- Primary completion
- 5 Mar 2027 (estimated)
- Study completion
- 5 Mar 2027 (estimated)
- First posted
- 6 May 2026 (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 this randomized controlled trial is to find the comparative effect of Active Release Technique and Myofascial release, each combined with eye exercises, on asthenopia, sleep quality, stress, pain and functional disability in patients with CMPS. A total of 44 participants will be randomized into two groups, ART + eye exercises and MFR+ eye exercises with interventions provided 3 days per week for 4 weeks. Outcomes will be assessed at baseline, 2 weeks and then after 4 weeks.
Detailed description
A musculoskeletal condition known as myofascial pain is characterized by discomfort in the region of a muscle and the fascia, the connective tissue that surrounds it. In addition to having several trigger sites, the pain may be local or widespread. Trigger points are very sensitive muscle foci that radiate pain to the surrounding area and hurts to touch. In particular, the rhomboids, trapezius, levator scapulae, supraspinatus, and infraspinatus often affected muscles in the cervical area. Acute or chronic pain is possible, and it is most likely brought on by overuse, altered posture, or muscular injury. Cervical myofascial pain is highly prevalent globally. A 2021 study by Kamran Ezzati found that 88.9% of Iranian participants had at least one neck trigger point. Similarly, a 2024 study by Sahib Rehman et al in Pakistan reported high prevalence of Myofascial Trigger Points in cervical radiculopathy patients, with mean scores of MTrPs.
Cervical myofascial pain or neck muscle pain is often caused by poor posture or prolonged use of electronic devices, leading to muscle knots or trigger points. A component of myofascial pain is the emotional stress we carry which contributes to muscle tension (in the form of, increased activation of the "fight or flight" response) releasing stress hormones like cortisol that increase muscle tension. As a health care profession, we know that physical injuries like whiplash cause damage to the structures of the neck and may also alter how certain structures respond post injury (inflammation and stiffness). There are many other conditions, such as degenerative disc disease, osteoarthritis, and fibromyalgia, both predispose the patient to altered spinal posture. As a result, muscle may function differently resulting in myofascial pain Cervical myofascial pain can be managed with orthopedic manual techniques like Active Tissue Release (ATR) and Myofascial Release (MFR). ATR, developed by Dr. Michael Leahy, combines pressure with movement to break down adhesions, improve circulation, and reduce trigger point activity. It helps restore muscle balance and relieve postural strain. MFR, popularized by John F. Barnes, uses gentle sustained pressure to release fascial restrictions, improve blood flow, and reduce nervous system overactivity. Both techniques enhance mobility, reduce pain, and promote better posture and function in the neck.
Combining these interventions with eye exercises targets both neuromuscular and visual dysfunction, offering a holistic approach to improving sleep quality, reducing stress, and alleviating cervical pain. The study addresses a gap in evidence by directly comparing ART and MFR with integrated eye exercises, potentially guiding physiotherapists and clinicians toward the most effective treatment strategy for CMPS.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind (participant)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Active Release Technique + Eye exercises | Other | Other: Active Release Technique + Eye exercisesActive Release Technique + Eye exercises |
| Myofascial Release + Eye exercises | Other | Other: Myofascial Release + Eye exercises |
Who may qualify
- Ages
- 18 to 40 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult
Key inclusion criteria (6 listed)
- • Both genders
Key exclusion criteria (5 listed)
- • Subjects with a history of cervical trauma or surgery
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 |
|---|---|---|
| Myofascial Release + Eye exercises* MFR applied with forearm/ulnar border of palm, gliding towards neck base/upper scapula, Sustained gentle pressure is maintained, held until a release (softening/yield) of fascial tissue is felt; the pressure is gradually increased as tolerance allows. * 3-4 glides × 90 seconds each, according to tolerance. * Frequency: 3 days/week for 4 weeks. * Followed by the same Eye Exercises as in experimental group | Other | Myofascial Release + Eye exercises |
| Active Release Technique + Eye exercisesART applied to cervical region (upper trapezius, Levator scapula and SCM) deep tension stretch with thumb over the tender areas , repeated 3-5 times. Frequency: 3 days/week for 4 weeks Followed by Eye exercises (3 days/week for 4 weeks) * Trataka (focusing on one point) = 30s/ 3 times * Eye ball movements = 10 reps/ 2sets i. Sideways ii. Up and down iii. Two ways diagonal movement iv. Clockwise and anticlockwise rotational movements * Eye blinking and opening = 10 reps/ 2sets * Palming = 30s/1 time | Other | Active Release Technique + Eye exercises |
Primary outcome
: Neck Disability Index (NDI)
Time frame: Baseline, 2 weeks and 4 weeks (one-month follow-up)
The Neck impairment Index (NDI) is a self-report questionnaire designed to measure the self-rated impairment of patients with neck pain and to establish how neck pain impacts a patient's everyday life. A vertical scale from 0 to 5 is used to rate the questions; After scoring, 0-4 points (0-8%) indicate no disability, 5-14 points (10-28%) indicate mild disability, 15-24 points (30-48%) indicate moderate disability, 25-34 points (50-64%) indicate severe disability, and 35-50 points (70-100%) indicate complete disability
Numeric Pain Rating Scale NPRS
Time frame: Baseline, 2 weeks and 4 weeks (one-month follow-up)
The numeric pain rating scale (NPRS) is a tool used to assess pain intensity, where patients rate their pain on a scale of 0 to 10, with 0 representing no pain and 10 representing the worst possible pain.
Pittsburgh Sleep Quality Index (PSQI)
Time frame: Baseline, 2 weeks and 4 weeks (one-month follow-up)
The Pittsburgh Sleep Quality Index (PSQI) is a standardized questionnaire used to assess sleep quality and disturbances over a one-month period. It consists of 19 self-rated questions grouped into seven components: subjective sleep quality, sleep latency, sleep duration, habitual sleep efficiency, sleep disturbances, use of sleep medication, and daytime dysfunction. a global score ranging from 0 to 21. A global PSQI score greater than 5 indicates poor sleep quality, while a score of 5 or below reflects good sleep quality.
ASQ-17 (Asthenopia Survey Questionnaire)
Time frame: Baseline, 2 weeks and 4 weeks (one-month follow-up)
The ASQ-17 (Asthenopia Survey Questionnaire) is a self-administered questionnaire that measures asthenopia (or eye strain) and associated symptoms. The ASQ-17 covers 7 items of eye strain symptoms, 6 items of visual symptoms and 4 items of systemic and psychological symptoms with a maximum total score of 51 and an optimal cut-off threshold value of 12.5, indicating the presence of asthenopia.
Perceived Stress Scale (PSS)
Time frame: Baseline, 2 weeks and 4 weeks (one-month follow-up)
The Perceived Stress Scale (PSS) is a widely used psychological instrument designed to measure the degree to which individuals perceive their lives as stressful. The scale typically includes 10 items (PSS-10), yielding a total score ranging from 0 to 40. Scoring involves reversing the scores for positively worded items (items 4, 5, 7, and 8), then summing all item scores. Interpretation of scores is generally categorized as follows: 0-13 indicates low stress, 14-26 suggests moderate stress, and 27-40 reflects high perceived stress. Higher scores indicate greater levels of perceived stress.
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 3 Jun 2026.
- Individual participant dataSharing planned: No
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Kinesio Taping for Upper Trapezius Myofascial Trigger Points
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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.
KINZA ANWAR, MS-OMPT 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 Myofascial Release + Eye exercises and Active Release Technique + Eye exercises in people with Cervical Myofascial Pain Syndrome, 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 6 inclusion and 5 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: opening soon, as of the sponsor's last update on 3 Jun 2026. 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?
This study is still under way. Results are not available in the source record yet.
How can a doctor refer a patient or contact the research team?
Contact KINZA ANWAR, MS-OMPT (+92-3239735427, kinza.anwar@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: Baseline, 2 weeks and 4 weeks (one-month follow-up)). The study lists 5 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
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 3 Jun 2026.