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Text Neck SyndromeNCT07646392

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

A study testing Cervical stabilization exercises with reverse NAGs and Cervical stabilization exercises without reverse NAGs in people with Text Neck Syndrome, run by Riphah International University at 1 site in Pakistan.

Not yet recruiting

Opening soon. The study is approved but enrolment has not started yet. Sites may already take enquiries.

Sites and contacts
Official record
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Trial summary

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… Read more about this study

Who is it for?
Ages 18 to 35 years
Conditions the study is for
Text Neck Syndrome
What is being tested?
Cervical stabilization exercises with reverse NAGs and Cervical stabilization exercises without reverse NAGs
Could I receive a placebo?
No, everyone receives an active treatment
How many people
42 participants
Where
1 sitePakistan
Study dates
30 May 2026to 30 Aug 2026
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 35 years
  • All sexes
  • No healthy volunteers
  • Adult

Who may be able to join

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

Who cannot join

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

Trial locations and contacts

1 site in 1 country. Contact the study team or a site near you to ask about taking part.

Samrood Akram, PhD* contact

03324806143

samrood.akram@riphah.edu.pk

Pakistan1 site
  • Sunrise Medicare Center Faisalabad

    Faisalābad, Punjab Province

    Ahmad Siddique, MS-OMPT, +92 321 6688944, Shafqatpolyclinic@gmail.com

Other trials in Pakistan

About this study

Official 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

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.

Read the detailed description

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.

Being tested
Cervical stabilization exercises with reverse NAGs, Cervical stabilization exercises without reverse NAGs
Keywords
Neck pain, disability, Range of motion
Medical subject headings
Neck Pain

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Cervical stabilization exercises with reverse NAGsOther

    1. 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 NAGsOther

    1. 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.

Study groups in NCT07646392
Study groupRoleWhat they receive
Cervical stabilization exercises with reverse NAGsExperimentalCombining cervical stabilization exercises with Natural Apophyseal Glides (NAGs) is a highly effective, evidence-based approach for treating "text neck syndrome" (forward head posture). Reverse NAGs are gentle, oscillatory manual therapy techniques that, when combined with stabilization exercises, alleviate pain, correct posture, and restore a pain-free range of motion.
Receives: Other: Cervical stabilization exercises with reverse NAGs
Cervical stabilization exercises without reverse NAGsActive comparatorCervical stabilization exercises target the deep neck flexors and upper back muscles to correct forward head posture, reduce strain, and restore the neck's natural alignment.
Receives: Other: Cervical stabilization exercises without reverse NAGs

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. 1. Numeric pain rate scale (NPRS)

    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

    Measured: upto 4 weeks

  2. 2. Neck Disability index (NDI)

    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

    Measured: Upto 4 weeks

  3. 3. Universal Goniometer (UG):

    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).

    Measured: Upto 4 weeks

  4. 4. Craniovertebral Angle:

    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

    Measured: Upto 4 weeks

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted12 Jun 2026
  2. Study start30 May 2026 (estimated)
  3. Primary completion30 Jul 2026 (estimated)
  4. Study completion30 Aug 2026 (estimated)

Resources

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
Outcomes assessor
Enrolment
42 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07646392
Sponsor's protocol ID
REC/RCR&AHS/25/0125 Shomaiza
Status last verified
Jun 2026
First submitted
8 Jun 2026
Last updated
12 Jun 2026
Results posted
No
FDA-regulated drug
No
FDA-regulated device
No

Publications

  • lsiwed KT, Alsarwani RM, Alshaikh SA, Howaidi RA, Aljahdali AJ, Bassi MM. The prevalence of text neck syndrome and its association with smartphone use among medical students in Jeddah, Saudi Arabia. Journal of Musculoskeletal Surgery and Research. 2021;5(4):266-72.

  • Rashid A, Sahry S, Tabasum H, Farooq M, Ali Z, Younas MW. Prevalence of Text Neck Syndrome and its Association with Forward Head Posture and Aerobic Capacity Among Medical Students. Insights-Journal of Health and Rehabilitation. 2024;2(2 (Health & Allied)):23-8.

  • Bhende R, Shinde S, Jain P. Effect of Integrated Postural Training in Individuals with Text Neck Syndrome. Journal of Kinesiology and Exercise Sciences. 2024;34(108):10-9.

  • Kaya M, Ucgun H, Denizoglu Kulli H. The effect of proprioceptive neuromuscular facilitation on individuals with text neck syndrome: A randomized controlled study. Medicine (Baltimore). 2024 Jul 26;103(30):e38716. doi: 10.1097/MD.0000000000038716.

    PubMed 39058818
  • Yüzbaşıoğlu Ü, Ekici E, Aytar A. Pain of Modern Age Text Neck Syndrome: A Traditional Review. İstanbul Gelişim Üniversitesi Sağlık Bilimleri Dergisi. 2024(24):1321-31.

  • SAl Miaraj A, Bhat I. Prevalence of Text Neck Syndrome and Its Association with Mobile Phone Usage Among University Academic Staff. Int J Phys Med Rehabil. 2021;9(10).

  • Anand B, Sharma P. Association of Hand Performance with Neck Disability in Text Neck Syndrome among College Students. Indian Journal of Physiotherapy and Occupational Therapy. 2020;14(4):13.

  • Shah J, Soni K. Effectiveness of pilates along with conventional exercise program and conventional exercise program alone in subjects with text neck syndrome. International Journal of Science and Research (IJSR). 2021;10:1322-6.

  • Ahmed HH, Abdelhamid SA, Elhafez HM, Shimaa A, Abd El Azeim S. EFFECT OF TEXT-NECK SYNDROME ON SCAPULAR INDEX AND RESPIRATORY FUNCTIONS IN DIFFERENT AGE GROUPS. 2021

  • Piruta J, Kulak W. Physiotherapy in Text Neck Syndrome: A Scoping Review of Current Evidence and Future Directions. J Clin Med. 2025 Feb 19;14(4):1386. doi: 10.3390/jcm14041386.

    PubMed 40004916

Questions about this trial

What is this clinical trial studying?

A study testing Cervical stabilization exercises with reverse NAGs and Cervical stabilization exercises without reverse NAGs in people with Text Neck 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 3 inclusion and 8 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 12 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 Samrood Akram, PhD* (03324806143, samrood.akram@riphah.edu.pk), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

1. Numeric pain rate scale (NPRS) (time frame: upto 4 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 NCT07646392, which also lists 10 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 12 Jun 2026.

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