Text Neck SyndromeSPRINT-SKATENCT07812909
Effects of Sprinter and Skater on Text Neck Syndromes
A study testing Coordinative locomotor training group in people with Text Neck Syndrome, run by University of Faisalabad at 1 site in Pakistan.
Trial summary
This study will explore the combined effects of sprinter and skater synergy exercises on pain, muscle activation, and postural alignment in individuals with Text Neck Syndrome (TNS). TNS is characterized by forward head posture, neck pain, and muscle imbalance resulting from prolonged use of smartphones and computers. Read more about this study
- Who is it for?
- Ages 25 to 45 years
- Conditions the study is for
- Text Neck Syndrome
- What is being tested?
- Coordinative locomotor training group
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 50 participants
- Where
- 1 sitePakistan
- Study dates
- 24 Apr 2026to 9 Aug 2026
- 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 25 to 45 years
- All sexes
- No healthy volunteers
- Adult
Who may be able to join
- Participants who meeted the following criteria, eligible for inclusion in the study:
- Age between 25 and 45 years (both male and female participants).
- Diagnosed with Clinical signs of Text Neck Syndrome (TNS)
- Forward head posture (measured using craniovertebral angle (CVA)).
- Rounded shoulders and scapular elevation (measured via postural assessment)
- History of at least 4 - 6 hours of computer or mobile device use daily for 6 months or more
Show all 10Show fewer
- Numeric Pain Rating Scale (NPRS) score between 3 and 6 (indicating moderate pain)
- Craniovertebral Angle of less than 50°, indicating significant postural deviation
- Willingness to provide informed consent and participate in the intervention protocol for 8 weeks.
- Participants must be able to commit to completing the 8 week intervention, including in person sessions and home exercises.
Who cannot join
- Participants were excluded from the study if they meet any of the following criteria
- Previous surgery, history of cervical or shoulder surgery, or any major trauma to the neck or shoulder region
- Reported neurological or vestibular disorders, any condition affecting posture or balance, such as neurological disorders, vestibular impairments, or dizziness (e.g., vertigo, balance dysfunction)
- Reported congenital spinal deformities, diagnosis of congenital spinal deformities such as scoliosis, torticollis, or kyphosis that could interfere with postural assessment or training
- Participation in other rehabilitation programs current participation in another rehabilitation program focused on posture correction, neck pain, or musculoskeletal disorders during the study period
- Female participants who are pregnant or have medical contraindications to moderate physical exercise
- Individuals with serious cardiovascular, musculoskeletal, or neurological diseases that might contraindicate participation in moderate physical activity (e.g., uncontrolled diabetes, severe heart disease, or cancer)
- Individuals with a pain level greater than 6 on the NPRS or those with significant functional disability in the neck and upper back, which might impede their participation in the intervention.
Trial locations and contacts
1 site in 1 country.
Pakistan1 site
Department of Rehabilitation Sciences, The University of Faisalabad
Faisalābad, Punjab Province, 0092
About this study
Official title: Combined Effects of Sprinter and Skater Synergy Training on Pain, Muscle Activation and Postural Alignment in Individuals With Text Neck Syndrome
This study will explore the combined effects of sprinter and skater synergy exercises on pain, muscle activation, and postural alignment in individuals with Text Neck Syndrome (TNS). TNS is characterized by forward head posture, neck pain, and muscle imbalance resulting from prolonged use of smartphones and computers. Its prevalence has increased rapidly, particularly among adolescents and young adults who spend long hours on digital devices. The study aims to evaluate Coordinated Locomotor Training (CLT), using sprinter and skater synergy movement patterns, as a novel intervention for managing TNS. These dynamic, whole body movement patterns are designed to promote coordinated muscle activation, improve postural control, and enhance neuromuscular coordination. A randomized controlled trial design will be used, with participants assigned to either an intervention group receiving CLT based training or a control group receiving lifestyle and ergonomic advice only. Outcome measures will include pain intensity, postural alignment measured by craniovertebral angle, muscle activation, and quality of life. The findings will help determine whether synergy based movement training offers a more effective alternative to conventional physiotherapy for TNS management.
Read the detailed description
Detailed Description (5.2) - Copy Paste:
Background: Digital technology has become a vital part of daily life, changing the way people work, communicate and relax and resulting in unprecedented levels of screen time for all generations. Handheld smart devices, such as smartphones, tablets and computers, have become an essential part of the professional, academic and social lives. But with this technological improvement there has been a significant increase in technology-related musculoskeletal disorders. Neck pain, particularly, is one of the biggest causes of disability globally, especially among young adults and people who work in an office environment performing prolonged sitting postures .The cervical structures may be affected by mechanical stress caused by the prolonged flexed position held while using a smartphone and computer, also known as Text Neck Syndrome (TNS), and there may be a shift in neuromuscular control. New epidemiological evidence in recent years reveals that over 4 hours of digital device use has a detrimental effect on the prevalence of FHP, cervical discomfort, and cervical functional capacity among people. This was reflective of the fact that there has been a change in human behaviors in the digital age from acute injury to chronic postural dysfunction.
Objectives: To evaluate the effect of the combination of synergy exercises (sprinting and skater) on the intensity of pain, muscle activation and posture in people suffering from Text Neck Syndrome (TNS). Secondary objectives include determining which technique shows significantly greater improvement and providing evidence-based recommendations for physiotherapy practice in Pakistan.
Methodology Research type The study design for this research was randomized clinical trials. Study population People of both genders aged 25-45 years with Text neck syndrome Study setting Habib Bank of Pakistan, National Bank of Pakistan, Meezan bank Duration of study Study was completed after the approval of synopsis within 4 months. Sample technique Consecutive sampling technique were used for sampling. Sample size The sample size of 50 participants (25 per group) were included calculated by using G power app.
Allocation and randomization Randomization was carried out using a computer generated random number generator to ensure unbiased group allocation. At the start of the study, a sequence of random number was generated and used to assign participants to either Group A or Group B. As participants were enrolled, they were allocated to groups according to this predefined sequence, ensuring that each participant had an equal chance of being placed in either group.
Intervention Group A : Coordinated Locomotor Training (CLT) The CLT protocol was based on Janda's tonic phasic muscle theory, aimed to restore reciprocal muscle activation patterns and postural balance Duration: 8 weeks Frequency: 3 sessions per week Session Length: 40 minutes Table 1 : Session Phases Phase Repetitions / Sets Description Warm-up Hot pack: 10 minutesChin tuck: 2 sets × 10 reps (10 sec hold)Scapular retraction: 2 sets × 10 reps An electric hot pack was applied for approximately 10 minutes prior to intervention to enhance tissue extensibility and circulation. This was followed by chin tuck exercises for deep neck flexor activation and scapular retraction exercises to promote postural muscle engagement.
Main CLT Phase 2 sets × 10 repetitions per side Alternating Sprinter and Skater synergy exercises performed in supine, sitting, and standing positions to activate deep neck flexors, rhomboids, and serratus anterior while inhibiting upper trapezius and pectoralis major/minor.
Integration Phase 2 sets × 10 repetitions Sequential Sprinter → Skater → Sprinter movement patterns to improve interlimb coordination and neuromuscular control.
Relaxation / Cool Down 5 breathing cycles Gentle breathing and relaxation exercises to reduce muscle tension and promote recovery.
Participants also perform brief home based micro sessions (5-8 minutes) during work hours to maintain postural endurance.
Group B: control group: The control group was received a structured program of conventional physiotherapy exercises focusing on improving neck stability, activating postural muscles, and reducing muscle tightness. Conventional protocols sued "deep cervical flexor training, scapular strengthening, and stretching exercises" that significantly improve pain, posture, and functional outcomes in individuals with neck pain and forward head posture.
Intervention Parameters
- Duration: 8 weeks
- Frequency: 3 sessions per week
- Session Length: 40 minutes Table 2: Session Phases for Control Group Phase Repetitions / Sets Description Warm-up Hot pack: 10 minutesChin tuck: 2 sets × 10 reps (10 sec hold)Scapular retraction: 2 sets × 10 reps An electric hot pack was applied for approximately 10 minutes prior to intervention to enhance tissue extensibility and circulation. This was followed by chin tuck exercises for deep neck flexor activation and scapular retraction exercises to promote postural muscle engagement.
Cervical Stabilization Exercises 2 sets × 10reps (10 sec hold) Deep neck flexor exercises (chin tuck in supine and sitting positions) to improve cervical stability and correct forward head posture.
Scapular Strengthening 2 sets × 10 reps Scapular retraction and prone horizontal abduction exercises targeting middle and lower trapezius and rhomboids to improve postural control.
Stretching Exercises 2 sets× 10 reps per muscle (20 sec hold) Static stretching of upper trapezius, levator scapulae, and pectoralis muscles in sitting to reduce muscle tightness and improve flexibility.
Relaxation / Cool Down 5 breathing cycles Gentle breathing and relaxation exercises to reduce muscle tension and promote recovery.
- Conditions
- Text Neck Syndrome
- Being tested
- Coordinative locomotor training group, control group
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Coordinative locomotor training groupOther
Participants allocated to the Coordinated Locomotor Training (CLT) group were received an intervention based on Janda's tonic-phasic muscle theory, which aimed to restore reciprocal muscle activation patterns, improve postural alignment, and enhance neuromuscular coordination by facilitating coordinated movement synergies. The intervention were administered over 8 weeks, with three supervised sessions per week, and each session lasts for approximately 25-30 minutes.
Each treatment session begun with a warm-up phase, during which an electric hot pack wase applied to the cervical and upper thoracic region for approximately 10 minutes to increase local circulation, reduce muscle stiffness, and improve soft tissue extensibility. Following thermotherapy, participants performed chin tuck exercises (2 sets of 10 repetitions with a 5-10-second hold) to activate the deep cervical flexor muscles, followed by scapular retraction exercises (2 sets of 10 repetitions) to facilitate activation of the
control groupOther
Each treatment session were begin with a warm-up phase, during which an electric hot pack were applied to the cervical and upper thoracic region for approximately 10 minutes to increase local circulation, reduce muscle stiffness, and improve soft tissue extensibility. This will be followed by chin tuck exercises (2 sets of 10 repetitions with a 5-10-second hold) to facilitate activation of the deep cervical flexor muscles and scapular retraction exercises (2 sets of 10 repetitions) to activate the scapular stabilizers and promote optimal postural alignment.
The cervical stabilization phase was included deep cervical flexor exercises performed in both supine and sitting positions, with participants completing 2 sets of 10-12 repetitions, maintaining each contraction for 5-10 seconds. These exercises ere intended to improve cervical stability, enhance endurance of the deep neck flexor muscles, and correct forward head posture.
The scapular strengthening phase was consisted of scapular re
| Study group | Role | What they receive |
|---|---|---|
| Coordinative locomotor training group | Experimental | Coordinated Locomotor Training (CLT) The CLT protocol wass based on Janda's tonic phasic muscle theory, aimed to restore reciprocal muscle activation patterns and postural balance.
Duration: 8 weeks Frequency: 3 sessions per week Session Length: 25-30 minutes Table 1 : Session Phases Phase Repetitions / Sets Description Warm-up Hot pack: 10 minutesChin tuck: 2 sets × 10 reps (5-10 sec hold)Scapular retraction: 2 sets × 10 reps An electric hot pack was applied for approximately 10 minutes prior to intervention to enhance tissue extensibility and circulation. This was followed by chin tuck exercises for deep neck flexor activation and scapular retraction exercises to promote postural muscle engagement.
Main CLT Phase 2 sets × 10 repetitions per side Alternating Sprinter and Skater synergy exercises performed in supine, sitting, and standing positions to activate deep neck flexors, rhomboids, and serratus anterior while inhibiting upper trapezius and pectoralis major/minor.
Integra Receives: Other: Coordinative locomotor training group |
| Conventional physiotherapy group | Experimental | Conventional Physical therapy Intervention Parameters
* Duration: 8 weeks
* Frequency: 3 sessions per week
* Session Length: 30-40 minutes Group B: control group: The control group was received a structured program of conventional physiotherapy exercises focusing on improving neck stability, activating postural muscles, and reducing muscle tightness. Conventional protocols were used "deep cervical flexor training, scapular strengthening, and stretching exercises" that significantly improve pain, posture, and functional outcomes in individuals with neck pain and forward head posture Receives: Other: control group |
What is being measured
The primary outcome is the main question the study is designed to answer.
pain
Outcome measuring tools Numeric pain rating scale Was used to measure pain intensity at rest and after work tasks. Participants rate their pain from 0 ("no pain") to 10 ("worst pain imaginable"). A decrease of ≥2 points were indicated clinically significant improvement.
Measured: Baseline (week 0) midline (week 4) and post-intervention (week 8)
Muscle Activation
Deep cervical flexor muscle activation was assessed using the Craniocervical Flexion Test (CCFT) the five progressive stages of the test, with minimal recruitment of superficial flexors
Measured: Baseline (0week) midline (4week) post treatment (8 weeks)
Postural Alignment
Change in Postural Alignment by Craniovertebral angle Measured using the APECS App, a validated photogrammetric tool .The angle between the tragus and C7 vertebra with respect to the horizontal line determined forward head posture. CVA < 50° indicated postural deviation.
Measured: Baseline(0 week) midline Assessment(4 week) post treatment(8week)
Secondary outcomes (1)
Quality of Life
Change in Quality of Life by WHOQOL Brief A 26item questionnaire assessing physical, psychological, social, and environmental domains of quality of life. Higher scores indicate better health related well being
Measured: Baseline (week 0, before first intervention session) and midline intervention (week 4) and post intervention (week 8)
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted10 Sep 2026
- Study start24 Apr 2026
- Primary completion24 Jun 2026
- Study completion9 Aug 2026
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (67)Papers the sponsor has linked to this study.
- Other trials for Text 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
- Single blind
- Who is masked
- Outcomes assessor
- Enrolment
- 50 participants (actual)
Sponsor and investigators
- Lead sponsor
- University of Faisalabad
- Sponsor type
- University, hospital or other
- Responsible party
- Sponsor
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07812909
- Sponsor's protocol ID
- 2024-MSPT-042
- Acronym
- SPRINT-SKATE
- Status last verified
- Sep 2026
- First submitted
- 11 Aug 2026
- Last updated
- 10 Sep 2026
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- Undecided: not decided yet
Publications
Yasmeen N (2023) Evaluation of fixaspine and mckenzie exercises in comparison with postural text reminders on neck pain among office workers: A pilot study. International Journal of Physiotherapy and Research 11(2): 4483-4496.
Xu Y, Feng M, Wu R, Wang Y, Yang Z, Wang Z, Kang Z, Xie L, Liu H. Effect of adding proprioceptive neuromuscular facilitation to conventional physiotherapy on scapular balance and shoulder proprioception in adolescents with idiopathic scoliosis: a randomised controlled trial protocol. BMJ Open. 2025 Nov 19;15(11):e106848. doi: 10.1136/bmjopen-2025-106848.
PubMed 41263915Tyagi H and Sharma R (2025) Effect of postural corrective exercises in forward head posture: A Systematic Review. Journal of clinical and diagnostic research 19(1): 33-40
Tsantili AR, Chrysikos D, Troupis T. Text Neck Syndrome: Disentangling a New Epidemic. Acta Med Acad. 2022 Aug;51(2):123-127. doi: 10.5644/ama2006-124.380.
PubMed 36318004Trovato B, Roggio F, Sortino M, Zanghi M, Petrigna L, Giuffrida R, Musumeci G. Postural Evaluation in Young Healthy Adults through a Digital and Reproducible Method. J Funct Morphol Kinesiol. 2022 Oct 28;7(4):98. doi: 10.3390/jfmk7040098.
PubMed 36412760Skevington SM, Lotfy M, O'Connell KA; WHOQOL Group. The World Health Organization's WHOQOL-BREF quality of life assessment: psychometric properties and results of the international field trial. A report from the WHOQOL group. Qual Life Res. 2004 Mar;13(2):299-310. doi: 10.1023/B:QURE.0000018486.91360.00.
PubMed 15085902Sharma D, Sharma N, Tak A et al. (2022) Prevalence of text neck syndrome among doctors. Journal of Clinical Research and Applied Medicine 2(2): 33-40.
Seidi F, Bayattork M, Minoonejad H, Andersen LL, Page P. Comprehensive corrective exercise program improves alignment, muscle activation and movement pattern of men with upper crossed syndrome: randomized controlled trial. Sci Rep. 2020 Nov 26;10(1):20688. doi: 10.1038/s41598-020-77571-4.
PubMed 33244045Satti L, Abdelnour H, Yousif B et al. (2025) Text neck syndrome among students at the National University in Sudan. World Journal of Advanced Research and Reviews 28(3): 1501-1507.
Sariyildiz A, Deniz V and Basaran S (2024) Effectiveness of corrective exercise program on alignment, muscle activation and biomechanical properties in forward head posture: A randomized controlled trial. Cukurova Medical Journal 49(4): 1082-1092.
Salameh MA, Boyajian SD, Amaireh EA, Jamal B, Alrfooh H, AbuKhalaf K, Alzu'bi OM, Al-Tanbouz HD, Alzyoud K. Prevalence of text neck syndrome, its impact on neck dysfunction, and its associated factors among medical students: A cross-sectional study. Work. 2024;79(3):1111-1119. doi: 10.3233/WOR-230678.
PubMed 38875069Safiri S, Kolahi AA, Hoy D, Buchbinder R, Mansournia MA, Bettampadi D, Ashrafi-Asgarabad A, Almasi-Hashiani A, Smith E, Sepidarkish M, Cross M, Qorbani M, Moradi-Lakeh M, Woolf AD, March L, Collins G, Ferreira ML. Global, regional, and national burden of neck pain in the general population, 1990-2017: systematic analysis of the Global Burden of Disease Study 2017. BMJ. 2020 Mar 26;368:m791. doi: 10.1136/bmj.m791.
PubMed 32217608Saeed H (2022) Relationship between neck pain, functional disability, and workstation factors among computer users in Faisalabad, Pakistan. Pakistan Journal of Physical Therapy (PJPT) 5(2).
Ruivo RM, Pezarat-Correia P, Carita AI. Cervical and shoulder postural assessment of adolescents between 15 and 17 years old and association with upper quadrant pain. Braz J Phys Ther. 2014 Jul-Aug;18(4):364-71. doi: 10.1590/bjpt-rbf.2014.0027. Epub 2014 Jul 18.
PubMed 25054381Rajeev R (2026) Role of smartphone overuse and digital posture resulting in forward head posture leading to temporomandibular joint dysfunction in adults: A physiotherapy intervention study. Indian Journal of Physical Therapy 7(1): 196-202.
Study at a glance
From the registry record, last updated by the sponsor on 10 Sep 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Combined Effects of Sprinter and Skater Synergy Training on Pain, Muscle Activation and Postural Alignment in Individuals With Text Neck Syndrome
- ClinicalTrials.gov ID
- NCT07812909
- Acronym / sponsor ID
- SPRINT-SKATE / 2024-MSPT-042
- Conditions
- Text Neck Syndrome
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 50 participants (actual)
- Lead sponsor
- University of FaisalabadUniversity, hospital or other
- Study start
- 24 Apr 2026 (actual)
- Primary completion
- 24 Jun 2026 (actual)
- Study completion
- 9 Aug 2026 (actual)
- First posted
- 10 Sep 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.
This study will explore the combined effects of sprinter and skater synergy exercises on pain, muscle activation, and postural alignment in individuals with Text Neck Syndrome (TNS). TNS is characterized by forward head posture, neck pain, and muscle imbalance resulting from prolonged use of smartphones and computers. Its prevalence has increased rapidly, particularly among adolescents and young adults who spend long hours on digital devices. The study aims to evaluate Coordinated Locomotor Training (CLT), using sprinter and skater synergy movement patterns, as a novel intervention for managing TNS. These dynamic, whole body movement patterns are designed to promote coordinated muscle activation, improve postural control, and enhance neuromuscular coordination. A randomized controlled trial design will be used, with participants assigned to either an intervention group receiving CLT based training or a control group receiving lifestyle and ergonomic advice only. Outcome measures will include pain intensity, postural alignment measured by craniovertebral angle, muscle activation, and quality of life. The findings will help determine whether synergy based movement training offers a more effective alternative to conventional physiotherapy for TNS management.
Detailed description
Detailed Description (5.2) - Copy Paste:
Background: Digital technology has become a vital part of daily life, changing the way people work, communicate and relax and resulting in unprecedented levels of screen time for all generations. Handheld smart devices, such as smartphones, tablets and computers, have become an essential part of the professional, academic and social lives. But with this technological improvement there has been a significant increase in technology-related musculoskeletal disorders. Neck pain, particularly, is one of the biggest causes of disability globally, especially among young adults and people who work in an office environment performing prolonged sitting postures .The cervical structures may be affected by mechanical stress caused by the prolonged flexed position held while using a smartphone and computer, also known as Text Neck Syndrome (TNS), and there may be a shift in neuromuscular control. New epidemiological evidence in recent years reveals that over 4 hours of digital device use has a detrimental effect on the prevalence of FHP, cervical discomfort, and cervical functional capacity among people. This was reflective of the fact that there has been a change in human behaviors in the digital age from acute injury to chronic postural dysfunction.
Objectives: To evaluate the effect of the combination of synergy exercises (sprinting and skater) on the intensity of pain, muscle activation and posture in people suffering from Text Neck Syndrome (TNS). Secondary objectives include determining which technique shows significantly greater improvement and providing evidence-based recommendations for physiotherapy practice in Pakistan.
Methodology Research type The study design for this research was randomized clinical trials. Study population People of both genders aged 25-45 years with Text neck syndrome Study setting Habib Bank of Pakistan, National Bank of Pakistan, Meezan bank Duration of study Study was completed after the approval of synopsis within 4 months. Sample technique Consecutive sampling technique were used for sampling. Sample size The sample size of 50 participants (25 per group) were included calculated by using G power app.
Allocation and randomization Randomization was carried out using a computer generated random number generator to ensure unbiased group allocation. At the start of the study, a sequence of random number was generated and used to assign participants to either Group A or Group B. As participants were enrolled, they were allocated to groups according to this predefined sequence, ensuring that each participant had an equal chance of being placed in either group.
Intervention Group A : Coordinated Locomotor Training (CLT) The CLT protocol was based on Janda's tonic phasic muscle theory, aimed to restore reciprocal muscle activation patterns and postural balance Duration: 8 weeks Frequency: 3 sessions per week Session Length: 40 minutes Table 1 : Session Phases Phase Repetitions / Sets Description Warm-up Hot pack: 10 minutesChin tuck: 2 sets × 10 reps (10 sec hold)Scapular retraction: 2 sets × 10 reps An electric hot pack was applied for approximately 10 minutes prior to intervention to enhance tissue extensibility and circulation. This was followed by chin tuck exercises for deep neck flexor activation and scapular retraction exercises to promote postural muscle engagement.
Main CLT Phase 2 sets × 10 repetitions per side Alternating Sprinter and Skater synergy exercises performed in supine, sitting, and standing positions to activate deep neck flexors, rhomboids, and serratus anterior while inhibiting upper trapezius and pectoralis major/minor.
Integration Phase 2 sets × 10 repetitions Sequential Sprinter → Skater → Sprinter movement patterns to improve interlimb coordination and neuromuscular control.
Relaxation / Cool Down 5 breathing cycles Gentle breathing and relaxation exercises to reduce muscle tension and promote recovery.
Participants also perform brief home based micro sessions (5-8 minutes) during work hours to maintain postural endurance.
Group B: control group: The control group was received a structured program of conventional physiotherapy exercises focusing on improving neck stability, activating postural muscles, and reducing muscle tightness. Conventional protocols sued "deep cervical flexor training, scapular strengthening, and stretching exercises" that significantly improve pain, posture, and functional outcomes in individuals with neck pain and forward head posture.
Intervention Parameters
- Duration: 8 weeks
- Frequency: 3 sessions per week
- Session Length: 40 minutes Table 2: Session Phases for Control Group Phase Repetitions / Sets Description Warm-up Hot pack: 10 minutesChin tuck: 2 sets × 10 reps (10 sec hold)Scapular retraction: 2 sets × 10 reps An electric hot pack was applied for approximately 10 minutes prior to intervention to enhance tissue extensibility and circulation. This was followed by chin tuck exercises for deep neck flexor activation and scapular retraction exercises to promote postural muscle engagement.
Cervical Stabilization Exercises 2 sets × 10reps (10 sec hold) Deep neck flexor exercises (chin tuck in supine and sitting positions) to improve cervical stability and correct forward head posture.
Scapular Strengthening 2 sets × 10 reps Scapular retraction and prone horizontal abduction exercises targeting middle and lower trapezius and rhomboids to improve postural control.
Stretching Exercises 2 sets× 10 reps per muscle (20 sec hold) Static stretching of upper trapezius, levator scapulae, and pectoralis muscles in sitting to reduce muscle tightness and improve flexibility.
Relaxation / Cool Down 5 breathing cycles Gentle breathing and relaxation exercises to reduce muscle tension and promote recovery.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind (outcomes assessor)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Coordinative locomotor training group | Experimental | Other: Coordinative locomotor training groupCoordinated Locomotor Training (CLT) The CLT protocol wass based on Janda's tonic phasic muscle theory, aimed to restore reciprocal muscle activation patterns and postural balance. Duration: 8 weeks Frequency: 3 sessions per week Session Length: 25-30 minutes Table 1 : Session Phases Phase Repetitions / Sets Description Warm-up Hot pack: 10 minutesChin tuck: 2 sets × 10 reps (5-10 sec hold)Scapular retraction: 2 sets × 10 reps An electric hot pack was applied for approximately 10 minutes prior to intervention to enhance tissue extensibility and circulation. This was followed by chin tuck exercises for deep neck flexor activation and scapular retraction exercises to promote postural muscle engagement. Main CLT Phase 2 sets × 10 repetitions per side Alternating Sprinter and Skater synergy exercises performed in supine, sitting, and standing positions to activate deep neck flexors, rhomboids, and serratus anterior while inhibiting upper trapezius and pectoralis major/minor. Integra |
| Conventional physiotherapy group | Experimental | Other: control groupConventional Physical therapy Intervention Parameters * Duration: 8 weeks * Frequency: 3 sessions per week * Session Length: 30-40 minutes Group B: control group: The control group was received a structured program of conventional physiotherapy exercises focusing on improving neck stability, activating postural muscles, and reducing muscle tightness. Conventional protocols were used "deep cervical flexor training, scapular strengthening, and stretching exercises" that significantly improve pain, posture, and functional outcomes in individuals with neck pain and forward head posture |
Who may qualify
- Ages
- 25 to 45 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult
Key inclusion criteria (10 listed)
- Participants who meeted the following criteria, eligible for inclusion in the study:
Key exclusion criteria (8 listed)
- Participants were excluded from the study if they meet any of the following criteria
- Previous surgery, history of cervical or shoulder surgery, or any major trauma to the neck or shoulder region
- Reported neurological or vestibular disorders, any condition affecting posture or balance, such as neurological disorders, vestibular impairments, or dizziness (e.g., vertigo, balance dysfunction)
- Reported congenital spinal deformities, diagnosis of congenital spinal deformities such as scoliosis, torticollis, or kyphosis that could interfere with postural assessment or training
- Participation in other rehabilitation programs current participation in another rehabilitation program focused on posture correction, neck pain, or musculoskeletal disorders during the study period
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 |
|---|---|---|
| Coordinative locomotor training groupParticipants allocated to the Coordinated Locomotor Training (CLT) group were received an intervention based on Janda's tonic-phasic muscle theory, which aimed to restore reciprocal muscle activation patterns, improve postural alignment, and enhance neuromuscular coordination by facilitating coordinated movement synergies. The intervention were administered over 8 weeks, with three supervised sessions per week, and each session lasts for approximately 25-30 minutes. Each treatment session begun with a warm-up phase, during which an electric hot pack wase applied to the cervical and upper thoracic region for approximately 10 minutes to increase local circulation, reduce muscle stiffness, and improve soft tissue extensibility. Following thermotherapy, participants performed chin tuck exercises (2 sets of 10 repetitions with a 5-10-second hold) to activate the deep cervical flexor muscles, followed by scapular retraction exercises (2 sets of 10 repetitions) to facilitate activation of the | Other | Coordinative locomotor training group |
| control groupEach treatment session were begin with a warm-up phase, during which an electric hot pack were applied to the cervical and upper thoracic region for approximately 10 minutes to increase local circulation, reduce muscle stiffness, and improve soft tissue extensibility. This will be followed by chin tuck exercises (2 sets of 10 repetitions with a 5-10-second hold) to facilitate activation of the deep cervical flexor muscles and scapular retraction exercises (2 sets of 10 repetitions) to activate the scapular stabilizers and promote optimal postural alignment. The cervical stabilization phase was included deep cervical flexor exercises performed in both supine and sitting positions, with participants completing 2 sets of 10-12 repetitions, maintaining each contraction for 5-10 seconds. These exercises ere intended to improve cervical stability, enhance endurance of the deep neck flexor muscles, and correct forward head posture. The scapular strengthening phase was consisted of scapular re | Other | Conventional physiotherapy group |
Primary outcome
pain
Time frame: Baseline (week 0) midline (week 4) and post-intervention (week 8)
Outcome measuring tools Numeric pain rating scale Was used to measure pain intensity at rest and after work tasks. Participants rate their pain from 0 ("no pain") to 10 ("worst pain imaginable"). A decrease of ≥2 points were indicated clinically significant improvement.
Muscle Activation
Time frame: Baseline (0week) midline (4week) post treatment (8 weeks)
Deep cervical flexor muscle activation was assessed using the Craniocervical Flexion Test (CCFT) the five progressive stages of the test, with minimal recruitment of superficial flexors
Postural Alignment
Time frame: Baseline(0 week) midline Assessment(4 week) post treatment(8week)
Change in Postural Alignment by Craniovertebral angle Measured using the APECS App, a validated photogrammetric tool .The angle between the tragus and C7 vertebra with respect to the horizontal line determined forward head posture. CVA < 50° indicated postural deviation.
1 secondary outcome
Quality of Life
Time frame: Baseline (week 0, before first intervention session) and midline intervention (week 4) and post intervention (week 8)
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 10 Sep 2026.
- BackgroundYasmeen N (2023) Evaluation of fixaspine and mckenzie exercises in comparison with postural text reminders on neck pain among office workers: A pilot study. International Journal of Physiotherapy and Research 11(2): 4483-4496.
- Background: PubMed 41263915Xu Y, Feng M, Wu R, Wang Y, Yang Z, Wang Z, Kang Z, Xie L, Liu H. Effect of adding proprioceptive neuromuscular facilitation to conventional physiotherapy on scapular balance and shoulder proprioception in adolescents with idiopathic scoliosis: a randomised controlled trial protocol. BMJ Open. 2025 Nov 19;15(11):e106848. doi: 10.1136/bmjopen-2025-106848.
- BackgroundTyagi H and Sharma R (2025) Effect of postural corrective exercises in forward head posture: A Systematic Review. Journal of clinical and diagnostic research 19(1): 33-40
- Background: PubMed 36318004Tsantili AR, Chrysikos D, Troupis T. Text Neck Syndrome: Disentangling a New Epidemic. Acta Med Acad. 2022 Aug;51(2):123-127. doi: 10.5644/ama2006-124.380.
- Background: PubMed 36412760Trovato B, Roggio F, Sortino M, Zanghi M, Petrigna L, Giuffrida R, Musumeci G. Postural Evaluation in Young Healthy Adults through a Digital and Reproducible Method. J Funct Morphol Kinesiol. 2022 Oct 28;7(4):98. doi: 10.3390/jfmk7040098.
- Background: PubMed 15085902Skevington SM, Lotfy M, O'Connell KA; WHOQOL Group. The World Health Organization's WHOQOL-BREF quality of life assessment: psychometric properties and results of the international field trial. A report from the WHOQOL group. Qual Life Res. 2004 Mar;13(2):299-310. doi: 10.1023/B:QURE.0000018486.91360.00.
- BackgroundSharma D, Sharma N, Tak A et al. (2022) Prevalence of text neck syndrome among doctors. Journal of Clinical Research and Applied Medicine 2(2): 33-40.
- Background: PubMed 33244045Seidi F, Bayattork M, Minoonejad H, Andersen LL, Page P. Comprehensive corrective exercise program improves alignment, muscle activation and movement pattern of men with upper crossed syndrome: randomized controlled trial. Sci Rep. 2020 Nov 26;10(1):20688. doi: 10.1038/s41598-020-77571-4.
- BackgroundSatti L, Abdelnour H, Yousif B et al. (2025) Text neck syndrome among students at the National University in Sudan. World Journal of Advanced Research and Reviews 28(3): 1501-1507.
- BackgroundSariyildiz A, Deniz V and Basaran S (2024) Effectiveness of corrective exercise program on alignment, muscle activation and biomechanical properties in forward head posture: A randomized controlled trial. Cukurova Medical Journal 49(4): 1082-1092.
- Background: PubMed 38875069Salameh MA, Boyajian SD, Amaireh EA, Jamal B, Alrfooh H, AbuKhalaf K, Alzu'bi OM, Al-Tanbouz HD, Alzyoud K. Prevalence of text neck syndrome, its impact on neck dysfunction, and its associated factors among medical students: A cross-sectional study. Work. 2024;79(3):1111-1119. doi: 10.3233/WOR-230678.
- Background: PubMed 32217608Safiri S, Kolahi AA, Hoy D, Buchbinder R, Mansournia MA, Bettampadi D, Ashrafi-Asgarabad A, Almasi-Hashiani A, Smith E, Sepidarkish M, Cross M, Qorbani M, Moradi-Lakeh M, Woolf AD, March L, Collins G, Ferreira ML. Global, regional, and national burden of neck pain in the general population, 1990-2017: systematic analysis of the Global Burden of Disease Study 2017. BMJ. 2020 Mar 26;368:m791. doi: 10.1136/bmj.m791.
- Individual participant dataSharing planned: Undecided. not decided yet
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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.
The record lists no contact. Use the official record to reach the sponsor.
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Coordinative locomotor training group in people with Text Neck Syndrome, run by University of Faisalabad 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 10 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: finished, as of the sponsor's last update on 10 Sep 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?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
pain (time frame: Baseline (week 0) midline (week 4) and post-intervention (week 8)). The study lists 3 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 NCT07812909, which also lists 67 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 10 Sep 2026.