Text Neck SyndromeTNSNCT07887711
Comparative Study Between Proprioceptive Neuromuscular Facilitation and Post-facilitation Stretching in Text Neck Syndrome
A study testing Proprioceptive Neuromuscular Facilitation, Post-facilitation Stretching and traditional treatment in people with Text Neck Syndrome, run by Cairo University.
Trial summary
this study will be conducted to investigate the effect of Proprioceptive Neuromuscular Facilitation (PNF) stretching and Post Facilitation Stretching (PFS) on neck pain intensity, Cranio Vertebral Angle (CVA), cervical ROM and neck functional disability level in patients with text neck syndrome Read more about this study
- Who is it for?
- Ages 18 to 44 years
- Conditions the study is for
- Text Neck Syndrome
- What is being tested?
- Proprioceptive Neuromuscular Facilitation, Post-facilitation Stretching and traditional treatment
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 51 participants
- Where
- No sites listed yet
- Study dates
- 27 Oct 2026to 20 Apr 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 44 years
- All sexes
- No healthy volunteers
- Adult
Who may be able to join
- Age diagnosed with text neck syndrome by a licensed physician.
- Are between 18 and 44 years of age.
- Use mobile phones for more than 3-4 hours daily
Who cannot join
- Have cervical radiculopathy or disc herniation.
- Have a history of cervical neck trauma or surgery.
- Present with neurological deficits or vestibular disorders.
Trial locations and contacts
No sites are listed yet. Contact the study team or a site near you to ask about taking part.
About this study
this study will be conducted to investigate the effect of Proprioceptive Neuromuscular Facilitation (PNF) stretching and Post Facilitation Stretching (PFS) on neck pain intensity, Cranio Vertebral Angle (CVA), cervical ROM and neck functional disability level in patients with text neck syndrome
Read the detailed description
Text Neck Syndrome (TNS) is increasingly being recognized as a widespread health concern, particularly among adolescents and young adults due to the frequent and prolonged use of smartphones and handheld electronic devices. Maintaining a forward head posture (FHP) for extended periods places abnormal stress on the cervical spine, disrupting normal biomechanics. Around 75% of the global population spends several hours daily looking down at mobile screens, which significantly increases the mechanical load on the neck-from approximately 5 kg in a neutral position to over 27 kg at 60 degrees of cervical flexion. This repetitive strain places individuals at high risk for developing musculoskeletal disorders such as TNS.PNF has been shown to improve posture, mobility, and coordination by recruiting both deep and superficial cervical muscles through functional, multidirectional patterns. This method enhances the integration of voluntary movement and proprioceptive feedback, which are often impaired in individuals with TNS due to repetitive poor posture. As a technique, it not only helps relieve pain but also supports long-term neuromuscular adaptations. However, despite its popularity in clinical practice, further controlled research is still needed to better understand its lasting neurophysiological effects in people with postural disorders like TNS. Post facilitation stretching, in contrast, takes a more direct approach to muscle lengthening. By applying an isometric contraction to a shortened muscle followed by a sudden relaxation and stretch, this technique effectively reduces hypertonicity and improves flexibility. It is especially useful for addressing the postural tightness often seen in the upper trapezius and levator scapulae in TNS cases. The neuromuscular reset achieved by this method helps decrease muscular resistance and improve movement efficiency. Although the results are promising, there is still limited comparative evidence on how PFS performs relative to other techniques, including PNF, particularly in TNS management. This study is designed to address that gap by directly comparing the clinical outcomes of PNF and PFS in individuals with TNS. Both techniques have demonstrated individual effectiveness in enhancing cervical function and reducing discomfort, but no study to date has rigorously evaluated them against each other in a standardized clinical population. The findings of this research will therefore provide valuable insights to guide evidence-based clinical decision-making for physiotherapists and rehabilitation professionals
- Conditions
- Text Neck Syndrome
- Being tested
- Proprioceptive Neuromuscular Facilitation, Post-facilitation Stretching, traditional treatment
- Keywords
- Proprioceptive Neuromuscular Facilitation, Post-facilitation Stretching, Text Neck Syndrome
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Proprioceptive Neuromuscular FacilitationOther
the patients will receive proprioceptive neuromuscular facilitation for levator scapulae, upper trapezius and sternocleidomastoid muscle in the form of Contract-Relax technique. in addition to traditional treatment in the form of postural correction exercises (chin tucks and scapular retraction) and strengthening exercises for deep cervical flexors and scapular stabilizers. Exercises are typically performed in 3 sets of 10 repetitions.
Post-facilitation StretchingOther
the patients will receive Post-Facilitation Stretching Technique for levator scapulae, upper trapezius and sternocleidomastoid muscle. The participant will lie supine, placing the affected hand under the ipsilateral thigh to promote shoulder depression.For the upper trapezius, the same will be applied, except ipsilateral rotation will be used.For the sternocleidomastoid muscle, the therapist will position the neck into extension, contralateral side flexion, and ipsilateral rotation until resistance is felt. This position effectively elongates the sternocleidomastoid muscle while maintaining patient comfort and control throughout the stretch.The muscle will be returned to mid-range.The participant will perform a near-maximal isometric contraction for 10 seconds.Upon rapid relaxation, the therapist will apply an aggressive stretch beyond the tissue barrier .The procedure will be repeated five times for each muscle. plus tradional treatment
traditional treatmentOther
the patients will receive traditional treatment in the form of postural correction exercises (chin tucks and scapular retraction) and strengthening exercises for deep cervical flexors and scapular stabilizers. Exercises are typically performed in 3 sets of 10 repetitions.
| Study group | Role | What they receive |
|---|---|---|
| Proprioceptive Neuromuscular Facilitation | Experimental | Seventeen patients with text neck syndrome will receive proprioceptive neuromuscular Facilitation stretching technique in addition to the traditional treatment three times per week for 4 weeks Receives: Other: Proprioceptive Neuromuscular Facilitation; Other: traditional treatment |
| Post-facilitation Stretching | Experimental | Seventeen patients with text neck syndrome will receive post-facilitation stretching technique in addition to the traditional treatment three times per week for 4 weeks Receives: Other: Post-facilitation Stretching; Other: traditional treatment |
| traditional treatment | Active comparator | Seventeen patients with text neck syndrome will receive the traditional treatment three times per week for 4 weeks Receives: Other: traditional treatment |
What is being measured
The primary outcome is the main question the study is designed to answer.
craniovertebral angle
craniovertebral angle will be measured by lateral photographe.A lateral photograph is taken at the level of the participant's shoulder using a digital camera placed at a fixed distance.The anatomical landmarks (tragus of the ear and C7 spinous process) are identified and marked either physically or digitally using posture analysis software.The craniovertebral angle is calculated as the angle between:A horizontal line passing through C7, andA line connecting C7 to the tragus.CVA < 48-50°: Indicates forward head posture (FHP),CVA ≥ 50°: Suggests a normal or neutral head posture.
Measured: up to four weeks
cervical range of motion
cervical range of motion will be measured by cervical range of motion device
Measured: up to four weeks
Secondary outcomes (2)
pain intesinty
Pain intensity will be assessed using the Visual Analogue Scale (VAS). The VAS is a 10-centimeter horizontal line anchored by two descriptors: "no pain" (0) and "worst pain imaginable" (10). Each participant will be instructed to place a vertical mark along the line indicating the intensity of their pain. The distance (in cm) from the "no pain" anchor to the participant's mark will be measured and recorded as the pain score (
Measured: up to four weeks
neck disability
The Neck Disability Index (NDI) is the most widely used and validated self-report questionnaire for assessing neck pain-related disability.Questions include activities of daily living, such as: personal care, lifting, reading, work, driving, sleeping, recreational activities, pain intensity, concentration and headache. Each question is measured on a scale from 0 (no disability) to 5.The total score will be obtained by summing the item scores, yielding a total range from 0 to 50.
Measured: up to four weeks
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted21 Oct 2026
- Study start27 Oct 2026 (estimated)
- Primary completion20 Apr 2027 (estimated)
- Study completion20 Apr 2027 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Text Neck SyndromeStudies of the same condition, open and under way.
- More trials run by Cairo 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
- Model description
- Proprioceptive Neuromuscular Facilitation and Post-facilitation Stretching
- Masking
- Single blind
- Who is masked
- Outcomes assessor
- Enrolment
- 51 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Cairo University
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Omnia Raafat Mohamed Khalaf, Cairo University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07887711
- Sponsor's protocol ID
- P.T.REC/012/006623
- Acronym
- TNS
- Status last verified
- Oct 2026
- First submitted
- 14 Oct 2026
- Last updated
- 21 Oct 2026
- Results posted
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
Study at a glance
From the registry record, last updated by the sponsor on 21 Oct 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Comparative Study Between Proprioceptive Neuromuscular Facilitation and Post-facilitation Stretching in Text Neck Syndrome
- ClinicalTrials.gov ID
- NCT07887711
- Acronym / sponsor ID
- TNS / P.T.REC/012/006623
- Conditions
- Text Neck Syndrome
- Keywords
- Proprioceptive Neuromuscular Facilitation, Post-facilitation Stretching, Text Neck Syndrome
- Study type
- Interventional
- Recruitment status
- Not yet recruiting
- Enrolment
- 51 participants (estimated)
- Lead sponsor
- Cairo UniversityUniversity, hospital or other
- Study start
- 27 Oct 2026 (estimated)
- Primary completion
- 20 Apr 2027 (estimated)
- Study completion
- 20 Apr 2027 (estimated)
- First posted
- 21 Oct 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 be conducted to investigate the effect of Proprioceptive Neuromuscular Facilitation (PNF) stretching and Post Facilitation Stretching (PFS) on neck pain intensity, Cranio Vertebral Angle (CVA), cervical ROM and neck functional disability level in patients with text neck syndrome
Detailed description
Text Neck Syndrome (TNS) is increasingly being recognized as a widespread health concern, particularly among adolescents and young adults due to the frequent and prolonged use of smartphones and handheld electronic devices. Maintaining a forward head posture (FHP) for extended periods places abnormal stress on the cervical spine, disrupting normal biomechanics. Around 75% of the global population spends several hours daily looking down at mobile screens, which significantly increases the mechanical load on the neck-from approximately 5 kg in a neutral position to over 27 kg at 60 degrees of cervical flexion. This repetitive strain places individuals at high risk for developing musculoskeletal disorders such as TNS.PNF has been shown to improve posture, mobility, and coordination by recruiting both deep and superficial cervical muscles through functional, multidirectional patterns. This method enhances the integration of voluntary movement and proprioceptive feedback, which are often impaired in individuals with TNS due to repetitive poor posture. As a technique, it not only helps relieve pain but also supports long-term neuromuscular adaptations. However, despite its popularity in clinical practice, further controlled research is still needed to better understand its lasting neurophysiological effects in people with postural disorders like TNS. Post facilitation stretching, in contrast, takes a more direct approach to muscle lengthening. By applying an isometric contraction to a shortened muscle followed by a sudden relaxation and stretch, this technique effectively reduces hypertonicity and improves flexibility. It is especially useful for addressing the postural tightness often seen in the upper trapezius and levator scapulae in TNS cases. The neuromuscular reset achieved by this method helps decrease muscular resistance and improve movement efficiency. Although the results are promising, there is still limited comparative evidence on how PFS performs relative to other techniques, including PNF, particularly in TNS management. This study is designed to address that gap by directly comparing the clinical outcomes of PNF and PFS in individuals with TNS. Both techniques have demonstrated individual effectiveness in enhancing cervical function and reducing discomfort, but no study to date has rigorously evaluated them against each other in a standardized clinical population. The findings of this research will therefore provide valuable insights to guide evidence-based clinical decision-making for physiotherapists and rehabilitation professionals
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind (outcomes assessor)
- Number of arms
- 3
- Model description
- Proprioceptive Neuromuscular Facilitation and Post-facilitation Stretching
| Arm | Type | Receives |
|---|---|---|
| Proprioceptive Neuromuscular Facilitation | Experimental | Other: Proprioceptive Neuromuscular Facilitation, Other: traditional treatmentSeventeen patients with text neck syndrome will receive proprioceptive neuromuscular Facilitation stretching technique in addition to the traditional treatment three times per week for 4 weeks |
| Post-facilitation Stretching | Experimental | Other: Post-facilitation Stretching, Other: traditional treatmentSeventeen patients with text neck syndrome will receive post-facilitation stretching technique in addition to the traditional treatment three times per week for 4 weeks |
| traditional treatment | Active comparator | Other: traditional treatmentSeventeen patients with text neck syndrome will receive the traditional treatment three times per week for 4 weeks |
Who may qualify
- Ages
- 18 to 44 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult
Key inclusion criteria (3 listed)
- Age diagnosed with text neck syndrome by a licensed physician.
- Are between 18 and 44 years of age.
- Use mobile phones for more than 3-4 hours daily
Key exclusion criteria (3 listed)
- Have cervical radiculopathy or disc herniation.
- Have a history of cervical neck trauma or surgery.
- Present with neurological deficits or vestibular 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 |
|---|---|---|
| Proprioceptive Neuromuscular Facilitationthe patients will receive proprioceptive neuromuscular facilitation for levator scapulae, upper trapezius and sternocleidomastoid muscle in the form of Contract-Relax technique. in addition to traditional treatment in the form of postural correction exercises (chin tucks and scapular retraction) and strengthening exercises for deep cervical flexors and scapular stabilizers. Exercises are typically performed in 3 sets of 10 repetitions. | Other | Proprioceptive Neuromuscular Facilitation |
| Post-facilitation Stretchingthe patients will receive Post-Facilitation Stretching Technique for levator scapulae, upper trapezius and sternocleidomastoid muscle. The participant will lie supine, placing the affected hand under the ipsilateral thigh to promote shoulder depression.For the upper trapezius, the same will be applied, except ipsilateral rotation will be used.For the sternocleidomastoid muscle, the therapist will position the neck into extension, contralateral side flexion, and ipsilateral rotation until resistance is felt. This position effectively elongates the sternocleidomastoid muscle while maintaining patient comfort and control throughout the stretch.The muscle will be returned to mid-range.The participant will perform a near-maximal isometric contraction for 10 seconds.Upon rapid relaxation, the therapist will apply an aggressive stretch beyond the tissue barrier .The procedure will be repeated five times for each muscle. plus tradional treatment | Other | Post-facilitation Stretching |
| traditional treatmentthe patients will receive traditional treatment in the form of postural correction exercises (chin tucks and scapular retraction) and strengthening exercises for deep cervical flexors and scapular stabilizers. Exercises are typically performed in 3 sets of 10 repetitions. | Other | Post-facilitation Stretching, Proprioceptive Neuromuscular Facilitation, traditional treatment |
Primary outcome
craniovertebral angle
Time frame: up to four weeks
craniovertebral angle will be measured by lateral photographe.A lateral photograph is taken at the level of the participant's shoulder using a digital camera placed at a fixed distance.The anatomical landmarks (tragus of the ear and C7 spinous process) are identified and marked either physically or digitally using posture analysis software.The craniovertebral angle is calculated as the angle between:A horizontal line passing through C7, andA line connecting C7 to the tragus.CVA < 48-50°: Indicates forward head posture (FHP),CVA ≥ 50°: Suggests a normal or neutral head posture.
cervical range of motion
Time frame: up to four weeks
cervical range of motion will be measured by cervical range of motion device
2 secondary outcomes
pain intesinty
Time frame: up to four weeks
neck disability
Time frame: up to four weeks
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 21 Oct 2026.
Related trials for Text Neck Syndrome
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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.
Questions about this trial
What is this clinical trial studying?
A study testing Proprioceptive Neuromuscular Facilitation, Post-facilitation Stretching and traditional treatment in people with Text Neck Syndrome, run by Cairo University.
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 3 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 21 Oct 2026. Status can change between updates, so confirm with the study contact before making plans.
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 Omnia Raafat, master (01205053134, omnya.raafat96@gmail.com), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
craniovertebral angle (time frame: up to four weeks). The study lists 2 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 21 Oct 2026.