Text Neck SyndromeNCT07921004
Effects of Alexander Technique Versus Feldenkrais Somatic Training in Patients With Text Neck Syndrome
A study testing Alexander Technique, Feldenkrais Somatic training and Base line Treatment (Standard PT protocol) in people with Text Neck Syndrome, run by Riphah International University at 1 site in Pakistan.
Trial summary
in this era, increasing use of smart gadgets such as mobile phones, laptops, computers etc has led to rise in musculoskeletal disorders, particularly Text Neck Syndrome, which is characterized by neck and upper back pain with prolonged neck flexion and forward head posture. Read more about this study
- Who is it for?
- Ages 18 to 40 years
- Conditions the study is for
- Text Neck Syndrome
- What is being tested?
- Alexander Technique, Feldenkrais Somatic training and Base line Treatment (Standard PT protocol)
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 46 participants
- Where
- 1 sitePakistan
- Study dates
- 28 Oct 2026to 10 Jan 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
- Male and Female are included
- Age between 18- 40 years age
- Using smart phone ≥4 hours/day
- Neck pain duration ≥3 months
- Neck pain increase by sustained posture
- NDI score range from >20 points
- Cranio-vertebral angle ≤ 48°
Who cannot join
- Any trauma or injury on cervical and thoracic spine
- History of cervical spine surgery
- Specific neck pathologies (cervical disc herniation, radiculopathy, inflammatory conditions, spinal infection and tumor)
- Congenital Spinal deformity
- Psychological problem
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, 1 recruiting
- Recruiting
Riaz Mansoor Trust Hospital
Lahore, Punjab Province, 54000
Mehwish Irfan, +923204435562, Umine2i2@gmail.com
About this study
Official title: Effects of Alexander Technique Versus Feldenkrais Somatic Training on Pain, Cranio-Vertebral Angle and Disability in Patients With Text Neck Syndrome
in this era, increasing use of smart gadgets such as mobile phones, laptops, computers etc has led to rise in musculoskeletal disorders, particularly Text Neck Syndrome, which is characterized by neck and upper back pain with prolonged neck flexion and forward head posture. Somatic education approaches such as the Alexander Technique and Feldenkrais Method offer alternative strategies by emphasizing postural awareness, movement quality, and neuromuscular re-education rather than repetitive exercise alone. The study will be conducted as a randomized clinical trial and the assessor will be blind. Sample size of 46 subjects will be taken according to inclusion criteria and subjects will be allocated in two groups by computer generator software. Conventional intervention will be received as a standardized treatment protocol in both groups with additional intervention. Group A will receive Alexander technique while Group B will receive Feldenkrais technique. The data will be analyzed using appropriate statistical methods to evaluate the effectiveness of each intervention. This study's results can provide valuable information to healthcare professionals on how to manage Text neck syndrome.
Read the detailed description
PROJECT SUMMARY:
In this modern era, increasing use of smart gadgets such as mobile phones, laptops, computers etc has led to rise in musculoskeletal disorders, particularly Text Neck Syndrome, which is characterized by neck and upper back pain with prolonged neck flexion and forward head posture. Although conventional physiotherapy interventions such as postural correction, strengthening, and stretching have demonstrated benefits; however, persistent symptoms, functional limitations, and reduced treatment adherence remain challenges. Somatic education approaches such as the Alexander Technique and Feldenkrais Method offer alternative strategies by emphasizing postural awareness, movement quality, and neuromuscular re-education rather than repetitive exercise alone. The Alexander Technique focuses on optimizing the head-neck-spine relationship, reducing unnecessary muscle tension, and modifying habitual movement patterns through conscious inhibition and direction, whereas the Feldenkrais Method employs gentle, awareness-based movement lessons and functional integration to enhance sensorimotor organization, proprioception, and movement efficiency. Both approaches may contribute to improved posture, reduced pain and enhanced functional outcomes in individuals with neck pain.
The study will be conducted as a randomized clinical trial and the assessor will be blind. Sample size of 46 subjects will be taken according to inclusion criteria and subjects will be allocated in two groups by computer generator software. Conventional intervention will be received as a standardized treatment protocol in both groups with additional somatic intervention. Group A will receive Alexander technique while Group B will receive Feldenkrais technique. The primary outcomes measured will be pain, disability, and cranio-cervical angle. The study will collect data at baseline and four weeks using validated outcome measures. The data will be analyzed using appropriate statistical methods to evaluate the effectiveness of each intervention. In this study, participants in both groups will receive treatment twice a week, with a total of eight treatment sessions over the four-week study period. The results of the study will provide valuable insights into the efficacy of Alexander technique and Feldenkrais training in managing Text neck syndrome. This study's results can provide valuable information to healthcare professionals on how to manage Text neck syndrome and may contribute to the development of future research in this area.
- Conditions
- Text Neck Syndrome
- Being tested
- Alexander Technique, Feldenkrais Somatic training, Base line Treatment (Standard PT protocol)
- Keywords
- Disability, Neck pain, Postural balance, Somatic training, Text Neck syndrome
- Medical subject headings
- Neck Pain
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Alexander TechniqueOther
Each patient will receive a total number of eight treatment sessions over a four-week period and each session is about 45 min. There will be 3 sessions in per week. Constructive rest-5 min, Gentle cervical rotation in supine , 4-5 each side, Head and neck release awareness in sitting, Semi supine arm awareness, Sitting Posture Re-education: Ask the patient to hold the phone at eye level, Sitting to standing by Alexander Method, Gentle cervical rotation sitting, Functional Reaching with AT Cues, Stimulated phone use training, Sustained posture awareness drill
Feldenkrais Somatic trainingOther
Each patient will receive a total number of eight treatment sessions over a four-week period and each session is about 45 min. There will be 3 sessions in per week. Body scan in supine, small circles in supine , Chin nodding in supine lying, Jaw-neck awareness (ask the patient to open \& close mouth gently), Head turning with shoulder awareness (patient is in supine position, ask the patient to turn head right while noticing left shoulder and move to the alternate sides.), Eye-head coordination (ask the patient to move eyes right first, then head follows then reverse direction.), Side-lying head lift (1 cm), Scapula-neck relationship (patient in standing, ask the patient to gently slide shoulder up/down while head rests and therapist observe neck response.), Thoracic rolling in supine, Pelvic rocking with in supine lying, Standing weight shift + head response, Walking with free neck, Text neck re education
Base line Treatment (Standard PT protocol)Other
TENS (10 min), Hot pack (10 min), Soft tissue mobilization, Grade I, II matland mobilization of cervical spine, AROM (10 reps- 2 sets), Upper trapezius stretch (5 sets, hold for 15-30 sec), Levator Scapulae stretch (5 sets, hold for 15-30 sec), SCM stretch (5 sets, hold for 15-30 sec), Pectoralis major stretch (5 sets, hold for 15-30 sec), Cervical isometrics in flexion, extension and side bending (5-10 sets, hold for 10 sec).
| Study group | Role | What they receive |
|---|---|---|
| Alexander Technique | Experimental | Not described Receives: Other: Alexander Technique; Other: Base line Treatment (Standard PT protocol) |
| Feldenkrais Somatic training | Experimental | Not described Receives: Other: Feldenkrais Somatic training; Other: Base line Treatment (Standard PT protocol) |
What is being measured
The primary outcome is the main question the study is designed to answer.
NPRS (Numeric Pain Rating Scale)
Numeric pain rating scale were used to measure the intensity level of the patient's pain. Scale consists of 11 points, ranging from 0 -10. 0 is no pain and 10 is the worst imaginable pain. Subjects select the number that best symbolizes their level of pain.
0= No pain 1-3= Mild pain 4-6= Moderate pain 7-10= severe pain
Measured: From enrollment to end of week 4
NDI (Neck Disability Index)
The Neck Disability Index is the most general measure for evaluating self-perceived disability in patients with neck pain. Each question has six options to rate the disability level from 0 (no disability) to 5 (total disability). The numeric responses for each question are summed for a total score between 0 and 50.
No disability= 0 - 4 Mild= 5 - 14 Moderate= 15 - 24 Severe= 25 - 34 Complete Disability = 35 - 50
Measured: From enrolment to end of week 4
Photogrammetry for Cranio-vertebral angle
Photogrammetry is a most commonly used noninvasive tool to assess cranio-vertebral angle or posture alignment. Participants will be asked to stand or seated in normal or relaxed posture. Lateral photographs were taken and mark the spinous process of C7 and tragus of ear. The angle between the line joining from tragus to C7 spinous process and horizontal line will be measured with the help of Image J. Software to determine cranio-vertebral angle.
Measured: From enrollment to end of week 4
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted6 Nov 2026
- Study start28 Oct 2026
- Primary completion1 Dec 2026 (estimated)
- Study completion10 Jan 2027 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (5)Papers the sponsor has linked to this study.
- Other trials for Text Neck 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
- Double blind
- Who is masked
- Participant, Outcomes assessor
- Enrolment
- 46 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Riphah International University
- Sponsor type
- University, hospital or other
- Responsible party
- Sponsor
- Investigators
- Ali Raza, Principal investigator, Riphah International University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07921004
- Sponsor's protocol ID
- REC/RCR & AHS/25/0186
- Status last verified
- Nov 2026
- First submitted
- 2 Nov 2026
- Last updated
- 6 Nov 2026
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Publications
Klein SD, Bayard C, Wolf U. The Alexander Technique and musicians: a systematic review of controlled trials. BMC Complement Altern Med. 2014 Oct 24;14:414. doi: 10.1186/1472-6882-14-414.
PubMed 25344325Shadi N, Khalaghi K, Seyedahmadi M. Comparing the effects of Pilates, corrective exercises, and Alexander's technique on upper cross syndrome among adolescent girls student (ages 13-16): a six-week study. BMC Sports Sci Med Rehabil. 2024 Jun 28;16(1):143. doi: 10.1186/s13102-024-00933-2.
PubMed 38943175Qin D, Qin Y, Wang Y, Xue L, Peng Y. RETRACTED: Effects of the Alexander technique on pain and adverse events in chronic non-specific neck pain: A systematic review and meta-analysis. PLoS One. 2024 Nov 22;19(11):e0313526. doi: 10.1371/journal.pone.0313526. eCollection 2024.
PubMed 39576801Brummer M, Walach H, Schmidt S. Feldenkrais 'Functional Integration' Increases Body Contact Surface in the Supine Position: A Randomized-Controlled Experimental Study. Front Psychol. 2018 Oct 24;9:2023. doi: 10.3389/fpsyg.2018.02023. eCollection 2018.
PubMed 30405500Jain S, Janssen K, DeCelle S. Alexander technique and Feldenkrais method: a critical overview. Phys Med Rehabil Clin N Am. 2004 Nov;15(4):811-25, vi. doi: 10.1016/j.pmr.2004.04.005.
PubMed 15458754
Study at a glance
From the registry record, last updated by the sponsor on 6 Nov 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Effects of Alexander Technique Versus Feldenkrais Somatic Training on Pain, Cranio-Vertebral Angle and Disability in Patients With Text Neck Syndrome
- ClinicalTrials.gov ID
- NCT07921004
- Acronym / sponsor ID
- REC/RCR & AHS/25/0186
- Conditions
- Text Neck Syndrome
- Keywords
- Disability, Neck pain, Postural balance, Somatic training, Text Neck syndrome
- Study type
- Interventional
- Recruitment status
- Recruiting
- Enrolment
- 46 participants (estimated)
- Lead sponsor
- Riphah International UniversityUniversity, hospital or other
- Study start
- 28 Oct 2026 (actual)
- Primary completion
- 1 Dec 2026 (estimated)
- Study completion
- 10 Jan 2027 (estimated)
- First posted
- 6 Nov 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.
in this era, increasing use of smart gadgets such as mobile phones, laptops, computers etc has led to rise in musculoskeletal disorders, particularly Text Neck Syndrome, which is characterized by neck and upper back pain with prolonged neck flexion and forward head posture. Somatic education approaches such as the Alexander Technique and Feldenkrais Method offer alternative strategies by emphasizing postural awareness, movement quality, and neuromuscular re-education rather than repetitive exercise alone. The study will be conducted as a randomized clinical trial and the assessor will be blind. Sample size of 46 subjects will be taken according to inclusion criteria and subjects will be allocated in two groups by computer generator software. Conventional intervention will be received as a standardized treatment protocol in both groups with additional intervention. Group A will receive Alexander technique while Group B will receive Feldenkrais technique. The data will be analyzed using appropriate statistical methods to evaluate the effectiveness of each intervention. This study's results can provide valuable information to healthcare professionals on how to manage Text neck syndrome.
Detailed description
PROJECT SUMMARY:
In this modern era, increasing use of smart gadgets such as mobile phones, laptops, computers etc has led to rise in musculoskeletal disorders, particularly Text Neck Syndrome, which is characterized by neck and upper back pain with prolonged neck flexion and forward head posture. Although conventional physiotherapy interventions such as postural correction, strengthening, and stretching have demonstrated benefits; however, persistent symptoms, functional limitations, and reduced treatment adherence remain challenges. Somatic education approaches such as the Alexander Technique and Feldenkrais Method offer alternative strategies by emphasizing postural awareness, movement quality, and neuromuscular re-education rather than repetitive exercise alone. The Alexander Technique focuses on optimizing the head-neck-spine relationship, reducing unnecessary muscle tension, and modifying habitual movement patterns through conscious inhibition and direction, whereas the Feldenkrais Method employs gentle, awareness-based movement lessons and functional integration to enhance sensorimotor organization, proprioception, and movement efficiency. Both approaches may contribute to improved posture, reduced pain and enhanced functional outcomes in individuals with neck pain.
The study will be conducted as a randomized clinical trial and the assessor will be blind. Sample size of 46 subjects will be taken according to inclusion criteria and subjects will be allocated in two groups by computer generator software. Conventional intervention will be received as a standardized treatment protocol in both groups with additional somatic intervention. Group A will receive Alexander technique while Group B will receive Feldenkrais technique. The primary outcomes measured will be pain, disability, and cranio-cervical angle. The study will collect data at baseline and four weeks using validated outcome measures. The data will be analyzed using appropriate statistical methods to evaluate the effectiveness of each intervention. In this study, participants in both groups will receive treatment twice a week, with a total of eight treatment sessions over the four-week study period. The results of the study will provide valuable insights into the efficacy of Alexander technique and Feldenkrais training in managing Text neck syndrome. This study's results can provide valuable information to healthcare professionals on how to manage Text neck syndrome and may contribute to the development of future research in this area.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Double blind (participant, outcomes assessor)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Alexander Technique | Experimental | Other: Alexander Technique, Other: Base line Treatment (Standard PT protocol) |
| Feldenkrais Somatic training | Experimental | Other: Feldenkrais Somatic training, Other: Base line Treatment (Standard PT protocol) |
Who may qualify
- Ages
- 18 to 40 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult
Key inclusion criteria (7 listed)
- Male and Female are included
- Age between 18- 40 years age
- Using smart phone ≥4 hours/day
- Neck pain duration ≥3 months
- Neck pain increase by sustained posture
Key exclusion criteria (5 listed)
- Any trauma or injury on cervical and thoracic spine
- History of cervical spine surgery
- Specific neck pathologies (cervical disc herniation, radiculopathy, inflammatory conditions, spinal infection and tumor)
- Congenital Spinal deformity
- Psychological problem
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 |
|---|---|---|
| Alexander TechniqueEach patient will receive a total number of eight treatment sessions over a four-week period and each session is about 45 min. There will be 3 sessions in per week. Constructive rest-5 min, Gentle cervical rotation in supine , 4-5 each side, Head and neck release awareness in sitting, Semi supine arm awareness, Sitting Posture Re-education: Ask the patient to hold the phone at eye level, Sitting to standing by Alexander Method, Gentle cervical rotation sitting, Functional Reaching with AT Cues, Stimulated phone use training, Sustained posture awareness drill | Other | Alexander Technique |
| Feldenkrais Somatic trainingEach patient will receive a total number of eight treatment sessions over a four-week period and each session is about 45 min. There will be 3 sessions in per week. Body scan in supine, small circles in supine , Chin nodding in supine lying, Jaw-neck awareness (ask the patient to open \& close mouth gently), Head turning with shoulder awareness (patient is in supine position, ask the patient to turn head right while noticing left shoulder and move to the alternate sides.), Eye-head coordination (ask the patient to move eyes right first, then head follows then reverse direction.), Side-lying head lift (1 cm), Scapula-neck relationship (patient in standing, ask the patient to gently slide shoulder up/down while head rests and therapist observe neck response.), Thoracic rolling in supine, Pelvic rocking with in supine lying, Standing weight shift + head response, Walking with free neck, Text neck re education | Other | Feldenkrais Somatic training |
| Base line Treatment (Standard PT protocol)TENS (10 min), Hot pack (10 min), Soft tissue mobilization, Grade I, II matland mobilization of cervical spine, AROM (10 reps- 2 sets), Upper trapezius stretch (5 sets, hold for 15-30 sec), Levator Scapulae stretch (5 sets, hold for 15-30 sec), SCM stretch (5 sets, hold for 15-30 sec), Pectoralis major stretch (5 sets, hold for 15-30 sec), Cervical isometrics in flexion, extension and side bending (5-10 sets, hold for 10 sec). | Other | Alexander Technique, Feldenkrais Somatic training |
Primary outcome
NPRS (Numeric Pain Rating Scale)
Time frame: From enrollment to end of week 4
Numeric pain rating scale were used to measure the intensity level of the patient's pain. Scale consists of 11 points, ranging from 0 -10. 0 is no pain and 10 is the worst imaginable pain. Subjects select the number that best symbolizes their level of pain. 0= No pain 1-3= Mild pain 4-6= Moderate pain 7-10= severe pain
NDI (Neck Disability Index)
Time frame: From enrolment to end of week 4
The Neck Disability Index is the most general measure for evaluating self-perceived disability in patients with neck pain. Each question has six options to rate the disability level from 0 (no disability) to 5 (total disability). The numeric responses for each question are summed for a total score between 0 and 50. No disability= 0 - 4 Mild= 5 - 14 Moderate= 15 - 24 Severe= 25 - 34 Complete Disability = 35 - 50
Photogrammetry for Cranio-vertebral angle
Time frame: From enrollment to end of week 4
Photogrammetry is a most commonly used noninvasive tool to assess cranio-vertebral angle or posture alignment. Participants will be asked to stand or seated in normal or relaxed posture. Lateral photographs were taken and mark the spinous process of C7 and tragus of ear. The angle between the line joining from tragus to C7 spinous process and horizontal line will be measured with the help of Image J. Software to determine cranio-vertebral angle.
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 6 Nov 2026.
- Background: PubMed 25344325Klein SD, Bayard C, Wolf U. The Alexander Technique and musicians: a systematic review of controlled trials. BMC Complement Altern Med. 2014 Oct 24;14:414. doi: 10.1186/1472-6882-14-414.
- Background: PubMed 38943175Shadi N, Khalaghi K, Seyedahmadi M. Comparing the effects of Pilates, corrective exercises, and Alexander's technique on upper cross syndrome among adolescent girls student (ages 13-16): a six-week study. BMC Sports Sci Med Rehabil. 2024 Jun 28;16(1):143. doi: 10.1186/s13102-024-00933-2.
- Background: PubMed 39576801Qin D, Qin Y, Wang Y, Xue L, Peng Y. RETRACTED: Effects of the Alexander technique on pain and adverse events in chronic non-specific neck pain: A systematic review and meta-analysis. PLoS One. 2024 Nov 22;19(11):e0313526. doi: 10.1371/journal.pone.0313526. eCollection 2024.
- Background: PubMed 30405500Brummer M, Walach H, Schmidt S. Feldenkrais 'Functional Integration' Increases Body Contact Surface in the Supine Position: A Randomized-Controlled Experimental Study. Front Psychol. 2018 Oct 24;9:2023. doi: 10.3389/fpsyg.2018.02023. eCollection 2018.
- Background: PubMed 15458754Jain S, Janssen K, DeCelle S. Alexander technique and Feldenkrais method: a critical overview. Phys Med Rehabil Clin N Am. 2004 Nov;15(4):811-25, vi. doi: 10.1016/j.pmr.2004.04.005.
- Individual participant dataSharing planned: No
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part.
Ali Raza 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 Alexander Technique, Feldenkrais Somatic training and Base line Treatment (Standard PT protocol) 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 7 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: looking for participants now, as of the sponsor's last update on 6 Nov 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 Imran Amjad (+923324390125, imran.amjad@riphah.edu.pk), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
NPRS (Numeric Pain Rating Scale) (time frame: From enrollment to end of week 4). 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 NCT07921004, which also lists 5 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 6 Nov 2026.