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This study aims to compare the effectiveness of Bowen Therapy and Post-Isometric Relaxation Technique (PIRT) in the management of Text Neck Syndrome, a musculoskeletal condition caused by prolonged forward head posture during mobile phone or screen use.
The study follows a randomized clinical trial design, ensuring that participants are randomly assigned to either the Bowen Therapy group or the PIRT group to minimize bias.
The total study duration is nine months, including a six-week treatment phase and a three-week follow-up period. Assessments will be conducted at baseline, mid-intervention (3 weeks), post-intervention (6 weeks), and follow-up (9 weeks) to evaluate the short-term and sustained effects of both interventions.
A consecutive sampling technique will be used, and participants who meet the inclusion and exclusion criteria will provide informed written consent before enrollment.
The sample size was determined using G*Power software (v3.1.9.7), based on previous research (Seemal et al., 2022), with an assumed large effect size (d = 1.0), α = 0.05, and 80% power. After accounting for a 20% attrition rate, a total of 42 participants (21 per group) will be included in the study.
Overall, this study seeks to provide evidence on which therapeutic approach-Bowen Therapy or Post-Isometric Relaxation-is more effective in reducing pain, improving range of motion, and enhancing posture in individuals with Text Neck Syndrome.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Bowen Therapy Group | Experimental | Participants in this group will receive Bowen Therapy after baseline assessment of forward head posture, cervical range of motion, pain intensity, and functional limitation. The intervention will consist of three sessions per week for six weeks (total 18 sessions), each lasting approximately 30-45 minutes. A standardized Bowen Therapy protocol will be applied, focusing on the cervical and upper back/shoulder regions. Techniques include gentle rolling moves with the therapist's thumb over the sternocleidomastoid (SCM), scalenes, suboccipitals, upper trapezius, levator scapulae, and pectoralis muscles, performed while the patient is in prone or seated position. The procedure incorporates short pauses between moves to facilitate neuromuscular integration. |
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| Post-Isometric Relaxation Technique Group | Active Comparator | Participants in this group will receive Post-Isometric Relaxation Technique (PIRT) sessions, administered three times per week for six weeks (total 18 sessions), each lasting 30-45 minutes. The intervention involves the standardized application of PIRT on upper trapezius, sternocleidomastoid, levator scapulae, suboccipital, scalene, and pectoralis muscles. Each muscle will be positioned at its resistance barrier, and participants will perform a 5-10 second, 20% effort isometric contraction against therapist resistance, followed by 2-3 seconds of relaxation and gentle stretch toward the new barrier. The process will be repeated 3-5 times per muscle. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Bowen therapy | Other | Participants will receive Bowen Therapy sessions three times per week for six weeks. Gentle rolling moves will be applied to the cervical and upper back muscles to reduce pain, muscle tension, and improve posture. |
| Measure | Description | Time Frame |
|---|---|---|
| Change in Neck Pain Intensity Measured by the Numeric Pain Rating Scale | Neck pain intensity will be assessed using the Numeric Pain Rating Scale (NPRS), an 11-point self-reported scale ranging from 0 (no pain) to 10 (worst imaginable pain). Participants will rate their average neck pain over the previous 24 hours by selecting a number from 0 to 10. The primary outcome is the change in NPRS score from baseline to 6 weeks, with higher scores indicating greater pain intensity and lower scores indicating improvement. | Baseline and 6 weeks (post-intervention) |
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Inclusion Criteria:
Neck pain intensity of at least 4 to 7 on Numeric Pain Rating Scale. Daily screen time of ≥4 hours per day including smartphones, tablet, laptop, and desktop use for at least 5 days per week.
Exclusion Criteria:
Ongoing treatment for neck pain from another healthcare provider. Neurological conditions affecting muscle tone or coordination. Severe postural abnormalities from congenital conditions.
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| UIPT, UOL, Lahore | Lahore | Pakistan |
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| Post-Isometric Relaxation Technique (PIRT) | Other | Participants will undergo PIRT sessions three times per week for six weeks, involving gentle isometric contractions and relaxation of targeted neck and shoulder muscles to improve flexibility and reduce discomfort. |
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