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Neck pain is a common musculoskeletal disorder that significantly affects quality of life and daily activities, with an annual prevalence of 30-50% worldwide. This randomized clinical trial aims to compare the effects of myofascial release therapy and dynamic cupping on neck pain and posture in school-based children aged 7-12 years. A total of 40 children with neck pain and postural deviations will be recruited from schools and randomly assigned to either a myofascial release group or a dynamic cupping group (20 participants each) for a 6-week intervention. Children with skin conditions, neurological symptoms, recent analgesic use, or assistive device use will be excluded. Outcomes will be assessed using the Visual Analog Scale, goniometer, and plumb line test, and data will be analyzed using SPSS version 27 to determine the effectiveness of both interventions in reducing pain and improving posture.
Neck pain is a highly prevalent musculoskeletal disorder that significantly impairs quality of life and restricts social, academic, and physical activities. Globally, neck pain is ranked as the fourth leading cause of disability, with an annual prevalence estimated between 30% and 50%. Chronic neck pain is defined as pain or discomfort experienced along the posterior cervical spine, extending from the superior nuchal line to the first thoracic spinous process, persisting for more than three months. In school-aged children, prolonged poor posture, excessive screen use, and heavy schoolbags contribute to the increasing incidence of neck pain and postural deviations, making early intervention essential.
This study is designed as a randomized clinical trial to evaluate and compare the effectiveness of myofascial release therapy and dynamic cupping therapy in reducing neck pain and correcting postural deviations in school-based children. The study will be conducted in selected schools, where data collection and treatment sessions will take place. Children aged 7 to 12 years, both boys and girls, who present with neck pain and observable postural deviations will be included in the study. Exclusion criteria will consist of children with skin infections, open wounds, or dermatological conditions in the neck or upper back region, neurological symptoms, recent use of analgesic medications, or reliance on assistive devices, to ensure participant safety and reduce confounding variables.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Myofascial release therapy | Active Comparator | The participants in this group will receive myofascial release therapy. Stretching of neck muscles: hold of 15-30 seconds, repeat for 2 sets Isometric setting of neck muscle: (for 12 seconds, repeated for 2 sets, with 1- minute rest between sets) (neck flexion, neck extension, side flexion without changing their length or the angle of the joint, essentially holding a static position) Postural exercise for neck: (chin tucks) (shoulder elevation and drop) (shoulder retraction and protraction) (Cobra/Sphinx Pose) (hold for 5-10 sec, 2x set) |
|
| Dynamic cupping | Experimental | The participants in this group will receive dynamic cupping. Stretching of neck muscles: hold of 15-30 seconds, repeat for 2 sets Isometric setting of neck muscle: (for 12 seconds, repeated for 2 sets, with 1- minute rest between sets) (neck flexion, neck extension, side flexion without changing their .length or the angle of the joint, essentially holding a static position) 3. Dynamic cupping: Dynamic cupping involves applying a silicone or plastic cup to lubricated skin and creating gentle suction by squeezing the cup 2-3 time. Once suction is established, the therapist glides the cup smoothly over the muscle fibers in slow, controlled stroke linear, circular, or fan-shape to mobilize soft tissue and fascia. The cup should move without causing excessive pulling or discomfort, typically for 2 minutes per area. The suction level is moderate to keep the cup attached while allowing movement |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Myofascial release therapy | Other | The participants in this group will receive myofascial release therapy. Stretching of neck muscles: hold of 15-30 seconds, repeat for 2 sets Isometric setting of neck muscle: (for 12 seconds, repeated for 2 sets, with 1- minute rest between sets) (neck flexion, neck extension, side flexion without changing their length or the angle of the joint, essentially holding a static position) Postural exercise for neck: (chin tucks) (shoulder elevation and drop) (shoulder retraction and protraction) (Cobra/Sphinx Pose) (hold for 5-10 sec, 2x set) |
| Measure | Description | Time Frame |
|---|---|---|
| posture correction | Posture correction refers to the improvement in head, neck, and shoulder alignment, particularly reduction in forward head posture and rounded shoulders. It is measured using objective tools such as craniovertebral angle, postural assessment scales, or photographic analysis. Improvement is indicated by increased alignment angles and a more neutral upright posture. | 4th day |
| Measure | Description | Time Frame |
|---|---|---|
| rang of motion | Range of motion refers to the degree of movement available at the cervical spine in all directions, including flexion, extension, lateral flexion, and rotation. It is measured using tools such as a goniometer or inclinometer to assess functional mobility. Improvement is indicated by increased pain-free movement and greater cervical mobility in all planes. | 4th day |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| IMRAN AMJAD, PhD | Contact | 9233224390125 | IMRAN.AMJAD@RIPHAH.EDU.PK | |
| MUHAMMAD ASIF JAVEED, MS-PT | Contact | 9233224209422 | a.javeed@riphah.edu.pk |
| Name | Affiliation | Role |
|---|---|---|
| EAYZA RIAZ, MS-PT | RIPHAH INTERNATINAAL UNIVERSITY | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Imran Amjad | Recruiting | Lahore | 54000 | Pakistan |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 36305079 | Background | Guo Y, Lv X, Zhou Y, Li Z, She H, Bai L, Bao J. Myofascial release for the treatment of pain and dysfunction in patients with chronic mechanical neck pain: Systematic review and meta-analysis of randomised controlled trials. Clin Rehabil. 2023 Apr;37(4):478-493. doi: 10.1177/02692155221136108. Epub 2022 Oct 27. | |
| 41355013 | Background |
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| ID | Term |
|---|---|
| D019547 | Neck Pain |
| ID | Term |
|---|---|
| D010146 | Pain |
| D009461 | Neurologic Manifestations |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |
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| ID | Term |
|---|---|
| D000089803 | Myofascial Release Therapy |
| ID | Term |
|---|---|
| D008405 | Massage |
| D064746 | Therapy, Soft Tissue |
| D026201 | Musculoskeletal Manipulations |
| D000529 | Complementary Therapies |
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|
| dynamic cupping | Other | Dynamic cupping involves applying a silicone or plastic cup to lubricated skin and creating gentle suction by squeezing the cup 2-3 time. Once suction is established, the therapist glides the cup smoothly over the muscle fibers in slow, controlled stroke linear, circular, or fan-shape to mobilize soft tissue and fascia. The cup should move without causing excessive pulling or discomfort, typically for 2 minutes per area. The suction level is moderate to keep the cup attached while allowing movement, and the therapist continuously adjusts pressure based on feedback. After treatment, the cup is gently lifted to release suction, and the skin is checked for any irritation |
|
| Mihcioglu EK, Guchan Topcu Z, Tunali AN, Mihcioglu S, Tomac H. Instrument-assisted soft tissue mobilization as a promising approach for children with chronic neck pain: A single-blind, randomized study. J Back Musculoskelet Rehabil. 2026 May;39(3):1044-1052. doi: 10.1177/10538127251401084. Epub 2025 Dec 7. |
| D013812 |
| Therapeutics |
| D026741 | Physical Therapy Modalities |
| D012046 | Rehabilitation |