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The prolonged use of electronic devices in the population nowadays contributes to the development of various musculoskeletal disorders affecting the neck. One such condition is the Text neck syndrome characterized by neck pain and muscular imbalance in the region as well as development of forward head posture. Some additional symptoms include headaches, impaired range of motion and eye strain. Eyeball exercises have been shown to improve symptoms of neck pain, and cervical stabilization has demonstrated positive effects on the deep cervical flexors, thereby improving forward head posture and other neck-associated symptoms. However, the combined effect of these two interventions has not been studied to treat text neck syndrome before. The primary outcome measures include the pain measured through Numeric Pain Rating Scale (NPRS) and pain pressure threshold (algometer), whereas the secondary outcome measures include the craniovertebral angle (CVA) and functional disability measured through neck disability index (NDI).
Text neck syndrome is a musculoskeletal syndrome characterized by neck pain, forward head posture, muscular imbalance, headache, reduced range of motion and eye problems. In the present era where everything is done through electronic devices and gadgets it is difficult to maintain a proper posture, which affects most importantly the cervical region. Prolonged use of these gadgets have led to the development of text neck syndrome which is a new pandemic these days. Constant screen use has detrimental effects on eyes that effects our neck as well, therefore the use of eyeball exercises has shown to improve the symptoms of neck pain. Cervical stabilization focuses on the deep neck flexor muscles which become weak and inactive in text neck syndrome. Cervical stabilization has shown improvements in the activation of these muscles as well as improved their strength along with improving the forward head posture. the combined effects of both these treatment regimes has not been studied yet in text neck syndrome individuals therefore the purpose of this randomized clinical trial will be to assess the combined effects of these treatment approaches on text neck syndrome. The Numeric Pain Rating Scale (NPRS) will be used to assess and measure the pain intensity along with NDI (neck disability index) that will help in functional evaluation and will serve as the primary outcome measures in this study. The Craniovertebral Angle (CVA) and Pain Pressure Threshold (PPT) measured through algometer will also be measured and will be the secondary outcome measures in this study.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Interventional Group A | Experimental | These patients will receive physiotherapy care along with cervical stabilization exercises and eyeball exercises. Treatment schedule: 3 sessions on alternate days for 6 weeks. |
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| Interventional Group B | Active Comparator | These patients will receive physiotherapy care along with cervical stabilization exercises and placebo treatment in place of eyeball exercises. Treatment schedule: 3 sessions on alternate days for 6 weeks. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Physiotherapy care, Cervical Stabilization and Eyeball Exercises | Other | Physiotherapy care: 30minutes of physiotherapy, including hotpack for 10 minutes,cervical stretching (3sets/15-second hold,5 repetitions), cervical isometrics (5-10 reps/3sets), postural correction exercises (5-10 reps/2-3 sets), active ROMs of the neck.•Cervical Stabilization: Pressure biofeedback unit will be used, the patient will perform chin tucks while the inflated unit is below the head at 20mmHg initially, and will be raised to 30mmHg. A 10 seconds hold with 10 repetitions, including a 10-second rest interval between. A total of 3sets will be performed with 15second interval between each set. 15 minutes total •Eyeball exercises:The patient is then asked to carry out the described eyeball movements, each movement to be held for 10 seconds and repeated 4 times through the maximum range,directions: Leftward, rightward, upper left, lower left, upper and lower right, left and right side circular, leftward and rightward figure 8 rotation. 2sets with 15seconds interval. 15 mins total. |
| Measure | Description | Time Frame |
|---|---|---|
| Pain Intensity | Change in pain intensity measured using the Numeric Pain rating Scale (NPRS, 0-10 cm). | Baseline, at 3rd week and at 6th week |
| Neck Disability | Functional disability measured using the Neck Disability Index (NDI) - Urdu validated version. | Baseline, at 3rd week and at 6th week |
| Measure | Description | Time Frame |
|---|---|---|
| Craniovertebral Angle (CVA) | Postural alignment measured as the craniovertebral angle (CVA) using Kinovea software from standardized lateral-view photographs | Baseline, at 3rd week and at 6th week |
| Pain Pressure Threshold (PPT) |
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Inclusion Criteria:
NDI scoring: >5 and <24 Duration of screen usage: 4-6hours/day Pain: ranging from mild - moderate 4-7 NPRS -
Exclusion Criteria:
Already undergoing physical therapy Cervical trauma, radiculopathy, pregnancy, malignancies, torticollis, herniation, stenosis, osteoporosis, etc Diagnosed with a CNS abnormality
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| Name | Affiliation | Role |
|---|---|---|
| Sahreen Anwar, Ph.D | University of Lahore | Study Chair |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| The University of Lahore Teaching Hospital | Lahore | Punjab Province | 54782 | Pakistan |
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| ID | Term |
|---|---|
| D000377 | Agnosia |
| ID | Term |
|---|---|
| D010468 | Perceptual Disorders |
| D019954 | Neurobehavioral Manifestations |
| D009461 | Neurologic Manifestations |
| D009422 | Nervous System Diseases |
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| Phyisotherapy Care, Cervical Stabilization and placebo exercises | Other | Physiotherapy care:30minutes of physiotherapy, including hotpack for 10 minutes, cervical stretching(3sets/15second hold, 5reps), cervical isometrics(5-10 reps/3sets), postural correction exercises(5-10 reps/2-3 sets), active ROMs of the neck.•Cervical stabilization: Pressure biofeedback unit will be used, the patient will perform chin tucks while the inflated unit is below the head at 20mmHg initially, and will be raised to 30mmHg. A10seconds hold with 10 repetitions, including a 10second rest interval between. A total of 3sets will be performed with 15second interval between each set,15 minutes total. •Placebo treatment:These exercises will take 10-15 minutes and the purpose is to engage the patient. These exercises do not have any effect on the ocular muscle of the eye and will only serve as a source of relaxation and lubrication for the eyes of the patient: blink slowly & fully (10reps,3sets with10-15seconds interval), fix gaze (10seconds, 3-5reps), eyes closed breathing 60seconds. |
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Pain sensitivity will be measured using the Algometer
| Baseline, at 3rd week and at 6th week |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |