Comparative Effect of Scapular Stabilization vs Thoracic Extension Exercises in Young Adults With Text Neck Syndrome.

Forward Head Posture Clinical Trial

Official title:

Comparative Effect of Scapular Stabilization Versus Thoracic Extension Exercises on Pain, Disability, Range of Motion, and Craniovertebral Angle in Young Adults With Text Neck Syndrome.

Clinical Trial Details — Status: Recruiting

Administrative data

• NCT number: NCT06108752
• Other study ID #: REC/RCR & AHS/23/0161
• Status: Recruiting
• Phase: N/A
• Start date: May 8, 2023
• Est. completion date: January 8, 2024

Study information

• Verified date: November 2023
• Source: Riphah International University
• Contact: Imran Amjad, PHD
• Phone: 03324390125
• Email: imran.amjad[@]riphah.edu.pk
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

The aim of the study is to compare the effect of scapular stabilization versus thoracic extension exercises on pain, disability, range of motion, and cranio-vertebral angle in young adults with Text Neck Syndrome.

Description:

Text neck has emerged as a widespread modern epidemic that affects people of all ages, particularly younger populations, as they are exposed to handheld mobile device use for several hours a day beginning at a very early age. The relation between the posture due to handheld mobile device use and neck pain is still debatable. To manage the maladaptive posture of the cervical spine, indirect treatment instead of direct treatment of the neck can be used, which is the basis for the concept of regional interdependence, i.e., the cause of pain becomes the cause of damage to other body parts. Therefore, not treating the damaged part, but indirectly treating the area of cause can alleviate the symptoms. A bio-dynamic relationship between the cervical and thoracic spine is associated with exercise, an important factor causing neck pain. Therefore, many clinicians pay attention to the thoracic spine of patients with neck pain and recommend thoracic extension exercises. On the other hand, many researchers recommended scapular stabilization exercise as a recovery treatment for imbalanced scapular muscles caused by forward head posture.

This study investigates how exercise programs not directly applied to the cervical spine affect people with text neck syndrome. The significance of the current study is to evaluate the comparison between concentric and eccentric exercise which is previously rarely investigated.

Recruitment information / eligibility

• Status: Recruiting
• Enrollment: 36
• Est. completion date: January 8, 2024
• Est. primary completion date: December 8, 2023
• Accepts healthy volunteers: No
• Gender: All
• Age group: 19 Years to 30 Years

Eligibility

Inclusion Criteria:

• Both male and female participants with forward head posture or text neck syndrome

• Participants with neck pain from the past three months

• Smart-phones must be used for at least =3 hours each day

• Participants with craniovertebral angle <53° will be included in this study

Exclusion Criteria:

• History of cervical and thoracic spine surgery within the past three months

• Serious pathological conditions within the past three months

• Congenital spinal anomalies, or rheumatoid arthritis

• Neurological signs and severe psychological disorders

Related Conditions & MeSH terms

• Forward Head Posture
• Neck Syndrome
• Syndrome

Intervention

Other:
• Scapular stabilization exercises
The scapular stabilization exercises will be comprised of four exercise programs. Each exercise will be performed with two sets of 15 reps, 10 sec per rep 40 min per day, thrice per week for a total of six weeks. Baseline treatment will be the application of a hot pack for 7-10 minutes and cervical active range of motion exercises.
• Thoracic extension exercises
Thoracic extension exercises will be comprised of three exercise programs. Each exercise will be performed with two sets of 15 reps, 10 sec per rep 40 min per day, thrice per week for a total of six weeks. Baseline treatment will be the application of a hot pack for 7-10 minutes and cervical active range of motion exercises.

Locations

Country	Name	City	State
Pakistan	Punjab Employees Social Security Institute	Lahore	Punjab

Sponsors (1)

Lead Sponsor	Collaborator
Riphah International University

Country where clinical trial is conducted

Pakistan, 

References & Publications (17)

Alpayci M, Ilter S. Isometric Exercise for the Cervical Extensors Can Help Restore Physiological Lordosis and Reduce Neck Pain: A Randomized Controlled Trial. Am J Phys Med Rehabil. 2017 Sep;96(9):621-626. doi: 10.1097/PHM.0000000000000698. — View Citation

Cho J, Lee E, Lee S. Upper thoracic spine mobilization and mobility exercise versus upper cervical spine mobilization and stabilization exercise in individuals with forward head posture: a randomized clinical trial. BMC Musculoskelet Disord. 2017 Dec 12;18(1):525. doi: 10.1186/s12891-017-1889-2. — View Citation

Dindaroglu F, Kutlu P, Duran GS, Gorgulu S, Aslan E. Accuracy and reliability of 3D stereophotogrammetry: A comparison to direct anthropometry and 2D photogrammetry. Angle Orthod. 2016 May;86(3):487-94. doi: 10.2319/041415-244.1. Epub 2015 Aug 12. — View Citation

Dissanayaka TD, Pallegama RW, Suraweera HJ, Johnson MI, Kariyawasam AP. Comparison of the Effectiveness of Transcutaneous Electrical Nerve Stimulation and Interferential Therapy on the Upper Trapezius in Myofascial Pain Syndrome: A Randomized Controlled Study. Am J Phys Med Rehabil. 2016 Sep;95(9):663-72. doi: 10.1097/PHM.0000000000000461. — View Citation

Fiebert I, Kistner F, Gissendanner C, DaSilva C. Text neck: An adverse postural phenomenon. Work. 2021;69(4):1261-1270. doi: 10.3233/WOR-213547. — View Citation

Ghamkhar L, Arab AM, Nourbakhsh MR, Kahlaee AH, Zolfaghari R. Examination of Regional Interdependence Theory in Chronic Neck Pain: Interpretations from Correlation of Strength Measures in Cervical and Pain-Free Regions. Pain Med. 2020 Feb 1;21(2):e182-e190. doi: 10.1093/pm/pnz206. — View Citation

Kang NY, Im SC, Kim K. Effects of a combination of scapular stabilization and thoracic extension exercises for office workers with forward head posture on the craniovertebral angle, respiration, pain, and disability: A randomized-controlled trial. Turk J Phys Med Rehabil. 2021 Sep 1;67(3):291-299. doi: 10.5606/tftrd.2021.6397. eCollection 2021 Sep. — View Citation

Kong YS, Kim YM, Shim JM. The effect of modified cervical exercise on smartphone users with forward head posture. J Phys Ther Sci. 2017 Feb;29(2):328-331. doi: 10.1589/jpts.29.328. Epub 2017 Feb 24. — View Citation

Koseki T, Kakizaki F, Hayashi S, Nishida N, Itoh M. Effect of forward head posture on thoracic shape and respiratory function. J Phys Ther Sci. 2019 Jan;31(1):63-68. doi: 10.1589/jpts.31.63. Epub 2019 Jan 10. — View Citation

Moezy A, Sepehrifar S, Solaymani Dodaran M. The effects of scapular stabilization based exercise therapy on pain, posture, flexibility and shoulder mobility in patients with shoulder impingement syndrome: a controlled randomized clinical trial. Med J Islam Repub Iran. 2014 Aug 27;28:87. eCollection 2014. — View Citation

Nejati P, Lotfian S, Moezy A, Moezy A, Nejati M. The relationship of forward head posture and rounded shoulders with neck pain in Iranian office workers. Med J Islam Repub Iran. 2014 May 3;28:26. eCollection 2014. — View Citation

Sindhu BS, Shechtman O, Tuckey L. Validity, reliability, and responsiveness of a digital version of the visual analog scale. J Hand Ther. 2011 Oct-Dec;24(4):356-63; quiz 364. doi: 10.1016/j.jht.2011.06.003. Epub 2011 Aug 6. — View Citation

Singla D, Veqar Z. Association Between Forward Head, Rounded Shoulders, and Increased Thoracic Kyphosis: A Review of the Literature. J Chiropr Med. 2017 Sep;16(3):220-229. doi: 10.1016/j.jcm.2017.03.004. Epub 2017 Sep 28. — View Citation

Suvarnnato T, Puntumetakul R, Uthaikhup S, Boucaut R. Effect of specific deep cervical muscle exercises on functional disability, pain intensity, craniovertebral angle, and neck-muscle strength in chronic mechanical neck pain: a randomized controlled trial. J Pain Res. 2019 Mar 7;12:915-925. doi: 10.2147/JPR.S190125. eCollection 2019. — View Citation

Suwaidi ASA, Moustafa IM, Kim M, Oakley PA, Harrison DE. A Comparison of Two Forward Head Posture Corrective Approaches in Elderly with Chronic Non-Specific Neck Pain: A Randomized Controlled Study. J Clin Med. 2023 Jan 9;12(2):542. doi: 10.3390/jcm12020542. — View Citation

Warda DG, Nwakibu U, Nourbakhsh A. Neck and Upper Extremity Musculoskeletal Symptoms Secondary to Maladaptive Postures Caused by Cell Phones and Backpacks in School-Aged Children and Adolescents. Healthcare (Basel). 2023 Mar 10;11(6):819. doi: 10.3390/healthcare11060819. — View Citation

Yoo WG. Effect of thoracic stretching, thoracic extension exercise and exercises for cervical and scapular posture on thoracic kyphosis angle and upper thoracic pain. J Phys Ther Sci. 2013 Nov;25(11):1509-10. doi: 10.1589/jpts.25.1509. Epub 2013 Dec 11. — View Citation

* Note: There are 17 references in all — Click here to view all references

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Neck disability index (NDI)	Changes from baseline. NDI is a valid and reliable tool having values ranging from 0.50 to 0.98.; The NDI assessment involves a 10-item, 50-point index questionnaire that assesses the effects of neck pain and symptoms during a range of functional activities.	6 weeks
Primary	Visual analogue scale (VAS)	Changes from baseline. The visual analogue scale (VAS) is a simple and frequently used method for the assessment of variations in intensity of pain. The reliability of the VAS for disability is moderate to good i.e. 0.98. However, its validity is questionable.	6 weeks
Primary	Goniometer for cervical range of motion	Changes from baseline. Goniometer has fair inter-tester reliability ranging from 0.79-0.92. Validity of this tool is good i.e. 0.97-0.98 This tool is most commonly used in the clinical settings for evaluating joint range of motion.	6 weeks
Primary	Photogrammetry for craniovertebral angle (image j software)	Changes from baseline. 'Image J', is an analysis software with high reliability and validity.; This study will assess the craniovertebral angle using a digital camera. The camera will be placed 1.5 m from the participant's right side to take a lateral photographic view of the participant's head and neck in a seated position. The craniovertebral angle is the angle between the horizontal line passing the 7th Cervical vertebra (C7) and the line extending from C7 to the tragus of the ear. The resulting maladaptive posture of the neck will be determined using Image J software.	6 weeks