Eyeball Exercises and Cervical Stabilization in Text Neck Syndrome

July 24, 2026 updated by: University of Lahore

Effects of Eyeball Exercises and Cervical Stabilization in Text Neck Syndrome: a Randomized Clinical Trial

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).

Study Overview

Status

Status

Indicates the current recruitment status or the expanded access status.
Enrolling by invitation

Conditions

Conditions

The disease, disorder, syndrome, illness, or injury that is being studied. On ClinicalTrials.gov, conditions may also include other health-related issues, such as lifespan, quality of life, and health risks.

Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.

Detailed Description

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.

Study Type

Study Type

Describes the nature of a clinical study. Study types include interventional studies (also called clinical trials), observational studies (including patient registries), and expanded access.
Interventional

Enrollment (Estimated)

Enrollment

The number of participants in a clinical study. The "anticipated" enrollment is the target number of participants that the researchers need for the study.
74

Phase

Phase

The stage of a clinical trial studying a drug or biological product, based on definitions developed by the U.S. Food and Drug Administration (FDA). The phase is based on the study's objective, the number of participants, and other characteristics. There are five phases: Early Phase 1 (formerly listed as Phase 0), Phase 1, Phase 2, Phase 3, and Phase 4. Not Applicable is used to describe trials without FDA-defined phases, including trials of devices or behavioral interventions.
  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Pakistan
    • Punjab Province
      • Lahore, Punjab Province, Pakistan, 54782
        • The University of Lahore Teaching Hospital

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Eligibility Criteria

The key requirements that people who want to participate in a clinical study must meet or the characteristics they must have. Eligibility criteria consist of both inclusion criteria (which are required for a person to participate in the study) and exclusion criteria (which prevent a person from participating). Types of eligibility criteria include whether a study accepts healthy volunteers, has age or age group requirements, or is limited by sex.

Ages Eligible for Study

  • Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • Neck Disability Index (NDI) scoring: >5 and <24
  • Duration of screen usage: 4-6 hours/day
  • Pain: ranging from mild - moderate 4-7 Numeric Pain Rating Scale (NPRS)

Exclusion Criteria:

  • Already undergoing physical therapy
  • Cervical trauma, radiculopathy, pregnancy, malignancies, torticollis, herniation, stenosis, osteoporosis, etc
  • Diagnosed with a CNS abnormality

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Single

Arms and Interventions

Participant Group / Arm

Participant Group / Arm

A group or subgroup of participants in a clinical trial that receives a specific intervention/treatment, or no intervention, according to the trial's protocol.
Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.
Experimental: Physiotherapy care, Cervical stabilisation and eyeball exercises
These patients will receive physiotherapy care along with cervical stabilization exercises and eyeball exercises. Treatment schedule: 3 sessions on alternate days for 6 weeks.
Other: Physiotherapy care, Cervical Stabilization and Eyeball Exercises
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.
Active Comparator: Physiotherpy care, Cervical stabilisation and placebo
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.
Other: Phyisotherapy Care, Cervical Stabilization and placebo exercises
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.

What is the study measuring?

Primary Outcome Measures

Primary Outcome Measures

In a clinical study's protocol, the planned outcome measure that is the most important for evaluating the effect of an intervention/treatment. Most clinical studies have one primary outcome measure, but some have more than one.
Outcome Measure
Measure Description
Time Frame
Pain Intensity
Time Frame: Baseline, at 3rd week and at 6th week

Change in pain intensity measured using the Numeric Pain rating Scale (NPRS, 0-10 cm).

Lower limit: 0 Upper limit: 10 Lower value means less pain
Baseline, at 3rd week and at 6th week
Neck Disability
Time Frame: Baseline, at 3rd week and at 6th week

Functional disability measured using the Neck Disability Index (NDI) - Urdu validated version.

Lower limit: 0 Upper limit: 50 Lower value indicates lesser disability
Baseline, at 3rd week and at 6th week

Secondary Outcome Measures

Secondary Outcome Measures

In a clinical study's protocol, a planned outcome measure that is not as important as the primary outcome measure for evaluating the effect of an intervention but is still of interest. Most clinical studies have more than one secondary outcome measure.
Outcome Measure
Measure Description
Time Frame
Craniovertebral Angle (CVA)
Time Frame: Baseline, at 3rd week and at 6th week
Postural alignment measured as the cranio-vertebral angle (CVA) using Kinovea software from standardised lateral-view photographs Lower limit: 0 Upper limit: 180 Higher values mean better posture (less forward head)
Baseline, at 3rd week and at 6th week
Pain Pressure Threshold (PPT)
Time Frame: Baseline, at 3rd week and at 6th week
Pain sensitivity will be measured using the Algometer. Lower limit: 0 kg/cm² Upper limit: 10 kg/cm² Higher values mean less tenderness
Baseline, at 3rd week and at 6th week

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Sponsor

The organization or person who initiates the study and who has authority and control over the study.
University of Lahore

Investigators

Investigators

A researcher involved in a clinical study. Related terms include site principal investigator, site sub-investigator, study chair, study director, and study principal investigator.
  • Study Chair: Sahreen Anwar, Ph.D, University of Lahore

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

Study Start

The actual date on which the first participant was enrolled in a clinical study. The "anticipated" study start date is the date that the researchers think will be the study start date.
November 15, 2025

Primary Completion (Estimated)

Primary Completion

The date on which the last participant in a clinical study was examined or received an intervention to collect final data for the primary outcome measure. Whether the clinical study ended according to the protocol or was terminated does not affect this date. For clinical studies with more than one primary outcome measure with different completion dates, this term refers to the date on which data collection is completed for all the primary outcome measures. The "anticipated" primary completion date is the date that the researchers think will be the primary completion date for the study.
August 15, 2026

Study Completion (Estimated)

Study Completion

The date on which the last participant in a clinical study was examined or received an intervention/treatment to collect final data for the primary outcome measures, secondary outcome measures, and adverse events (that is, the last participant's last visit). The "anticipated" study completion date is the date that the researchers think will be the study completion date.
September 15, 2026

Study Registration Dates

First Submitted

First Submitted

The date on which the study sponsor or investigator first submitted a study record to ClinicalTrials.gov. There is typically a delay of a few days between the first submitted date and the record's availability on ClinicalTrials.gov (the first posted date).
June 28, 2026

First Submitted That Met QC Criteria

First Submitted That Met QC Criteria

The date on which the study sponsor or investigator first submits a study record that is consistent with National Library of Medicine (NLM) quality control (QC) review criteria. The sponsor or investigator may need to revise and submit a study record one or more times before NLM's QC review criteria are met. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
June 28, 2026

First Posted (Actual)

First Posted

The date on which the study record was first available on ClinicalTrials.gov after National Library of Medicine (NLM) quality control (QC) review has concluded. There is typically a delay of a few days between the date the study sponsor or investigator submitted the study record and the first posted date.
July 6, 2026

Study Record Updates

Last Update Posted (Actual)

Last Update Posted

The most recent date on which changes to a study record were made available on ClinicalTrials.gov. There may be a delay between when the changes were submitted to ClinicalTrials.gov by the study's sponsor or investigator (the last update submitted date) and the last update posted date.
July 27, 2026

Last Update Submitted That Met QC Criteria

Last Update Submitted That Met QC Criteria

The most recent date on which the study sponsor or investigator submitted changes to a study record that are consistent with National Library of Medicine (NLM) quality control (QC) review criteria. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
July 24, 2026

Last Verified

Last Verified

The most recent date on which the study sponsor or investigator confirmed the information about a clinical study on ClinicalTrials.gov as accurate and current. If a study with a recruitment status of recruiting; not yet recruiting; or active, not recruiting has not been confirmed within the past 2 years, the study's recruitment status is shown as unknown.
September 1, 2025

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

Other Study ID Numbers

Identifiers or ID numbers other than the NCT number that are assigned to a clinical study by the study's sponsor, funders, or others. These numbers may include unique identifiers from other trial registries and National Institutes of Health grant numbers.
  • UOL/IREB/25/12/0041

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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