Comparative Effects of SNAG Vis GONG's Mobilization in Text Neck Syndrome Patients (SNAG-GONG)

July 17, 2026 updated by: Dr Noreen Kiran; PT, University of Faisalabad

Comparative Effects of SNAG Versus GONG's Mobilization in Text Neck Syndrome Among Final Year Medical Students of The University of Faisalabad

Text neck syndrome is a common musculoskeletal disorder caused by prolonged smartphone and computer use, resulting in neck pain, forward head posture, and functional disability. Manual therapy techniques, including Sustained Natural Apophyseal Glides (SNAG) and GONG's Mobilization, are frequently used to manage cervical dysfunction.

This quasi-experimental pretest-posttest comparative study aimed to compare the effectiveness of SNAG and GONG's Mobilization on pain intensity, craniovertebral angle, and neck disability in individuals with text neck syndrome. Participants divided into 2 groups (Treatment group A and B) were undergo baseline and post-intervention assessments followed a 12-week treatment program

Study Overview

Status

Status

Indicates the current recruitment status or the expanded access status.
Completed

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 has emerged as a growing health concern due to increased use of smartphones, laptops, and other digital devices. Prolonged forward head posture places excessive mechanical stress on cervical structures, leading to neck pain, muscle imbalance, postural abnormalities, and functional limitations.

Manual therapy interventions such as Sustained Natural Apophyseal Glides (SNAG) and GONG's Mobilization have demonstrated beneficial effects in managing cervical spine dysfunction. However, evidence comparing these two techniques specifically in individuals with text neck syndrome remains limited.

A quasi-experimental pretest-posttest comparative study conducted. 48 participants were recruited aged 18-25 years from The University of Faisalabad. Participants diagnosed with text neck syndrome allocated into two treatment groups according to the study protocol. The participants divided into 2 groups (A and B) Both groups received moist heat therapy for 10 minutes before intervention. Group A received SNAG mobilization, while Group B received GONG's Mobilization. Treatment sessions were conducted three times per week on alternate days for 12 weeks.

Outcomes and outcome measuring tools were pain intensity by using the Numeric Pain Rating Scale (NPRS), Craniovertebral angle by Goniometer, and neck disability by Neck Disability Index (NDI).

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 (Actual)

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.
48

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
      • Faisalabad, Punjab Province, Pakistan, 38000
        • The University of Faisalabad (TUF)

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:

  • Both Male and Female who engage in prolonged computer and phone usage for more than 4 hours per day for over a year
  • Neck pain (3 to 8 on NPRS)
  • Altered cranio-vertebral angle<49 degree

Exclusion Criteria:

  • Recent cervical spine fracture/injury
  • Congenital malformation
  • Recent history of head and neck surgery
  • Congenital torticollis

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: Non-Randomized
  • Interventional Model: Parallel Assignment
  • Masking: None (Open Label)

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: Baseline PLUS GONG's mobilization
Participants in this arm received baseline treatment consisting of a moist hot pack applied to the cervical region for 10 minutes, followed by GONG's Mobilization. GONG's Mobilization was administered for 10-15 repetitions per session over approximately 20 minutes, three sessions per week on alternate days for 12 weeks. Outcome measures, including pain intensity (Numeric Pain Rating Scale), craniovertebral angle, and Neck Disability Index, were assessed before and after the intervention period.
Procedure: Moist Heat Therapy
A moist hot pack was applied to the cervical region for 10 minutes before the manual therapy intervention in both study groups
Procedure: GONG's Mobilization
GONG's Mobilization was administered to the cervical spine using 10-15 repetitions per session for approximately 20 minutes, three sessions per week on alternate days for 12 weeks
Active Comparator: Baseline plus SNAG
Participants in this arm received baseline treatment consisting of a moist hot pack applied to the cervical region for 10 minutes, followed by Sustained Natural Apophyseal Glides (SNAG). SNAG was administered for 10-15 repetitions per session over approximately 20 minutes, three sessions per week on alternate days for 12 weeks. Outcome measures, including pain intensity (Numeric Pain Rating Scale), craniovertebral angle, and Neck Disability Index, were assessed before and after the intervention period
Procedure: Moist Heat Therapy
A moist hot pack was applied to the cervical region for 10 minutes before the manual therapy intervention in both study groups
Procedure: Sustained Natural Apophyseal Glide (SNAG)
SNAG mobilization was applied to the cervical spine with 10-15 repetitions per session for approximately 20 minutes, 3 sessions per week on alternate days for 12 weeks

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
Craniovertebral Angle
Time Frame: Baseline and Week 12 (end of the intervention)
Craniovertebral angle was measured using a universal goniometer to assess forward head posture
Baseline and Week 12 (end of the intervention)

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
Pain intensity
Time Frame: Baseline and Week 12 (end of intervention)
Pain intensity was assessed using the Numeric Pain Rating Scale (NPRS), an 11-point self-reported scale ranging from 0 (no pain) to 10 (worst imaginable pain)
Baseline and Week 12 (end of intervention)

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 Faisalabad

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.
  • Principal Investigator: Noreen Kiran, PhD, University of Faisalabad

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.
October 25, 2025

Primary Completion (Actual)

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.
April 10, 2026

Study Completion (Actual)

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.
June 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).
July 17, 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.
July 17, 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 22, 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 22, 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 17, 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.
July 1, 2026

More Information

Terms related to this study

Keywords

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.
  • 2023-MS-PT-064

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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