Effect of Exercise Among Turtle Neck Syndrome in Pakistani Patients

Turtle neck also known as Text neck or anterior head syndrome is an overuse syndrome which occurs due to repetitive stress to neck, either by hanging it down or forward using phone or electronic devices. Typical signs and symptoms include pain and stiffness in the neck, shoulder pain and increase curvature of spine. It is becoming a global burden as people of almost all ages are getting affected.

The objective of the study is to find out theEffect of Exercise among Turtle Neck Syndrome in Pakistani Population. A total of 100 participants will be included in the study having both males and females. The pain pattern will be assessed by Visual Analog Scale and Posture Grid Assessment tool will be used to assess posture before and after the treatment session.

The study will be divided into three main sections or groups. One group will be treated by myofascial release only while other group will be treated by muscle energy technique for the management of turtle neck syndrome. Third group will receive both MFP and MET exercise. People having neck pain and those who will be willing to participate will be included in the study.

Study Overview

• Status: Completed
• Conditions: Neck Pain
• Intervention / Treatment: Procedure: myofascial release; Procedure: muscle energy technique; Procedure: MFR & MET; Procedure: conventional therapy

Detailed Description

The participants will be divided into four groups namely group A, B, C and D. Initially all the participants will be assessed by posture grid assessment tool to check their postural deviations. People meeting the inclusion criteria will be recruited. Group A will receive Muscle Energy Technique (MET) exercise, Group B will receive Myofascial release (MFP) therapy, Group C will receive both MFP and MET and group D will receive conventional treatment. Pre and post Visual analog scale (VAS) will be used to check pain scale and posture grid assessment tool to check postural angles .Pre-assessment will be done on day one and post at the last day of session. The total duration of treatment will be four weeks.

Consent will be taken from the patients. Only those patients meeting the inclusion criteria and screening questions will included in the study and those who will be willing to participate.

• Study Type: Interventional
• Enrollment (Actual): 100
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Pakistan
  • Sindh
    • Karachi, Sindh, Pakistan, 021
      • Khadija

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years to 35 years (Adult)
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• both males and females will be included
• patients having non specific neck pain
• usage of mobile more than six hours
• patients willing to participate

Exclusion Criteria:

• pregnant females
• patients having cervical disc bulge or herniation disoriented patients
• patients not willing to participate
• patients having any deformity

Study Plan

How is the study designed?

Design Details

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

Number of Arms

4

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: group 1 myofascial release; soft tissue release technique to release tension from muscles which relieves pain and increase range of motion	Procedure: myofascial release; Soft tissue release will be performed on the trapezius, sub occipital and sternocleidomastoid muscles. The visual analog scale will be used to check pain intensity. Algometer will be used to check the pain pressure threshold and tissue hardness. neck disability index will be used to check neck disability
Experimental: group 2 muscle energy technique; soft tissue release technique to release tension from muscles which relieves pain and increase range of motion	Procedure: muscle energy technique; Muscle energy Technique will be performed on the trapezius, sub occipital and sternocleidomastoid muscles. The visual analog scale will be used to check pain intensity. Algometer will be used to check the pain pressure threshold and tissue hardness. neck disability index will be used to check neck disability
Experimental: group 3 MFR & MET; combination of two soft tissue release techniques to release tension from muscles which relieves pain and increase range of motion	Procedure: MFR & MET; combination of myofascial release and muscle energy technique will be performed on the trapezius, suboccipital and sternocleidomastoid muscles. The visual analog scale will be used to check pain intensity. Algometer will be used to check the pain pressure threshold and tissue hardness. neck disability index will be used to check neck disability
Experimental: group 4 conventional therapy; combination of traditional techniques to relieve pain and spasm	Procedure: conventional therapy; traditional physical therapy devices are used to relieve pain and spam. this will include a hot pack, ultrasound, and TENS (Transcutaneous electrical nerve stimulation)

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
visual analog scale	For pain intensity visual analog scale will be used. a patient oriented scale ranging from 0-10. 0 means no pain, 1-3 means mild pain, 4-6 means moderate pain and 7-10 means severe pain.	2 years
Neck disability Index	to check disability, Neck disability Index will be used. It's a ten section questionnaire. Each item has scoring of 0-5. For each section the total possible score is 5. Points are summed to a total score. 0-4points (0-8%) no disability, 5-14points ( 10 - 28%) mild disability, 15-24points (30-48% ) moderate disability, 25-34points (50- 64%) severe disability, 35-50points (70-100%) complete disability	2 years
The tissue hardness assessed by Algometer measured in Newtons	For tissue hardness, Algometer will be used. It's a device that calculates the hardness when given pressure against the stimuli. The value is measured in Newtons.	2 years
Pain pressure threshold assessed by Algometer measured in Newtons	For Pain pressure threshold, Algometer will be used. It's a device that calculates the pain pressure threshold when given pressure against the stimuli. The value is measured in Newtons.	2 years

Collaborators and Investigators

• Sponsor: University of Karachi
• Investigators: Principal Investigator: Khadija Tul Kubra, M.phil, University of Karachi

Publications and helpful links

General Publications

• Phadke A, Bedekar N, Shyam A, Sancheti P. Effect of muscle energy technique and static stretching on pain and functional disability in patients with mechanical neck pain: A randomized controlled trial. Hong Kong Physiother J. 2016 Apr 14;35:5-11. doi: 10.1016/j.hkpj.2015.12.002. eCollection 2016 Dec.
• Ajimsha MS, Al-Mudahka NR, Al-Madzhar JA. Effectiveness of myofascial release: systematic review of randomized controlled trials. J Bodyw Mov Ther. 2015 Jan;19(1):102-12. doi: 10.1016/j.jbmt.2014.06.001. Epub 2014 Jun 13.

Helpful Links

• Related Info

Study record dates

Study Major Dates

• Study Start (Actual): April 1, 2022
• Primary Completion (Actual): December 1, 2022
• Study Completion (Actual): June 30, 2023

Study Registration Dates

• First Submitted: January 20, 2023
• First Submitted That Met QC Criteria: February 15, 2023
• First Posted (Actual): February 16, 2023

Study Record Updates

• Last Update Posted (Actual): November 30, 2023
• Last Update Submitted That Met QC Criteria: November 29, 2023
• Last Verified: November 1, 2023

More Information

Terms related to this study

• Keywords: neck pain; pain pressure threshold; text neck syndrome; Turtle neck syndrome; tissue hardness
• Additional Relevant MeSH Terms: Pathologic Processes; Pain; Neurologic Manifestations; Disease; Syndrome; Neck Pain
• Other Study ID Numbers: KTKYasin

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO
• IPD Plan Description: no their is no plan to share IPD

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No