Comparison of Bowen Therapy and Post-isometric Relaxation Technique in Patients With Text Neck Syndrome

Comparison of Bowen Therapy and Post-Isometric Relaxation Technique in Patients With Text Neck Syndrome

This study aims to compare the effectiveness of Bowen Therapy and Post-Isometric Relaxation Technique (PIRT) in the management of Text Neck Syndrome, a musculoskeletal condition caused by prolonged forward head posture during mobile phone or screen use.

The study follows a randomized clinical trial design, ensuring that participants are randomly assigned to either the Bowen Therapy group or the PIRT group to minimize bias.

The total study duration is nine months, including a six-week treatment phase and a three-week follow-up period. Assessments will be conducted at baseline, mid-intervention (3 weeks), post-intervention (6 weeks), and follow-up (9 weeks) to evaluate the short-term and sustained effects of both interventions.

A consecutive sampling technique will be used, and participants who meet the inclusion and exclusion criteria will provide informed written consent before enrollment.

The sample size was determined using G*Power software (v3.1.9.7), based on previous research (Seemal et al., 2022), with an assumed large effect size (d = 1.0), α = 0.05, and 80% power. After accounting for a 20% attrition rate, a total of 42 participants (21 per group) will be included in the study.

Overall, this study seeks to provide evidence on which therapeutic approach-Bowen Therapy or Post-Isometric Relaxation-is more effective in reducing pain, improving range of motion, and enhancing posture in individuals with Text Neck Syndrome.

Study Overview

• Status: Completed
• Conditions: Text Neck Syndrome
• Intervention / Treatment: Other: Bowen therapy; Other: Post-Isometric Relaxation Technique (PIRT)

• Study Type: Interventional
• Enrollment (Actual): 42
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Pakistan
  • Lahore, Pakistan
    • UIPT, UOL, Lahore

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• Adults aged between 18 to 35 years, inclusive of both genders. Craniovertebral angle less than 50 degrees indicating forward head posture. Self-reported neck pain onset or worsening associated with screen use e.g. pain and stiffness during or after prolonged device use.

Neck pain intensity of at least 4 to 7 on Numeric Pain Rating Scale. Daily screen time of ≥4 hours per day including smartphones, tablet, laptop, and desktop use for at least 5 days per week.

Exclusion Criteria:

• Cervical radiculopathy or myelopathy. History of Cervical Spine Surgery. Recent (within three months) trauma to neck or shoulder region. Diagnosis of fibromyalgia, rheumatoid arthritis or any other inflammatory joint condition.

Ongoing treatment for neck pain from another healthcare provider. Neurological conditions affecting muscle tone or coordination. Severe postural abnormalities from congenital conditions.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Bowen Therapy Group; Participants in this group will receive Bowen Therapy after baseline assessment of forward head posture, cervical range of motion, pain intensity, and functional limitation. The intervention will consist of three sessions per week for six weeks (total 18 sessions), each lasting approximately 30-45 minutes. A standardized Bowen Therapy protocol will be applied, focusing on the cervical and upper back/shoulder regions. Techniques include gentle rolling moves with the therapist's thumb over the sternocleidomastoid (SCM), scalenes, suboccipitals, upper trapezius, levator scapulae, and pectoralis muscles, performed while the patient is in prone or seated position. The procedure incorporates short pauses between moves to facilitate neuromuscular integration.	Other: Bowen therapy; Participants will receive Bowen Therapy sessions three times per week for six weeks. Gentle rolling moves will be applied to the cervical and upper back muscles to reduce pain, muscle tension, and improve posture.; Other: Post-Isometric Relaxation Technique (PIRT); Participants will undergo PIRT sessions three times per week for six weeks, involving gentle isometric contractions and relaxation of targeted neck and shoulder muscles to improve flexibility and reduce discomfort.
Active Comparator: Post-Isometric Relaxation Technique Group; Participants in this group will receive Post-Isometric Relaxation Technique (PIRT) sessions, administered three times per week for six weeks (total 18 sessions), each lasting 30-45 minutes. The intervention involves the standardized application of PIRT on upper trapezius, sternocleidomastoid, levator scapulae, suboccipital, scalene, and pectoralis muscles. Each muscle will be positioned at its resistance barrier, and participants will perform a 5-10 second, 20% effort isometric contraction against therapist resistance, followed by 2-3 seconds of relaxation and gentle stretch toward the new barrier. The process will be repeated 3-5 times per muscle.	Other: Bowen therapy; Participants will receive Bowen Therapy sessions three times per week for six weeks. Gentle rolling moves will be applied to the cervical and upper back muscles to reduce pain, muscle tension, and improve posture.; Other: Post-Isometric Relaxation Technique (PIRT); Participants will undergo PIRT sessions three times per week for six weeks, involving gentle isometric contractions and relaxation of targeted neck and shoulder muscles to improve flexibility and reduce discomfort.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change in Neck Pain Intensity Measured by the Numeric Pain Rating Scale	Neck pain intensity will be assessed using the Numeric Pain Rating Scale (NPRS), an 11-point self-reported scale ranging from 0 (no pain) to 10 (worst imaginable pain). Participants will rate their average neck pain over the previous 24 hours by selecting a number from 0 to 10. The primary outcome is the change in NPRS score from baseline to 6 weeks, with higher scores indicating greater pain intensity and lower scores indicating improvement.	Baseline and 6 weeks (post-intervention)

Collaborators and Investigators

• Sponsor: University of Lahore

Study record dates

Study Major Dates

• Study Start (Actual): December 11, 2025
• Primary Completion (Actual): February 11, 2026
• Study Completion (Actual): February 11, 2026

Study Registration Dates

• First Submitted: November 17, 2025
• First Submitted That Met QC Criteria: March 15, 2026
• First Posted (Actual): March 18, 2026

Study Record Updates

• Last Update Posted (Actual): March 20, 2026
• Last Update Submitted That Met QC Criteria: March 17, 2026
• Last Verified: March 1, 2026

More Information

Terms related to this study

• Other Study ID Numbers: Ayesha Iftikhar

Drug and device information, study documents

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