Myofascial Release and Dynamic Cupping in Children

Comparative Effects of Myofascial Release Therapy and Dynamic Cupping on Neck Pain and Posture in School Going Children.

Neck pain is a common musculoskeletal disorder that significantly affects quality of life and daily activities, with an annual prevalence of 30-50% worldwide. This randomized clinical trial aims to compare the effects of myofascial release therapy and dynamic cupping on neck pain and posture in school-based children aged 7-12 years. A total of 40 children with neck pain and postural deviations will be recruited from schools and randomly assigned to either a myofascial release group or a dynamic cupping group (20 participants each) for a 6-week intervention. Children with skin conditions, neurological symptoms, recent analgesic use, or assistive device use will be excluded. Outcomes will be assessed using the Visual Analog Scale, goniometer, and plumb line test, and data will be analyzed using SPSS version 27 to determine the effectiveness of both interventions in reducing pain and improving posture.

Study Overview

• Status: Recruiting
• Conditions: Neck Pain
• Intervention / Treatment: Other: Myofascial release therapy; Other: dynamic cupping

Detailed Description

Neck pain is a highly prevalent musculoskeletal disorder that significantly impairs quality of life and restricts social, academic, and physical activities. Globally, neck pain is ranked as the fourth leading cause of disability, with an annual prevalence estimated between 30% and 50%. Chronic neck pain is defined as pain or discomfort experienced along the posterior cervical spine, extending from the superior nuchal line to the first thoracic spinous process, persisting for more than three months. In school-aged children, prolonged poor posture, excessive screen use, and heavy schoolbags contribute to the increasing incidence of neck pain and postural deviations, making early intervention essential.

This study is designed as a randomized clinical trial to evaluate and compare the effectiveness of myofascial release therapy and dynamic cupping therapy in reducing neck pain and correcting postural deviations in school-based children. The study will be conducted in selected schools, where data collection and treatment sessions will take place. Children aged 7 to 12 years, both boys and girls, who present with neck pain and observable postural deviations will be included in the study. Exclusion criteria will consist of children with skin infections, open wounds, or dermatological conditions in the neck or upper back region, neurological symptoms, recent use of analgesic medications, or reliance on assistive devices, to ensure participant safety and reduce confounding variables.

• Study Type: Interventional
• Enrollment (Estimated): 45
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: IMRAN AMJAD, PhD; Phone Number: 9233224390125; Email: imran.amjad@riphah.edu.pk
• Study Contact Backup: Name: MUHAMMAD ASIF JAVEED, MS-PT; Phone Number: 9233224209422; Email: a.javeed@riphah.edu.pk

Study Locations

• Pakistan
  • Lahore, Pakistan, 54000
    • Recruiting
    • Imran Amjad
    • Contact: MUHAMMAD ASIF JAVEED, MS-PT; Phone Number: 923224209422; Email: A.JAVEED@RIPHAH.EDU.PK

Participation Criteria

Eligibility Criteria

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

Description

Inclusion Criteria:

• Children with age 13 to 16.
• Both boys and girls
• neck pain (NPRS score from 7 to 10)
• Presence of postural deviations (will be access by using Plumb line test)

Exclusion Criteria:

• Skin infections, open wounds, or dermatological conditions in the neck/upper back region
• Neurological symptoms (cerebral palsy, muscular dystrophy, multiple sclerosis)
• Recent use of analgesics
• use of assistive devices (collars)

Study Plan

How is the study designed?

Design Details

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

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Active Comparator: Myofascial release therapy; The participants in this group will receive myofascial release therapy. Stretching of neck muscles: hold of 15-30 seconds, repeat for 2 sets Isometric setting of neck muscle: (for 12 seconds, repeated for 2 sets, with 1- minute rest between sets) (neck flexion, neck extension, side flexion without changing their length or the angle of the joint, essentially holding a static position) Postural exercise for neck: (chin tucks) (shoulder elevation and drop) (shoulder retraction and protraction) (Cobra/Sphinx Pose) (hold for 5-10 sec, 2x set)	Other: Myofascial release therapy; The participants in this group will receive myofascial release therapy. Stretching of neck muscles: hold of 15-30 seconds, repeat for 2 sets Isometric setting of neck muscle: (for 12 seconds, repeated for 2 sets, with 1- minute rest between sets) (neck flexion, neck extension, side flexion without changing their length or the angle of the joint, essentially holding a static position) Postural exercise for neck: (chin tucks) (shoulder elevation and drop) (shoulder retraction and protraction) (Cobra/Sphinx Pose) (hold for 5-10 sec, 2x set)
Experimental: Dynamic cupping; The participants in this group will receive dynamic cupping. Stretching of neck muscles: hold of 15-30 seconds, repeat for 2 sets Isometric setting of neck muscle: (for 12 seconds, repeated for 2 sets, with 1- minute rest between sets) (neck flexion, neck extension, side flexion without changing their .length or the angle of the joint, essentially holding a static position) 3. Dynamic cupping: Dynamic cupping involves applying a silicone or plastic cup to lubricated skin and creating gentle suction by squeezing the cup 2-3 time. Once suction is established, the therapist glides the cup smoothly over the muscle fibers in slow, controlled stroke linear, circular, or fan-shape to mobilize soft tissue and fascia. The cup should move without causing excessive pulling or discomfort, typically for 2 minutes per area. The suction level is moderate to keep the cup attached while allowing movement	Other: dynamic cupping; Dynamic cupping involves applying a silicone or plastic cup to lubricated skin and creating gentle suction by squeezing the cup 2-3 time. Once suction is established, the therapist glides the cup smoothly over the muscle fibers in slow, controlled stroke linear, circular, or fan-shape to mobilize soft tissue and fascia. The cup should move without causing excessive pulling or discomfort, typically for 2 minutes per area. The suction level is moderate to keep the cup attached while allowing movement, and the therapist continuously adjusts pressure based on feedback. After treatment, the cup is gently lifted to release suction, and the skin is checked for any irritation

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
posture correction	Posture correction refers to the improvement in head, neck, and shoulder alignment, particularly reduction in forward head posture and rounded shoulders. It is measured using objective tools such as craniovertebral angle, postural assessment scales, or photographic analysis. Improvement is indicated by increased alignment angles and a more neutral upright posture.	4th day

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
rang of motion	Range of motion refers to the degree of movement available at the cervical spine in all directions, including flexion, extension, lateral flexion, and rotation. It is measured using tools such as a goniometer or inclinometer to assess functional mobility. Improvement is indicated by increased pain-free movement and greater cervical mobility in all planes.	4th day

Collaborators and Investigators

• Sponsor: Riphah International University
• Investigators: Principal Investigator: EAYZA RIAZ, MS-PT, RIPHAH INTERNATINAAL UNIVERSITY

Publications and helpful links

General Publications

• Guo Y, Lv X, Zhou Y, Li Z, She H, Bai L, Bao J. Myofascial release for the treatment of pain and dysfunction in patients with chronic mechanical neck pain: Systematic review and meta-analysis of randomised controlled trials. Clin Rehabil. 2023 Apr;37(4):478-493. doi: 10.1177/02692155221136108. Epub 2022 Oct 27.
• Mihcioglu EK, Guchan Topcu Z, Tunali AN, Mihcioglu S, Tomac H. Instrument-assisted soft tissue mobilization as a promising approach for children with chronic neck pain: A single-blind, randomized study. J Back Musculoskelet Rehabil. 2026 May;39(3):1044-1052. doi: 10.1177/10538127251401084. Epub 2025 Dec 7.

Study record dates

Study Major Dates

• Study Start (Actual): January 29, 2025
• Primary Completion (Estimated): July 9, 2026
• Study Completion (Estimated): August 19, 2026

Study Registration Dates

• First Submitted: February 23, 2026
• First Submitted That Met QC Criteria: May 4, 2026
• First Posted (Actual): May 8, 2026

Study Record Updates

• Last Update Posted (Actual): May 8, 2026
• Last Update Submitted That Met QC Criteria: May 4, 2026
• Last Verified: May 1, 2026

More Information

Terms related to this study

• Keywords: neck pain; posture; myofascial release; dynamic cupping
• Additional Relevant MeSH Terms: Pain; Neurologic Manifestations; Pathological Conditions, Signs and Symptoms; Signs and Symptoms; Neck Pain; Therapeutics; Complementary Therapies; Physical Therapy Modalities; Rehabilitation; Therapy, Soft Tissue; Musculoskeletal Manipulations; Massage; Myofascial Release Therapy
• Other Study ID Numbers: REC/RCR&AHS/EAYZARIAZ

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