Influence of Fun Physical Activities on Neck Pain and Posture in Children

Effects of Fun Games Activities on Neck Pain and Posture Among School Going Children

Neck pain is becoming increasingly common in school-aged children, mainly due to prolonged use of electronic devices and poor posture (especially forward head posture), often referred to as "text neck syndrome." Other contributing factors include sedentary lifestyles, heavy school bags, and rapid growth during adolescence. While this issue has been widely studied in adults and teenagers, research focusing on younger children is limited. This study aims to evaluate the effects of fun-game activities, cervical stretching exercises, and postural education in reducing neck pain and improving posture among school-going children.

Study Overview

• Status: Recruiting
• Conditions: Neck Pain; Posture Disorders in Children
• Intervention / Treatment: Other: fun game activities; Other: neck isometrics

Detailed Description

This study will utilize a controlled trial design. Data collection will take place at two educational institutions in Sialkot: The Spirit School and the Concept School System, located on Paris Road .It will be conducted over duration of eight weeks. A total of fourteen school-going teenagers with forward neck posture and neck pain will be selected. Participants will be randomly divided into two groups. Group A, the intervention group, will receive a structured cervical stretching and posture education program titled "fun-game activities" for eight weeks, with sessions conducted three days per week, each lasting 30 minutes. The exercise program will include a combination of warm-up activities, neck-specific and postural strengthening exercises (such as chin tucks, wall angels, tree pose, plank on knees, and balloon reach), and engaging cool-down or game-based tasks to maintain student motivation. Exercises will progress in complexity every two weeks to enhance cervical mobility and postural control. Group B will serve as the control group and will continue with baseline and their routine daily activities. Non-probability convenient sampling will be followed. The inclusion criteria for participation include teenagers of either gender with forward neck posture and associated neck pain. Exclusion criteria such as scoliosis, pain resulting from injuries like fractures, or having had undergone any surgical procedures. Data will be collected using three validated tools: a goniometer to measure cervical range of motion (flexion, extension, rotation, and lateral bending), the Neck Disability Index (NDI) to assess functional limitations due to neck pain, and the Visual Analogue Scale (VAS) to evaluate pain intensity.

• Study Type: Interventional
• Enrollment (Estimated): 90
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Imran Amjad, Phd; Phone Number: 03324390125; Email: imran.amjad@riphah.edu.pk
• Study Contact Backup: Name: Muhammad Asif Javed, PhD*; Phone Number: +923224209422; Email: a.javed@riphah.edu.pk

Study Locations

• Pakistan
  • Punjab Province
    • Sialkot, Punjab Province, Pakistan
      • Recruiting
      • The Spirit School

Participation Criteria

Eligibility Criteria

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

Description

Inclusion Criteria:

• Student with Forward neck posture with angle 48 ° measured with kinovea software.
• Teenagers (School going age ≤ 15 yrs)
• Both gender
• Children with neck pain

Exclusion Criteria:

• Children with scoliosis
• Pain due to frank injuries (like fractures)
• Patients having had any recent surgical procedure would not be enrolled in this study.

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
Experimental: fun game activities; The experimental group will receive fun-game exercises and postural education along with baseline treatment	Other: fun game activities; The study will run for 10 months, with sessions 3 times per week (30 minutes each). Group A will follow an 8-week fun, structured program including warm-ups, posture exercises (e.g., chin tucks, wall angels, plank), and interactive games and breathing activities, progressing every two weeks.
Active Comparator: neck isometrics; The active comparator will receive fun-game exercises and postural education along with baseline treatment	Other: neck isometrics; Group B will perform isometric neck exercises and continue normal school activities without additional structured training. The program aims to improve posture and reduce neck pain in children

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Goniometer	A goniometer is a simple instrument used to measure the range of motion (ROM) of joints in the body. It is commonly used in physiotherapy and rehabilitation to assess joint angles and monitor progress over time. It typically consists of: A stationary arm (placed along a fixed body part) A movable arm (aligned with the moving body segment) A fulcrum or axis (placed over the joint being measured) The goniometer is used to evaluate movements such as flexion, extension, abduction, and rotation. It helps clinicians determine joint limitations, track improvements, and guide treatment plans.	3rd Day

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
NDI Questionnaire	This questionnaire has been designed to give us information as to how your neck pain has affected your ability to manage in everyday life. Please answer every section and mark in each section only the one box that applies to you. We realise you may consider that two or more statements in any one section relate to you, but please just mark the box that most closely describes your problem.	3rd Day

Other Outcome Measures

Outcome Measure	Measure Description	Time Frame
Visual Analogue Scale	The Visual Analogue Scale (VAS) is a simple and widely used tool to measure a person's pain intensity. It typically consists of a 10 cm straight line, where: One end represents "no pain" (0) The other end represents "worst possible pain" (10) The patient is asked to mark a point on the line that best represents their level of pain. The distance from the "no pain" end to the marked point is then measured and recorded as the pain score. VAS is easy to use, quick, and effective for tracking changes in pain over time in both clinical and research settings.	3rd Day

Collaborators and Investigators

• Sponsor: Riphah International University
• Investigators: Principal Investigator: Armeeza Naseer, MS, Riphah International University

Publications and helpful links

General Publications

• Hestbaek L, Leboeuf-Yde C, Kyvik KO, Manniche C. The course of low back pain from adolescence to adulthood: eight-year follow-up of 9600 twins. Spine (Phila Pa 1976). 2006 Feb 15;31(4):468-72. doi: 10.1097/01.brs.0000199958.04073.d9.
• David D, Giannini C, Chiarelli F, Mohn A. Text Neck Syndrome in Children and Adolescents. Int J Environ Res Public Health. 2021 Feb 7;18(4):1565. doi: 10.3390/ijerph18041565.
• Brattberg G. Do pain problems in young school children persist into early adulthood? A 13-year follow-up. Eur J Pain. 2004 Jun;8(3):187-99. doi: 10.1016/j.ejpain.2003.08.001.

Study record dates

Study Major Dates

• Study Start (Actual): April 14, 2026
• Primary Completion (Estimated): July 5, 2026
• Study Completion (Estimated): July 5, 2026

Study Registration Dates

• First Submitted: May 5, 2026
• First Submitted That Met QC Criteria: May 5, 2026
• First Posted (Actual): May 11, 2026

Study Record Updates

• Last Update Posted (Actual): May 11, 2026
• Last Update Submitted That Met QC Criteria: May 5, 2026
• Last Verified: May 1, 2026

More Information

Terms related to this study

• Keywords: neck pain; child; schools; posture; stretching exercise
• Additional Relevant MeSH Terms: Pain; Neurologic Manifestations; Pathological Conditions, Signs and Symptoms; Signs and Symptoms; Neck Pain
• Other Study ID Numbers: Armeeza Naseer

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