Eyeball Exercises and Cervical Stabilization in Text Neck Syndrome

Effects of Eyeball Exercises and Cervical Stabilization in Text Neck Syndrome: a Randomized Clinical Trial

The prolonged use of electronic devices in the population nowadays contributes to the development of various musculoskeletal disorders affecting the neck. One such condition is the Text neck syndrome characterized by neck pain and muscular imbalance in the region as well as development of forward head posture. Some additional symptoms include headaches, impaired range of motion and eye strain. Eyeball exercises have been shown to improve symptoms of neck pain, and cervical stabilization has demonstrated positive effects on the deep cervical flexors, thereby improving forward head posture and other neck-associated symptoms. However, the combined effect of these two interventions has not been studied to treat text neck syndrome before. The primary outcome measures include the pain measured through Numeric Pain Rating Scale (NPRS) and pain pressure threshold (algometer), whereas the secondary outcome measures include the craniovertebral angle (CVA) and functional disability measured through neck disability index (NDI).

Study Overview

• Status: Enrolling by invitation
• Conditions: Text Neck Syndrome
• Intervention / Treatment: Other: Physiotherapy care, Cervical Stabilization and Eyeball Exercises; Other: Phyisotherapy Care, Cervical Stabilization and placebo exercises

Detailed Description

Text neck syndrome is a musculoskeletal syndrome characterized by neck pain, forward head posture, muscular imbalance, headache, reduced range of motion and eye problems. In the present era where everything is done through electronic devices and gadgets it is difficult to maintain a proper posture, which affects most importantly the cervical region. Prolonged use of these gadgets have led to the development of text neck syndrome which is a new pandemic these days. Constant screen use has detrimental effects on eyes that effects our neck as well, therefore the use of eyeball exercises has shown to improve the symptoms of neck pain. Cervical stabilization focuses on the deep neck flexor muscles which become weak and inactive in text neck syndrome. Cervical stabilization has shown improvements in the activation of these muscles as well as improved their strength along with improving the forward head posture. the combined effects of both these treatment regimes has not been studied yet in text neck syndrome individuals therefore the purpose of this randomized clinical trial will be to assess the combined effects of these treatment approaches on text neck syndrome. The Numeric Pain Rating Scale (NPRS) will be used to assess and measure the pain intensity along with NDI (neck disability index) that will help in functional evaluation and will serve as the primary outcome measures in this study. The Craniovertebral Angle (CVA) and Pain Pressure Threshold (PPT) measured through algometer will also be measured and will be the secondary outcome measures in this study.

• Study Type: Interventional
• Enrollment (Estimated): 74
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Pakistan
  • Punjab Province
    • Lahore, Punjab Province, Pakistan, 54782
      • The university of lahore teaching hospital

Participation Criteria

Eligibility Criteria

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

Description

Inclusion Criteria:

NDI scoring: >5 and <24 Duration of screen usage: 4-6hours/day Pain: ranging from mild - moderate 4-7 NPRS -

Exclusion Criteria:

Already undergoing physical therapy Cervical trauma, radiculopathy, pregnancy, malignancies, torticollis, herniation, stenosis, osteoporosis, etc Diagnosed with a CNS abnormality

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Study Plan

How is the study designed?

Design Details

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

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Interventional Group A; These patients will receive physiotherapy care along with cervical stabilization exercises and eyeball exercises. Treatment schedule: 3 sessions on alternate days for 6 weeks.	Other: Physiotherapy care, Cervical Stabilization and Eyeball Exercises; Physiotherapy care: 30minutes of physiotherapy, including hotpack for 10 minutes,cervical stretching (3sets/15-second hold,5 repetitions), cervical isometrics (5-10 reps/3sets), postural correction exercises (5-10 reps/2-3 sets), active ROMs of the neck.•Cervical Stabilization: Pressure biofeedback unit will be used, the patient will perform chin tucks while the inflated unit is below the head at 20mmHg initially, and will be raised to 30mmHg. A 10 seconds hold with 10 repetitions, including a 10-second rest interval between. A total of 3sets will be performed with 15second interval between each set. 15 minutes total •Eyeball exercises:The patient is then asked to carry out the described eyeball movements, each movement to be held for 10 seconds and repeated 4 times through the maximum range,directions: Leftward, rightward, upper left, lower left, upper and lower right, left and right side circular, leftward and rightward figure 8 rotation. 2sets with 15seconds interval. 15 mins total.
Active Comparator: Interventional Group B; These patients will receive physiotherapy care along with cervical stabilization exercises and placebo treatment in place of eyeball exercises. Treatment schedule: 3 sessions on alternate days for 6 weeks.	Other: Phyisotherapy Care, Cervical Stabilization and placebo exercises; Physiotherapy care:30minutes of physiotherapy, including hotpack for 10 minutes, cervical stretching(3sets/15second hold, 5reps), cervical isometrics(5-10 reps/3sets), postural correction exercises(5-10 reps/2-3 sets), active ROMs of the neck.•Cervical stabilization: Pressure biofeedback unit will be used, the patient will perform chin tucks while the inflated unit is below the head at 20mmHg initially, and will be raised to 30mmHg. A10seconds hold with 10 repetitions, including a 10second rest interval between. A total of 3sets will be performed with 15second interval between each set,15 minutes total. •Placebo treatment:These exercises will take 10-15 minutes and the purpose is to engage the patient. These exercises do not have any effect on the ocular muscle of the eye and will only serve as a source of relaxation and lubrication for the eyes of the patient: blink slowly & fully (10reps,3sets with10-15seconds interval), fix gaze (10seconds, 3-5reps), eyes closed breathing 60seconds.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Pain Intensity	Change in pain intensity measured using the Numeric Pain rating Scale (NPRS, 0-10 cm).	Baseline, at 3rd week and at 6th week
Neck Disability	Functional disability measured using the Neck Disability Index (NDI) - Urdu validated version.	Baseline, at 3rd week and at 6th week

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Craniovertebral Angle (CVA)	Postural alignment measured as the craniovertebral angle (CVA) using Kinovea software from standardized lateral-view photographs	Baseline, at 3rd week and at 6th week
Pain Pressure Threshold (PPT)	Pain sensitivity will be measured using the Algometer	Baseline, at 3rd week and at 6th week

Collaborators and Investigators

• Sponsor: University of Lahore
• Investigators: Study Chair: Sahreen Anwar, Ph.D, University of Lahore

Study record dates

Study Major Dates

• Study Start (Actual): November 15, 2025
• Primary Completion (Estimated): August 15, 2026
• Study Completion (Estimated): September 15, 2026

Study Registration Dates

• First Submitted: June 28, 2026
• First Submitted That Met QC Criteria: June 28, 2026
• First Posted (Actual): July 6, 2026

Study Record Updates

• Last Update Posted (Actual): July 6, 2026
• Last Update Submitted That Met QC Criteria: June 28, 2026
• Last Verified: September 1, 2025

More Information

Terms related to this study

• Keywords: Randomized clinical trial; Physiotherapy; pain management; Text neck syndrome; neck disability index; Cervical Stabilization; Pressure biofeedback unit; Eyeball exercises
• Additional Relevant MeSH Terms: Neurologic Manifestations; Nervous System Diseases; Neurobehavioral Manifestations; Perceptual Disorders; Pathological Conditions, Signs and Symptoms; Signs and Symptoms; Agnosia
• Other Study ID Numbers: UOL/IREB/25/12/0041

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