Comparative Effects of SNAG Vis GONG's Mobilization in Text Neck Syndrome Patients (SNAG-GONG)

Comparative Effects of SNAG Versus GONG's Mobilization in Text Neck Syndrome Among Final Year Medical Students of The University of Faisalabad

Text neck syndrome is a common musculoskeletal disorder caused by prolonged smartphone and computer use, resulting in neck pain, forward head posture, and functional disability. Manual therapy techniques, including Sustained Natural Apophyseal Glides (SNAG) and GONG's Mobilization, are frequently used to manage cervical dysfunction.

This quasi-experimental pretest-posttest comparative study aimed to compare the effectiveness of SNAG and GONG's Mobilization on pain intensity, craniovertebral angle, and neck disability in individuals with text neck syndrome. Participants divided into 2 groups (Treatment group A and B) were undergo baseline and post-intervention assessments followed a 12-week treatment program

Study Overview

• Status: Completed
• Conditions: Forward Head Posture; Text Neck Syndrome
• Intervention / Treatment: Procedure: Moist Heat Therapy; Procedure: GONG's Mobilization; Procedure: Sustained Natural Apophyseal Glide (SNAG)

Detailed Description

Text neck syndrome has emerged as a growing health concern due to increased use of smartphones, laptops, and other digital devices. Prolonged forward head posture places excessive mechanical stress on cervical structures, leading to neck pain, muscle imbalance, postural abnormalities, and functional limitations.

Manual therapy interventions such as Sustained Natural Apophyseal Glides (SNAG) and GONG's Mobilization have demonstrated beneficial effects in managing cervical spine dysfunction. However, evidence comparing these two techniques specifically in individuals with text neck syndrome remains limited.

A quasi-experimental pretest-posttest comparative study conducted. 48 participants were recruited aged 18-25 years from The University of Faisalabad. Participants diagnosed with text neck syndrome allocated into two treatment groups according to the study protocol. The participants divided into 2 groups (A and B) Both groups received moist heat therapy for 10 minutes before intervention. Group A received SNAG mobilization, while Group B received GONG's Mobilization. Treatment sessions were conducted three times per week on alternate days for 12 weeks.

Outcomes and outcome measuring tools were pain intensity by using the Numeric Pain Rating Scale (NPRS), Craniovertebral angle by Goniometer, and neck disability by Neck Disability Index (NDI).

• Study Type: Interventional
• Enrollment (Actual): 48
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Pakistan
  • Punjab Province
    • Faisalabad, Punjab Province, Pakistan, 38000
      • The University of Faisalabad (TUF)

Participation Criteria

Eligibility Criteria

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

Description

Inclusion Criteria:

• Both Male and Female who engage in prolonged computer and phone usage for more than 4 hours per day for over a year
• Neck pain (3 to 8 on NPRS)
• Altered cranio-vertebral angle<49 degree

Exclusion Criteria:

• Recent cervical spine fracture/injury
• Congenital malformation
• Recent history of head and neck surgery
• Congenital torticollis

Study Plan

How is the study designed?

Design Details

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

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Baseline PLUS GONG's mobilization; Participants in this arm received baseline treatment consisting of a moist hot pack applied to the cervical region for 10 minutes, followed by GONG's Mobilization. GONG's Mobilization was administered for 10-15 repetitions per session over approximately 20 minutes, three sessions per week on alternate days for 12 weeks. Outcome measures, including pain intensity (Numeric Pain Rating Scale), craniovertebral angle, and Neck Disability Index, were assessed before and after the intervention period.	Procedure: Moist Heat Therapy; A moist hot pack was applied to the cervical region for 10 minutes before the manual therapy intervention in both study groups; Procedure: GONG's Mobilization; GONG's Mobilization was administered to the cervical spine using 10-15 repetitions per session for approximately 20 minutes, three sessions per week on alternate days for 12 weeks
Active Comparator: Baseline plus SNAG; Participants in this arm received baseline treatment consisting of a moist hot pack applied to the cervical region for 10 minutes, followed by Sustained Natural Apophyseal Glides (SNAG). SNAG was administered for 10-15 repetitions per session over approximately 20 minutes, three sessions per week on alternate days for 12 weeks. Outcome measures, including pain intensity (Numeric Pain Rating Scale), craniovertebral angle, and Neck Disability Index, were assessed before and after the intervention period	Procedure: Moist Heat Therapy; A moist hot pack was applied to the cervical region for 10 minutes before the manual therapy intervention in both study groups; Procedure: Sustained Natural Apophyseal Glide (SNAG); SNAG mobilization was applied to the cervical spine with 10-15 repetitions per session for approximately 20 minutes, 3 sessions per week on alternate days for 12 weeks

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Craniovertebral Angle	Craniovertebral angle was measured using a universal goniometer to assess forward head posture	Baseline and Week 12 (end of the intervention)

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Pain intensity	Pain intensity was assessed using the Numeric Pain Rating Scale (NPRS), an 11-point self-reported scale ranging from 0 (no pain) to 10 (worst imaginable pain)	Baseline and Week 12 (end of intervention)

Collaborators and Investigators

• Sponsor: University of Faisalabad
• Investigators: Principal Investigator: Noreen Kiran, PhD, University of Faisalabad

Study record dates

Study Major Dates

• Study Start (Actual): October 25, 2025
• Primary Completion (Actual): April 10, 2026
• Study Completion (Actual): June 15, 2026

Study Registration Dates

• First Submitted: July 17, 2026
• First Submitted That Met QC Criteria: July 17, 2026
• First Posted (Actual): July 22, 2026

Study Record Updates

• Last Update Posted (Actual): July 22, 2026
• Last Update Submitted That Met QC Criteria: July 17, 2026
• Last Verified: July 1, 2026

More Information

Terms related to this study

• Keywords: neck disability; Forward head posture; craniovertebral angle; Text neck syndrome; GONG's Mobilization; sustained natural appophyseal glide
• Other Study ID Numbers: 2023-MS-PT-064

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