Investigation of the Effectiveness of Proprioceptive Neuromuscular Facilitation Techniques in Text Neck Syndrome

Smartphones and tablets are increasingly widespread mobile technological devices used for many purposes such as communication, transportation, entertainment, education and security. Increasing use of mobile technology leads to various symptoms such as insomnia, difficulty concentrating and anxiety, especially musculoskeletal problems. "Text neck" is a musculoskeletal problem seen in individuals who use smartphones and tablets for a long time due to increased head and neck flexion posture. It causes neck, back, shoulder, and head pain, insomnia, tingling and numbness in the hands. Implementation of exercise programs for both preventive and therapeutic purposes is one of the main goals in this picture dominated by posture and pain problems. Proprioceptive neuromuscular facilitation (PNF) treatment technique; In the 1940s by H. Kabat and M. Knott, PNF was expressed as a means of facilitating neuromuscular responses by stimulation of proprioceptors. It is stated that it increases joint stabilization, strength, normal range of motion, endurance and circulation and is effective in improving coordination. Although PNF techniques have been used for different spinal problems, there is no study investigating PNF techniques in text neck syndrome. The study was aimed to compare the effect of a method including muscle relaxation in the anterior elevation direction and repetition techniques in the posterior depression direction from PNF neck patterns on pain intensity, neck normal range of motion, neck muscle endurance, posture and functionality in individuals with text neck syndrome with another method including ergonomic adjustments and simple cervical exercises recommended in the literature to be included in standard treatment.

Smartphones and tablets are increasingly widespread mobile technological devices used for many purposes such as communication, transportation, entertainment, education and security. Increasing use of mobile technology leads to various symptoms such as insomnia, difficulty concentrating and anxiety, especially musculoskeletal problems. "Text neck" is a musculoskeletal problem seen in individuals who use smartphones and tablets for a long time due to increased head and neck flexion posture. It causes neck, back, shoulder, and head pain, insomnia, tingling and numbness in the hands. Implementation of exercise programs for both preventive and therapeutic purposes is one of the main goals in this picture dominated by posture and pain problems. Proprioceptive neuromuscular facilitation (PNF) treatment technique; In the 1940s by H. Kabat and M. Knott, PNF was expressed as a means of facilitating neuromuscular responses by stimulation of proprioceptors. It is stated that it increases joint stabilization, strength, normal range of motion, endurance and circulation and is effective in improving coordination. Although PNF techniques have been used for different spinal problems, there is no study investigating PNF techniques in text neck syndrome. The study was aimed to compare the effect of a method including muscle relaxation in the anterior elevation direction and repetition techniques in the posterior depression direction from PNF neck patterns on pain intensity, neck normal range of motion, neck muscle endurance, posture and functionality in individuals with text neck syndrome with another method including ergonomic adjustments and simple cervical exercises recommended in the literature to be included in standard treatment. Our study is planned as a randomized controlled, prospective, single-blind case-control study. Demographic and clinical information of all participants to be included in the study will be recorded with the "Demographic and Clinical Information Form". Neck pain will be assessed by visual analog scale (VAS), cervical joint normal range of motion will be assessed by cervical flexion, cervical extension, cervical lateral flexion and cervical rotation normal range of motion measurements, neck muscle endurance will be assessed by neck flexor and extensor muscle endurance tests, posture will be assessed by New York Posture Evaluation Scale and functionality will be assessed by Neck Disability Index.

Eligibility Criteria:
Inclusion Criteria:

* at least 1 year of using a smartphone
* using smartphones\>4 hours per day, having recurrent neck pain which is increased by sustained posture and feeling of stiffness on turning the head and neck after long usages
* be able to read written and understand spoken language and willing to participate were included.

Exclusion Criteria:

* Subjects with spinal infections or inflammatory disorders
* a history of neck surgery, trauma, torticollis, scoliosis, malignancies, pregnancy, diagnosed disc prolapse, stenosis, herniation, spondylolisthesis, osteoporosis
* currently continuing or participating in a regular exercise program
* unable to perform tests or exercises because of diagnosed comorbidities or presently undergoing medication or physical therapy treatments