Comparative Effect of Scapular Stabilization vs Thoracic Extension Exercises in Young Adults With Text Neck Syndrome.

Study Overview
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Brief Summary
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The aim of the study is to compare the effect of scapular stabilization versus thoracic extension exercises on pain, disability, range of motion, and cranio-vertebral angle in young adults with Text Neck Syndrome.

Detailed Description
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Text neck has emerged as a widespread modern epidemic that affects people of all ages, particularly younger populations, as they are exposed to handheld mobile device use for several hours a day beginning at a very early age. The relation between the posture due to handheld mobile device use and neck pain is still debatable. To manage the maladaptive posture of the cervical spine, indirect treatment instead of direct treatment of the neck can be used, which is the basis for the concept of regional interdependence, i.e., the cause of pain becomes the cause of damage to other body parts. Therefore, not treating the damaged part, but indirectly treating the area of cause can alleviate the symptoms. A bio-dynamic relationship between the cervical and thoracic spine is associated with exercise, an important factor causing neck pain. Therefore, many clinicians pay attention to the thoracic spine of patients with neck pain and recommend thoracic extension exercises. On the other hand, many researchers recommended scapular stabilization exercise as a recovery treatment for imbalanced scapular muscles caused by forward head posture. This study investigates how exercise programs not directly applied to the cervical spine affect people with text neck syndrome. The significance of the current study is to evaluate the comparison between concentric and eccentric exercise which is previously rarely investigated.

Official Title
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Comparative Effect of Scapular Stabilization Versus Thoracic Extension Exercises on Pain, Disability, Range of Motion, and Craniovertebral Angle in Young Adults With Text Neck Syndrome.

Conditions
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Neck Syndrome, Forward Head Posture

Intervention / Treatment
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* Other: Scapular stabilization exercises
* Other: Thoracic extension exercises


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Both male and female participants with forward head posture or text neck syndrome Participants with neck pain from the past three months Smart-phones must be used for at least ≥3 hours each day Participants with craniovertebral angle <53° will be included in this study Exclusion Criteria: History of cervical and thoracic spine surgery within the past three months Serious pathological conditions within the past three months Congenital spinal anomalies, or rheumatoid arthritis Neurological signs and severe psychological disorders

Ages Eligible for Study
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Minimum Age: 19 Years
Maximum Age: 30 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Scapular Stabilization Exercises<br>Scapular stabilization exercises along with the hot pack and cervical active range of motion exercises | Other: Scapular stabilization exercises<br>* The scapular stabilization exercises will be comprised of four exercise programs. Each exercise will be performed with two sets of 15 reps, 10 sec per rep 40 min per day, thrice per week for a total of six weeks. Baseline treatment will be the application of a hot pack for 7-10 minutes and cervical active range of motion exercises.<br>|
| Experimental: Thoracic Extension Exercises<br>Thoracic extension exercises along with the hot pack and cervical active range of motion exercises | Other: Thoracic extension exercises<br>* Thoracic extension exercises will be comprised of three exercise programs. Each exercise will be performed with two sets of 15 reps, 10 sec per rep 40 min per day, thrice per week for a total of six weeks. Baseline treatment will be the application of a hot pack for 7-10 minutes and cervical active range of motion exercises.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Neck disability index (NDI) | Changes from baseline. NDI is a valid and reliable tool having values ranging from 0.50 to 0.98. The NDI assessment involves a 10-item, 50-point index questionnaire that assesses the effects of neck pain and symptoms during a range of functional activities. | 6 weeks | 
| Visual analogue scale (VAS) | Changes from baseline. The visual analogue scale (VAS) is a simple and frequently used method for the assessment of variations in intensity of pain. The reliability of the VAS for disability is moderate to good i.e. 0.98. However, its validity is questionable. | 6 weeks | 
| Goniometer for cervical range of motion | Changes from baseline. Goniometer has fair inter-tester reliability ranging from 0.79-0.92. Validity of this tool is good i.e. 0.97-0.98 This tool is most commonly used in the clinical settings for evaluating joint range of motion. | 6 weeks | 
| Photogrammetry for craniovertebral angle (image j software) | Changes from baseline. 'Image J', is an analysis software with high reliability and validity. This study will assess the craniovertebral angle using a digital camera. The camera will be placed 1.5 m from the participant's right side to take a lateral photographic view of the participant's head and neck in a seated position. The craniovertebral angle is the angle between the horizontal line passing the 7th Cervical vertebra (C7) and the line extending from C7 to the tragus of the ear. The resulting maladaptive posture of the neck will be determined using Image J software. | 6 weeks | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Craniovertebral angle, Scapular stabilization exercises, Thoracic extension, Text neck syndrome, Range of motion, Pain, Disability