Effectiveness of Instrumental Assisted Soft Tissue Mobilization Versus Conventional Treatment on Administrative Staff for Text Neck Syndrome

In this modern era, people are using smartphone, tablets, computers and other digital devices for almost 5 to 8 hours a day. This has led to noticeable musculoskeletal disorders. Text neck syndrome has increasingly prevalent across all age groups, among students, office worker, administrative workers and people with more screen time. Repetitive stress injury and posture strain leads to neck pain, stiffness, headache, shoulder tension and decrease ROM. It determines the effectiveness of instrumental assisted soft tissue mobilization vs. conventional treatment for pain, range of motion and functional mobility on administrative staff for text neck syndrome.

This study is designed as a randomized control trial involving 48 participant with text neck syndrome to evaluate and compare the effectiveness of interventions. Participants will be diagnose by consultant neurologist at DHQ sheikhupura. It will be an Assessor Blinded Randomized Controlled Trial following CONSORT Statement Guidelines. The study will be conducted for 4 weeks and 3 session per week, with data collection at baseline pre intervention and post intervention. Participants will be randomly assigned to a control and experimental group. Control group having isometric strengthening and experimental group will receive isometric strengthening followed by instrumental assisted soft tissue mobilization.

The result will help to identify evidence based treatment approach that can be clinically used

• progressive isometric exercises (Other), also known as progrssive isometric exercises, progressive resisted excercises, manual therapy: Isometric cervical exercises strengthen the neck muscles by applying resistance with your hand while keeping your head completely still, with no joint movement. These exercises are generally performed in a seated or standing position with upright, relaxed shoulders
• Instrument-Assisted Soft Tissue Mobilization (Device), also known as IASTM: instrumental assisted soft tissue mobilization will be given by MT2 blade. It will be targeting upper trapezius, levator scapulae, splenius capitis and sternocleidomastoid muscles for text neck syndrome.

Primary outcomes

• Numeric Pain Rating Scale [From enrollment to the end of treatment at four weeks.]: It is simple, reliable and valid scale to measure pain intensity scale as simply asked the patient to rate their pain intensity on scale from 0-10. As 0 =no pain and 10=worst pain.The primary expected outcomes for this study will be to measure pain by using Numeric pain rating scale.
• Goniometer [From enrollment to treatment at four weeks.]: It is non-invasive measuring tool used in clinic to measure active cervical range of motion in all direction. For Cervical flexion and extension participants will sit on chair in upright position and foot flat on floor. Fulcrum will be placed on ear canal. Stationary arm of goniometer will be align perpendicular to the floor and moving arm with the base of nares.. For lateral flexion fulcrum will be placed on spinous process of C7, stationary arm will align in the spine and moving arm aligned with head midline, reference to occipital protuberance. The patient will be asked to bend head towards shoulder without rotation. Fulcrum will be over centre of cranial aspect of head .stationary arm will align with acromial process and moving arm with the tip of nose, than participant will be instructed to rotate head to each side as far as possible. Data will be recorded in degrees .
• Neck Disability Index Scale [From enrollment to the end of treatment at four week.]: NDI is condition specific questionnaire compromising of 10 items to assess pain and functional status which is mostly used for reporting neck pain. NDI is reliable and valid questionnaire. Patient score above 5-24 were included. This questionnaire has been designed to give us information as to how your neck pain has affected your ability to manage in everyday life.

Sex: All, ages: 25 Years to 50 Years

Inclusion Criteria:

Participant will be diagnose by consultant neurologist at DHQ sheikhupura on the bases of following criteria :

* Workers with Text Neck Syndrome diagnosed via Forward head Posture (through measuring craniovertebral angle) <50°

  * Age group between 25-50 year, both genders, using digital gadgets like (computer, laptop and mobile) for more than 4 hours
  * Experiencing neck pain either radiating or not
  * Exhibit forward head posture habits
  * Muscle weakness and NDI score is between 5-24, NPRS score above 3 and having informed consent.

Exclusion Criteria:

* Person having history of trauma

  * Pregnant, using neck support gadgets
  * Neck surgery, cervical radiculopathy
  * Currently having fever and infection
  * Myelopathy and not informed consent

• Dr. Hira Khalid, Principal investigator, university of health sciences lahore pakistan